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167 Cards in this Set
- Front
- Back
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What is addison's disease?
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autoimmune process that causes the adrenal glands to underproduce cortisol and aldosterone
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What are early symptoms of addison's disease?
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nonspecific weakness and fatigue; making it difficult to diagnose
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What are symptoms of addison's disease?
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hyperpigmentation of skin and mucous membranes, progressive fatigue, gastrointestinal disturbance, nausea, vomiting, weight loss, tendon calcification, hypoglycemia; may cause potassium elevation, which can lead to ascending myopathy, causing flaccid paraplegia and polyneuropathy
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What is cushings syndrome?
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oversecretion of cortisol by the adrenal cortex or long-term use of corticosteriods due to inflammatory disorders (iatrogenic Cushing's syndrome)
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What are symptoms of cushing's syndrome?
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moon face appearance, cervical fat pad, truncal obesity, muscle wasting and weakness, osteoporosis, hypertension, easy bruising, depression, excessive facial hair, ruddy complexion, slow wound healing
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What is hypothyroidism?
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condition resulting from decreased thyroid hormone condition, causing generalized depression of the metabolism; diagnosed is TSH is elevated
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What are symptoms of hypothyroidism?
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cold intolerance, excessive fatigue and lethary, headaches, weight gain, dry skin, increasing thinness/brittleness of hair and nails, peripheral edema, peripheral neuropathy, proximal weakness
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What is hyperthyroidism?
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condition resulting from excessive production of thyroid hormone (graves' disease) resulting in a generalized elevation of body metabolism; diagnosed if TSH is depressed
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What are symptoms of hyperthyroidism?
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tachycardia, increased sweating, heat intolerance, increased appetite, dyspnea, weight loss and inability to gain weight, anxity, goiter (enlargement of thyroid gland), exophthalmia (caused by hypertrophy of eye muscles coupled with increase in connective tissue in the orbit, eye seems to bulge out)
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What do the parathyroid glands secrete?
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parathyroid hormone (PTH), which regulates calcium and phosphorus metabolism
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What is hyperparathyroidism?
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excess PTH leads to an elevated calcium level and decreased serum phosphate level; this causes demineralization of the bone and subsequent loss of bone strength and density; most often discovered as asymptomatic hypercalcemia upon diagnosis
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What are the symptoms of hyperparathyroidism (hypercalcemia)?
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proximal weakness, fatigue, drowsiness, arthralgia/myalgia, depression, glove/stocking sensory loss, osteopenia/fractures, confusion/memory loss, pancreatitis, gout, osteitis fibrosa cystica (bone lesions called brown tumors)
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What is hypoparathyroidism?
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decreased or absend production of PTH, most commonly due to removal/injury of parathyroid gland; diagnosed with low serum calcium and high phosphorous and low serum PTH level
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What are the symptoms of hypoparathyroidism?
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neck stiffness/muscle cramps, seizures, irritability, depression, skeletal muscle twitching, cardiac arrhythmias, paresthesias (tingling finger tips and mouth), Chvostek's sign (twitching of facial muscles with tapping of facial nerve in front of ear)
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What is the function of the pancreas?
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acts as an exocrine gland, producing digestive enzymes; also acts as endocrine gland, producing insulin and glucagons
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What is thyroid function regulated by?
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hypothalamus and pituitary feedback controls, as well as an intrinsic regulatory mechanism within the gland itself
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What is diabtes mellitus?
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chronic systemic disorder caused by defective or deficient insulin action in the body and disruption of the metabolism of carbohydrates, fats, and proteins
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What is type 1 diabetes?
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insulin-dependent DM (IDDM) or juvenile onset; immune mediated, causes beta cell destruction that usually results in absolute insulin deficiency; Criteria include fasting glucose level of > 126 mg/dL or "casual" blood glucose level of >200 plus symptoms of DM
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What is type 2 diabetes?
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non-insulin-dependent DM (NIDDM) or adult onset; characterized by defective insulin production and/or impaired receptor binding of insulin; Occurs mainly in adults >30 yrs; Obesity, family history, race, or women with high birth weight babies can be factors; treatment includes diet and exercise; criteria same as IDDM
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What test confirms hypoglycemia?
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blood glucose <50-60 mg/dL
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What are the symptoms of hypoglycemia?
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skin is pale, cool, and diaphoretic; disoriented or agitated, headache, blurred vision, slurred speech, tachycardia with palpitations, weak/shaky, loss of consciousness
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What test confirms hyperglycemia?
