Other Systems 2

weight gain with pregnancy

25-35 lbs

essential for baby nourishment

MSK changes with pregnancy

postural changes: forward head, kyphosis, increased lordosis, anterior pelvic tilt

MSK changes pregnancy treatment

postural education

stretching of tight muscles, strengthening of weaker ones

pelvic stabilization exercises

pelvic tilts

CVS changes pregnancy

blood pressure low in 1st and 2nd trimester

increase 3rd trimester

supine lying causes compression of inferior vena cava, declines cardiac output, supine hypotensive syndrome

resting HR pregnancy change

increase 10-20 bpm

R or L sidelying during pregnancy

left

decreases compression of inferior vena cava, maximizes cardiac output, decreases GERD as internal organs relazed and improves maternal and fetal circulation

Which of the following is MOST APPROPRIATE regarding physiological changes related to pregnancy?

a. blood pressure increases second trimester, decreases third trimester

b. cardiac output is decreased in pregnancy

c. resting heart rate decreased in pregnancy

d. metabolic rate and heat production increases during pregnancy

d. metabolic rate and heat production increases during pregnancy

after an uncomplicated, vaginal delivery of child, patient is seen again for PT. During treatment, patient begins to report headache with visual disturbance, then suddenly develops a seizure, Which condition is MOST LIKELY seen in this patient?

a. preeclampsia

b. gestational diabetes

c. eclampsia

d. ectopic pregnancy

c. eclampsia

Preeclampsia

pregnancy induced acute hypertension after 20th week of gestation

increase in protein in urine, hyperreflexia, edema, headache, sudden weight gain seen

blood pressure: 140/90 mmHg second abnormal BP reading 4 hours after first confirms diagnosis

medical emergency

contraindication to exercise in pregnancy

hemodynamically significant heart disease

restrictive lung disease

incompetent cervix: early dilation

vaginal bleeding

placenta previa after 26 weeks: placenta is locaetd on the uterus position in which it may detach the babt is delivered

preeclampsia or pregnancy induced hypertension

rupture of membranes

premature labor

maternal type 1 diabetes

severe anemia

a patient after an uncomplicated delivery, has a 3 cm diastasis recti and weak abdominal muscles. Which of the following exercises is MOST APPROPRIATE for inital phase of rehab?

a. modified plank on forearms and knees

b. head lifts with arms bracing the abdomen

c. curl ups with hands behind the head

d. deep breathing exercises in bridging position

b. head lifts with arms bracing the abdomen

treatment for diastasis recti

head lift

head lift with pelvic tilt

Gastroesophageal Reflux Disease (GERD)

reflux of gastric content of the gastroduodenal contents into the esophagus

GERD symptoms

heart burn 30 minutes after eating and at night lying down

dysphagia

sour taste - from regurgitation of acids

hoarseness of voice

atypical pain of the head and neck

GERD complications

aspiration pneumonia, asthma

esophagitis

Which of the following guidelines is MOST APPROPRIATE in treating patients with gastroesophageal reflux disease?

a. exercises should be performed in supine position

b. encourage the patient to sleep on right side to prevent nocturnal reflex

c. instruct patient to perform valsalva maneuvers during exercise

d. encourage the patient to elevate the head of the bed while lying down

d. encourage the patient to elevate the head of the bed while lying down

GERD Treatment

maintain upright positions

eat meals at least 3-4 hours before sleep

avoid supine - tends to straighten the esophagus

sleep on left side prevent nocturnal reflex

exercise must be completed 2-3 hours after eating or before meals

avoid spicy, chocolate, fatty food, peppermint

drugs: antacids, H2 receptor blockers, proton pump inhibitors

a patient is referred to the PT clinic for right side shoulder pain. patient reports having dark colored urine and exhibits palmar erythema. Which of the following structures is the MOST LIKELY source of the referred pain?

a. prostate

b. appendix

c. liver

d. kidney

c. liver

mid back scapula pain referral

esophagus, gallbladder, stomach, pancreas, kidney

mid back scapula pain referral mnemonic

PEGS

left shoulder pain referral

heart

diaphragm

spleen

tail of pancreas

right shoulder pain referral

gallbaldder

liver

head of pancreas

pelvis/low back/sacrum pain referral

colon

appendix

pelvic viscera

pancoast tumor

upper lung tumor

pain referred in C8-T2 nerve distribution

mimics TOS

pain referral pattern pancoast tumor

pain top of shoulder

ipsilateral shoulder

RUQ pain pattern

peptic ulcers

gallbladder pathology

head of pancrease

RUQ pain mnemonic

good luck harry potter kid

RLQ pain pattern

appendix

crohns

RLQ pain mnemonic

AC

LLQ pain pattern

diverticulitis

ulcerative colitis

IBS

LLQ pain mnemonic

please dont get a DUI

LUQ pain pattern

body + tail of pancreas

spleen pathology

diaphragm

heart

kidney

LUQ pain mnemonic

dont be a silly kid harry

a patient presents to the clinic with severe pain in their L shoulder after a recent motor vehicle accident. During the physical examination, the patient reports increased pain in their L shoulder when their leg is elevated. Which of the following conditions is MOST LIKELY associated with these symptoms?

a. liver laceration

b. myocardial infarction

c. spleen rupture

d. kidney contusion

c. spleen rupture

Hiatial Hernia pain referral

shoulder

femoral hernia pain referral

lateral pelvic wall

groin pain

inguinal hernia pain referral

groin pain

umbilical hernia pain referral

mid to lower abdomen