Exam 2 Flashcards
(112 cards)
1
Q
Full thickness, circumferential, telescoping of rectal wall protrudes from anus visible externally
A
External complete recital prolapse
2
Q
Funnel shape unfold of upper rectal wall during defecation
A
Internal rectal prolapse
3
Q
Loosening of submucosal attachments to muscularis propria of distal rectummucosal layer of rectal wall hemmorhoids
A
Mucosal prolapse
4
Q
Prolapse of mucosal layer of rectal wall does not protrude externally internal hemorrhoids
A
Internal mucosal prolapse
5
Q
How much urine does the bladder hold day and night?
A
1.5-2 cups 150 ml
4 cup night
Extreme 6-8 1L borderline rupture
6
Q
Normal amounts of urination daily? Seconds? Amount?
A
6-7 void 50-25 ml each time
Average 21s +|- 13
Less than 8 didn’t have to go
7
Q
What color is urine if you have a kidney stone? What about if it’s brown? Consistency of major kidney infection?
A
Bloody
Rhabdo protein break down for creatine
Turbid
8
Q
Bubbly urine?
A
Means proteins, solid amino acids not broken down, protinuria or malabsorption
9
Q
Amount of BM each day?
A
Once is normal every other day fine
Abnormal 2+ days extreme 1 per month
10
Q
Normal characteristics of poo
A
Smooth and snake like firm and cracked medium brown
11
Q
What does poo look like if constipated? Soft clear blond?
Mushy with ragged edges?
A
Lumpy
Lacking fiber
Inflammation or dehydration
12
Q
Green, yellow, black, white, blood stained poo
A
G: food too quick through large intestine lots of veggies or dye
Y: greasy foul smelling extra fat malabsorption celiacs
B: internal bleeding ulcer, cancer iron smell
W: bile duct obstruction some meds see doc
R: cancer, see doc
13
Q
How should you pee?
A
Bearing down causes increased pressure
Holding urine too long can lead to irritation leading to involuntary contraction over full
Don’t drink enough urine is concentrated limits its ability to hold urine
14
Q
How should you poo?
A
Bearing down increased pressure
Holding poo too long increased constipation and risk of impaction
Don’t drink enough - constipation
High fiber = easier defacation
Caffeine, same amount in water to neutralize
15
Q
Why squats potty?
A
Puborectalis muscle can fully relax allowing colon to empty quickly and completely 35 degree
16
Q
The removal of the uterus and Fallopian tubes with it
A
Hysterectomy
17
Q
Partial 1 or 2
A
Oophrectomy
18
Q
Fallopian tubes cauterized, sterile without abrupt change
A
Tubal ligation
19
Q
Starts at Fallopian tube about 60%
A
Uterine cancer
20
Q
Fallopian tube removal
A
Sapenectomy
21
Q
Cervix removed and uterus and Fallopian tubes
A
Total hysterectomy
22
Q
Debridement and conization debrief cervix and take section of cervix if abnormal cell for cervical cancer bleeding common
A
D&C
23
Q
Burn entire uterine wall, endometriosis severe cycles can eliminate period
A
Ablation
24
Q
When do you complete oophrectomy?
A
For repeated cyst with pain ovarian cancer ectopic pregnancy
25
When tubal ligation?
Birth control, rarely done most insurance covers cost saving
26
Decreased risk of cancer and birth control performed more often
Salopinectomy
27
Cancer endometriosis ectopic pregnancy
Hysterectomy
28
When total hysterectomy
Metastasized cancer started in uterus cervix or other will close vagina vault taking cervix
29
When D& C
Abnormal cell
30
Can cervical cancer cause ectopic pregnancy?
Yes
31
When is ablation done?
Endometriosis and heavy menustration
32
The age of the pregnancy as measured by time from the mothers last menstrual cycle
Gestational age
33
What happens in days 6-12?
Blastocyst imbed in uterus begin embryonic stage
34
Week 4
Heart is a single vessel SA AND AV cause contraction
35
When is neural tube closed?
Week 5
36
Weeks 6,7,9
Lungs
Brain ventricles and 4 heart chamber
Fetal heart tone on Doppler and spontaneous limb movements
37
When is the transition for fetus to embryo?
10 weeks
38
When do you feel movement?
Week 21
39
What happens to hair and nails during pregnancy?
Hair grows thicker and fuller increased estrogen over entire body
Nails thicker
Mom May lose hair after delivery
40
What happens to skin?
Stretch marks from lg fetus and rapid weight gain vitamin E and cocoa butter may help
41
What results from increased melanin during pregnancy?
Dark patches on upper lip and face
42
When do boobs become tender?
3rd trimester
43
What happens so joints during pregnancy?
Relaxin is released to assist in loosens pelvis affects whole body increase risk sprain and strain
44
What happens to feet?
Swell from pressure on vena cava increased fluid retention
| Arch’s May permanently flatten due to relaxin
45
What is/are Braxton-hicks?