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blood glucose >180 mg/dL
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What are some symptoms of hyperglycemia?
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skin is dry and flushed, fruity breath odor, frequent urination (polyuria), unusual thirst (polydipsia), extreme hunger, unusual weight loss (10lbs in 1 month), extreme fatigue, irritability, blurred vision, fungal infections (toenails, skin folds), dizziness
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What are 3 complications of DM?
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atherosclerosis, infection/impaired wound healing, neuropathy
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What other systemic symptoms might be involved with DM?
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periarthritis (bilateral hands and shoulder pain), hand stiffness (limited joint mobility, flexor tenosynovities, dupuytren's contracture, CRPS), depression
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What are the interventions for DM?
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maintain blood glucose levels within range of 80-120 mg/dL by diet, exercise, and medication (includes insulin and oral hypoglycemic agents)
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What are the exercise precautions with DM?
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avoid exercise if blood glucose levels are >250 mg/dL with evidence of urinary ketones or blood glucose levels near 300 mg/dL with/without urinary ketones; do not exercise during peak insulin times
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What affect does exercise have on the body?
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insulin-like effect; accelerates the movement of glucose out of bloodstream and into the peripheral tissues where it is needed; insulin + exercise can result in hypoglycemia
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How long should you wait to exercise patient following insulin injection?
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2-4 hours
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How much should you decreased insulin dose by prior to exercise? Post exercise?
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30-35%; up to 30%
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When is the best time to exercise a pt with diabetes?
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1 hour after a meal; increase carbs at least 24 hours before and after exercise
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When checking blood glucose prior to exercise what should you do with a patient <70? >250?
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give carbs, retest in 15 min; do not exercise
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What can develop is regards to foot care in DM patients?
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vascular deficiencies and diminished sensation; pts with diabetes at risk for developing plantar ulcerations and other deformities such as claw toes
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What should be involved in a foot care program for DM patients?
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wash (do not soak) feet daily in warm water followed by application of petroleum jelly/lotion; toenails should be cut straight across by podiatrist; clean, white socks should be worn, with minimal wrinkles, and wide jogging or walking shoes are recommended; use different shoes or alternate shoes each day
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What are symptoms of dehydration?
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initially, thirst and weight loss; dryness of mouth, throat, face, absence of sweat; increased body temperature; low urine output; postural hypotension (increased HR with 10 bpm, systolic bP drop of 20 with sit to stand); dizziness when standing; increased hematocrit
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What is water intoxication?
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excess of extravellular water in relationship to solutes, resulting in hyponatremia
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What symptoms are associated with excess fluid?
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decreased mental alertness, sleepiness, anorexia, poor motor coordination, confusion, convulsions, sudden weight gain, warm, moist skin, hyperventilation, mild peripheral adema, low serum sodium, low hematocrit, signs of increased intracerebral pressure, slow pulse, increased systolic BP (>10mmHg) and decreased diastolic BP (>10mmHg)
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What is edema?
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excess of solutes and water, caused by decreased cardiac output, endocrine imbalances, loss of serum proteins, vein obstruction
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What are the symptoms of edema?
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weight gain, excess fluid, pitting edema, increased BP, jugular venous distention (JVD), congestive heart failure, effusions (pleural/pericardial/peritoneal)
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What is the treatment for edema?
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diuretics (thiazide diuretics); these meds inhibit sodium and water resorption by the kidneys
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What are symptoms of potassium depletion?
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muscle weakness, fatigue, cardiac arrhythmias, abdominal distention, nausea, and vomiting
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What is metabolic alkalosis?
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occurs when either an abnormal loss of acid or excess accumulation of bicarbonate occurs; can be caused by upper GI suctioning, diabetic therapy, and ingestion of large amounts of base substances like antiacids
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What are symptoms of metablic alkalosis?
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nausea, prolonged vomiting, diarrhea, confusion, irritability, agitation, restlessness, muscle weakness, paresthesias, convulsions, slow shallow breathing, eventual coma; symptoms can affect muscular function by causing muscle fasciculation and cramping
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What is metabolic acidosis?
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occurs when there is an accumulation of acids or a deficit of bases; can be caused by diabetic ketoacidosis, renal failure, severe diarrhea, and drug or chemical toxicity; blood pH decreases below 7.35
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What are symptoms of metabolic acidosis?
