Women's Health Flashcards

1
Q

What’s a typical body weight around the start of menarche?

A

> 90lbs

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2
Q

What is oligomenorrhea?

A

Delayed onset

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3
Q

What is polymenorrhea?

A

More frequent

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4
Q

What is menorrhagia?

A

Excessive flow

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5
Q

What is hypomenorrhea?

A

Scant flow

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6
Q

What is epimenorrhea?

A

Bleeding between periods

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7
Q

_______ form of estrogen before menopause

A

Estradiol

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8
Q

________ form of estrogen after menopause

A

Estrone

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9
Q

What is estriol?

A

Estriol byproduct of estrogen metabolism

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10
Q

What does estrogen do?

A
● Metabolizes fat for energy 
● Natural diuretic 
● Natural antidepressant 
● Facilitate thyroid hormone interaction
● Relieves hormonal headache
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11
Q

What does progesterone do?

A
● Normalizes blood clotting 
● Restores libido 
● Maintains endometrium secretory functions 
● Prevents endometrial Cancer 
● Balances estrogen
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12
Q

What is endometriosis?

A

It is a hormone dependent disorder in which endometrial tissue are deposited in other parts of the body, like the kidneys intestines, and Fallopian tubes. It causes scarring, adhesions, abnormal cycles, infertility, and pain.

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13
Q

Pt is 20-40 yo female c/o abdominal pain. She reports having abnormal cycles and infertility. What is the diagnosis and treatment?

A

Endometriosis

Treatments: laser cautery

Endometriosis makes up~ 24% of all hysterectomies

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14
Q

What is the average age of menopause in the US?

A

51

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15
Q

What are some factors that might determine when someone gets menopause?

A

Nutrition, weight, genes, smoking

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16
Q

What is the cut off for premature menopause?

A

< 40 yo

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17
Q

Climacteric Change of Life starts ___ years before menopause lasts for ____ years after.

A

10-15 years before

10 years after

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18
Q

In menopause, Cyclic estradiol (increases/ decreases/ ceases) as directed from the hypothalamus.

A

Ceases

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19
Q

As ovarian production decreases, the hypothalamus sends proteins to stimulate serum_____ and ___ to rise dramatically and stay high for two years

A

FSH (E) and LH (P)

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20
Q

What. Are some musculoskeletal changes that follow menopause?

A
● Muscle weakness 
● Backache / joint pain 
● Bone thinning 
● Bloating 
● Headaches
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21
Q

True or false; caffeine and red wine can relieve the symptoms of menopause

A

False; they may cause heat flashes

Sorry, ladies.

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22
Q

The ovaries may refer pain to

A

T 12 and medial thigh

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23
Q

The Fallopian tubes may refer pain to

A

T11 and T12

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24
Q

The uterus may refer pain to

A

T10-L1, lower abdomen

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25
Q

The cervix may refer pain to

A

S2-4 and sacral base

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26
Q

The vagina may refer pain to

A

Low back and butt

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27
Q

The ureter and uterine ligament may refer pain to

A

Across lumbosacral area

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28
Q

The rectum and trigone may refer pain to

A

Sacral apex of bladder

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29
Q

Pain may be referred to T12 and the medial thigh by the

A

Ovaries

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30
Q

Pain may be referred to T11 and T12 by the

A

Fallopian tubes

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31
Q

Pain may be referred to T10-L1 and lower abdomen by the

A

Uterus

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32
Q

Pain may be referred to S2-4 and the sacral base by the

A

Cervix

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33
Q

Pain may be referred to low back and butt by the

A

Vagina, vag, vajayjay, crotch, hoo ha, chacha, nether region, downstairs

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34
Q

Pain may be referred to across the lumbosacral area by the

A

Ureter and uterine lig

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35
Q

Pain may be referred to sacral apex of the bladder by the

A

Rectum and trigone

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36
Q

What are some postural changes associated with pregnancy?

A
● Cervical, Thoracic, and Lumbar curves increase 
● Rounded Shoulder 
● Hyper-extended knees 
● Pronated Feet 
● Widen Base of Support
37
Q

What are some postural dysfunctions common with pregnancy?

A
● Thoracic Outlet Syndrome 
● Carpal Tunnel Syndrome 
● Low Back Pain 
● Lumbar or Sacral Root Irritation
● Public Separation 
● Ilial Position Faults 
● Occasional Parasthesias 
● Worsening of
Preexisting Conditions-Spondylolisthesis
38
Q

True or false; during the first trimester, it is dangerous to have a patient lay on her back because the fetus is at risk of crushing the vena cava

A

False, second

39
Q

Which hormone may cause pregnant women to become hypermobile?

A

Relaxin

40
Q

True or false; pregnancy can cause women to have TMJ problems

A

True

41
Q

Pt is a pregnant female c/o pain, paresthesia, numbness, and clumsiness with her hands. You observe atrophy in median distribution. What is her diagnosis?

A

Carpal tunnel syndrome

42
Q

What do a +phalens and +tinel’s tests indicate?

A

Carpal tunnel

43
Q

True or false; When carpal tunnel develops during pregnancy, the most common option is for the women to undergo surgery after they’ve given birth.

A

False; it usually resolves

44
Q

What is thought to be the cause of carpal tunnel during pregnancy?

A

Elevation of the ribcage during pregnancy is thought to be a potential cause

45
Q

Which disorder can be described as tenosynovitis or inflammation of the abd pollicis longus and extensor pollicis brevis tendon sheaths ?

A

De Quervain’s

46
Q

How do you treat De Quervain’s disease?

A

Tx using ice, phono, ionto, bracing, retraining, rest and work toward stretching and strengthening

47
Q

Thoracic outlet syndrome becomes symptomatic secondary to __________, causing a compression of the nerve bundle at the C8-T1 dorsal outlet

A

head and neck postural changes

48
Q

What is the normal amount of separation between the rectus abdominus muscle?

