S3L2: Types of Pelvic Floor Dysfunction, Diastisis Recti Abdominis, Female Athletic Triad, Other Considerations Flashcards
Due to deficiencies in the PFMs, urethra, bladder,
and/or sphincter that it is difficult to maintain
urethral closure pressure
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
a. STRESS URINARY INCONTINENCE
Loss of urine with increased intraabdominal
pressure such as coughing, laughing, sneezing,
or physical exertion
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
a. STRESS URINARY INCONTINENCE
Unable to maintain closed sphincters which
leads to spontaneous voiding with
increased intraabdominal pressure
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
a. STRESS URINARY INCONTINENCE
Etiology may be due to pregnancy, vaginal
delivery (overstretch), pelvic surgery, pelvic
organ prolapse, neurologic causes, active
lifestyle, obesity, and aging
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
a. STRESS URINARY INCONTINENCE
Modified T/F:
The pelvic area can be overstretched after birth and not
return to normal due to lack of exercise. Aging can produce unwanted stress, while obesity leads to wear and tear and causes overstretch and muscular weakness
T F
Involuntary leakage accompanied by or
immediately preceded by the sudden onset of
the urge to void that cannot be deferred easily
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
B
Can be caused by involuntary detrusor
contraction that overcomes the sphincter
mechanism
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
B
Can also be caused by poor bladder compliance
that is due to the loss of the viscoelastic
properties of the bladder
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
B
May be neurogenic in nature (spinal cord injury,
spinal stenosis, multiple sclerosis, and stroke
leading to catheter usage or idiopathic). Non-neurogenic may be caused by radiation
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
B
Occurs when the patient experiences both SUI
and UUI Sx
a. STRESS URINARY INCONTINENCE
b. URGE URINARY INCONTINENCE
c. MIXED URINARY INCONTINENCE
C
Due to increased abdominal pressure under stress (weak
pelvic floor muscles)
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
A
Due to involuntary contraction of the bladder muscles
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
B
Due to blockage of the urethra
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
C
Blockage may be caused by benign hypertrophy
sometimes
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
C
Due to disturbed function of the nervous system
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
D
overactive stretch reflex of bladder → slight stretch and the bladder will void immediately
a. STRESS INCONTINENCE
b. URGE INCONTINENCE
c. OVERFLOW INCONTINENCE
d. NEUROGENIC INCONTINENCE
D
How many % percent is the prevalence of UI?
34
Give 5 Risk Factors for UI
Race, hormonal status, obesity, history of pregnancy
or childbirth, chronic disease (e.g. DM), constipation,
family history, Risk increase with smoking, increased BMI, and increased parity
Modified T/F:
High-level male athletes have an SUI prevalence of 41.5%. Constipation is a risk factor for UI.
F T (high-level female athletes)
Modified T/F:
One of the treatments for UI are behavioral interventions like regulating fluid intake. Medications can be given to pts with UI
T T
Modified T/F:
UI pts are contraindicated to surgical procedures. A behavioral intervention may include diet change, bladder training, and increasing BW by 5%.
F F (UI pts may be treated c surgery, Reduction of BW by 5%)
Modified T/F:
Timed voiding and suppression plan should be for 12 wks. It should have a 3 hrs goal in between voiding, start by 30 min then progress.
T F (15 min)
Modified T/F:
A behavioral intervention may be to reduce BW by 5% & ↓ incontinence sx by 10%. Pt education alone can ↓ incontinence sx by 28%
F T (incontinence sx by 47%)
Give 2 Exercise-based treatments for UI
- PFM contraction or Kegel’s (Strengthen PFMs)
- Biofeedback (A probe is inserted to see if the muscles are contracting properly)
Modified T/F:
Urinary urgency is the complaint of a sudden desire to pass urine which is difficult to defer. Frequent urination for more than 1-2 hours is abnormal
T F (Frequent urination for more than 3-4 hours is abnormal)
Modified T/F:
Underactivity of the detrusor reflex attributable to the
disruption of the complex micturition reflex from
neurologic diseases (hyperactive stretch reflexes of
bladder). Urinary urgency and frequency may also be caused by UTI
F T (Overactivity)
Explain how UTI can cause urinary urgency and frequency.