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headache, fatigue, drowsiness, lethary, nausea, vomiting, diarrhea, muscular twitching, convulsions, coma, rapid deep breathing
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What is gout?
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excess uric acid in the blood results in the deposition of urate crystals in the joints, soft tissues, and kidneys, causing a painful inflammatory response
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What are the symptoms of gout?
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acute monoarticular inflammatory arthritis, redness, swelling, low-grade fever, malaise; primarily affects peripheral joints of the hand, metatarsophalangeal joint of great toe, instep, ankle, heel, knee, and wrist
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What is the treatment for gout?
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urate-lowering drugs such as colchicines, NSAIDs or steroids, allopurinol to reduce hyperuricemia; rest, elevation, and joint protection during the acute phase
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What is hemochromatosis?
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autosomal recessive hereditary disorder, characterized by excessive absorption of iron by the small intenstines; asymptomatic in early stages; once disease is evidence irriversable organ damage has already taken place
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What are the symptoms of hemochromatosis?
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arthropathy, arthralgias, myalgias, progressive weakness, bilateral pitting edema LE, hyperpigmentation of the skin, CHF, loss of body hair DM
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What is osteoporosis?
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combo of decreased bone mass and microdamage to bone structure, resulting in susceptibility to fractures
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What is primary osteoporosis?
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deterioration of bone mass unassociated with other chronic illness or disease, can occur in both genders at all ages but mostly follows menopause in women
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What is secondary osteoporosis?
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deterioration of bone mass associated with other disorders such as chronic renel failure, rheumatoid arthritis, malabsorption syndromes, chronic respiratory disease, malignancies, and chronic chemical dependencies
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What are the symptoms of osteoporosis?
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back pain (episodic, acute low thoracic); compression fractures of the spine, bone fractures, decrease in height, kyphosis, dowager's hump, decreased activity tolerance, early satiety
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What is osteomalacia?
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softening of the bones without loss of the bone matrix, caused by Vitamin D deficiency in adults; the decalcification of the bones takes place primarily in spine, pelvis, and Les; xray exam reveals transverse, fracture-like lines in affected bones
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What are the symptoms of osteomalacia?
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bone pain, skeletal deformities, fractures, severe muscle weakness, myalgia; similar condition in children, before epiphyseal plate closure, is called rickets; it presents itself at the metaphyseal ends of the long bones as well as the sternal ends of the ribs
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What is paget's disease?
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characterized by exccessive bone resorption and formation in a haphazard fashion, producing bone that is larger, less compact, more vascular, and more susceptible to fractures; clinical presentation varies greatly from asymptomatic to a disabling, painful form where bones are extremely deformed and fracture easily; bones most commonly affected include skull, pelvic, spine, sacrum, femur, and tibia
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What are the symptoms of paget's disease?
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pain, stiffness, fatigue, headache and dizziness, vertebral compression and collapse, fractures, deformity, bowing of the long bones, periosteal tenderness
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What is the treatment for paget's disease?
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not needed when patient is asymptomatic; if pt has symptoms, drug therapy is required
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What is cancer?
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rapidly proliferating cellular malignancy that results in unregulated cell growth, lack of differentiation, and the ability to invade local tissues and metastasize
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What are some treatment options for cancer?
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surgery, radiation therapy, chemotherapy
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What is the function of the liver?
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excretes bilirubin; produces 500 to 1500 mg of bile daily, produces clotting factors, stores vitamins, produces albumin and plasma proteins, contributes to the immune system by reducing the amount of toxins and filtering the blood of our digestive system
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What are some symptoms of liver disease?
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gastrointestinal symptoms, edema/ascites, dark urine, light-colored or clay-colored feces, anorexia, skin changes (jaundice, spider angiomas, bruising, palmar erythema), right upper quadrant abdominal pain
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What musculoskeletal pain is associated with liver disease?
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thoracic pain between the scapulae, right shoulder, right upper trapezius, right interscapular area, right subscapular area
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What can be caused by lack of detoxification of ammonia by the liver, resulting in numbness and tingling bilaterally?
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Bilateral carpal tunnel
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What is Rhabdomyolysis?
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potentially fatal condition involving the breakdown of muscle tissue, presents with muscle aches, cramps, weakness, and soreness; can be caused by liver failure due to statin use (cholesterol-lowering drugs like Zocor, Lipitor, Crestor)
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What are the neurological symptoms associated with liver disease?
