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Flashcards in OMM in Prego Deck (62):
1

What is the role of OMT in the treatment of pain in labor? How does it change the length of labor?

Reduces x2

2

What are the goals of OMT for the prego? (5)

-Prevent complications by increasing homeostasis
-Increase respiratory excursion
-Venous return
-allow easy delivery
-Decreased discomfort

3

What is the cause of the mechanical stress that is added by pregnancy?

Change center of gravity

4

What are the physiological changes with pregnancy?

Increased fluids

5

What happens to the venous/lymphatic return with prego?

Decreased efficacy of lymphatic d/t changes in mechanics

Venous congestion of the CNS

6

What do hormones do to venous and lymphatic return?

Decrease

7

What fraction of pregos experience LBP with prego?

more than half

8

What are the risk factors for the development of LBP in prego? (3)

Heavy labor
Smoking
h/o LBP

9

Where does pain from LBP radiate to with LBP?

Thighs, but not legs

10

True or false: Most women who complain of LBP in pregnancy continue to have pain postpartum

True

11

What happens to the risk of sciatica with each subsequent pregnancy?

Increases

12

What are the things that aggravate LBP?

Prolonged standing and walking

13

What causes the LBP with prego? (per Osteopaths)

Thought is that untreated SDs that are exacerbated from prego

14

What causes the improvement of symptoms of RA with pregnancy? (2)

-Increased cortisol secretion
-Increased alpha-glycoprotein in the maternal serum that decrease inflammation

15

What happens to ankylosing spondylitis with pregnancy?

Aggravated because of increased stress on the SI joint

16

What happens to the spinal curves with pregnancy? Why?

Compensation of anterior pelvic tilt causes an increased lumbar lordosis

17

Is there an increased rupture of lumbar discs with pregnancy?

No

18

What is the more common cause of radicular symptoms in prego?

Direct pressure on the nerve root or lumbar plexus by the uterus

19

What happens to the paraspinal muscles posteriorly with pregnancy?

Shorten

20

What is the most common muscle in the back that is affected with pregnancy?

Psoas

21

True or false: the psoas supports the growing fetus

True

22

What is the cause of sacroiliitis?

Excessive connective tissue stretch and microtrauma from the anterior pelvic tilt

23

Posterior pelvic pain often radiates where? Where should it NOT radiate to?

Below the knee, but NOT into the ankle or foot

24

How do you differentiate pelvic pain radiation in pregnancy from sciatica?

neuro exam normal with normal prego pelvic pain

25

What is the effect of scoliosis on pregnancy? Why?

If curvature is greater than 25 degrees, then increases chances of a premature birth d/t increased relaxin secretion

26

The apex of the baby's skull affects what joint motions in the mother?

pelvis and sacral

27

What causes the plantar surface of the foot change with pregnancy?

Increased weight

28

Why muscle fatigue with prego?

Moving more weight

29

What causes the increased rib dysfunction with pregnancy?

increased breast weight

30

What causes the increased incidence of HA with prego?

Decreased venous drainage

31

What are the goals of OMM to the pelvis with pregnancy?

Increase circulation to pelvis to meet the metabolic needs of fetal development

32

Back pain at night after lying in pregnancy?

Changes in osmotic forces

33

What is the most important OMT treatment for prego women?

Address venous and lymphatics

34

What causes hemorrhoids/varicosities with pregnancy?

Sluggish venous return

35

What causes CNS congestion with prego?

Reversal of venous flow into vertebral and spinal membranes

36

What is the name of the venous plexus that is contained within the spine? What is its drainage dependent on?

-Valveless venous vertebral plexus

-Drainage dependent upon the testing pressure within the thorax and abdomen

37

What is the effect of relaxin?

Increases the mobility of the SI joint and symphysis pubis AND increased laxity of the ligaments of the pelvis

38

What structure secretes relaxin in pregnancy?

Corpus luteum

39

What happens to the levels of relaxin throughout pregnancy?

Increased in 1st trimester, then decreases

40

What structures produce progesterone in the 2nd and 3rd trimester?

Placenta

41

What is the effect of progesterone on fluid levels?

Increases retention

42

What increases the tidal volume in pregnant women?

Changes in the thoracic cage and increased relaxin and progesterone levels

43

What are the spinal SNS levels for the uterus?

T10-L1

44

What is the parasympathetic innervation to the uterus?

S2-S4

45

What causes the sacroiliitis with pregnancy?

Laxity produced by relaxin placing extra strain on the SI joints

46

What are the areas to treat for hyperemesis gravidarum?

C2 and T5-T9

47

What is the sacral dysfunction that is caused by birthing? Why?

BST

Flexion of the back

48

What are the three stages of pregnancy prior to labor and delivery? When does each occur?

1. Structural stage (1-28 wks)
2. Congestive stage (28-36)
3. Preparatory stage (36-delivery)

49

What should be done in the structural stage (1-12 weeks) of pregnancy? What sort of OMM techniques are appropriate?

H and P
Address SDs

Any treatment style is appropriate

50

What are the structural changes in the 12-28 weeks? (3)

-anterior pelvic tilt
-Increased lumbar lordosis
-Compensatory thoracic kyphosis and cervical suboccipital strain

51

What is the main goal of OMM treatment for the congestive stage of pregnancy?

Restoring motion of the diaphragms

52

True or false: any treatment style is appropriate for the congestive stage

True

53

What OMM motion should be optimized during the prep stage?

Craniosacral motion

54

OMM for labor and delivery?

-thoracic and lumbar spine
-innominates
-restrictions of the SI joint

55

True or false: any treatment style is appropriate for the labor and delivery stage

False--aggressive styles are not well tolerated

56

True or false: isolytic correction of the pubic bone during labor/deliver stage is NOT appropriate

True

57

What area should be focused on in the recovery stage (postpartum stage)

SI joint
Sacrum

58

True or false: smoking is a risk factor for the development of LBP in pregnancy

True

59

True or false: race is a risk factor for the development of LBP i pregnancy

False-- is not

60

True or false: multiparous women generally complain more often of LBP

False--less

61

What happens to the following in pregnancy:
-Chest circumference
-Subcostal angle
-Diaphragm

-Increased chest circumference
-Increase subcostal angle
-Diaphragm push superiorly 4 cm, but increases in excursion

62

What is the OMT treatment that should be considered if labor is not progressing (prior to starting oxytocin)?

Thoracolumbar stimulation