Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
48 Cards in this Set
- Front
- Back
|
Stages of Uterine Prolapse
|
1 – Uterus in upper half of vagina 2 – Descended to opening of vagina 3 – Uterus protrudes out of the vagina 4 – Completely out of the vagina |
|
|
Bradleys loop
|
Loop 1- Frontal lobe to reticular formation Voluntarycontrol of micturition, awareness of voiding Loop 2 – Pons to sacral micturition center Maintainsduration of detrusor contraction (lesion increases PRV) Loop 3 – Sacral micturition center to bladder Coordinatesbladder contraction (Para) w/ sphincter relaxation (Symp inhibits pudendalnerve) Loop 4 – Cerebral cortex to sacral micturition center Volitionalcontrol of sphincters |
|
|
Types of Urinary Incontinence
|
1.
Mixed Incontinence – Combination or urge and stress |
|
|
Physical Therapy management of urinary incontinence
|
Behavioral Bladder retraining Pelvic Floor Exercises Biofeedback Pt. Education |
|
|
PFM exercise forvulvar vestibulitis/Vestibulodynia |
Biofeedback down training
Trigger point releasefrom Obtruator, levator ani, STP |
|
|
Physical therapytreatment for IC (Biofeedback, muscle reeducation to decrease holding &bladder retraining) |
|
|
|
Symptoms associated with vulvodynia |
Burning pain in absence of relevant visible findings Burning, itching, stinging, sexual pain, inflame signs,urge fw, pain posture, ROM --General –entire vulva --LocalizedVestibule/clitoris |
|
|
Voidinginterval for bladder retraining |
Lengthen voiding interval by 15 - 30
|
|
|
Function of the Pudendal nerve (sensory, motor, mixed) |
Mixed
|
|
|
Mechanism of action of Alpha blockers in patient withbenign prostatic hyperplasia |
To Relax the smooth muscles of the prostate and bladderneck to improve urine flow and reduce bladder blockage |
|
|
Physiological mechanism of Pudendal/ pelvicreflex inhibitory loop |
|
|
|
Most common complication following TURP procedure |
|
|
|
PNF D2 for hypertonic dysfunction |
Use of Hip flexors, abductors, and external rotators toturn off pelvic floor -Squatting -Prone -ChildsPose |
|
|
Doesthe pudendal nerve carry parasympathetic nerve fibers? |
No
|
|
|
PVR normal value |
0-50mL |
|
|
Symptomsassociated with Benign prostatic hyperplasia |
IncUrinary fq Incompleteemptying Cannot delayurination Weak stream Painafter urination/ejaculation |
|
|
Alaycock evaluation of the PFM (PERFECT) |
Power –0-5 of MVC Endurance– 10 sec Reps –up to 10 FastTwitch – up to 10 |
|
|
ExternalPelvic clock exam palpation at 3 & 9 |
Superficialtransverse perineal muscles: perineal body to medial ischial tuberosity
|
|
|
Evaluationfor diagnosing vulvodynia (cotton swab test ) |
Gentlepressure of cotton swab around vulva/vestibule will produce pts symptoms. --Ratesensitivity and describe pain |
|
|
Fluidsconsidered a bladder irritant |
Caffine Alcohol CitricAcid CarbonatedDrinks |
|
|
Paradoxical contraction of the puborectalisaffect what function |
|
|
|
Symptomsassociated with vaginismus
|
Involuntarycontraction and spasm of the perineal muscles, making vaginal penetrationimpossible or painful Ptreports “something blocking the entrance” or “tight spot” |
|
|
Physical therapy treatment for dyspareunia
|
Manual Therapy Ther Ex Relaxation Training Pt. Edu EMG Modalities |
|
|
Pelvicfloor exercise for prolapse ( 4 phases of rehabilitation)
|
-Developmentof the ability to be aware of the region -Specificlocalized training and relaxation -Exercisingfunctionally related muscle groups with graded load -Integratingmovements into daily activities to make the automatic |
|
|
Muscles that provide accessory contraction as apatient attempts to isolate her pelvic floor muscles
|
|
|
|
Effect of dehydration on bladder habit
|
|
|
|
Mechanismof sympathomimetic drugs prescribed for urinary incontinence
|
