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9 Cards in this Set
- Front
- Back
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28 yr. old pregnant patient - 32 weeks gestation presents with low back pain, what should you think until proven otherwise?
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She is in labor!
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What is ROA?
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Right Occiput Posterior
Baby is head down and the back is to the side- The right side |
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what can be a common cause of rib and thoracic SD in pregnancy?
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breast growth
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How can impaired blood flow in the abdominal cavity during pregnancy lead to headaches?
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posterior abdominal veins shunt their blood to the vertebral blood venous supply
this can back up into the spinal cord or even the brain leading to venous congestion-->headaches |
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Describe sympathetic innervation of the pelvis
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IML-->sympathetic chain ganglia (no synapse)-->lumbar splanchnic to paravertebral ganglia (synapse)-->target
T1-L2/3 (in pregnancy it is T10/11 that is affected) remember: in Parasympathetics you have PELVIC splencnics, that do not synapse at paravertebral ganglia, but instead synapse in the target organ cell wall, then send a few more short axons to the specific target organ |
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How can dorsal rami lead to back pain in pregnancy?
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they innervate the different ligamentous structures in the spine (ant/post longitudinal ligament, etc)
these ligamentous structures get increased stress/stretch due to pregnancy |
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What are the 4 things you want to think about that indicated OMT in pregnancy?
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Gravitational stresses:
Increased lumbar lordosis T12-L1 (downward pull on diaphragm) Rib & thoracic S/D secondary to breast enlargement Lymphatic congestion: Fascial distortions Downward pull on diaphragm Venous congestion: Headaches Viscerosomatic reflex: Sympathetics = T10-T11 Parasympathetics = S2-4 |
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How do post partum pts end up with sciatica? tx?
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Piriformis is stretched from being on the stirrups and they are taken off really quickly...this strains it
treat with piriformis counterstrain |
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Contraindications in pregnancy to OMT
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ANY BLEEDING
Threatened or incomplete abortion Ectopic pregnancy Placenta previa Abruptio placenta Eclampsia or severe pre-eclampsia |
