Term
| What word defines the condition of carrying a developing embryo in the uterus, the state of wellness associated with interrelated changes occuring throughout the woman's body as the fetus develops? |
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Definition
| Pregnancy: the condition of carrying a developing embryo in the uterus, the state of wellness associated with interrelated changes occuring throughout the woman's body as the fetus develops |
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Term
| What word defines the length of time from conception to birth (in mammals)? |
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Definition
| Gestation: The length of time from conception to birth (in mammals) |
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Term
| How is gestation calculated in humans? |
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Definition
Gestation in humans is calculated form the 1st day of the last menstrual period
*normal gestation in humans: 40 weeks (280 days)
* normal range: 37 weeks (259 days) to 41 weeks (287 days)* |
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Term
| What is the gestation time of a woman at FULL TERM? |
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Definition
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Term
True or false?
Gestation time is species specific. |
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Definition
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Term
| What is the gestation time of infants classified premature? |
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Definition
| Premature: infants born prior to the 37th week |
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Term
| What word defines the union of ovum with spermatozoa of the male? |
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Definition
| fertilization: union of ovum with spermatozoa of the male (carried in seminal fluid). |
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Term
| Where does fertilization usually take place? |
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Definition
Fertilization usually takes place in the fallopian tube.
*the fertilized ovum enters the uterus to implant and continue development* |
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Term
| If the ovum is developped outside the uterus, what do you call that pregnancy? |
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Definition
| Ectopic pregnancy: pregnancy in whihc ovum develops outside the uterus |
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Term
| What are possible sites of ectopic pregnancy? |
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Definition
Ectopic pregnancy may develop in:
> cervix
> abdomen
> fallopian tubes |
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Term
| What forms the outer wall of the blastocyst? |
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Definition
Blastocyst is formed by CHORION
> chorion: extraembryonic membrane forming blastocyst (in early development) |
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Term
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Definition
| chorion = trophoblast + inner lining of mesoderm |
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Term
| Which structure of the chorion develops an intimate connection wtih the endometrium and gives rise to the placenta? |
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Definition
Chorionic villi
*Chorionic villus: cell that becomes the placenta in uterine lining |
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Term
| What structure supplies blood/oxygen/nutrients to the fetus? |
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Definition
Chorionic villus/villi: cells that becomes the placenta in uterine lining
> it is the fetal sac supplying blood/nutrients/oxygen to the fetus
> gives rise to the placenta |
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Term
| Name the functions of the placenta |
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Definition
> provides blood, oxygen and nutrients to the fetus (through chorionic villi)
> produces hormone: HCG, progesterone and estrogen
> structural anchor on uterus for the fetus
> processes/filters fetal waste and puts it back into mother's sytem to excrete |
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Term
| What word defines the oval/discoid spongy structure in the uterus (of mammals) through which the fetus derives its nourishment? |
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Definition
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Term
| Which hormone is used to detect pregnancy in urine tests? |
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Definition
| HCG/ human chorionic gonadotropin hormone |
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Term
True or False?
Both mother and fetus share the same blood system |
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Definition
FALSE: mother and fetus have separate blood system
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Term
| Which substances can cross the placenta and be harmful to the fetus? |
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Definition
| Alcohol, drugs, and some viruses |
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Term
| Which structure attaches to the placenta through which umbillical vessels pass to the fetus? |
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Definition
Umbilical cord
> attach from placenta
> 2 arteries and 1 vein pass through umbillical vessels
> cord is about 50 cm long at full term (40 weeks) |
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Term
| What does the amnion of a pregnant woman contain? |
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Definition
Amnion contains/protects the amniotic fluid (nourishing and protecting liquid)
> amnion: sac surrounding and protecting the fetus |
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Term
| What is the normal increase size of the uterus during gestation? |
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Definition
| Uterus increases 5-6 times in size during gestation |
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Term
| What does "post partum" mean? |
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Definition
| post partum = after childbirth |
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Term
| When does nausea/vomiting usually occur? |
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Definition
During first trimester because of the hormonal influx
*not always in the morning* |
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Term
| How much does the blood volume increase during pregnancy? |
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Definition
Blood volume increases 45-50%
> needed for extra blood flow, perfusion to kidneys and other organs
> compensates for blood loss during delivery
> ↑ CO by 40% halfway through gestation
> size/position of heart increases 12% |
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Term
| Why does blood pressure decreases slightly during pregnancy? |
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Definition
> BP decreases as there is less peripheral resistance on BP wall (peripheral resistance = BP/CO)
> diastolic ↓ after 12-25 weeks and then ↑ after 2nd trimester |
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Term
True or false?
