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16 Cards in this Set

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What are the goals of OMM during pregnancy?
1. functionality, not normalcy
2. relief of pain
3. movement of fluids
4. function of pelvic floor
What are the primary changes that occur in pregnancy that could make use of treatment with OPP?
1. /\ lumbosacral curve
2. altered center of gravity
3. duck waddling gait
4. 20 - 30 lb weight gain
5. /\ heaviness/size of breast
6. /\ size, weight of uterus
7. nausea, vomiting
8. chest wall expansion
How does the center of gravity change?
center of gravity changes up to T8-T11 and control changes from ligamentous balance to muscle controlled balance
What muscle is strained by center of gravity change in pregnancy?
iliopsoas
What two muscles act against each other to constantly maintain balance with pregnancy?
psoas vs. piriformis

both muscles should be evaluated
What postural changes occur in pregnancy?
/\ lumbar lordosis
/\ thoracic kyphosis
weight shifts to heels
gait changes to waddling as hips widen
What happens to proprioception during pregnancy?
since the body is constantly changing, proprioception is always adapting. women tend to be clumsy.
What uterus supportive anatomy changes during pregnancy?
round ligament (pain in 2nd trimester)
abdominal wall
uterosacral ligament
What relevant hormones play a role in the first trimester?
relaxin - ligaments of pubic symphysis and SI joints to relax

progesterone
What are the major changes in the second trimester?
round ligament change
center of gravity change
proprioception change
fluid shift
What major changes occur in the third trimester?
visceral compression
lung compression
maximum lumbar spine strain
worst edema
What is the autonomic innervation of the uterus?
T10 - L2 Sympathetic
S2 - S4 (pelvic splanchnic) Parasympathetic
How can dysfunction during pregnancy be prevented?
1. exercise
2. antepartum/postpartum balance training
3. healthy weight gain
4. stretching exercise
What anatomical regions would most benefit from OPP treatment during pregnancy?
1. SI joints
2. pubes
3. thoracolumbar spine
4. lymphatics
5. pelvic floor
What are the contraindications for OMM during pregnancy?
1. abruptio placenta
2. placenta previa/undiagnosed vaginal bleeding
3. chorioamnionitis
4. ectopic pregnancy
5. threatened/incomplete AB
6. eclampsia/severe preeclampsia
7. prolapsed umbilical cord
8. preterm labor or premature ruptured membranes
When delivery occurs, how does anatomy change?
1. pelvic inlet/outlet must enlarge
2. sacrum must counternutate for engagement and nutate for delivery