PHTH 727 Pelvic Floor Disorders Assessment

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Questions and Answers

What is one common surgical treatment option for treating a prolapsed pelvic organ?

Coronary artery bypass

Hysterectomy (correct)

Laparoscopic appendectomy

Cholecystectomy

Which of the following is NOT a pelvic floor muscle training method mentioned for prolapse treatment?

Kegel exercises

Biofeedback

Cognitive behavioral therapy (correct)

Regular exercise

Which nutritional strategy can help manage constipation in individuals with prolapse?

Reducing fiber intake

Increasing water intake (correct)

Eating more processed foods

Limiting physical activity

Which behavior modification is recommended to avoid worsening prolapse symptoms?

Valsalva maneuver Signup and view all the answers

What is a pessary used for in the context of pelvic organ prolapse?

To support pelvic organs Signup and view all the answers

Which of the following is a physiological change that occurs during pregnancy?

Increased cardiovascular output Signup and view all the answers

What adaptation in urinary changes is likely to occur during pregnancy?

Increased urinary frequency Signup and view all the answers

What is a common symptom associated with pelvic organ prolapse?

Pain with intercourse Signup and view all the answers

What is the primary function of the coccygeus and levator ani muscles?

Support the bowel, bladder, and uterus Signup and view all the answers

Which type of muscle fibers are predominantly found in the pelvic floor muscles?

70% slow twitch and 30% fast twitch Signup and view all the answers

How does the autonomic nervous system influence the tone of pelvic floor muscles?

It inhibits tone to allow for urination and defecation. Signup and view all the answers

What anatomical structures interrupt the urogenital diaphragm in females?

Vagina and urethra Signup and view all the answers

What is a key characteristic of the transverse perineal muscles?

They are fast-acting fibers that fatigue easily. Signup and view all the answers

Which of the following muscles plays a significant role in hip external rotation and pelvic floor activation?

Obturator internus Signup and view all the answers

What additional function is provided by the pelvic floor besides supporting organs?

Facilitates sexual function and proprioception Signup and view all the answers

What role does the resting tone of pelvic floor muscles play in bodily functions?

It keeps the anorectal and bladder angles closed. Signup and view all the answers

Which muscle group is associated with significant hip and back pain when there is pelvic floor dysfunction?

Associated muscles like piriformis and obturator internus Signup and view all the answers

Activation of pelvic floor muscles during sexual activity is primarily beneficial for which purpose?

Increasing circulation to the pelvis Signup and view all the answers

What is a common symptom of pelvic organ prolapse?

Lump in vaginal area Signup and view all the answers

What percentage of women with children experience pelvic organ prolapse?

About 50% Signup and view all the answers

What is a 2nd degree uterine prolapse?

Descent beyond cervix into introitus Signup and view all the answers

Which option best describes a cystocele?

Bladder bulging into the anterior vaginal wall Signup and view all the answers

Which symptom is likely to worsen with prolonged standing or straining?

Back pain Signup and view all the answers

What is the most common type of pelvic floor disorder?

Urinary incontinence Signup and view all the answers

What could be associated with pelvic floor muscle dysfunction?

Urinary incontinence Signup and view all the answers

Which type of pelvic organ prolapse involves the rectum?

Rectocele Signup and view all the answers

Study Notes

Assessment of Core Positions

Observation includes seated and standing drawing in with leg and arm movement, incorporating weighted/resisted training.
Leg lift exercises are performed from a supine position near a wall, with gradually increasing distance from the wall and potential for resistance.

Pelvic Floor Disorders

Conditions arising from weakened pelvic floor muscles and ligaments, impairing support for pelvic organs.
Common disorders: prolapse, urinary incontinence, fecal incontinence, often linked to pelvic floor muscle dysfunction.

Prolapse

Refers to descent or decreased support of internal pelvic organs; affects approximately half of women post-childbirth.
Association with other pelvic issues like stress incontinence and overactive bladder.

Types of Prolapse

Cystocele: bladder protrudes into the anterior vaginal wall.
Rectocele: rectum bulges into the posterior vaginal wall.
Uterine prolapse: uterus descends into the vagina.
Severity ranges from first-degree (minimal descent) to third-degree (protrusion through vaginal opening).

Signs and Symptoms of Prolapse

Presence of a lump in the vaginal area.
Pain or pressure sensations, especially in prolonged standing or during strain.
Painful intercourse, back pain, abdominal cramping.
Symptoms may alleviate when lying down; can involve urinary or fecal abnormalities.

Pelvic Floor Muscle Role

Muscles, primarily coccygeus and levator ani, support bowel, bladder, and uterus, consisting of 70% slow-twitch and 30% fast-twitch fibers.
Resting tone maintains anorectal and bladder angles, while relaxation enables evacuation.
Autonomic nervous system plays a role in managing resting tone.

Urogenital Diaphragm

Muscular structure extends from anterior pubic bone to rectum, interrupted by vagina and urethra in females.
Contains fast-acting muscle fibers that assist in sexual function and incontinence control.
Encouraging muscle contractions can enhance circulation in sexual organs.

Associated Muscles

Hip movements connect with pelvic floor function; include piriformis and obturator internus.
Dysfunction in these areas can lead to pelvic floor complications.

Obturator Internus

Functions actively during hip flexion and walking; assists in pelvic floor stability.
Plays a crucial role in urinary function and pelvic pain regulation.

Summary of Pelvic Floor Muscle Functions

Support pelvic organs and intra-abdominal pressure.
Maintain continence through sphincteric tone.
Participate in sexual function and sensation.

Postpartum Considerations

Common postures in postpartum women can affect pelvic floor health.
Awareness and self-reporting of prolapse symptoms and pelvic discomfort is essential.

Prolapse Treatment Options

Surgical interventions include mesh or suspension procedures and hysterectomies.
Non-surgical options: pessaries, pelvic floor muscle training, biofeedback, improved posture, hydration, and dietary fiber intake.
Emphasizes regular exercise and manual techniques to support the perineum, alongside behavioral modifications to reduce strain during activities.

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Description

This quiz focuses on the assessment techniques used in PHTH 727, particularly regarding pelvic floor disorders. It covers various positions and movements for core observation, including seated and standing drawing in, as well as leg lifts with resistance. Test your understanding of these assessment strategies in physical therapy.