Varicosities and edema rarely occur during pregnancy |
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Definition
False
Varicosities and edema is common during pregnancy |
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Term
| When is abdominal massage beneficial during pregnancy? |
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Definition
Abdominal massage is beneficial d uring 2nd or 3rd trimester
> stretch of skin can be edema based |
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Term
| Which areas of the body are affected from "pregnancy mask"? |
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Definition
| Pregnancy mask : around cheeks |
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Term
| What is the scientifical term for stretch marks? |
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Definition
Striae gravidarum
> superficia fascia = white
> deeper fascia = red
*vitamin E is recommended* |
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Term
| During pregnancy, the linea alba darkens to then become.... |
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Definition
| Linea alba darkens and becomes the linea nigra |
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Term
| Which hormone directly effects the lungs and the respirator center of the brain? |
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Definition
Progesterone effects the lungs and respiratory center of the brain
> full ventilation of lung demishes during pregnancy from pressure of the uterus on the lungs |
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Term
| What is administered to a pregnant woman in order to aid with morning sickness? |
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Definition
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Term
| Why do pregnant women have to urinate more frequently? |
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Definition
| Increased urination from pressure on the bladder during pregnancy |
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Term
| Is acne common during pregnancy? |
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Definition
| Acne is common during pregnancy |
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Term
| Name the primary health care provider during pregnancy and support roles during labour. |
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Definition
Primary health care provider:
> Obstetrician
> Family DR (GP)
> Midwife
Labour support role:
> Doula
*Doula is within our scope of practice* |
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Term
| What are S/S of extra uterine implantation? |
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Definition
extra uterine implantation/ectopic pregnancy S/S > sudden sharp/severe early abdominal cramping
*achyness in lower abdomen normal in early pregnancy - this pain is different* |
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Term
| Spontaneous abortion prior to the 20th week of pregnancy is defined as... |
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Definition
| Miscarriage: spontaneous abortion before 20 weeks |
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Term
| Spontaneous abortion after 20 weeks of gestation is defined as... |
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Definition
Stillbirth (after 20th week)
*miscarriage = before 20th week* |
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Term
| What are S/S of miscarriage? |
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Definition
Miscarriage S/S
> vaginal bleeding/ intermittent pain (usually in low back to abdominal cramps)
*cause: severe physical shock, developmental/genetic abnormality, acute infection* |
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Term
| Which condition is recognized from painless vaginal bleeding as S/S and detected through ultrasound? |
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Definition
painless vaginal bleeding s/s = Placenta Previa
> 1/200 pregnancies
> when placenta attaches low in uterus, cause an increased risk at putting pressure on the cervix = causes cervix to open too soon
> may have hemorrhage or early labour/delivery
> bed rest is required |
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Term
True or false?
