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PTRS 845 Final > Women's Health [Guest Lecture] > Flashcards

Women's Health [Guest Lecture] Flashcards

(51 cards)

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1
Q

4 Parts of the Pelvic Girdle

A
  1. Bony pelvis (ilium, ischium, pubis)
  2. Sacrum
  3. Spine
  4. Femur bones
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2
Q

List the 3 layers of the Pevlic Floor Musculature

A

Layer 1 = bulbospongiosus, ischiocavernosus, superficial transverse perineal

Layer 2 = sphincter urethrae, compressure urethrae, deep transverse perineal

Layer 3 = iliococcygeus, puporectalis, pubococcygeus (leavator ani), obturator internus

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3
Q

List the muscles included in the posterior musculature of the pelvic girdle

A
  1. Glute max/med/min
  2. Piriformis
  3. Obturator internus/externus
  4. Quadratus femoris
  5. Adductor magnus/longus
  6. HS
  7. Superior/Inferior gemelli
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4
Q

Muscle: Prime mover of the sacrum

A

Piriformis

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5
Q

List the muscles included in the anterior musculature of the pelvic girdle

A
  1. Psoas
  2. Iliacus
  3. Rectus abdominus
  4. Internal/External oblique & Abdominals
  5. TA
  6. Adductor longus/brevis
  7. Gracilis
  8. TFL
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6
Q

Describe the 2 ways that iliopsoas has a close relationship with the pelvic floor

A
  1. By fascia connections
  2. By innervation
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7
Q

Muscle Type: controls intra-abdominal pressure and is important for proper body mechanics, breathing, and voiding

A

Core muscles (pelvic floor, TA, multifidus, diaphragm)

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8
Q

Describe the movement of the pelvic floor and diaphragm with breathing

A

Inhalation: both move down

Exhalation: both recoil, move up

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9
Q

List the 5 Functions of the Pelvic Floor Muscles

A
  1. Supportive
  2. Sphincteric
  3. Sexual
  4. Stability
  5. Sump-pump
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10
Q

Pelvic floor function: helps to support organs and forms the bottom of the core

A

Supportive

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11
Q

Pelvic floor function: controls openings of the urethra, rectum, and vagina

A

Sphincteric

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12
Q

Pelvic floor function: Assists the SI, pubic symphysis, lumbosacral, and hip joints

A

Stability

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13
Q

Pelvic floor function: assissts venous and lympathic movement

A

Sump-pump

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14
Q

Describe when the sacrum is held tightest and why

A

Held tighter during WB due to the self locking characteristics of the sacrum itself

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15
Q

Term: Two structurally separate joints that act as one functional unit

A

Bicondylar

ex. TMJ, Hip, Knee

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16
Q

Term: Movement accompanied by a correlative movement at another location

A

Bicondylar Joints

They can move in opposite directions and still be bicondylar

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17
Q

Biomechanics of Gait – What’s going one when…

  1. L Swing Phase
  2. L Heel Strike
A
  1. Sacrum rot R; L-Spine rot OPPOSTIE
  2. L Piriformis contraction, Sacrum rot L
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18
Q

Type of Pelvic Floor Dysfunction: Leads to incontinence, LBP, joint instability, prolapse, pelvic congestion, mm imbalance

A

Weakness

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19
Q

Type of Pelvic Floor Dysfunction: Leads to pelvic and LBP, SI and hip imbalances, often incontinence and voiding dysfunction, pelvic congestion

A

Hypertonus

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20
Q

Clinical Presentation:

  • Leaking urine
  • Voiding dysfunction
  • Heavy feeling in abdomen
  • LBP, SI, Hip/Pelvic pain
  • Poor posture and force closure
A

Core Mm Weakness

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21
Q

Clinical Presentation:

  • Pain in back, low abdomen, posterior thigh, coccyx
  • vulvar/clitoral or testicular/scrotal/penile burning
  • pain with intercouse, defecation, sitting
  • incontinence/voiding dysfunction
  • constipation
  • poor posture
  • over use of global mm
  • hip ROM decreased
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A

Hypertonus Dysfunction

22
Q

Describe pelvic girdle pain

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A

Pain in 1+ of the joints of the pelvic girdle (SI, LS, Symphsis, Hip)

23
Q

Clinical Presentation:

  • occurs post-partum or 24-36 wks gestation
  • posteriorly located pain or in groin or over pubis
  • lacks specific NR distribution
  • difficulty with change of position
  • prolonged walking, stairs, carrying
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A

