Mid term

Question 1

Lumbar pain during pregnancy can stem from multiple sites such as:

Answer 1

• facet joints
• paraspinal muscles
• supporting ligaments of the SI joint
• discogenic

Question 2

what is the cause of back pain during pregnancy

Answer 2

• abdominal muscles become less effective at remain neutral posture
• lumbar lordosis may increase
• the center of gravity as a whole shifts posteriorly and inferiorly as the spine moves posterior to the center of gravity

Question 3

___ allows pelvic expansion to accommodate the enlarging uterus . its levels increases tenfold reaching its peak at the 14th week

Answer 3

Relaxin

Question 4

Joint laxity due to pregnancy can cause hyper mobility to the following joints:

Answer 4

• SI joints
• Pubic Symphysis
• Wrist and Ankle

Question 5

the pubic symphysis widens in pregnancy from its normal width ___mm to a max of ___mm

Answer 5

• .5

- 12

Question 6

Widening of the pubic symphysis come the possibility of ________ of the pubis

Answer 6

vertical displacement

Question 7

Movement of the ____ increases a lot during pregnancy

Answer 7

SI joint

Question 8

Hypermobile SI joint can lead to:

Answer 8

• discomfort when the ligament structures are stretched
• pain walking and lying down
• pain is deep and achy sore

Question 9

Disc Pain

Answer 9

• Süden onset , sharp , radiating pain
• usually accompanied by antalgia
• sharp pain is produced going into flexion

Question 10

Facet Syndrome

Answer 10

• Achy, sore dull pain - after prolonged periods of rest

- if dull is produced while into extension it is ore likely facet syndrome

Question 11

list the factors that affect subluxation in pregnancy

Answer 11

• number of pregnancies
• status of the pelvic musculature
• lifestyle
• level of exercise
• past trauma to the pelvis
• different types and shape of pelvis

Question 12

when adjusting the pregnant patient you should avoid _____

Answer 12

prolonged supine positions

Question 13

a _____ incision around the areola increases your risk of having breastfeeding problems

Answer 13

smile

Question 14

what is the optimal position for the baby in utero

Answer 14

Occiput Anterior position

- the baby is at a longitudinal lie, caudal presentation with head in slight flexion

Question 15

Name this position:
with the face up toward the mother’s abdomen and in the longitudinal position with the head down
- in this fetal position a baby can’t extend his or her head out of the pubic bone which can make delivery more difficult

Answer 15

Occiput Posterior

Question 16

what is the AKAs for occiput posterior

Answer 16

• facial
• brow
• sunny side up
• VOP

Question 17

Name this breech position:
the head is located near the top of the uterus and buttocks facing the birth canal with both hips in flexion and knees in extension

Answer 17

Frank Breech

Question 18

_____ is the most common type of breech presentation

Answer 18

Frank

Question 19

Name this breech position:
the head will be located near the top of the uterus , legs folded at the knees and crossed and feet near the buttocks . Hips are flex and the knees are flexed

Answer 19

Complete Breech

Question 20

name this breech position:

the baby in the head up position with one leg in extension and both hips in flexion

Answer 20

Incomplete breech

Question 21

name this breech position:
the baby will be in the horizontal position
- few babies begin labor in this position

Answer 21

transverse lie

Question 22

This baby’s head is up with one hip one hip in flexion

Answer 22

footling breech

Question 23

How to dterime fetal position :

Answer 23

• mom tells you

Question 24

In leopards first maneuver what are we doing and what are we looking for?

Answer 24

locating the fetal part at the lower uterine segment apply slight counter pressure

Question 25

Leopold's second maneuver entails what ?

Answer 25

same positioning as the first maneuver. palpating for the baby's head positioning

Question 26

how do you perform Leopold/s third maneuver and what are you looking for

Answer 26

palpate down the lateral walls of the uterus to the cervical area. identify the spine and the extremities

Question 27

What are you locating in Leopold's fourth maneuver?