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confusion, sleep disturbances, hyperactive reflexes, and asterixis (flapping tremor usually of the hands)
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What is hepatitis?
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acute or chronic inflammation of the liver due to viral or chemical cause, drug reaction, or alcohol abuse
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What is viral hepatitis?
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types A, B, C, D, E, and G
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How are hepatitis A and E primarily transmitted?
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via fecal-oral route (contaminated water/food)
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How are hepatitis B, C, D, and G primarily transmitted?
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bloodborn pathogens
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What are the three stages of hepatitis?
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initial/preicteric (1-3 wks); icteric/jaundiced stage (peaks in 1-2 wks, persists for 6-8 wks); recovery period (3-4 months)
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What are the risk factors for hepatitis?
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injection drug use, acupuncture, tattoo insciption/removal, ear/body piercing, operative procedures, liver transplant recipient, blood/plasma transfusion
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What is cirrhosis?
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chronic hepatic disease characterized by the destruction of the liver and replacement of connective tissues by fibrous bands, resulting in obstruction of blood and lymph flow; mostly caused by alcohol abuse
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What are symptoms of cirrhosis?
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mild right upper quadrant pain, GI symptoms (anorexia, indigestion, weight loss, nausea, vomiting, diarrhea, or constipation), dull abdominal ache, weakness, and quick fatigue
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What is portal hypertension?
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elevated pressure in the portal vein, causing blood to bypass the liver through collateral vessels
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What are symptoms of portal hypertension?
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ascites, dilated collateral veins, esophageal varices (upper GI), hemorrhoids (lower GI), splenomegaly, thrombocytopenia (decreased platelets)
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What is the function of the gallbladder?
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stores the bile, which assists in emulsification, absorption, and digestion of fat
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What are the symptoms of gallbladder disease?
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right upper quadrant pain, jaundice (blockage of bile duct), low grade fever/chills, indigestion, nausea, excessive belching and flatulence, intolerance of fatty foods, persistent pruritus (itching), sudden excruciating pain mid-epigastrium with referral to back and right shoulder (acute cholecystitis)
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What is an indication of gallstones?
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pain and nausea 1-3 hours after eating
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What is cholelithiasis?
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the presence or formation of gallstones, leading cause of hospitilization among adults
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What is biliary colic?
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gallstone gets lodged in neck of gallbladder; presents with right upper abdominal pain that comes and goes in waves
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What is cholecystitis?
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blockage of gallstones in the cystic duct causing infection or inflammation of the gallbladder; presents as steady severe pain in right upper quadrant that increases rapidly, lasting several minutes to hours; nausea, vomiting, fever, jaundice, GI symptoms, chills, tenderness over gallbladder and tenth right rib anteriorly may be present
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What is cholangitis?
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gallstones lodged in the common bile duct; leads to jaudice, as well as possible infection of the liver
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What is GERD?
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gastroesophageal reflux disease; inflammation of the esophagus due to backflow of stomach acids and other stomach content (pepsin and bile)
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What are the symptoms of GERD?
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heartburn, reflux, painful swallowing, bitter taste in mouth, and chest pain
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What are some complications with GERD?
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aspiration pneumonia, esophagitis, asthma, Barrett's esophagus (cancer)
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What are some treatment options for GERD?
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antacids, H2 receptor blockers, proton pump inhibitors
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What is gastritis?
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inflammation of the lining of the stomach limited to the mucosa, classified as acute or chronic; develops in association with serious illness or various medications such as aspirin or other NSAIDs (>3 mo); acute gastritis associated with stress
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What are the symptoms of gastritis?
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epigastric pain with abdominal distention, loss of appetite and nausea
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What is a peptic ulcer?
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loss of the lining of the lower esophagus, stomach, and duodenum, most likely caused by infection with H. pylori or chronic use of NSAIDs causing stomach ulcers; untreated ulcers can be life threatening, perforating the stomach
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What are the symptoms of a peptic ulcer?
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epigastric pain described as "heartburn"; burning, gnawing, cramping pain in the epigastic area, near the xiphoid; back pain; pain comes in waves and last several minutes; may radiate below the costal areas into the back
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What are the symptoms associated with a stomach ulcer?
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pain is related to seccretion of acid, presence of food increases the pain
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What are the symptoms of a duodenal ulcer?
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pain is prominent when the stomach is empty, between meals, and in the early morning
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What are complications associated with peptic ulcers?