Inflammation of the bladder → sensory afferent
upregulation → detrusor muscle instability
Modified T/F:
Lack of estrogen leads to vaginal and urethral irritation causing infection. Hypoactive PFMs and aging process can also be a culprit.
T F (Hyperactive)
Give 4 symptoms of urinary urgency and frequency
Post Voiding pain
Urethral pain d/t inc tone
Hesitancy
Incomplete bladder emptying
T or F: History of sexual abuse and severe anxiety disorder must also be taken into consideration in pts c urinary urgency and frequency.
True
Identification:
Pelvic Floor Myofascial Pain is characterized by what 3?
pain, muscular taut bands, and trigger points that cause pain referral with pressure
Identification:
Pelvic Floor Myofascial Pain is caused by what 3?
Caused by overuse, dysfunctional postures, and weakness of PFMs
Identification:
Pelvic Floor Myofascial Pain can contribute to what 3?
Can contribute to dysparenuria, painful sexual intercourse, and chronic pelvic pain
Identification:
Pelvic Floor Myofascial Pain may have a hx of what 2?
History of birth trauma or sexual abuse
Modified T/F:
Pelvic Floor Myofascial Pain is present in 70% of women (14-79y/o) with CPP. Pelvic Floor Myofascial Pain is present in 22% of women with pregnancy related pelvic girdle pain
F F
22% of women (14-79y/o) with CPP
70% of women with pregnancy related pelvic girdle pain
Modified T/F:
Pelvic Floor Myofascial Pain is present in 52% of women with chronic lumbopelvic pain that began during pregnancy. Pelvic Floor Myofascial Pain is present in 22% of community dwelling adults
T F
25% of community dwelling adults
Modified T/F:
Pelvic PT is the mainstay of treatment for Pelvic Floor Myofascial Pain. This includes myofascial techniques combined with neuromuscular education.
T T
Modified T/F:
Soft tissue mob & exercises for pelvic girdle, hip, spine, and core muscles are contraindicated for Pelvic Floor Myofascial Pain. Obturator internus & piriformis help increase pain in pelvic floor d/t proximity to the pelvic
floor.
F T
we can also release pelvic floor muscles, do soft tissue mob for trigger points, & give exercises for pelvic girdle, hip, spine, and core muscles
Modified T/F:
NSAIDs & antidepressants can be given to Pelvic Floor Myofascial Pain. Myofascial techniques & neuromuscular education are contraindicated for Pelvic Floor Myofascial Pain
T F
NSAIDs, antidepressants, other medications can be given
Give 4 goals for Pelvic Floor Myofascial Pain treatment:
Restore muscle imbalances
Improve function
Improve posture
Reduce pain
T or F: A lot of pregnant women have bodily pains when it comes to their pregnancy d/t changes of the body
True
Give 5 changes of the body during pregnancy
↑ in body mass
Lengthening of the abdominal muscles
↑ in lumbar lordosis
↑ in anterior pelvic tilt
↑ in pelvic tilt
↑ in ligamental laxity
↑ demands for the hip extensors, hip abductors,
ankle plantar flexors, and PFMs.
Give 3 areas where pain may arise for pregnancy and post-partum pelvic floor dysfunction
lumbar spine, pelvic girdle, hip, and PFM
Modified T/F:
Pt may come to you with low back diagnosis but it
may be the hip or pelvic floor that is causing the
pain. Musculoskeletal pain during pregnancy can arise
from numerous areas: pelvic & shoulder girdle, lumbar spine, and PFMs.
T F
Musculoskeletal pain during pregnancy can arise
from numerous areas: pelvic girdle, lumbar spine,
hip, and PFMs.
Identification:
Most common cause of back and pelvic pain in
pregnancy
Pelvic Girdle Pain
Modified T/F:
Pelvic Girdle Pain is experienced between the anterior iliac crest and the gluteal fold. Etiologies include mechanical, hormonal, inflammatory, collagen abnormalities, and neural.
F T
Experienced between the posterior iliac crest and the
gluteal fold