Answer 27

locate the cephalic prominence to identify head position | sinciput vs. occiput

Question 28

Auscultation of the fetal heart in the upper fundal segment indicates what presentation

Answer 28

head up

Question 29

Auscultation of the fetal heart in the lower half of the uterus indicates what presentation

Answer 29

possible vertex presentation

Question 30

The C-section rates are?

Answer 30

was 4.5% in US in 1965 32. 8% in US today - 46% in China - 40% in italy - 14% in Nordic countries

Question 31

________ ______ extends from an attachment posterior laterally to the supra-vaginal portion of the cervix, encircles the rectum and attaches to the fascia over the sacrum

Answer 31

Uterosacral Ligament

Question 32

______ ______ originates from the uterus and insert into the pubic ramus... it is not a true ligament. it has muscle fibers which gives it ability to contract

Answer 32

round ligament

Question 33

What is Webster's technique protocol for a breech baby

Answer 33

1. check for leg lag 2. adjust sacrum on the side of leg lag 3. re-check the leg lag 4. hold abdominal trigger point in the lower quadrant opposite leg lag 5. repeat every other day, adjust nothing else that day 6. continue up to 3 weeks

Question 34

What is the Webster's Technique for a facial or brow baby

Answer 34

1. check for leg lag 2. adjust on the sacrum on the side of leg lag 3. re-check the leg lag 4. hold abdominal trigger points in the lower quadrant on the ipsilateral side of the leg lag 5. repeat every other day - adjust nothing else that day 6. continue up to 3 weeks

Question 35

What is Webster's Technique for a transverse lie baby

Answer 35

1. check for legal 2. adjust the sacrum as a BP sacrum 3. Re- check the leg lag 4. hold abdominal trigger points in the lower quadrant on bilaterally 5. repeat every other day- adjust nothing else that day 6. continue for up to 6 weeks

Question 36

How can water therapy help with turning the baby

Answer 36

- swimming in a warm pool can help - being in deep water may squeeze the fluids in the tissues into the bloodstream and increase the volume of amniotic fluid - increasing amniotic fluid by drinking plenty of water seems to help any method of trying to turn a breech baby as it gives the baby more buoyancy

Question 37

If a women with ___ is treated with antibiotics during labor , the risk of her infant developing and early ___ infection drops by 80%

Answer 37

-GBS( Group B Strep)

Question 38

_____ is a type of bacterial infection that can be found in a pregnant woman's vagina or rectum , 40% of healthy women have this

Answer 38

GBS

Question 39

Between 2000-2006 ___ of births were affected in the US with GBS

Answer 39

0.04%

Question 40

_________ _____ labor and childbirth without medical intervention , no drugs are given to relieve pain or aid the birth process

Answer 40

natural childbirth

Question 41

According to Dr. Towbin, he states that the pulling "normal axial pull" on the baby's head during delivery was pulled with _______ pounds of force

Answer 41

90-120 pounds of force

Question 42

List the factor in birth trauma

Answer 42

- large for date infants especially over 10 pounds - instrumental deliveries - vaginal breech delivery - abnormal or excessive traction during delivery

Question 43

Symptoms of birth trauma

Answer 43

- paralysis - unresponsiveness - bruising - deformities - developmental delays - extreme sleepiness - excessive crying - poor muscle crying

Question 44

Common birth traumas

Answer 44

- infant brain injury - Erb's palsy - Cephalohematoma - Cerebral palsy - fractures - bruising - Caput succedaneum - paralysis

Question 45

_____ is an abnormal or difficult childbirth or labor.

Answer 45

Dystocia

Question 46

Injuries resulting from shoulder dystocia

Answer 46

- broken clavicle - Fx arm - contusion's - Erb's palsy - congenital torticollis - maternal injury

Question 47

____ paralysis of the arm caused by injury to ventral rami of spinal nerves C5-C8 and T1

Answer 47

Erb;s Plast

Question 48

Signs and Symptoms of Erb's palsy

Answer 48

- limp arm - lack of spontaneous movement in the arm or hand - affected arm may flop when the infant is rolled from side to side - decreased grip on the affected side