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hemorrhage and perforation (may present as bright red or coffee-ground vomitus), as well as dark tarry stools (melena)
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What is diverticular disease?
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mucosa of the colon balloons out through weakened areas in the wall (diverticulosis), infections/inflammation of these microperforations is called diverticulitis
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What are the symptoms of diverticular disease?
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asymptomatic in 80% of people affected, episodic or constant left lower quadrant abdominal pain, pelvic pain, bloody stools, and constipation alternating with diarrhea
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What is appendicitis?
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inflammation of the vermiform appendix, which often results in necrosis and perforation with subsequent peritonitis
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What are the differential diagnosis associated with appendicitis?
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crohn's disease, perforated duodenal ulcer, gallbladder attacks, right kidney infection, ectopic pregnancy, ovarian cyst
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What are the symptoms of appendicitis?
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nausea, vomiting, fever, pain in waves first, becomes steady and is aggravated with movement, periumbilical and/or epigastric pain, right lower quadrant/right flank pain, right testicular pain; coated tongue and bad breath, abdominal muscular rigidity, positive McBurney's point (exquisite pain or tenderness when palpating between the umbilicus and right ASIS)
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What is pancreatitis?
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inflammation of the pancreas (acute or chronic), etiology unknown; chronic alcoholism, gallstones, or other agent toxicity may bring on pancreatitis attack
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What are the symptoms of pancreatitis?
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epigastric pain radiating to the back, nausea, vomiting, fever, perspiration, tachycardia, malaise, weakness, and jaundice
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What is the clinical presentation of pancreatic cancer?
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vague and nonspecific, contributing to delay in diagnosis and high mortality
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What are the common symptoms of pancreatic cancer?
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anorexia, weight loss, epigastric/upper abdominal pain with radiation to the back, jaundice, light-colored stools, constipation, nausea, vomiting, loss of appetite, weakness
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What is crohn's disease?
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chronic lifelong inflammatory disorder that can affect any segment of the intestinal tract and tissues in other organs; inflammation involves all layers of the bowel wall and is discontinuous (skip pattern)
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What are the symptoms of crohn's disease?
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intermittent pain in the periumbilical region, right lower quadrant pain with possible iliopsoas involvement, relief of low back pain after passing stool or gas; almost 25% of patients present with arthritis (mono- or polyarthritis)
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What is ulcerative colitis?
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chronic inflammatory disorder of the mucosa and submucosa of the colon in a continuous order
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What are the symptoms of ulcerative colitis?
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rectal bleeding, diarrhea (20 or more stools/day), nausea, vomiting, anorexia, weight loss, and decreased serum potassium; fever with acute colitis
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What is irritable bowel syndrome (IBS)?
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also known as spastic colon, irritable colon, nervous indigestion, functional dyspepsia, spastic colon, and laxative colitis; IBS is characterized by abnormal intestinal contractions as result of digestive tract's response to emotions, stress, and certain foods
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What are the symptoms of IBS?
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painful abdominal cramps, constipation, diarrhea, nausea and vomiting, anorexia, flatulence, foul breath; left lower quadrant pain; symptoms tend to disappear during sleep
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What are the risk factors for colorectal cancer?
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family history, increasing age >40, ulcerative colitis, crohn's disease, sedentary lifestyle
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What are the symptoms for colorectal cancer?
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persistent change in bowel pattern, rectal bleeding, abdominal/pelvis/back/sacral pain, diarrhea or constipation
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What are symptoms of colorectal cancer in the advance stages?
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constipation progressing to obstipation, diarrhea with copious amounts of mucus, nausea, vomiting, abdominal distention, weight loss, fatigue, and dyspnea; metastases most commonly to liver, lungs, bone, and brain; many cases are asymptomatic until metastases has occurred
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The upper urinary tract consists of the ….
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kidneys and ureters
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Renal and ureteral pain can be felt throughout which dermatomes?
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T10 and L1 dermatomes
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Renal pain is commonly felt where?
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in the unilateral posterior subcostal and costovertebral region, pain is mostly aching and dull in nature but can be sharp/colic type pain (with obstruction); not altered by change in body position
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What must you do if a Murphy's percussion test is positive?
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refer to physician
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What is a Murphy's percussion test?
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palpate 12th rib, palpate costovertebral angle (between 12th rib and the spine), bump (percuss) with ulnar border of non palpating hand to elicit force
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Where is ureteral pain commonly felt?
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in the groin and genital area; not altered by change in body position
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What are symptoms of renal cell carcinoma?