Pelvic Girdle Pain

24
Q

Describe the changes with pregnancy

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A
  • rib angle becomes more perpendicular
  • diaphragm elevates
  • center of gravity is shifted
  • abdominal wall distended
  • core function limited
  • hormones cause ligamentous laxity
25
The following are things to avoid with what complication: - Valsalva - Trunk stabilization/ab work
OB -- obstertic complications
26
List the things to be concerned with when treated pregnant women
- HR below 140 - Heat over the belly - Estim over belly/LB - Supine positioning
27
List signs of post partum depression
- not sleeping - losing/gaining wt rapidly - can't get out of bed - ignoring basic grooming - seems hopeless, feel helpless - lack of feeling for the baby - extreme anxiety or obsession for baby safety
28
Describe how the speed of delivery can cause pelvic floor trauma
Too slow = like running a marathon for pelvic floor mm Too fast = like a MVA for pelvic floor mm
29
Term: Leaks with increased abdominal pressure
Stress incontinence
30
Term: Leaks with strong urge to go
Urge incontinence
31
Term: Separation of the rectus abdominus mm along the linea alba
Diastasis Recti
32
Condition: Inflammatory response at pubic symphysis and ischial rami caused by susatined or repetitive trauma to the pubic symphysis
Osteitis Pubis
33
Condition: separation of the pubic bones anteriorly leads to outflaring of the iliac bones; sacrum is less tightly held and can move anteriorly
Pubic symphysis dislocation
34
Describe women's health related issues that can occur in the femal athlete
Eating disorders and over exercising results in low weight which can lead to irregular menstraution or amenorrhea which can lead to poor bone health
35
Term: Endometrial tissue grows outside of the uterus
Endometriosis
36
Describe the larger effects of endometriosis
It primarily affects the ovaries, bowel, and bladder can results in inflammation and scarring which can cause pain and impact fertility
37
List the 5 pain provocation tests
1. Thigh thrust 2. Sacral thrust 3. SI Distraction 4. SI Compression 5. Gaenslen
38
Desribe where you palpate the sacroiliac ligaments
Just below the PSIS
39
Describe how neuro testing presents with SIJ dysfunction
Neuro tests will be negative for SIJ dysfunction but may coexist likely due to mm tension, inflammation, and/or joint immobility
40
Desribe how you identify diastasis rectus abdominus (DRA)
In hooklying pt. lifts head to engage RA Place two fingers above and/or below umbilicus, if the mm separates to allow 2+ fingers in the gap it's considered DRA
41
Describe the tx for DRA
- Teach how to engage core WITH OUT RA - Strengthen TA, multifidus, pelvic floor mm
42
Condition: Pain for the coccyx or tail bone
Coccydynia
43
List the important parts of the pelvic floor assessment
- Systems review - Voiding patterns (should be able to pee for 8-10 mississippi) - Diet/fluid intake - MSK exam - External/Internal exam - EMG
44
Describe the make up of the pelvic floor muscles
80% slow twitch, 20% fast twitch fibers
45
Condition: - Increased tone of pevlic floor mm and mm of hip and trunk - Mm imbalance/incoordination of hip and trunk - Mobility impairment of scar/CT in perinuem, inner thight, abs - Diaphragm tightess/poor use - Dysfunction of pelvic joints - poor posture
Hypertonus dysfunction
46
Condition: - poor posture: hangs on ligaments/posterior pelvic tilt - weak or hypermobile hip/spine - weak gluteals and abdominal wall - prolapse
Weakness of pelvic girdle
47
Describe normal bladder habits
- void 5-7 times in 24 hours or every 2-3 hours - shouldn't have to get up at night to void - shouldn't have to strain to start flow - should never go "just in case" -- trains bladder it can't wait - shouldn't ignore urge for more than 4-5 hours
48
Describe normal bowel habits
- 1-3x/day or every other day - Bristol consistency 3-4 - No straining
49
Protocol: - Strengthen pelvic floor mm, abd, multifidus - Discourage overfiring of rectus abdominus - Start with prone gluteal work - Coordinate pelvic floor with diaphragm - Work on diaphragmatic breathing - Address mm imbalances and posture
Weakness/Stability protocol
50
Protocol: - Relaxation/down training pelvic floor muscles - Contract/relax to fatigue - Diaphragmatic breathing - Soft tissue mobilization - Posture
Hypertonus/Mobility protocol
51
Describe the benefits of diaphragmatic breathing
- Calms SNS and brings in PNS - Lowers HR - Boost immune system - Decreased inflammation - Boost happiness

PTRS 845 Final (11 decks)

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