Genital-Urinary

Question 1

Describe Functional Incontinence

Answer 1

Inability to reach toilet, or physical issue not allowing to reach bathroom in time

Question 2

Overflow Incontinence (also know as retention incontinence)

Answer 2

Continual leakage because bladder is full and unable to empty so it overflows typically due to issues with detrusor muscle

or obstruction

Cauda Equina and MS

Intervention
“improve flow”
fluid regulation

May require intermittent catheter

Question 3

Stress Incontinence

Answer 3

Loss in urine with intraabdominal pressure due to coughing, laughing, etc due to weak bladder.

Fix by strengthening pelvic floor (Kegel

Question 4

Urge Incontinence

Answer 4

Overactive (urge) due to involuntary contraction of the detrusor muscle

or reduced bladder capacity

Due to meds, infection, neuro, old folks

Fluid regulation
Scheduled voiding

Question 5

Prostatitis vs Benign Prostatic hyperplasia vs prostate cancer

Answer 5

*typically refer out b/c potential cancer

Prostatitis (infection usually)
- Acute conditions like fever, chills
- Local pain
- Nocturia
- Weak urine outflow

BPH (enlarged)
- Bladder distention, - frequency

PC
-Hematuria
- LBP (local)
- Cancer signs

Question 6

Detrusor muscle

Answer 6

Contracts to EXPEL urine (pushes on bladder)
When contracted, bladder contracts and squeezed pushing urine out

RELAXES TO STORE (keeps bladder stable)

So issues occur due to lack of motor control, with urge, and stress incontence people contract by mistake

Question 7

GFR rate levels for kidney

Answer 7

Stage 1 (Kidney damage but normal GFR) : 90 or more
Stage 2 (Mild decrease) 60-90
Stage 3 (Moderate) 30-60
Stage 4 (severe) 15-30
Stage 5 End stage Less than 15

Question 8

Lifestyle modifications for bladder symptoms

Answer 8

2,500 mL or 10 cups
Reduce irritants like coffee, alcohol, spicy, etc, artificial sweeteners
Schedule voiding would be every 3-4 hr
Fiber intake for bowels
No fluid within 2-3 hours of bed
Smoke cessation for stress
Weight loss to reduce pressure on the pelvic floor

Question 9

Changes with pregnancy

Answer 9

Increased ant tilt
Uterus ascends into the abdominal cavity
Ribs expand and the diaphragm elevates
Increased depth of respiration, TV, and MV
Increased O consumption 15-20 percent, blood volume increased 40-50, cardiac output 30-60
Supine causes hypotension due to IVC compression which is why left side-lying is ideal
Joints become hypermobile laxity due to relaxin
SI is very relaxed

Question 10

Back pain

Answer 10

Many reasons, but take severe back pain seriously

Question 11

Pelvic floor exercese

Answer 11

80-100 contractions daily

quick 3x10 is for stability with abd pressure
longer holds 3x5 w/ 5 sec hold for endurance, posture, etc.

Question 12

preeclampsia vs eclampsia

Answer 12

Preclampsia is high blood pressure, blood and protein issues
Eclampsia is what it can develop into, more severe and includes seizures, death

Question 13

Absolute contraindications

Answer 13

Multiple gestation with premature labor
Peristent bleeding in 2nd and 3rd trimester
Incompetent cervix
Obvioius stuff

Question 14

Ectopic pregnancy

Answer 14

An ectopic pregnancy occurs when a fertilized egg attaches outside of the uterus, usually in a fallopian tube. The pregnancy will miscarry and the embryo will not survive

Blood loss, back shoulder pain, in pregnant female

Question 15

Pregnancy exercise

Answer 15

mild to moderate 3x week
NWB exercise like cycling and swimming lower risk of injury
Require at least an extra 300 calories to stay afloat

For high risk
Abdominal contractions can cause uterine contractions
Avoid valsalva maneuver in exercises

Question 16

Kidney stone

Answer 16

Renal calculi radiates to groin perineal area area. Dependent on stone location

Question 17

Ureter vs urethra vs uterus

Answer 17

Ureter comes from kidney and goes to bladder

Urethra is where we pee out of both male and female

Uterus is where baby forms

Question 18

Diastasis recti

Answer 18

Seperation 2 cm or two fingers

Question 19

Pillos under R hip for

Answer 19

Pregnancy

Especially after 1st trimester

Question 20

Pelvic floor activation
Levels based on gravity

Answer 20

Easiest:

trendelenberg>Supine >hooklying >quadruped>Seated>standing>during activity

Question 21

Crede maneuver

Answer 21

pressure on lower abdomen for emptying

Question 22

Suprapubic tapping

Answer 22

Stimulates detrusor for emptying

Question 23

Cystitis

Answer 23

Goal is to relax and stretch muscles
Bladder infection

Question 24

Endometriosis

Answer 24

Development of endometrial tissue that lines uterus

Related to menstrual cycle
bleeds, scarring, adhesions

Manual therapy and tens to treat it

Question 25

Uterine prolapse

Answer 25

Treat with kegel exercises, biofeedback, intravaginal mechanincal support

Question 26

Coccyodynia

Question 27

Piriformis syndrome

Answer 27

like sciatica but related to pregnany.

Question 28

Symphysis pubic pain

Answer 28

May use muscle energy techniques, pelvic floor exercises, due to laxity weakness, and abnormal structure due after birth.

Question 29

Pelvic floor muscles

Answer 29

Must relax for urine and feces to pass when contracted, holds everything in place which is why these muscles must be trained with pelvic floor exercises with incontinence , because if weak it is not holding things in If too relaxed and not contracting then things come out = incontinence

Question 30

Diastasis Recti

Answer 30

1. With a 3-cm diastasis, the head lift is the most appropriate exercise initially. The patient braces the abdomen toward the midline to approximate the diastasis while performing the head lift. This will help to keep the separation of the abdominal muscles to a minimum, minimize the action of the obliques, and control intraabdominal pressure. 2. Given the strength of this patient's abdominal muscles in addition to the extent of the diastasis, this activity would be too strenuous and may further compromise the diastasis. The head lift should be performed exclusive of all other abdominal exercises until the diastasis is 2 cm or less. 3. Lower trunk rotation should be avoided until the diastasis is 2 cm or less. Due to the angle of attachment of the obliques into the linea alba, there is a possibility that trunk rotation exercises will perpetuate the diastasis. 4. With an abdominal strength of Fair minus (3-/5) and a diastasis of 3 cm, bilateral straight leg raises could cause a further separation of the diastasis by increasing intraabdominal pressure as the patient tries to stabilize while lifting the legs. The head lift corrective exercise should be performed exclusive of all other abdominal exercises until the diastasis is reduced to 2 cm or less.