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unexplained weight loss, fatigue, fever, back or flank pain, especially in a geriatric population
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What are symptoms of renal calculi (kidney stones)?
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severe pain in the flank and radiating to the groin; if stone is high, abdominal pain might occur as well
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What does the lower urinary tract consist of?
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bladder and urethra
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Where is bladder and urethral pain commonly felt?
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suprapubic region
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What are the symptoms that coincide with bladder and urethral pain?
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urinary urgency, sensation to void and dysuria (painful urination), low back pain, pelvic/abdominal pain, hematuria, dyspareunia (painful intercourse)
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What are some risk factors for urinary tract infection (UTI)?
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immobility, age, spinal cord injury, female gender, pregnancy, STD, chronic health problems (diabetes, gout, hypertension, obstructive urinary tract problems, urinary catheterization
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When should rehab be stopped for urinary/bladder patient?
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if fever > 102 deg, vomiting/nausea, or mental status changes
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What other symptoms might coincide with UTI?
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weakness, decreased ROM, postural instability
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What are four types of urinary incontinence?
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stress incontinence, urge incontinence, overflow incontinence, functional incontinence
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What is stress incontinence?
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loss of urine with increased abdominal pressure: coughing, sneezing, and laughing; related to pelvic floor weakness, urethral sphincter weakness bladder is normal
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What is urge incontinence?
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overactive bladder; involuntary loss of urine associated with an abrupt and strong desire to void; usually due to detrusor overactivity (DO) or urethral instability; can also be caused by meds, infection, and bladder tumor
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What is overflow incontinence?
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involuntary loss of urine associated with overdistention of the bladder without complete emptying of the bladder; caused by underactive or deficient detrusor muscle, diabetic neuropathy, fecal impaction, lower SCI, detrusor external sphincter dyssynergia (with MS), or prostate pathology
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What is functional incontinence?
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bladder functions normally, however mind-body connection is disrupted; seen with mobility and accessibility deficits, as well as cognitive deficits
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What are red flags in GI system screen?
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presence of blood in urine, csp pain conincides with GI issue, b/b incontinence with saddle anesthesia, back/shld pain w/ abnormal changes in color/odor/flow/amt of urine, positive Murphy's percussion, chronic kidney disease be aware of affects, dialysis can cause cramping and decreased BP (try not to do this right after)
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How long is pregnancy?
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40 weeks from conception to delivery, divided into three trimesters
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What are related symptoms of the first trimester of pregnancy? (weeks 1-12)
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woman may be nauseated or may vomit, is very fatigued, and will urinate more frequently; week 12 fetus is 2oz can kick, turn head, swallow, and beating heart
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What are related symptoms of the second trimester of pregnancy? (weeks 13-26)
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fatigue and nausea usually disappear and woman can feel fetus move; fetus is 2lbs and has slight change of surviving if born prematurely
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What are related symptoms of the first trimester of pregnancy? (weeks 1-12)
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frequent urination, back pain, sciatica, leg edema and fatigue, ligament pain, shortness of breath, and constipation; weight of infant 5-10 lbs, length 16-19 inches
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What changes might you see in the pulmonary system in relation to pregnancy?
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chest circumference increases by 5-7cm, diaphragm elevated by 4cm, TV is increased, TLC unchanged, 15-20% increase in oxygen consumption (natural hyperventilation state), dyspnea commonly present
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What changes might you see in the cardiovascular system in relation to pregnancy?
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blood volume increases 35-50% (1.5-2 liters) during, supine position will increase vena cava pressure, left side lying reduces this, resting HR increased 10-20 bpm, CO increased especially in left side lying where uterus puts least pressure on aorta, BP decreases
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If BP increases significantly…what may the mother be experiencing? Is it a medical emergency?
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preeclampsia, YES
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What changes might you see in the musculoskeletal system in relation to pregnancy?
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stretches abdominal muscles to elastic limit, increased hypermobility of joints that may predispose back, pelvis, Les to injury, pelvic floor drops up to 2.5cm
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What changes might you see in the thermoregulatory system in relation to pregnancy?
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basal metabolic rate increases to meet 300kilocaloria per day, fasting blood glucose lower during pregnancy
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What changes might you see in the mechanical system in relation to pregnancy?
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center of gravity shifts upward, increased lumbar lordosis, shoulder girdle/upper back round, weight shifts toward heels, walk with wider base of support
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What are 5 pregnancy induced pathologies to be aware of?
