Flashcards in OMM in Prego Deck (62):
What is the role of OMT in the treatment of pain in labor? How does it change the length of labor?
What are the goals of OMT for the prego? (5)
-Prevent complications by increasing homeostasis
-Increase respiratory excursion
-allow easy delivery
What is the cause of the mechanical stress that is added by pregnancy?
Change center of gravity
What are the physiological changes with pregnancy?
What happens to the venous/lymphatic return with prego?
Decreased efficacy of lymphatic d/t changes in mechanics
Venous congestion of the CNS
What do hormones do to venous and lymphatic return?
What fraction of pregos experience LBP with prego?
more than half
What are the risk factors for the development of LBP in prego? (3)
Where does pain from LBP radiate to with LBP?
Thighs, but not legs
True or false: Most women who complain of LBP in pregnancy continue to have pain postpartum
What happens to the risk of sciatica with each subsequent pregnancy?
What are the things that aggravate LBP?
Prolonged standing and walking
What causes the LBP with prego? (per Osteopaths)
Thought is that untreated SDs that are exacerbated from prego
What causes the improvement of symptoms of RA with pregnancy? (2)
-Increased cortisol secretion
-Increased alpha-glycoprotein in the maternal serum that decrease inflammation
What happens to ankylosing spondylitis with pregnancy?
Aggravated because of increased stress on the SI joint
What happens to the spinal curves with pregnancy? Why?
Compensation of anterior pelvic tilt causes an increased lumbar lordosis
Is there an increased rupture of lumbar discs with pregnancy?
What is the more common cause of radicular symptoms in prego?
Direct pressure on the nerve root or lumbar plexus by the uterus
What happens to the paraspinal muscles posteriorly with pregnancy?
What is the most common muscle in the back that is affected with pregnancy?
True or false: the psoas supports the growing fetus
What is the cause of sacroiliitis?
Excessive connective tissue stretch and microtrauma from the anterior pelvic tilt
Posterior pelvic pain often radiates where? Where should it NOT radiate to?
Below the knee, but NOT into the ankle or foot
How do you differentiate pelvic pain radiation in pregnancy from sciatica?
neuro exam normal with normal prego pelvic pain
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
The apex of the baby's skull affects what joint motions in the mother?
pelvis and sacral
What causes the plantar surface of the foot change with pregnancy?
Why muscle fatigue with prego?
Moving more weight
What causes the increased rib dysfunction with pregnancy?
increased breast weight
What causes the increased incidence of HA with prego?
Decreased venous drainage
What are the goals of OMM to the pelvis with pregnancy?
Increase circulation to pelvis to meet the metabolic needs of fetal development
Back pain at night after lying in pregnancy?
Changes in osmotic forces
What is the most important OMT treatment for prego women?
Address venous and lymphatics
What causes hemorrhoids/varicosities with pregnancy?
Sluggish venous return
What causes CNS congestion with prego?
Reversal of venous flow into vertebral and spinal membranes
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
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
What structure secretes relaxin in pregnancy?
What happens to the levels of relaxin throughout pregnancy?
Increased in 1st trimester, then decreases
What structures produce progesterone in the 2nd and 3rd trimester?
What is the effect of progesterone on fluid levels?
What increases the tidal volume in pregnant women?
Changes in the thoracic cage and increased relaxin and progesterone levels
What are the spinal SNS levels for the uterus?
What is the parasympathetic innervation to the uterus?
What causes the sacroiliitis with pregnancy?
Laxity produced by relaxin placing extra strain on the SI joints
What are the areas to treat for hyperemesis gravidarum?
C2 and T5-T9
What is the sacral dysfunction that is caused by birthing? Why?
Flexion of the back
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)
What should be done in the structural stage (1-12 weeks) of pregnancy? What sort of OMM techniques are appropriate?
H and P
Any treatment style is appropriate
What are the structural changes in the 12-28 weeks? (3)
-anterior pelvic tilt
-Increased lumbar lordosis
-Compensatory thoracic kyphosis and cervical suboccipital strain
What is the main goal of OMM treatment for the congestive stage of pregnancy?
Restoring motion of the diaphragms
True or false: any treatment style is appropriate for the congestive stage
What OMM motion should be optimized during the prep stage?
OMM for labor and delivery?
-thoracic and lumbar spine
-restrictions of the SI joint
True or false: any treatment style is appropriate for the labor and delivery stage
False--aggressive styles are not well tolerated
True or false: isolytic correction of the pubic bone during labor/deliver stage is NOT appropriate
What area should be focused on in the recovery stage (postpartum stage)
True or false: smoking is a risk factor for the development of LBP in pregnancy
True or false: race is a risk factor for the development of LBP i pregnancy
False-- is not
True or false: multiparous women generally complain more often of LBP
What happens to the following in pregnancy:
-Increased chest circumference
-Increase subcostal angle
-Diaphragm push superiorly 4 cm, but increases in excursion