Reproductive system CIS

Question 1

Nerves for erection

Answer 1

Pudendal N- S2,3,4 (somatic)

Pelvic Splanchnic N- S2,3,4 (Parasympathetic)

Question 2

Nerves for Orgasm

Answer 2

Lumbar Splanchnic N. L1,2 (sympathetic)

Question 3

Nerves for Ejaculation

Answer 3

Lumbar Splanchnic N via hypogastric N (sympathetics) to Vas and Seminal vesicles

Question 4

What promotes lymphatic flow?

Answer 4

• Pelvic diaphragm (active)

- Thoracic diaphragm (passive)

Question 5

Anterior chapman point of prostate

Answer 5

Posterior margin if ITB

Question 6

Anterior chapman point of ovaries/testes

Answer 6

Supra pubic bone

Question 7

Other facilitation in erection

Answer 7

L1-2
Sacrum
Inferior Mesenteric Ganglion

Question 8

Supine lumbar ME

Answer 8

Patient supine with knees bent
- Rotation: knees L or R
- Sidebend: feet L or R
Standard ME cycle

Question 9

Pelvic Diaphragm Redoming

Answer 9

Patient supine with knees bent

• Fingers in ipsilateral Ischial Rectal Fossa on pelvic diaphragm
• Pt contracts pelvic floor, ME cycle
• Perform B/L

Question 10

Congestive stage

Answer 10

• Poor drainage from legs
• Greater volume
• Ball-valve effect
• Impaired diaphragmatic motion
• Volume of abdomen

Treat: sacral, lumbar, thoracic, cervical

Question 11

Useful techniques for pregnant woman in congestive stage

Answer 11

• SI joint articulation

- Supine sacral MET

Question 12

Structure and function dysfunctions in dysmenorrhea

Answer 12

structural dysfunction: lymphatic and venous congestion- impedes the ability of the pelvic cavity to drain vascular and lymphatic fluids causing edema

Treat junctional areas to target diaphragms and improve fluid motion:

• Thoracolumbar junction
• Lumbosacral junction
• Diaphragms

Question 13

Viscerosomatic dysfunction in dysmenorrhea

Answer 13

Visceral irritaiton causes reflex changes at the:

• Thoraco-lumbar junction
• Lumbosacral junction
• Sacrum/sacroiliac joints

Question 14

Lumbo-sacral junction HVLA

Answer 14

1. Evaluate for LSJ rotation
2. Place pt on side with rotation side up
3. Isolate to the LSJ from below and above
4. Log roll to gain mechanical advantage
5. Thrust into the barrier
6. Recheck your findings

Question 15

Sacral rocking

Answer 15

Effective for fluid mobilization.
Takes the sacral base anteriorly into the “extension phase” of the craniosacral mechanism which is equivalent to performing a CV4 cranial technique.
Improves pt’s parasympathetic outflow to the involved organ

Question 16

Reasons for impotence

Answer 16

Reduction of parasympathetic tone resulting in the impairment of erectile capabilities

Reduction of sympathetic activity resulting in dysfunctional ejaculation disorders

Hypersympathetic tone producing premature ejaculation could come from the facilitation of the thoracolumbar level, L1-2

Question 17

Where is pain arising from fallopian tubes refer to?

Answer 17

Flank, iliac fossa, and down the anterior thigh to the knee

Question 18

Where is uterine pain felt?

Answer 18

Thoracolumbar junction, abdomen, and occassionally the sacral region

Question 19

What muscle may be a cause of anovulation?

Answer 19

Chronic psoas spasm

It is also reflective of the genitoiliopsoatic syndrome where chronic ovarian inflammation causes relfex psoas spasm

Question 20

Why is there congestion in the pregnant pt?

Answer 20

More blood gets to the tissues than can be returned by the venous system- Therefore the lymphatic system is essential

Question 21

What comprises the valveless venous system and how can it produce stress

Answer 21

The CNS, spinal cord, and bony vertebral column

The valveless system can produce patterns of flow which result in venous congestion in the tissues they are supposed to drain and decrease organ function

Question 22

When does primary dysmenorrhea occur?

Answer 22

only with ovulatory cycles

Question 23

How is the LS junction named when performing the pelvic roll

Answer 23

Named based on the position of ease.

If the left side of the pelvis lifts easier, inducing rotation to the right, then the LS junction is rotated right.

Question 24

Articular technique for the sacroiliac joint AKA Zink airplace

Answer 24

Dysfunction: sacroiliac, ilosacral

1. Have the patient in either the Sims’ position or on their side.
2. Stand behind the patient and place one hand on the sacrum at S2.
3. Grasp the top leg just below the knee and flex the knee and hip.
4. Flex the hip up to the S2 level (palpate for motion at S2). Abduct the thigh until you feel a slight resistance.
5. While maintaining abduction, circumduct and extend the leg allowing it to fall off the table at the end of extension. Take up slack during the entire motion. Respiratory cooperation may be added with the patient holding their breath during this maneuver.
6. Repeat on the opposite side.
7. This technique may also be used to mobilize a Type II Non-Neutral SD in the lumbar spine. Have the patient lie with the side of the rotated transverse process down, have them hug the table in the Sim’s position. Flex the patient’s top lower extremity until motion is palpated at the dysfunctional segment. The rest of the treatment is the same as the SI joint technique.

Question 25

Muscle energy for the b/l flexed sacrum AKA frog leg technique

Answer 25

Good for postpartum pts with a persistently b/l flexed sacrum.

1. Patient is supine with both hips and knees flexed, knees apart, and soles of the feet together.
2. Stand to the side of the patient and cup their sacrum with your caudad hand. The tips of the fingers grasp the junction of the L5 vertebra and the sacral base.
3. Your sacral hand gives traction in a caudad direction throughout the technique to move the sacral base posteriorly and the apex anteriorly.
4. The patient takes a deep breath and holds it while at the same time they steadily slide the feet downward toward the end of the table, keeping the soles of their feet together and their knees apart for as long as possible.
5. Several repetitions may be needed to correct the SD.
6. The lower extremity positioning helps to gap the SI joint. Your traction force on the sacrum moves the flexed sacrum into a more neutral position. The patient holds their breath to help encourage extension of the sacral base.