Question 49

______ is the most common fracture during birth, usually occurs with shoulder dystocia

Answer 49

clavicular Fx

Question 50

what are some major significance of clavicular fractures

Answer 50

- cause brachial plexus injury | - pneumothorax from perforation of the apical pleura

Question 51

Congenital torticollis - the head is typically tilted in lateral bending ___ the affected muscle and rotate toward the ___ side

Answer 51

- toward | - opposite

Question 52

In a pediatric exam, what are you looking for when examining the skin

Answer 52

- rashes - marks - dehydration - cyanosis - Jaundice

Question 53

What are some ways to look for dehydration

Answer 53

- depressed fontanels - chapped lips - tenting of the skin - diapers

Question 54

what may cause central cyanosis

Answer 54

- Pneumonia - congenital heart disease - pulmonary embolism - bronchiolitis

Question 55

what are some signs of head flattening

Answer 55

- head turned one way most of the time - head tilted to one side most of the time - flat spot or bald spot on back or one side of the head - bulging on one side of the head - one ear more forward than the other - asymmetry of the face

Question 56

_______ is the condition of the skull that is characterized by the premature closure of one or more sutures

Answer 56

craniosynostosis

Question 57

what are some sign and symptoms of plagiocephaly

Answer 57

- oblique head - parallelogram - flattening on one side of the back of the head, and a noticeable rounder shape on the other side

Question 58

What are you looking for when inspecting the face

Answer 58

- bell's plays - eyelid ptosis - conjunctivitis - vision - ear position - hearing

Question 59

What are you looking for when inspecting the mouth

Answer 59

- sucking - palate shape (steep , shallow, uneven) - TMJ - Tongue strength

Question 60

what are you looking for when inspection of the lower extremities and pelvis

Answer 60

- inguinal skin and folds - hip joint - gluteal let - gluteal folds

Question 61

_______ reflex : babies display it only when hungry and touched by another person, not when they touch themselves

Answer 61

rooting

Question 62

_____ reflex - referred to as the startle reaction . present at birth, peaks in the first month of life .. disappears by 4 months of age .... legs and head extend while the arms jerk up and out with the palms up, shortly afterward the arm are brought together and the hands clench into fists

Answer 62

moro reflex

Question 63

absence of the moro reflex can indicate:

Answer 63

injury due to birth trauma such as a fractured clavicle or injury to the brachial plexus

Question 64

_____ reflex- present at birth, when soles of feet touch flat surface there will attempt to walk ... reflex disappears at 6 weeks due to an increased ratio of leg weight to strength

Answer 64

walking/stepping

Question 65

______ _____ reflex - hold infant under the arms then tilt infant to one side.... the infant should try to laterally flex to maintain the horizon

Answer 65

Otolith Righting

Question 66

_____ reflex - present at birth ... turns head toward anything that strokes the cheek or mouth ... disappearing at 4 months

Answer 66

rooting

Question 67

______ reflex - present at birth ... linked with rooting and breastfeeding

Answer 67

sucking

Question 68

Palmar and plantar grasp- appears at birth and persists until _______ months of age .. perform bilaterally

Answer 68

5 ot 6 months of age

Question 69

_________ - present at birth up to 8 weeks ... skin along the side of an infant's back is stroked, the infant will swing towards that side

Answer 69

- gallant reflex | aka trunk incurvation

Question 70

Babinski reflex disappears around ____ mothnhs of age

Answer 70

12

Question 71

____ reflex is stimulated by momentarily shining a bright light directly into the infant;s eyes causing him or her to blink ... this reflex should not become inhibited

Answer 71

blink reflex

Question 72

_____ reflex - seen at birth and gradually disappears... examiner makes loud noise .. normal response is for the infant to blink their eyes

Answer 72

acoustic blink

Question 73

_____ reflex - shows up between 6 months to a year of age ... the infant is suspended in the prone position. the examiner will quickly change head position to mimic falling ... infant should extend arm down as to brace the fall

Answer 73

parachute

Question 74

_____ appears between 2 weeks up until 2 years . the reflex is when you hold the baby under the belly , they should arch their back and try to extend their head

Answer 74

Landau