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OPP Spring 2015 Exam 1 > 1.28.15 - Osteopathic in Pregnancy > Flashcards

1.28.15 - Osteopathic in Pregnancy Flashcards

(65 cards)

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1
Q

back pain

A

2/3 pregnant women

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2
Q

contributions to mechanical issues in pregnancy

A 
multifetal gestation
spinal curve
leg length inequality
weight gain
ligament laxity
SD
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3
Q

low back pain in pregnant women

A

maternal structure affects pregnancy

pregnancy affects maternal structure

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4
Q

most common cause of LBP in pregnant women

A

biomechanical instability

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5
Q

pregnancy posture

A

1 - change in maternal structure
2 - increased body fluid
3 - hormone changes

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6
Q

spinal curves in pregnancy

A

lumbar lordosis

thoracic kyphosis

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7
Q

compensation to changed posture

A 
shoulder back
head forward
increased lordosis
sacrum nutates** flexion
ribs flare
feet flatten
stance widens
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8
Q

posterior paraspinal muscles

A

shorten
-unbalanced by overstretched abdominals

psoas also shortens

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9
Q

relaxin levels

A

increase - result in joint laxity during pregnancy

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10
Q

pubic symphysis widens

A

10-12 week of pregnancy

refer pain to medial thighs or low back

gets worse with walking

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11
Q

peripheral nerves

A

susceptible to injury

-compression, traction, ischemia

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12
Q

meralgia paresthetica

A

lateral femoral cutaneous nerve

-during pregnancy gets neuropathy

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13
Q

lumbosacral plexopathy

A

prolonged sitting, standing, squatting
-prox-distal lower limb weamness

foot drop**

rare - lumbar disc herniation

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14
Q

foot drop

A

result of compression of preoneal division of sciatic in pelvis
or compression of common peroneal nerve at fibular head

consider double crush

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15
Q

spondylolisthesis

A

vertebral body anterior displacement on one below

most common L5-S1

women who have had children - more at L4-5**

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16
Q

important to examine on pregnant patient

A

hip ROM

  • don’t want to miss osteoporosis
  • or avascular necrosis of femoral head
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17
Q

pain with weight bearing

A

osteoporosis of hip

tx - reduce weight bearing

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18
Q

avascular necrosis of femoral head

A

higher adrenocorticoid metabolism
-also weight gain, E and P increase, increased joint pressure
-diagnosis - hip ROM testing
tx - reduced weight bearing

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19
Q

lumbar epidural venous plexus

A

IVC thrombosis

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20
Q

posterior placenta

A

pain with enlarging uterus putting strain on vascular bed connected to placenta

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21
Q

history of trauma

A

placenta abruption

sudden onset of back pain

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22
Q

postpartum depression

A

3x more likely in patients with lumbo-pelvic pain in pregnant women

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23
Q

exam in pregnant patient with LBP

A

ROM, muscle imbalance, leg length, DTR, posture, gait, degree of lordosis

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24
Q

tx of LBP in pregnant

A

avoid excess heat

nutrition - vit D**, magnesium (muscle relaxant)

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25
CI for OMT during pregnancy
undiagnosed vaginal bleeding abortion ectopic PPROM
26
indications for OMT during pregnancy
SD scoliosis edema, congestion, etc.
27
structural stage
0-12 weeks
28
symapthetics to uterus
T10-L2 - contractions and pain
29
parasympathetics to cervix
S2-4 - dilation
30
anterior stomach acidity chapmans
rib 5 and 6 MCL to sternum on left
31
anterior stomach decreased peristalsis chapans
rib 6 an 7 MCL to sternum on left
32
anterior gallbaldder chapmans
rib 6 and 7 MCL to sternum on right
33
anterior liver chapmans
rib 5/6 and 6/7 from MCl to sternum on right
34
anterior pancreas chapmans
rib 7/8 on right close to costochondral junction
35
posterior liver chapmans
intertransverse space midway SP and TP between T5,6,7 on right
36
gallbladder posterior chapmans
intertransverse space midway SP and TP T6/7 on right
37
posterior kidney chapmans
intertransverse space T12 and L1 | -midway between SP and TP
38
stomach peristalsis chapmans posterior
intertransverse space, midway between SP and TP | -between T6/7 on left
39
stomach acidity chapmans posterior
intertransverse space between Sp and TP between T5/6 on left
40
broad ligament anterior chapmans
greater trochanter to within 2 inches of knee joint outer aspect of femur
41
uterus anterior chapmans
upper edge of junction of pubic ramus with ischium
42
intestinal peristalsis chapmans anterior
constipation** between ASIS and greater trochanter
43
rectum anterior chapmans
around lesser trochanter
44
colon anterior chapmans
spastic constipation or colitis 1-2" wide -greater troachanter to inch of patella on antero-lateral aspect of femur right - upper 5th cecum, next 3/5 ascending colon, last 5th beginning of transverse colon left - 5th above knee end of transverse colon, middle 3/5 descending colon, last 1/5 sigmoid colon extreme upper end of trochanter on left side - rectosigmoid junction
45
posterior broad ligament chapmans
between PSIS and spinous process of L5
46
posterior uterus chapmans
tip of TP of L5 toward ilia crest between PSIS and SP of L5
47
posteroir vagina chapmans
leukorrhea -between PSIS and SP of L5, inner femoral condyle, and superiorly from 3-6" on posterior aspect also upper inner aspect of posteiror thigh 3-5" long and 1.5-2" wide on side of articulation of coccyx with sacrum
48
posterior clitoris chapmans
articulation of cocyx with sacrum
49
posterior hemorrhoids chapmans
sacrum close to ilium at lower end of SI joint | -and on ischial tuberosity
50
posterior colon chapmans
spastic constipation or colitis TP of L2 to TP of L4 -triangular area reaching across iliac crest
51
hyperemesis gravidarum
treat C2 and T5-9 as well as related chapmans
52
constipation chapmans
ASIS and greater trochanter anterior intestinal peristalsis point
53
late structural change
12-28 weeks - pelvis rotated anterior at S2 - increased lumbar lordosis - compensatory thoracic kyphosis - cervical lordosis
54
round ligament pain
anterior counterstrain points L3-5 tx
55
sharp inguinal pain
broad ligament
56
carpal tunnel syndrome
increased incidence in pre-eclampsia and HTN due to edematous state resolves after delivery
57
congestive stage
28-36 weeks graviational effect on uterus** increased pressure on lymph and venous edema** some get hypotensive - lay left lateral recumbent
58
upper GI VSR
T5-9
59
cranial during congestive stage
NO | -may provoke uterine contractions
60
preparatory stage
36 weeks to delivery weekly visits maintian structural balance and lymph flow psych support
61
influence uterine contractions
sympathetics
62
influence cervical dilation
parasympathetics
63
CV4
influence uterine contractions
64
recovery and maintenance stage
delivery to 6 weeks -done in 2 visits golden period return to normal pre gravid state
65
post partum depression
b/l flexed sacrum

OPP Spring 2015 Exam 1 (11 decks)

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