Pelvic Health Flashcards by Danielle Hood

True or false: Pelvic Health includes muscles, viscera, nerves, joints, emotions, nutrition, hormones, fascia, and lymph.

True

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True or false: The pudendal nerve only has sensory components.

False; motor and sensory

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True or false: Pudendal nerve is the only peripheral nerve to have autonomic and somatic fibers.

True

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What are the 5 S’s of the pelvic floor muscles?

Sphincteric
Supportive
Sexual
Stabilization
Sump Pump

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Voluntary Skeletal Muscles are:

65% slow twitch fibers & 35% fast twitch fibers
70% slow twitch fibers & 30% fast twitch fibers
35% slow twitch fibers & 65% fast twitch fibers
30% slow twitch fibers & 70% fast twitch fibers

65% slow twitch fibers & 35% fast twitch fibers

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The first layer of the pelvic floor includes what 6 structures?

Superficial Transverse Perineal
Bulbospongiosus
Ischiocavernosus
Perineal Body
External Anal Sphincter
Pudendal n.

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The second layer of the pelvic floor includes what?

Urogenital diaphragm

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The third layer of the pelvic floor includes what 5 structures?

Puborectalis/Pubovaginalis
Pubococcygeus
Iliococcygeus
Obturator Internus
Coccygeus

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A droopy pelvic floor is ______active, ______, and _______.

Underactive, hypotonic, inhibited

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A taut pelvic floor is ______active, and _______.

Overactive, taut

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Risk factors for pelvic floor dysfunction are Surgery, trauma, hormonal, pregnancy/childbirth, central sensitization/Psychophysiological disorder, & ________________.

Aging

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Why might we assess the abdominal canister for someone with pelvic dysfunction?

To see how well they can access their diaphragm and breathe. Also to look for scars, tension, contraction and relaxation.

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Pelvic Floor muscle local assessment is done by biofeedback, manual, and which of the following:

MRI
Xray
Real Time Ultrasound

Real time ultrasound

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Which of the following is not a Contraindication for Internal Assessment:

Lack of consent
Active infection
Post-op (<6-12wks)
Pediatric pt or pt w/o previous pelvic exam
Severe Vaginitis/vaginal atrophy
Third trimester of pregnancy
Severe pain/allodynia
First trimester of pregnancy

Third Trimester of pregnancy

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Fill in the blank:
Internal Manual Local Assessment involves:
M______ F_______
P________
C_________ T_____
N____

Muscle Function
Palpation
Connective Tissue
Nerve

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Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against gravity?

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Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have no active contraction?

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Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against strong resistance?

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Parasympathetic of Urination involves what nerve roots and what plexus?

S2-S4, Pelvic Plexus

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Sympathetic of Urination involves what nerve roots and what plexus?

T10-L2; Hypogastric Plexus

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Somatic of Urination involves what nerve roots and what plexus?

S2-S4; Pudendal

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Parasympathetic is the ______ phase and Sympathetic is the _______ phase.

Storage; Emptying

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During the storage phase the Cerebral Cortex says it is not time to go, the Pons inhibits the cortex, the Hypogastric n T10-L2 inhibits the ______ and stimulates the _____ ______, while the pelvic nerve is quiet and the pudendal nerve stimulates the external sphincter.

Detrusor, internal sphincter

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Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have a trace or a “flicker”?

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During the emptying phase the cerebral cortex says it's good to go, the Pons stimulates the pelvic nerve center, the Hypogastric nerve is ______, the Pelvic Nerve stimulates the _________ contraction, and the pudendal nerve relaxes the external sphincter.

quiet; detrusor

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they a very slight or weak contraction?

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against slight resistance?

"Normal" bladder function is voiding every __-__ hours or __-__ times a day and ___time(s) a night.

