Pelvic Floor

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Author:
rhondak
ID:
220196
Filename:
Pelvic Floor
Updated:
2013-05-18 22:36:13
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OB
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Description:
pelvic floor lecture
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  1. What are the functions of the pelvic floor muscles?



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    • 1 - Supportive
    • 2 - Sphincteric
    • 3 - Sexual




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  2. Types of urinary incontinence?
    • Stress
    • urge
    • mixed (stress and urge)
    • functional
  3. Involuntary loss of urine on effort or exertion, or on coughing or sneezing, exercise, lifting?
    Stress Urinary Incontinence (SUI)
  4. Causes of Stress Urinary Incontinence
    Supportive dysfunction and PFM weakness from 

    • Surgery
    • aging
    • childbirth
    • increased Intra-abd pressure (obese)
  5. Involuntary loss of urine with a strong urge to urinate with inablity to get to the bathroom on time
    Urge Incontinence of Urine (UUI)
  6. Causes of Urge Incontinence of Urine (UUI)
    Uninhibited bladder contractions of Detrusor muscle overactivity from:

    • aging          Parkinsons
    • UTI             CVA
    • irritants
    • DM
    • MS
  7. Dysfunction or overdrive of which system is the cause for rge urinary incontinence
    PARASYMPATHETIC SYSTEM OVERDRIVE
  8. What is the normal rate of urinary frequency?
    5-8x daily, or 0-1x a night
  9. Pelvic Organ Prolapse is defined as descent of which structures?
    • Anterior vaginal wall
    • Posterior vaginal wall
    • Apex of vagina
    • or cuff after hysterectomy
  10. What are the symptoms of pelvic organ prolapse
    • Heaviness or pressure in the pelvis
    • Low back pain
    • feelings of "falling out"
    • post void dribble
    • straining at stool - incomplete emptying of both
  11. Causes of POP?



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    • Genetic: collagen deficiency
    • Childbirth: 3rd vag, instrument delivery, large head
    • Chronic increased intra-abd pressure: obesity, constipation, work-related lifting
    • Surgery
    • Aging:tissue degeneration and dec. estrogen



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  12. Role of Levator Ani in POP
    Continuous postural support:

    Horizontal shelf for organs to decrease pressure on ligaments

    Precontracts before movement to provide support
  13. What are the risk factors for Fecal Incontinence
    Anal trauma, surgery or radiation

    Parity (# of vag births) & degree of tearing

    Cognitive impairment, limitation in ADLs
  14. What is the leading cause of nursing home placements?
    Fecal Incontinence
  15. According to the Rome-II criteria for constipation, you must have 2 of the following in 12 weeks for the past 12 months:
    Straining more than 25% of BMs

    Fewer than 3 BMs per week

    Sensation of incomplete evacuation

    Hard Stools more than 25% of BMs

    Needing digital manipulation
  16. What are the causes for constipation
    Lifestyle: ↓ fiber, inadequate hydration, immobility


    Psychological conditions

    Neurological Conditions

    Structural - POP, hemorrhoids

    Meds

    Pelvic floor dysfunction
  17. What is the common underlying factor in pelvic pain associated with PFM overactivity?
    A HYPERTONIC PELVIC FLOOR
  18. Define vaginismus
    Involuntary spasm of PFM restricting vag entrance of finger or penis and associated with pain

    Associated with personality, sexual anxiety, hx of abuse
  19. Define vulvodynia
    Vulvar discomfort that is burning or pinching characterized by constant pain and hypersensitivity of the vulvar vestibule
  20. Where is pain located with pudendal neuralgia?
    perineal, testicular, peri-anal, suprapubic, clitoral
  21. What are the components of the Laycock PERFECT scale?
    • P-power
    • E-endurance
    • R-repetitions
    • F-fast twitch
    • E-elevation
    • C-co contraction
    • T-timing of involuntary contraction
  22. What is the correct form for a Kegel exercise?
    "Squeeze" around the openings of the pelvis coupled with an "inward lift"
  23. What are the two types of kegel exercises?
    Long holds: slow twitch fibers work up to 10 second hold

    Quick flicks: fast twitch fibers with fast repeated contractions

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