Anticholinergicdrugs: block nerves that control bladder muscle contraction and allow forrelaxation of the bladder smooth muscle. Tricyclicantidepressants – “paralyze” smooth muscle of the bladder AlphaAgonist – contraction of the internal urethral sphincter and increases theurethral resistance to urinary flow |
|
|
Knackexercise |
Bracing,perineal lock, pelvic clutch, kegal when you cough Quick anticipatory PFMContraction or holding back |
|
|
General symptoms of hypotonic pelvic floordysfunction
|
Decreasedresting state of muscles, atrophy, weakness, poor nm control. Pelvicorgan prolapse Incontinence |
|
|
Differentiatebetween different types of prolapse
|
Cystocele– Ant V – Bladder Urethrocele– Ant V – Urethra Urethrocystocele– Ant V – Urethra and Bladder Rectocele– Post V – Rectum Enterocele– Post V – Intestines VaginalVault – Apical V - Vagina |
|
|
Gradesof pelvic floor muscle contraction (Laycock Modified Oxford Scale)
|
0 – None 1 –Trace 2 – Poor 3 – Fair 4 – Good 5 -Strong |
|
|
PSA normal & abnormal value |
Normal Below 4 1.Elevated 4-10 2. Cancer above 10 |
|
|
Symptomsassociated with BPH
|
IncUrinary fq Incompleteemptying Cannot delayurination Weak stream Painafter urination/ejaculation |
|
|
Manual therapy for male hypertonic pelvic floordysfunction |
Myofascial Trigger point Release -Softtissue mobilization -Contractrelax, skin rolling, strumming |
|
|
Symptomsassociated with pudendal neuropathy
|
Urgency/Fq Constipation LowLibido DecArousal/Hyperarousal Painduring erection LBP Prolongedsitting Numbnessor hypersensitivity of penis/scrotum Voiding and sexualdysfunction |
|
|
What is Subcutaneous Panniculosis |
-Increased thickness of subcutaneous tissue withacute tenderness upon pinch rolling in the subcutaneous tissue -Potential ischemia -Hypersensitivity -Hyperalgesia -Localized pain and inflammation of distant organs asdescribed by cutaneous-visceral reflex |
|
|
Components of perineal observation |
Contraction – assess anal wink, lift of perinealbody, does pt bear down/use thighs 1.Relax – return to baseline? 2. Bulge – distention around anus? |
|
|
Internal vaginal exam (three layers) |
Layer 1 – First knuckle – mild squeeze 1.Layer 3 – Third knuckle – Symmetrical contraction |
|
|
Urinalysis used to rule out?
|
Pyuria, Hemauria, proteinuria, glucosuria |
|
|
Complications following the surgical procedures intreating urinary incontinence
|
Infection Urinary Retention Development of urge incontinence after repair Development of urinary obstruction Post-Op Pain |
|
|
Symptoms associated with high grade cystocele
|
Vaginalbulging Vaginalpressure Dyspareunia UTI Obstructivevoiding UrinaryRetention |
|
|
Typical pelvic pain posture
|
Weak abdominals Shortened T/L fascia/iliopsoas Inc Pelvic Floor tone Fwd head posture Kyphosis Lumbar lordosis |
|
|
Common etiologies for levator ani syndrome |
-Abnormally inc muscle activity in the pelvic floormuscles resulting in acute or chronic pain. --Pain/Spasm in the coccyx, piriformia, glutealmuscles and posterior thigh --Physicaltrauma --Poorposture --ChildBirth --PelvicSurgery --LBP --SexualAbuse --Poorvoiding habits |
|
|
Mechanism behind PFM contraction to control urgency
|
-Withevery PFM contraction there is a short term reflex inhibition of the detrusormuscle. --Stay still –maintain control --Squeeze PF 5-6x --Relax and deepbreath --Urge gone –then walk to restroom |
|
|
Pessary used in which pathology? |
Pelvic Organ Prolpase
|
|
|
Physical therapy treatment in male pelvic floordysfunction
|
-Manual Therapy -Biofeedback -PF Exercise -PNF D2 / PFDrops -Stretching -Connective tissue manipulation -Relaxation technique -Fluid modification -Bladder retraining -Voiding modification -Lifestyle modification |
|
|
The goal of Intravaginal electrical stimulation ofthe PFM
|
To regainvolitional control of the PFM through passive activation Sensory branchof pudendal nerve is stimulated and will synapse with efferent at SC levelcausing contraction |
|
|
First desire to void
|
150-200mL Bladder takes 3 hours to fill |