2-4; 5-8; 1

"Normal" bladder function is having no: ________, __________, or _____ for storing or for emptying.

pushing, hesitation, pain

Abnormal bladder function is: Hesitation Post void dribble Difficulty delaying urge Discomfort/pain Leakage _________ peeing

Staccato

What are 4 Bladder habits to avoid:

Just in case peeing (JICCING) Hovering Self Dehydrating Power Peeing

Voiding dysfunction, pelvic organ prolapse, incomplete emptying, urinary urgency/frequency, urinary incontinence, Dysuria, and Painful Bladder Syndrome are all bladder issues with an overactive or underactive pelvic floor?

overactive

List the 7 Red Flags for pelvic dysfunction. H________ P________ UTI C________ Symptoms Poor R_____ Function S____ Anaesthesia R______ B___ T_____ N____ P____

Hematuria Persistent UTI Constitutional Sx (malaise, fever) Poor renal function Saddle anaesthesia Recent back trauma Night pain

True or false: Urinary Incontinence is associated with fall risk in the elderly.

True

What are the 4 types of Urinary Incontinence?

Stress Urge Mixed Functional

True or false: If someone has mixed Urinary Incontinence, you must treat the Stress Incontinence first.

False; Urge first

Nocturia is defined as voiding more than ___ times a night.

Common Characteristic of Urinary Incontinence: B_______ Mappers K__ I_ T___ Door Syndrome Claim to have S___ B____ers J____ers T_____ers A___ D____ Water P_____ Pee-ers

Bathroom Mappers Key in the door syndrome Claim to have Small bladders JICCERS Triggers Avoid drinking water Panic Peers

Which of the following is not a Risk factor for Urinary Urge Incontinence: Hx of abdominal/pelvic surgery Neurological Sexually Active Hx of UTI General Anxiety Disorder Clenchers Medications

Sexually active

What are 3 ways to suppress an Urge?

Diaphragmatic Breathing, Kegel, Brain inhibition

Caffeine, Alcohol, Acidic Foods, Carbonated Fluids, Artificial flavors, Dairy, Gluten, Sugar, Nicotine are all...

Bladder irritants

Bladder retraining includes:

Urge suppression techniques, Bladder diary

What type of incontinence is involuntary loss of urine with increased intra-abdominal pressure

Stress Urinary Incontinence (SUI)

Female genitalia Risk Factors for incontinence. A_______ H_______ P______ & L____ P_____ S_____

Anatomical Hormonal Pregnancy and Labor Pelvic Surgery

Male Genitalia Risk Factors for Incontinence. Post P_________ S_______

Post Prostatectomy Surgeries

ALL GENDERS Risk Factors for Incontinence C_____ Constipation A_____ A_____s High B___

Chronic Constipation Asthma Allergies High BMI

KNACK Intra-Abdominal pressure Management involves "SHHHHH" and what other 5 noises/actions?

Cough Hahaha Achoo blow nose Yell

True or false: The following are all reasons to refer to a pelvic health PT? Pt with multiple comorbidities Pt doesn't think you understand No improvement/Worsening after 4-6 visits Symptoms change (Pelvic pressure & pain)

True

T or F: There are more neurotransmitters in the gut than in the brain and spinal cord combined?

"Normal" Bowel function is __times a day to __ times a week.

3;3

Abnormal bowel function is __+ times a day or less than ___ times per week.

5;3

The poop chart goes from a 1-7. What is "normal" on this chart? and describe them.

3-4 3= sauage-shaped, better formed, visible cracks 4= smooth sausage, well formed, easy to pass

Stools that are very difficult to pass and resemble small nuts or hard lumps are what on the scale of 1-7 of the Poop Chat?

"Normal" stool is _______ strain and __-___ pieces.

Minimal strain, 1-2

Stool that is almost entirely liquid with no solid pieces is what on the Poop chart 1-7?

Abnormal stool is: _____ hard H____ your B______ Sitting on the toilet more than ___ Minutes.

Straining hard, holding your breath, 15 minutes

Stools that are easy to pass but have many soft blobs with clear edges is what on the Poop Chart 1-7?