Placental abruption does not require medical emergency. |
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Definition
False
Placental abruption requires medical emergency
> when placenta separates from uterine wall |
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Term
| What condition defines inflammation of a vein developping into a blood clot adhering to the wall of a vein? |
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Definition
Thrombophlebitis: rare disorder of pregnancy or post-partum; inflammation of a vein developping a blood clot adhering to wall of vein
*S/S: pain, tenderness, redness, swelling in the lower leg*
*treatment: bed rest and anti-coagulant meds* |
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Term
| When is temperature considered high/feverish? |
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Definition
ToC higher than 38oC is considered high body temperature/fever
> needs to be prolonged high temperature (for 24 hours)
> harmful to the fetus
> CI: hot tubs, saunas (raise body ToC)
> treatment: monitor/drink lots of fluids |
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Term
| When does pregnancy induced hypertension usually occur? |
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Definition
PIH: pregnancy induced hypertension
> hypertensive condition specific to pregnancy
> occurs after 28 weeks
> disappears after delivery |
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Term
| Rapid weight gain, protein in urine, high blood pressure and swelling from fluid retention are sign and symptoms from what conditions? |
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Definition
Pre-eclampsia: rapid weight gain, protein in urine, high BP, swelling from fluid retention
> can worse into eclampsia |
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Term
| What are signs and symptoms of eclampsia? |
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Definition
Eclampsia: convulsions, coma leading to fetal/maternal death
*occur in 5% of pregnancies*
*common in 1st pregnancies, teenagers, women over 30 years of age, chronic diabetes, high BP, when carrying multiple babies* |
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Term
| When is delivery considered preterm labour? How may we stop preterm labour? |
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Definition
Preterm labour: delivery prior to 37 weeks gestation
> stopped with meds (Tycolytic drugs/ steroids prior to 35 weeks for lung development) if not over 2-3 cm dilation/ if water has no broken
> risk of preterm labour: multiple births, under 18 yrs, previous preterm, miscarriage |
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Term
| What word defines persistent/excessive nausea and vomiting, worse than your typical "morning sickness"? |
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Definition
Hyperemesis gradidarum: excessive vomiting/nausea
> can involve weight loss, dehydration and changes in body chemistry
> MD monitored with meds (Diclectin) |
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Term
| Which condition affects the body's ability to use blood sugar (glucose) and inadequately produces insulin from the pancreas? |
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Definition
| Diabetes mellitus & gestation diabetes |
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Term
| When does gestational diabetes usually occur? |
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Definition
Gestational diabetes: occur usually in the 2nd trimester, between 2-12%
> blood glucose level monitored at 12 weeks
> requires monitoring of insulin and glucose
> larger baby is common
> treatment: diet/insulin administration
> risks: history of gestational diabetes, baby over 9 lbs, age over 25 yrs, hypertensive, twins |
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Term
| A woman is in her 13th week of gestation. What trimester is that? |
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Definition
13th week = three months = 1st trimester
> 1st trimester: week 1-13 |
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Term
| A woman is in her 18th week of gestation. Which trimester is that? |
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Definition
18th week = five months = 2nd trimester
> 2nd trimester: week 14-26
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Term
Is abdominal massage indicated on the 1st trimester?
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Definition
NO
> abdominal mx is CI'd : liability concern
> 2nd/3rd is indicated
*1st trimester = 0-13 weeks* |
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Term
What massage modifications should be done during the 1st trimester?
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Definition
> Leg mx (medial leg): thrombus/varicosities/bed rest
> easy around sacrum: stimulates labour
> mid-range, gentle stretch (relaxin softens ligamentous attachments)
> LOW GRADE rythmic mobs/joint play
> strengthen mm/jts with AR isometric exercises |
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Term
| Which position is to be avoided during the 1st trimester (0-13 weeks)? |
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Definition
prone OK but watch breast tenderness
> supine: 2 pillows for lumbar support
> side-lying
> semifowler's : 2 pillows under knees for lumbar support
*raise affected areas for edema and LD/GST* |
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Term
When will one experience dull ache above the pubic bone?
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Definition
dull ache above pubic bone = 1st trimester
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Term
| Modifying hydro, essential oils, reflexology/acupressure points/varicosities are CIs for which trimester? |
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Definition
1st trimester (0-13 weeks)
>modify hydro: no full body tx; wax to specific mm (IT band) OK (short time, cool/warm epsom salt bath)
>essential oils: citrus OK
>reflexology/acupressure: feet, sacrum, abdomen
>no direct pressure on VV (not spider veins) |
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Term
| When does fatigue/nausea dissipate? |
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Definition
during 2nd trimester
> 2nd trimester : week 14-26 |
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Term
| Which changes arise on the 2nd trimester? |
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Definition
> Striae gravidarum (stretch marks)
> linea alba becomes linea nigra
> plantar fasciitis, pes planus, callouses
> Braxton hicks: involuntary contraction of uterus (prep for labour)
> heartburn (as abodminal pressure ↑; constipation
> cervical/thoracic spine change with weight gain |
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Term
| Which position is CI'd during 2nd trimester? |
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Definition
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Term
| What are modifications/changes to do while massaging a woman in her 2nd trimester? |
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Definition
> gestational diabetes: discuss symptoms
> modify: leg mx, sacrum mx, gentle on ligamentous attachments
> bed rest: watch for clots in legs |
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Term
| Why is prone CI'd for someone in their 2nd trimester (week 14-26)? Which position is ideal? |
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Definition
prone = puts strain on ligaments and on baby; creates a pull on ligaments
>supine: bolster RIGHT hip to ↓ pressure on vena cava (15 min only/ prevent supine hypotension)
> sideline: left side is better (total blood flow ↓ work on heart) |
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Term
| Which structures/special considerations are taken for a massage in 2nd trimester? |
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Definition
Massage
> superficial abdominal mx for restrictions
> breast mx for drainage/ figure 8 towel
> Vitamin E for Striae Gravidarum
> extra pillows/bolsters for edematous clients
> massage GT: sleeping on side cause pain on GT and IT band/ fascial restrictions/ ischemia |
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Term
What is normal gestation time during the 3rd trimester?