A

2 cm at level of umbilicus
2 cm above umbilicus
THERE IS NO SEPARATION BELOW THE UMBILICUS

49
Q

True or false; 2 cm is a normal amount of separation in the rectus abdominus at the level and below the umbilicus

A

FALSE! ABOVE and at the level. NOT BELOW. ZERO BELOW.

50
Q

How do you examine a diastasis recti?

A

● Position pt in supine with knees bent
● She raises her head and shoulders until her neck is about 8 inches from the supporting surface
● The chin should be tucked and the arms stretched out
● The PT checks for a bulge in the central abdominal area, which is evident when the muscles have parted
● If present, it is defined by the number of fingers that
can be inserted horizontally into the the gap at the level of the umbilicus and 2 inches above and below

51
Q

True or false; treat diastasis recti with trunk rotation to strengthen the obliques to compensate for the weak rectus.

A

FALSE AVOID TRUNK ROTATION UNTIL THERE IS NO SEPARATION

52
Q

Why not treat diastasis recti with jackknifing or double leg lifts-possibility?

A

increasing separation between rectus abdominus muscles or injuring lower back

53
Q

When treating diastasis recti Ther ex is aimed at…

A

increasing the strength of the TA while protecting the Rectus.

54
Q

What are the causes of costal rib pain during pregnancy?

A

● incr. mobility of rib articulations
● flaring of lower ribs and widening of subcostal angle
● A-P and transverse diameters of thorax widen by 2cm
● circumference incr. by 6cm
● diaphragm elevated 4cm
● normal neurovascular bundle may be stretched over an elevated 1st rib
●diaphragmatic crura may add stress to anterior longitudinal ligament in lumbar area, esp. at L1 & L2

55
Q

True or false; To assess SI joint pain in a pregnant female, you should assess BOTH the anterior AND posterior innominate for malpositioning.

A

True

56
Q

Posterior innominate correction requires an _______ _________ force

A

Anterior torsion

57
Q

Anterior innominate correction requires a ________ _______ for correction

A

Posterior torsion

58
Q

True or false; a good treatment for women with SI joint pain is ambulation with widely Abducted legs on uneven terrain

A

False

59
Q

True or false; a good treatment for women with SI joint pain is frog kicks

A

False

60
Q

True or false; a good treatment for women with SI joint pain is splits

A

False

61
Q

True or false; a good treatment for women with SI joint pain is climbing the stairs with more than one step at a time

A

False

62
Q

True or false; a good treatment for women with SI joint pain is to educating them to swing one leg out at a time when getting up

A

False

63
Q

Which test will assess for symphysis pubis?

A

March test

64
Q

How do you examine a patient to assess for symphysis pubis?

A

● Tenderness over Symphysis
● Ends of some will be separated
● May feel several CM
● Shift when pt shifts wt

65
Q

If a patient has symphysis pubis, they should avoid which action?

A

Hip abduction

66
Q

Why might a pregnant woman’s back hurt?

A
● Added wt 
● Poor muscle tone 
● Increased lordosis 
● Changes in COG 
● Loose pelvic ligs.
67
Q

True or false; the piriformis may lengthen during pregnancy due to relaxin

A

False, it shortens, causing the waddling gait

68
Q

(Midline/ Mediolateral) episiotomy heals easier

A

Midline

69
Q

(Midline/ Mediolateral) episiotomy increases risk for sphincter damage

A

Midline

70
Q

(Midline/ Mediolateral) episiotomy increases risk for asymmetrical tissue
healing and scarring

A

Mediolateral

71
Q

Incontinence occurs during pregnancy and after delivery due to…

A

weakness and pressure on the bladder

72
Q

What are the verbal instructions for pelvic floor contractions?

A
● Long=hold 10-15 sec
● Short=hold 3sec
● 10 reps 3-5x/day
● Avoid valsalva
● Have pt use stop test once per week as it tests the external sphincter
73
Q

To which part of the body might you provide a Thiele’s massage?

A

Coccyx

74
Q

Which orthosis relieves pressure from pregnancy and increased blood flow

A

The baby hugger orthosis

75
Q

Valves in veins swell, causing __________ filling with distension

A

retrograde

76
Q

True or false; knee and patella dysfunction may occur, resulting in instability and chrondromalacia secondary to relaxin AND preexisting condition

A

True

77
Q

Which nerve palsie is caused by compression

of the fetal head before birth or during delivery?

A

Obturator L3-4

78
Q

Which nerve palsie is caused by Psoas m hemorrhage, pelvic trauma, or compression in the pelvic cavity?

A

Femoral L2-3

79
Q

Which nerve palsie iscaused by compression of the stirrups used in delivery?

A

Peroneal L4-5

80
Q

Feet are more likely to be (supinated/pronated), so strengthen the medial compartment and toe (flexors/ extensors)

A

Pronated

Flexors

81
Q

What is the goal of exercising during pregnancy?

A

Goal is to maintain maternal and fetal physiologic reserve

82
Q

During pregnancy, flood volume increases ___%

A

40

83
Q

Initially during pregnancy, blood CO2 increases ___%

A

20

84
Q

During pregnancy, pulse increases around ___bpm

A

15

85
Q

Duringpregnancy, vital capacity increases ____%

A

None, it remains unchanged, 0%

86
Q

During pregnancy, basal O2 consumption increases ___%

A

20%

87
Q

During pregnancy, metabolic demands increase around _____cal

A

300

88
Q

Vigorous maternal exercise can increase fetal HR ______ bpm. Max exercise can cause ___________.

A

5-15

fetal bradycardia

89
Q

If you’re having twins, exercise may be relatively contraindicated after _____weeks

A

24