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Third trimester (weeks 27-40) - Common complaints - 7
- Frequent urination
- Back pain
- Sciatica
- Leg edema and fatigue
- Ligament pain
- SOB
- Constipation
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Pregnancy - diaphragm elevated by how much?
4 cm (1.5 inch)
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Pregnancy - Total chest circumference INC by
5-7 cm (2-3 in)
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Pregnancy - O2 consumption
15%-20% INC w/natural state of hyperventilation throughout pregnancy
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Pregnancy - dyspnea present w/mild exercise @ how many weeks? Why?
- As early as 20 weeks
- D/t INC work of breathing from hyperventilation
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Pregnancy - Pulmonary - what is unchanged?
- Total lung capacity (or slightly DEC)
- RR
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Pregnancy - Respiratory - what is iNC?
- Tidal volume
- Depth of respiration
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Pregnancy - Respiratory - INC of edema & tissue congestion of what respiratory tract?
Upper - d/t hormonal changes
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Pregnancy - Cardio - what side to lay on to reduce effect of vena cava syndrome
Left
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Pregnancy - Cardio - supine position does what
P in inferior vena cava rises
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Pregnancy - Cardio - Resting HR - 2
- INC 10-20 bpm by full term
- Returns to normal within 6 weeks' post pregnancy
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Pregnancy - Cardio - CO
- INC
- Especially in left side-lying position - uterus puts least P on aorta
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Pregnancy - Cardio - BP - 2
- DEC early in 1st trimester (DEC in DBP)
- Significant INC - preeclampsia: medical emergency
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Pregnancy - Cardio - supine hypotensive syndrome - d/t what?
Decline in venous return & resulting DEC in CO
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Pregnancy - Cardio - Blood V
- INC 350% (1.5-2 liters)
- Returns to normal by 6-8 weeks' post pregnancy
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Pregnancy - Cardio - Venous P
INC to LE w/standing
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Pregnancy - MSK - joints
- Hypermobility
- Joint injury especially in WB joints of back, pelvis, & LE
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Pregnancy - MSK - ligaments
Hormones produce a systemic DEC in ligamentous tensile strength
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Pregnancy - MSK - pelvic floor
Drops up to 2.5 cm (1 inch)
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Pregnancy - Mechanical changes - COG - 2
- Shifts upward & forward
- Lumbar lordosis INC to compensate for this shift
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Pregnancy - Mechanical changes - Posture - 5
- INC thoracic kyphosis
- Scapular protraction - rounded shoulders
- UE IR
- INC cervical lordosis & FHP
- INC lumbar lordosis
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Testing for Diastasis recti - 3
- Hook-lying
- Pt slowly raise head & shoulders off of floor, reaching hands to knees, until spine of scapula leaves floor
- PT places finger of one hand horizontally across midline of abdomen at umbilicus
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Tx of Diastasis recti - Therex
Separation >/= 2 cm, or 2 finger widths - 3
Separation < 2 cm - 3
- Separation >/= 2 cm, or 2 finger widths:
- Head lift
- Head lift w/pelvic tilt
- Pelvic floor (Kegel) exercises
- Separation < 2 cm:Partial sit-ups w/KNEES BENT
- Pelvic tilts
- UTILIZE HANDS TO SUPPORT ABD WALL
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Tx of Diastasis recti - what should NOT be performed until diastasis recti has fully resolved? - 4
- Double leg lifts
- Curl ups (straight & diagonal)
- Leg lowering
- Quadruped positioning
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Preeclampsia is what?
Acute hypertension after 24th week of gestation
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S/S of preeclampsia - 6
- HT
- Edema
- Sudden excessive weight gain
- HA
- Visual disturbances
- Hyperreflexia
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Endometriosis is characterized by what?
Ectopic growth/function of endometrial tissue outside of uterus that is not able to be shed as uterine tissue during menstruation
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Endometrial tissue can lead to what?
Cysts & rupture, producing peritonitis, adhesions, & obstruction
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S/S Endometriosis - 4
- Pain
- Dysmenorrhea
- Dyspareunia (abnormal pain during sexual intercourse)
- Infertility
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Pregnancy - Effects of aerobic exercise - RR
DOES NOT INC proportionately w/moderate and severe exercise
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Pregnancy - Effects of aerobic exercise - hematocrit - 2
- During pregnancy is lowered
- Rises up to 10% within 15 min of beginning vigorous exercise
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Pregnancy - Contraindications to exercise - 9
- Incompetent cervix
- Early dilation of cervix
- Vaginal bleeding
- Placenta previa (too close to cervix)
- Rupture of membranes (amniotic fluid loss)
- Premature labor
- Maternal heart disease
- Maternal diabetes (could be gestational diabetes)
- HTN
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Pregnancy - Precautions to exercise - 8
- Multiple gestations
- Anemia
- Systemic infection
- Extreme fatigue
- MSK complaints c/or c/out pain
- Overheating
- Diastasis recti
- Uterine contractions
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Conditions that can occur w/INC frequency postmenopausally include - 6
- Worsening fibromyalgia
- Carpal tunnel syndrome
- Calles' fracture
- Impingement syndromes
- Adhesive capsulitis
- Osteoporosis
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Conditions that may result in pelvic, low back, or sacral pain after menopause - 5
- Endometriosis
- Ectopic pregnancy
- Ovarian cysts
- Late-stage ovarian cancer
- Pelvic inflammatory disease
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Pregnancy - Cessarian pt - PT - 3; avoid what & for how long?
- Pain - TENS - electrodes parallel to incision
- Gentle abdominal exercise - provide incisional support w/pillow
- Pelvic floor exercises
- NO heavy lifting for 4-6 wks
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Cystocele - prolapse of what?
Bladder into vagina
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