Stools shaped like sausage , visible lumps, and somewhat difficult to pass are what on poop chart 1-7?

Soft stools, fluffy and mushy with ragged edges are what on the poop chart 1-7?

Underactive Pelvic Floor causes these Bowel issues: F____ Incontinence F_____ Incontinence F_____ Smearing Rectal P______ Rectocele

Fecal Incontinence Flatus Incontinence Fecal Smearing Rectal Prolapse Rectocele

Rectocele is when B_____P _____ falls into the vaginal wall rather than the rectum.

Bowel Prolapse

Overactive Pelvic Floor causes these Bowel issues: C________ R____ Pain Anal F_______ B______ Urgency F____ Incontinence I____B____ S_____

Constipation Rectal Pain Anal Fissures Bowel Urgency Fecal Incontinence Irritable Bowel Syndrome

What are the two types of IBS (Irritable Bowel Syndrome)?

Constipation and Diarrhea

Is it "normal" to have a bowel movement during the middle of the night?

What are the Red Flags for Bowel issues? B____ in Stool B____ T____ S____ F_____ A_________ Pain Constitutional Sx Saddle Anaesthesia Recent B___ trauma Recent P____ surgery N____ pain U_______ W____ Loss

Blood in stool Black tarry stool Fever Abdominal pain Consitutional Sx (Malaise) Saddle Anaesthesis Recent back trauma Recent pelvic surgery Night pain Unexplained weight loss

T or F: Women struggle with constipation more than men.

Rome IV Criteria for Constipation involves what 5 things in 25% of your defecations? And less than ___ spontaneous defecations per week.

Straining Lumpy hard stools Sensation fo incomplete evacuation Sensation of anorectal obstruction Manual maneuvers to facilitate defecation 3

What are the 5 risk factors for Constipation?

Standard american diet Lack of activity Stress/anxiety/depression Medication Elderly

What type of constipation is it when your stool is difficult to pass? What usually causes it?

Normal transit constipation; poor diet

What type of constipation is it when stool moves at decreased rate? What usually causes it?

Slow transit constipation; medications, thyroid, neuro

What type of constipation is it when stool is difficult to pass due to pelvic floor dysfunction?

Outlet constipation

What manual therapy technique can you use as intervention for constipation?

I Love You Massage

What 3 things can you educate a patient with constipation on?

Diet, Toilet Ergonomics, Nervous System Calming

What 3 lifestyle modifications can people make if dealing with constipation?

more sleep, manage stress, nutrition

What is the trio to avoid constipation ?

Water, Fiber, Exercise

Recommended water intake to avoid constipation

1/2 your bodyweight in ounces

___-___ mg of fiber/day is recommended to avoid constipation

25-30

The Reverse Knack helps avoid Valsalva and includes: N_____ Spine Lean S____ F_____ R____ D______ B______ Jaw and Face R_____ M__ Breathing

Neutral spine Lean slightly forward Relax Diaphragmatic breathing Jaw and face relaxed Moo Breathing

Does the penis or the clitoris have more nerve endings?

clitoris (8000) compares to 4000

The following list represents what? Premature Ejaculation Erectile dysfunction Dyspareunia Pain w orgasm Persistent genital arousal disorder (PGAD)

Sexual issues for Assigned male at birth

The following list represents what? Dyspareunia Pain w orgasm Post coital pain PGAD (Persitent genital arousal disorder)

Sexual issues for Assigned female at birth

5 Risk factors for Sexual Dysfunction

Sexual Trauma Surgical Trauma Neurological Hx Psychological Hx Hormonal Imbalance

The following is a list of Treatment Approaches for Pelvic Pain. Explain what each mean: Top Down Inside Out Bottom Up

Top down= neuroscience, parasympathetic relaxation Inside out= Food, nutrition Bottom up= hands on, exercise

Pelvic Health Flashcards

(83 cards)