Practice contractions that begin at 28 weeks end of 2nd trimester
Uterus contracts for 30-60 seconds time uteurs
Increase placenta and soften cervix
46
Is morning sickness associated with female?
Slight increase from hormones
47
What is normal weight gain?
25-36
Obese mother should gain 10-20
Underweight mother should gain 28-45
48
General rule for weight gain during pregnancy?
2-4 pounds on 1st trimester
| 1 lb per week after that
49
What happens during each of the phases of delivery?
1st dilation and effacement of cervix
Early, active and transition
2nd pushing and birth
3rd delivery of placenta
50
Hours of 1st stage
6-1 water break membrane ruptures cervix dilates to 3-4cm
Active 4-6 cervix dilates to 4-7 labor truly begins epidural given
Transition 2 hours cervix 7-1 contractions 1-3 min apart don’t push!
51
What occurs during the second stage of delivery?
2 hours cervix dilates pushing begins contractions stronger and further apart episiotomy occurs at this point (cut)
52
What happens during the 3rd stage?
Driver placenta fee and smaller contractions may massage abdomen to assist in separation of placenta
53
what is Gestational diabetes, risks, complications and how do you manage?
High glucose levels
Obesity, Hispanic or AA, rapid weight gain, poor diet
Preeclampsia, large fetus, fetus with poor glucose control, poor liver function
Most with diet and exercise insulin
54
Occurence of preeclampsia?
20 weeks + hypertension with kidney involvement
55
Signs for preeclampsia
High bp swell in hands and face proteinuria headache back pain vomit headache blur vision dizzy
56
Manage preeclampsia
Delivery is only cute 36 weeks delivered
Too early mom in bed rest
Hospital if symptoms worsen
Meds to prevent seizures
57
What is placenta précis? Signs and management?
Placenta covers all or part of cervix opening
Painless vagina bleeding in 2nd/3rd trimester
Spotting
After 20 weeks mom cut back on activity
Bed rest bleeding heavily admit and c section
58
What is placenta abruption signs and management?
Placenta separates from uterine wall limits oxygen to fetus
Vaginal bleeding cramp ab pain and uterine tenderness
If separation is small bed rest until bleeding stops moderate complete bed rest and severe emergency delivery
59
What is diastasis recti signs risks and management?
Separation of linea alba
Palpable separation of recurs abdominis and pooching our of abdomen after delivery
Obesity and rapid weight gain
Surgery exercise and PT
60
What causes heart burn in women? What’s it associated with?
Fetus push on stomach and prego hormones
| Fetal hair Growth relaxed soft tissues causes hair growth
61
What to know about exercise and pregnancy?
Normal if weight gained fetus healthy no complications decrease as pregnancy goes on
62
Benefits of exercise during pregnancy?
Baby can be smarter
Labor and delivery faster and easier
Relieves aches and pain
Decrease gestational diabetes
63
Guidelines for exercise during pregnancy
Avoid heavy repetitive weight training during 1st trimester -increased miscarriage
If exhausted decrease intensity
No evidence of higher levels and complications
64
Back pain and pregnancy
```
Postural change and relaxin
Traditional exercise ok as position is safe
Body mechanics and posture train
Mobes caution with force
Modalities contra
```
65
SI pain and pregnancy
Pain from weight gain postural change and relaxin
Stabilizing exercises pregnancy belt
Avoid aggravating activities
Pain with multiple births or large kids
66
Treatment for diastsis recti
Treat only when less than 2 cm
Girdle after delivery
Hooky lying with sheet pull ends together then crunch hold 10 seconds repeat 10-15
67
4 important things about pelvic floor
Intraabdominal pressure
Organ position
Balance
Plastic in regards to birth
68
This is the sling between innominates pubis and sacrum / coccyx
Pelvic floor
69
Male vs female pelvis
Me more narrow angle long narrow sacrum and coccyx curves inward
Female larger angle coccyx straight and wide short sacrum
70
2 important muscles of pelvic triangle
Ischiocavernosus
| Transverse perineal superficialis
71
Urogenital triangle
Muscular border with ischiopibjc Ramos
| Infant passes through
72
Parous
Had an infant
73
How prevalent is incontinenece?
17 mil Americans
34 overactive bladder
2.9 mil periods incontinence
Number one reason for LTC
74
Prevalence in woman
Over 60 twice as prevalent as men same age most gave birth 1/3
75
Prevalence in males
30% report some increased frequency
| 27% urgency or overactive bladder
76
What sports have incontince?