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Diastasis recti, low back/pelvic pain, pelvic floor dysfunction, joint laxity, cesarean section
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What is diastasis recti?
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separation of the rectus abdominis muscles in the mid-line at the linea alba, less common in women with good abdominal tone prior to pregnancy, can product back pain
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How do you test for diastasis recti?
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In hooklying position, have pt slowly raise her head/shoulders off floor, reaching her hands toward the knees, until scapula leaves the floor; PT places finger of one hand horizontally across midline of abs at the umbilicus; diastasis is measured by number of fingers that can be placed between the rectus muscle bellies
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What abdominal exercises are safe for patients with less than 2 cm or 2 fingers width diastasis recti?
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head lift, head lift with pelvic tilt, kegal exercises; do not perform leg lifts, curl ups (straight/diagonal), leg lowering, and quadruped positioning until diastasis has fully resolved
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What are 3 reasons women commonly experience back pain with pregnancy?
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posture changes, increased ligament laxity, and decreased abdominal function
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What is the treatment for LBP in women during pregnancy?
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proper body mechanics, posture, improve work techniques, external stabilization with belts/corsets
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What modalities are contraindicated with pregnancy?
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deep heating agents, electrical stimulation, and traction
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When does pelvic floor dysfunction occur?
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when muscles and soft tissue laxity allows the pelvic organs to drop from their normal alignment because of increased pressure on the pelvic floor musculature
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What is an episiotomy?
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an incision in the pelvic floor, sometimes made during childbirth to enlarge the vaginal opening and allow faster delivery; can produce prolonged pain, result in scarring or become infected and reduce effectiveness of pelvic floor muscles
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What are indications for c-section?
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pelvic disproportion, failure of birth process to progress, fetal or maternal distress, and other complications
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Compression of the vena cava can occur after what month in pregnancy?
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4th month; increased in supine position
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What is a common condition to occur during pregnancy that requires extra carb intake during pregnancy?
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Hypoglycemia
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What are 7 contraindications to exercise during pregnancy?
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incompetent cervix (early dilation before full term), vaginal bleeding, placentra previa, rupture of membrances, premature labor, maternal heart disease, maternal diabetes or hypertension
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What are 8 precautions to exercise?
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multiple gestations, anemia, systemic infection, extreme fatigue, musculoskeletal pain, overheating, diastasis recti, uterine contractions (lasting hours after exercise)
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What are some common conditions that can occur with menopause?
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fibromyalgia, carpal tunnel syndrome, Colles' fracture, impingement syndrome, adhesive capsulitis, and osteoporosis
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What are some conditions that may result in pelvic, low back, or sacral pain?
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endometriosis, ectopic pregnancy, ovarian cysts, late-stage ovarian cancer, pelvic inflammatory disease
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What is bariatrics?
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the field of medicine that deals with treatment of conditions and diseases of patients who are overweight; includes exercise, education, and behavior modification
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What are the primary three leading causes of death associated with obesity?
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cardiovascular disease, diabetes, and cancer
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What are some other common medical problems associated with obesity?
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reflux and gall stones, thromboembolic disorders, sleep apnea, pulmonary compromise w/ possible decreased vital capacity, expiratory volume, and gas exchange
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What are some physical problems associated with obesity?
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impaired mobility, increased fall risk, increased fatigue and shortness of breath, increased hip, knee, and back pain, osteoarthritis of the knees, increased risk of skin breakdown including pressure ulcers and neuropathic ulcers
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What are some potential complications during exercise?
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increased risk of heat exhaustion or even heat stroke, hypohydration and decreased blood volume, difficulty with blood sugar regulation, excessive rise in BP, angina pectoris, joint irritation, excessive sweating resulting in skin chafing
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What are some considerations with the obese patient during exercise prescription?
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if pt is bedridden, semi-fowler position in preferred; if out of bed, should be adequate warm-up and stretching; progressively and slowly increase intensity, frequency, and duration; watch for excessive pronation
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What is the FITT principle for aerobic exercise?
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F: 4-6x/wk; I: begin 50% MHR, use RPE, T: 20-60min (can break into 10min session); T: walking, biking, pool
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What is the FITT principle for resistive exercise?
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F: 4x/wk; I: begin 30-40% max 1RM; T: 30min (1-2sets of 15-20reps w/ 3-10 diff exercises); T: walking, biking, pool
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