Woman’s Health Flashcards
What does prostate do in men
- Acts as additional support for bladder.
- Produces fluid to carry sperm through and out of urethra
- Fibrous, CT outer shell that protects the pulpy insides
- Some fibers go into the internal and external sphincters
- Enlarges with age
Prostate cancer
Really common in older men - after 65
Watch and wait is more common lately
Prostatectomy is most common treatment which can result in damage to nerves, muscles, circulation
What can a prostatectomy cause
Total or partial urinary incontinence
Impotence
PT Considerations post prostatectomy
ADLS!!! You’re taking away a structure that helps support the bladder so have to help it and let it heal.
- Avoid valsalva and lifting
- Strenghten PF
- Address core stability
- Biofeedback super helpful
- diet — avoid things that irritate the bladder
When is it considered abnormal to not be potty trained
5 years old
Do you do an internal exam/treatment with kids
HECK NO
What are common issues that pediatric population suffers from that we can help as PF therapists
- Enuresis
- Constipation
- Encopresis
What is enuresis
Nighttime wetting
— Major factors = constipation and overactive bladder.
— PFM and bladder need to mature in tone and coordination
NOT A DELIBERATE ISSUE
How can we help enuresis
Ensure adequate fluid intake - don’t want them to become dehydrated
Treat the constipation
Teach exercises to quiet the bladder and strengthen and tone the PFM
Biofeedback with external sensors can be helpful
Desmopressin — Anti-diuretic that can be used with kids over 5
Support for parent
Constipation in kids
- Can create holding of urine causing large bladders and reflux
- Impacts overactive bladder and enuresis
How can we help constipation in kids
- Bowel massage
- Diet - making sure they are getting enough fiber
- Comfort with their bodies and discussing the topic. Important for them to realize defication is a normal topic
- Teach how to relax PFM - biofeedback helpful
What is encopresis
Fecal incontinence or soiling in a sense of underlying disease in a child who has learned voluntary control of bowels.
What three components do we look for if we suspect female athlete triad
- Amenorrhea/oligiomenorrhea
- Eating disorder/energy deficit
- Osteopenia/osteoporosis
Amenorrhea/oligiomenorrhea associated with…
Athletes secondary to low body fat, physical stress of exercise, and decreased caloric intake.
Can lead to less estrogen which is not good for bone density
3 months without period is warning
When do females have peak bone mass
Between 25-30 years old
What is the cascade explaining lower estrogen levels in female athlete triad
Energy deficit -> inhibits hypothalamus -> decreased gonadotropin releasing hormone -> decrease in LH and FSH release -> signal for release of estrogen decreases
Urinary incontinence in female athletes
High prevalence
Can be stress or urge incontinence but more commonly stress incontinence.
We need to be screening female athletes for this and get them help. Ask for details on SUI episodes to help them
Risk: high impact sports, disordered eating
What changes does the body go through during pregnancy
- Increased blood flow by 40-50%
- Increased heart rate by 10-15 bpm higher
- Weight gain
- Distorted body image and impaired balance (cog more anterior)
- Posture changes — lordosis, tight hip flexors, forward head
Increased estrogen leads to
Increased joint laxity
What are the exercise implications during pregnancy
- Weight gain -> exercise produces greater oxygen debt -> longer recovery time
- After 20th week = no supine
- Use L side lying during exercise or resting to decrease pressure on IVC — NO RIGHT SIDE LYING
If patient has to be supine put a towel under their (R) pelvis to offset the weight and be tipped slightly to (L)
What are exercise recommendations for pregnant ladies
Regular, moderate intensity for 30 minutes
Avoid high fall risk activities, scuba diving, exercising at high altitude
Gradual return to exercise of 4-6 weeks postpartum — may help with depression