Gymnastics running jumping high impact
17% boys 5-17
Lift and land stretches thing out
77
Emptying of the bladder
Micturition
78
Amount of urine left in bladder after urination
Post void residual
79
Risk factors for incontinence
Obesity: increased pressure on pelvic floor
Smoking: decreased collagen synthesis anatomical and neuro changes to bladder decreased functionally increased coming caused increased strain on pelvic floor
Diabetes: decreased sensitivity in bladder
Larger bladder capacity with larger PVR
Fill faster and go more often
80
Cost of incontince
Only 1/4 to 1/2 seek med attention
19.5 billion on UI products
12.6 billion overactive m
Stress UI 35% with UI
81
Loss of grime with strain on pelvic floor
Stress UI
82
Loss of urine with urge to urinate
Urge UI
83
Urinary urgency with increased frequency and no gurus without UTI
OAB
84
Loss of urine due to stress and urge
Mixed
85
What is the cause of SUI?
Weak pelvic floor due to abdominal pressure exceeds urethral pressure
86
Cause if OAB?
Detrusor overactivity-urinate and contract
Involuntary bladder muscle contraction during filling
Not always incontient
More dehydrated more concentrated more likely to void
87
Cause of UUI
Detrusor instability sudden urge contracts strong
Before full
Will have to go in 2-3 seconds
88
What causes weak pelvic floor?
```
Hysterectomy
Prolapse
Strain with constipation
Poor biomechanics with lifting
Shift of pelvis affecting muscle length
Scar in perineal and pelvic area
```
89
Etiology of OAB and UUI
UTI irritate lining of bladder
Neoplasia cancer other abnomarmal tissue growth
Post surgery
Bladder outlet obstruction enlarged prostate
Anxiety
Poor toileting habits too fq or too full
90
What is hyperactive bladder syndrome?
Inability to relax pelvic floor causing retention pelvic pain or painful
Bladder
Poor toilet habits
91
What meds affect UI?
Antichokinergic
Antipsychotic-sedate rigid pelvic floor
Diuretics worsen UI
92
Etiology of UI over distended bladder
```
Over distended bladder
Overflow incontince
Constant or intermittent dribble
High PVR
Can feel bladder not completely
Empty
Can’t feel bladder filling
```
93
Fluid intake
Too much - over distension
Too little- concentrated urine increased infection
Spicy foods, caffeine, sugary drinks, carbonation, acid food
94
Pregnancy and UI
```
Weak pelvic floor
Over stretch
Injury to ligaments
Damage to pudendal nerve
Pressure on pelvic floor from wet of fetus
During or after pregnancy
```
95
POP
Pelvic organs prolapse
96
Symptoms of prolapse
Discomfort, bleeding urinary leakage, fq, hesitancy, infection
Difficult bowel movement bulge near pelvic opening sense pressure on pelvic region and lower abdomen
97
Symptoms of severe prolapse
Heavy sensation in pelvic
Sit on ball
Push still place fingers invagina to push
lbP
Lift up bulge to start urination
Hesitation with weak stream or spray urine
Increased frequency and constant sensation of full bladder
98
Cause and risk factors if proplase
Increased age
Childbirth-multiple long and large
Chronic strain during BM and micturtion
Obesity increased weight of organs strain pelvic floor
Hysterectomy uterus supports other structures prior pelvic surgeries
Poor lifting mechanics over time
99
Stages of prolapse
```
0 none
1 1 cm above hymen
2 1 cm above or below
3 greater than 1 can to 2 cm
5 complete GI eversion
```
100
Grades of prolapse
0 no cystocele
1 prolapse less than 2 fingers
2 greater than 1.5 in
3 extend to posterior wall
101
Cystocele
Bladder prolapse
Urethricele - urethra with cystocele cystourethrocele
Front of vagina walll is weak herniation leaded to stress UI and urinary retention
Large PRV
102
Enterocele rectocele
| Uterocele vagina vault prolapse
Small bowel
Rectum
Uterine
Portions of vagina
103
Enterocele
Front and or back of vaginal wall weakens and can separate for small bowel to herniate
After hysterectomy
Can’t hold other organs back
104
Rectocele
Posterior wall of vagina weaken - rectum presses against wall
Posterior wall separatates- herniate into vagina
Bulge when having bowel movement -push stool out
105
Uterine prolapse
Uterosacral ligament weak - lig that supports vagina and uterus
Uterus prolapse into vagina
Telescoping
106
Vagina vault prolapse
Remove uterus 10% post hysterectomy
| Prolapse into vaginal canal with enterocele taken out makes wall weak
107
Rectal prolapse
More in men into or out of Anus young active men with predisposition
108
Degrees of rectal prolapse
1. Blood vessels prominent hemmorhoids
2. Prolapse with bearing down spontaneous reduction
3. Requires Manual reduction
4. Cannot be manually reduced
109
A full thickness circumferential telescoping of rectal wall which protrudes anus visible external
External complete rectal prolapse
110
Funnel shaped unfolding of upper rectal wall during defacation
Internal rectal prolapse
111
Loosening if submucosal attachment to muscularis propria distal rectummucosal later of rectal wall hemmorhoids
Mucosal prolapse
112
Prolapse of mucosa layer of rectal wall not protrude externally
Internal mucosal
