Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

S5 PTA Special Topics > women's health > Flashcards

women's health Flashcards

1
Q

the pelvic floor

A

PFM contract with an inward lift and squeeze; pelvis and spine should remain stationary

  • 30% fast twitch and 70% slow twitch: need to be able to hold longer and keep continence during sneeze, laugh, bump
  • PFM contraction proceeds active abd contractions to provide stability to pelvic girdle and to prevent perineal descent during increased abd pressure
  • innervated by S2-S4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

pelvic floor function

A
  • support pelvic organs
  • postural stabilizer that contracts prior to or with most movements to assist with postural core stabilization
  • mass PFM contraction for sphincter
  • contraction during orgasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

normal urination

A
  1. bladder fills
  2. first sensation to void
  3. normal desire to void
  4. micturation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

normal and good urinary habits

A
  • 5-8x/day adn 0-1x/night (1-2x/night above 65yo)
  • general guideline: urinate every 2-5hours
  • 8-10sec length of urination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

bladder health

A
  • drink water! 1/2oz per lb of body weight
  • avoid bladder irritant like caffeine, acid foods/drinks, alcohol
  • water sandwich
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pelvic flood disorders

A
  • PFM dysfunction classified by
  • symptoms: lower urinary tract, bowel, sexual function, vaginal, pain
  • signs: external obs and internal measurements
  • conditions: normal, underactive, overactive, non-functioning PFM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

urinary incontinence (stress)

A

any involuntary loss of urine with increased intraabdominal pressure and activity, related to PFM weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

urinary incontinence (urge)

A

any involuntary loss of urine on the way to the bathroom

  • frequency: >7-8x/day
  • urgency: intense, uncontrolled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

urinary incontinence (mixed)

A

both stress and urge, usually started by stress and followed by urge from poor habits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

fecal incontinence
and
incidence

A
  • any involuntary loss of stool, usually large and full evacuation
  • related to PFM weakness and/or anal sphincter defect (childbirth perineal tear)
  • incidence: 9% community, 20-90% elderly
  • related to PFM weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pelvic organ prolapse

A

named by area

  • apical uterus
  • procidentia: complete protrusion of uterus
  • cystocele: anterior bladder pressing into vaginal wall
  • rectocele: posterior rectum pressing into vaginal wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

underactive PFM symptoms

A
  • urinary or fecal incontinence
  • pelvic organ prolapse (posterior, anterior, apical)
  • caused by: childbirth, chronic increased pressure, chronic cough/asthma/smoking, repetitive valsalva, constipation/straining, high impact exercise, surgery, aging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

treatment for underactive PFM

A
  • strengthening: knack and squeeze before you sneeze
  • abdominal mm training/core stabilization
  • behavior retraining
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

causes overactive PFM

A
  • joint malalignment - habitual postural dysfunction - childbirth - surgery - sexual abuse - pelvic inflammation = hemorrhoids - bowel/bladder disorders - SCI - MS - parkinsons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

overactive PFM treatments

A
  • joint alignment/mobs/manips - mm re-ed - biofeedback - functional training/strengthening - posture and body mechanics - modalities - STM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

exercise considerations

A
  • 40% of women attempting to perform PFM contraction do so incorrectly even with proper verbal instruction
  • contraction of TA without PFM will cause increased intra-abd pressure which will cause excessive pressure in pelvic floor and increase risk for prolapse
  • exercise application
17
Q

PFM and TA

A
  • pair naturally co-contract
  • submax contraction of PFM can sometimes be used to facilitate abd contraction and vice versa
  • most important mm for SI stability are TA and PFM
18
Q

retraining co-contraction

A
  • maintain normal breathing (contract during exhale)
  • minimal contraction 5-10% effort (to avoid recruitment of global mm)
  • no movement of pelvis or spine during contraction
  • slow, controlled contraction
  • cue to encourage re-establishment of brain-body connection
  • stability with mobility, no rigidity
19
Q

musculoskeletal changes during pregnancy

A
  • rib cage, thoracic diameter
  • sacroiliac joint (pelcis ligaments loosen, SI locking mechanism becomes less)
  • pubic symphysis joint (cartilage w/ am interpubic disc; softens, possible separation
  • coccyx: increased weight and positional changes predispose the patient to coccygeal dysfunction (plop)
20
Q

diastasis rectus abdominus

A

DRA: separation of the rectus abdominis mm

  • due to stretching of the linea alba
  • noted at the level of the umbilicus or along the entire abdomen
  • caused by hormonal changes, increased weight, elongation of RA
  • occurs 3rd trimester in 66% of women
21
Q

DRA testing

A
  • assess in hooklying, measure distance between contracted recti
  • significant separation > 2.0cm
  • suggests impaired force closure of abdominal mm resulting in impaired load transfer and instability with vertical loading tasks
22
Q

PT treatment of DRA

A
  • abdominal binder
  • TA strengthening
  • education: avoid bearing down while holding breath, exhale during bowel movement, exhale during BLT/pushing/pulling, proper body mechanics with log roll, avoid sit ups, proper contractions of TA with PFM during ADLs
23
Q

typical changes in pregnancy

A
  • weight gain 25-35lbs
  • increased respiratory volume with greater ability to expel CO2
  • increased O2 consumption
  • increased blood volume (35-50%) wiht increased cardiac output (30-60%)
  • anemia: decreased RBC/vol leading to iron deficiency
  • PB decreases slightly during pregnancy and is lowest by 28wks (rises to pre-pregnancy levels by 36wks)
  • orthostatic hypotension
  • stretching of abdominal mm, skin, connective tissue
  • compression of internal organs
  • ligamentous laxity
  • postural changes (COG, increased lumbar lordosis, BOS)
24
Q

inferior vena cava

A
  • lies anterior to L3-L5
  • occlusion of vessels with supine
  • laterally displaces aorta, reduces maternal cardiac output
  • **avoid prolonged supine >3min
  • LEFT IS BEST
25
Q

Supine hypotensive syndrome

A
  1. Signs:
    - SOB - dizziness - restlessness - nausea - numbness/paresthesia in limbs - visual distrubances
  2. Symptoms:
    - increased RR - cyanosis - syncope - fainting - mm twitching or weakness - vomiting - diaphoresis - cold, clammy skin/legs - pupil changes or changes in eye movements
26
Q

avoid positions during pregnancy

A
  • abdominal compression
  • inversion
  • activities involving rapid, uncontrolled bouncing or swinging movements, or sharp twists
27
Q

caution with positions during pregnancy

A
  • buttocks higher than hips (bridging) due to risk of air embolism and disengaging fetus from pelvis
  • supine longer than 3 min after 4mo
  • positions that strain pelvic floor or abdominal mm (quadruped)
  • positions that encourage vigorous stretching of hip adductors
  • extreme asymmetrical LE positions
  • extreme end range of motion positions hip joints

S5 PTA Special Topics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions