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PTRS 845 Final > Women's Health [Guest Lecture] > Flashcards

Women's Health [Guest Lecture] Flashcards

1
Q

4 Parts of the Pelvic Girdle

A
  1. Bony pelvis (ilium, ischium, pubis)
  2. Sacrum
  3. Spine
  4. Femur bones
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2
Q

List the 3 layers of the Pevlic Floor Musculature

A

Layer 1 = bulbospongiosus, ischiocavernosus, superficial transverse perineal

Layer 2 = sphincter urethrae, compressure urethrae, deep transverse perineal

Layer 3 = iliococcygeus, puporectalis, pubococcygeus (leavator ani), obturator internus

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3
Q

List the muscles included in the posterior musculature of the pelvic girdle

A
  1. Glute max/med/min
  2. Piriformis
  3. Obturator internus/externus
  4. Quadratus femoris
  5. Adductor magnus/longus
  6. HS
  7. Superior/Inferior gemelli
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4
Q

Muscle: Prime mover of the sacrum

A

Piriformis

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5
Q

List the muscles included in the anterior musculature of the pelvic girdle

A
  1. Psoas
  2. Iliacus
  3. Rectus abdominus
  4. Internal/External oblique & Abdominals
  5. TA
  6. Adductor longus/brevis
  7. Gracilis
  8. TFL
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6
Q

Describe the 2 ways that iliopsoas has a close relationship with the pelvic floor

A
  1. By fascia connections
  2. By innervation
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7
Q

Muscle Type: controls intra-abdominal pressure and is important for proper body mechanics, breathing, and voiding

A

Core muscles (pelvic floor, TA, multifidus, diaphragm)

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8
Q

Describe the movement of the pelvic floor and diaphragm with breathing

A

Inhalation: both move down

Exhalation: both recoil, move up

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9
Q

List the 5 Functions of the Pelvic Floor Muscles

A
  1. Supportive
  2. Sphincteric
  3. Sexual
  4. Stability
  5. Sump-pump
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10
Q

Pelvic floor function: helps to support organs and forms the bottom of the core

A

Supportive

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11
Q

Pelvic floor function: controls openings of the urethra, rectum, and vagina

A

Sphincteric

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12
Q

Pelvic floor function: Assists the SI, pubic symphysis, lumbosacral, and hip joints

A

Stability

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13
Q

Pelvic floor function: assissts venous and lympathic movement

A

Sump-pump

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14
Q

Describe when the sacrum is held tightest and why

A

Held tighter during WB due to the self locking characteristics of the sacrum itself

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15
Q

Term: Two structurally separate joints that act as one functional unit

A

Bicondylar

ex. TMJ, Hip, Knee

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16
Q

Term: Movement accompanied by a correlative movement at another location

A

Bicondylar Joints

They can move in opposite directions and still be bicondylar

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17
Q

Biomechanics of Gait – What’s going one when…

  1. L Swing Phase
  2. L Heel Strike
A
  1. Sacrum rot R; L-Spine rot OPPOSTIE
  2. L Piriformis contraction, Sacrum rot L
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18
Q

Type of Pelvic Floor Dysfunction: Leads to incontinence, LBP, joint instability, prolapse, pelvic congestion, mm imbalance

A

Weakness

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19
Q

Type of Pelvic Floor Dysfunction: Leads to pelvic and LBP, SI and hip imbalances, often incontinence and voiding dysfunction, pelvic congestion

A

Hypertonus

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20
Q

Clinical Presentation:

  • Leaking urine
  • Voiding dysfunction
  • Heavy feeling in abdomen
  • LBP, SI, Hip/Pelvic pain
  • Poor posture and force closure
A

Core Mm Weakness

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21
Q

Clinical Presentation:

  • Pain in back, low abdomen, posterior thigh, coccyx
  • vulvar/clitoral or testicular/scrotal/penile burning
  • pain with intercouse, defecation, sitting
  • incontinence/voiding dysfunction
  • constipation
  • poor posture
  • over use of global mm
  • hip ROM decreased
A

Hypertonus Dysfunction

22
Q

Describe pelvic girdle pain

A

Pain in 1+ of the joints of the pelvic girdle (SI, LS, Symphsis, Hip)

23
Q

Clinical Presentation:

  • occurs post-partum or 24-36 wks gestation
  • posteriorly located pain or in groin or over pubis
  • lacks specific NR distribution
  • difficulty with change of position
  • prolonged walking, stairs, carrying
A

Pelvic Girdle Pain

24
Q

Describe the changes with pregnancy

A
  • rib angle becomes more perpendicular
  • diaphragm elevates
  • center of gravity is shifted
  • abdominal wall distended
  • core function limited
  • hormones cause ligamentous laxity
25
Q

The following are things to avoid with what complication:

  • Valsalva
  • Trunk stabilization/ab work
A

OB – obstertic complications

26
Q

List the things to be concerned with when treated pregnant women

A
  • HR below 140
  • Heat over the belly
  • Estim over belly/LB
  • Supine positioning
27
Q

List signs of post partum depression

A
  • not sleeping
  • losing/gaining wt rapidly
  • can’t get out of bed
  • ignoring basic grooming
  • seems hopeless, feel helpless
  • lack of feeling for the baby
  • extreme anxiety or obsession for baby safety
28
Q

Describe how the speed of delivery can cause pelvic floor trauma

A

Too slow = like running a marathon for pelvic floor mm

Too fast = like a MVA for pelvic floor mm

29
Q

Term: Leaks with increased abdominal pressure

A

Stress incontinence

30
Q

Term: Leaks with strong urge to go

A

Urge incontinence

31
Q

Term: Separation of the rectus abdominus mm along the linea alba

A

Diastasis Recti

32
Q

Condition: Inflammatory response at pubic symphysis and ischial rami caused by susatined or repetitive trauma to the pubic symphysis

A

Osteitis Pubis

33
Q

Condition: separation of the pubic bones anteriorly leads to outflaring of the iliac bones; sacrum is less tightly held and can move anteriorly

A

Pubic symphysis dislocation

34
Q

Describe women’s health related issues that can occur in the femal athlete

A

Eating disorders and over exercising results in low weight which can lead to irregular menstraution or amenorrhea which can lead to poor bone health

35
Q

Term: Endometrial tissue grows outside of the uterus

A

Endometriosis

36
Q

Describe the larger effects of endometriosis

A

It primarily affects the ovaries, bowel, and bladder can results in inflammation and scarring which can cause pain and impact fertility

37
Q

List the 5 pain provocation tests

A
  1. Thigh thrust
  2. Sacral thrust
  3. SI Distraction
  4. SI Compression
  5. Gaenslen
38
Q

Desribe where you palpate the sacroiliac ligaments

A

Just below the PSIS

39
Q

Describe how neuro testing presents with SIJ dysfunction

A

Neuro tests will be negative for SIJ dysfunction but may coexist likely due to mm tension, inflammation, and/or joint immobility

40
Q

Desribe how you identify diastasis rectus abdominus (DRA)

A

In hooklying pt. lifts head to engage RA

Place two fingers above and/or below umbilicus, if the mm separates to allow 2+ fingers in the gap it’s considered DRA

41
Q

Describe the tx for DRA

A
  • Teach how to engage core WITH OUT RA
  • Strengthen TA, multifidus, pelvic floor mm
42
Q

Condition: Pain for the coccyx or tail bone

A

Coccydynia

43
Q

List the important parts of the pelvic floor assessment

A
  • Systems review
  • Voiding patterns (should be able to pee for 8-10 mississippi)
  • Diet/fluid intake
  • MSK exam
  • External/Internal exam
  • EMG
44
Q

Describe the make up of the pelvic floor muscles

A

80% slow twitch, 20% fast twitch fibers

45
Q

Condition:

  • Increased tone of pevlic floor mm and mm of hip and trunk
  • Mm imbalance/incoordination of hip and trunk
  • Mobility impairment of scar/CT in perinuem, inner thight, abs
  • Diaphragm tightess/poor use
  • Dysfunction of pelvic joints
  • poor posture
A

Hypertonus dysfunction

46
Q

Condition:

  • poor posture: hangs on ligaments/posterior pelvic tilt
  • weak or hypermobile hip/spine
  • weak gluteals and abdominal wall
  • prolapse
A

Weakness of pelvic girdle

47
Q

Describe normal bladder habits

A
  • void 5-7 times in 24 hours or every 2-3 hours
  • shouldn’t have to get up at night to void
  • shouldn’t have to strain to start flow
  • should never go “just in case” – trains bladder it can’t wait
  • shouldn’t ignore urge for more than 4-5 hours
48
Q

Describe normal bowel habits

A
  • 1-3x/day or every other day
  • Bristol consistency 3-4
  • No straining
49
Q

Protocol:

  • Strengthen pelvic floor mm, abd, multifidus
  • Discourage overfiring of rectus abdominus
  • Start with prone gluteal work
  • Coordinate pelvic floor with diaphragm
  • Work on diaphragmatic breathing
  • Address mm imbalances and posture
A

Weakness/Stability protocol

50
Q

Protocol:

  • Relaxation/down training pelvic floor muscles
  • Contract/relax to fatigue
  • Diaphragmatic breathing
  • Soft tissue mobilization
  • Posture
A

Hypertonus/Mobility protocol

51
Q

Describe the benefits of diaphragmatic breathing

A
  • Calms SNS and brings in PNS
  • Lowers HR
  • Boost immune system
  • Decreased inflammation
  • Boost happiness

PTRS 845 Final (11 decks)

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