9a Ax Pelvic Floor Flashcards Preview

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Flashcards in 9a Ax Pelvic Floor Deck (28)
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1
Q

So, what do physiotherapists assess when performing a VE?

A
  1. Structural changes that could be contributing to symptoms
  2. Pelvic Floor contraction technique
  3. Pelvic Floor Strength / Co-ordination Assessment
2
Q

VE Step One - Observation

A

Initial anatomy at REST

Ability to perform a PELVIC FLOOR CONTRACTION

3: Ability to maintain a PFC DURING INCREASES IN IAP

4: Anatomy during a COUGH
5: Anatomy during VALSALVA

3
Q

PF strength grade 0

A

nil

4
Q

PF strength grade 1

A

flicker

5
Q

PF strength grade 2

A

weak, non fluttering pressure

6
Q

PF strength grade 3

A

moderate - small degree of lift

7
Q

PF strength grade 4

A

good examiners fingers firmly gripped. Lift against some resistance

8
Q

PF strength grade 5

A

very strong grip of fingers. lift afainst strong resistance

9
Q

PERFECT =

A
Power
Endurance
Reps
Fast ( nymber of fast, max contracts pt can perform before they can no longer acheive max)
ECT = every contraction timed
10
Q

Manometry

A

eg peritron

11
Q

Methods to quantify PF strength

A

EMG
Manometry
Vaginal cones

12
Q

Disadvanmtages vaginal cones

A

– Disadvantages
• Varying Vaginal Diameters
• Influenced by vaginal mucous amount

13
Q

Advantages Translabial / Transperineal(RTUS)

A

• Can visualise lifting action of pelvic floor
• Can visualise bladder, Uterus & Rectum
– Can assess Prolapse
– Can assess bladder neck mobility

14
Q

DisadvantagesTranslabial / Transperineal(RTUS)

A
  • Few people well trained

* Infection control issues

15
Q

Advantages Transabdominal / Suprapubic

A
  • Can visualise lifting action of pelvic floor
  • Avoids contact with genital area
  • Non-confronting for patient
16
Q

Disadvantages Transabdominal / Suprapubic

A

• Unable to visualise other organs (uterus,

rectum)

17
Q

Paper Towel Test Method

A

– Patient dries the perineum to eliminate any vaginal
discharge/prior leakage
– Pt hold folded tri-fold paper towel tightly against the
perineum
• 1. Patient is asked to cough hard 3 times
• 2. Dimensions of resultant wetted area is measured
• 3. Patient performs a further 3 coughs
• 4. Dimensions again recorded

\Attempt to Standardise bladder volume
• 2hours before patient should void and then drink 250mls
• 1hour before patient should drink another 250mls
• patient should then not empty bladder until after test

18
Q

Pad Tests

A
  1. 24 hour pad test (patient given multiple pads that are pre-weighed)
  2. 1hour pad test (patient wears one pad for 1hour)
19
Q

1 hour Pad Test

A

• Patient drinks 500mls of sodium free liquid within 15minutes
• Patient rests for 30min, then performs……
– Sit-stand x 10
– Cough vigorously x 10
– Run on the spot for 1min
– Bend to pick object up off floor x 5
– Hand wash for 1minute

20
Q

Normal Nocturnal Urine Production

Young Adults 20- 50

A

<20% 24hr urine volume

21
Q

Normal Nocturnal Urine Production

Middle Adults 50-65

A

< 25% 24 hr urine volume

22
Q

Normal Nocturnal Urine Production

– Older Adults > 65yrs

A

< 33% 24hr urine volume

23
Q

Deferring urge: 1

A

Could Delay 1hr

24
Q

Deferring urge 2

A

Could Delay 30min

25
Q

Deferring urge 3

A

Could Delay 15min

26
Q

Deferring urge 4

A

Couldn’t Delay 5min

27
Q

Urge 0 bladder volume

A

0-150

28
Q

The Pitfall of Bladder Diaries

A

Bladder diaries don’t definitely tell you what was in the bladder at
the time of voiding!!!!!!!!!! What if there is a high post void residual????