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|
Definition
| 3rd trimester : week 27-40 |
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Term
| What changes are present during the 3rd trimester (week 27-40)? |
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Definition
> Diastus recti: split rectus abdominus mm
> pubis symphisis separates
> plantar fasciitis
> lightening: baby drops/engages on top of cervix
> frequent Braxton hicks
> fatigue/nausea returns (pressure on stomach)
> bladder compromised |
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Term
| What massage considerations should be applied to alleviate pain from diastus recti? |
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Definition
diatus recti: split rectus abdominus mm
> mx: apply strokes from lateral to medial (into midline) |
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Term
| Which position is accepted during 3rd trimester (week 27-40)? |
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Definition
sideline
>supine: bolster right hip for max of 15 min (takes pressure off vena cava)
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Term
| What test will you perform if someone in their 3rd trimester complains of constant calf cramps? |
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Definition
Homan's sign to rule out DVT
> hydro recommended: cold foot bath
> mx: GTO release/reciprocal inhibition
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Term
| What may cause calf cramps? |
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Definition
| calf cramps: caused by calcium/magnesium imbalance |
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Term
| Which muscles/structures should be monitored during massage on the 3rd trimester? |
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Definition
monitor
> rectus abdominus mm
> pubis symphysis (no gapping or squishing)
* change position with care *
**modify leg mx, sacrum, ligamentous attachments** |
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Term
| When is sex of the fetus distinguishable? |
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Definition
sex is distinguishable on the 12th week (1st trimester)
12 weeks
> can move arms, fingers, toes
> fingerprints present
> can smile, frown, suck and swallow
> 3" long, 1 oz |
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Term
| When is fetal heartbeat detectable with ultrasound? |
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Definition
fetal heartbeat is detectable with ultrasound on the 8th week (1st trimester)
> less than 1" long
> face formed with rudimentary eyes, ears, mouth, teeth
> brain is forming
> arms and legs are moving
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Term
| When is heartbeat of the fetus audible through a stethoscope? |
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Definition
Heartbeat is audible through stethoscope at 20 weeks (2nd trimester)
> 10-12" long
> sucks thumbs
> hiccups
> hair, eyelashes, eyebrows formed
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Term
| When does the fetus assume the birth position? |
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Definition
Fetus assumed birth position at 32 weeks
> 16 1/2-18" long
> responds to sounds
> bones of head are soft/flexible
> iron is stored in liver
> periods of sleeps and wakefulness |
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Term
| When do fingernails/toenails form on a fetus? |
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Definition
Fingernails/toenails formed at 16 weeks (2nd trimester)
> strong heartbeat
> downy hair (lanugo) covering body
> coordinated mvmts: rolls over in amniotic fluid
> 5 1/2" long, 4oz
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Term
True or false?
The fetus is less active on the 2nd trimester |
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Definition
False
Fetus is less active one 3rd trimester (week 36-38)
> gain immunities from mother at weeks 36-38
> 19", 6lbs |
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Term
| When is the fetus very active? |
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Definition
Fetus is very active at 28 weeks/ 7 months (3rd trimester)
> adding body fat
> rudimentary breathing present
> 14-17" long, 21/2 -3 lbs |
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Term
| When is colostrum present in alveoli of the breasts? |
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Definition
Colostrums present in alveoli in 2nd trimester (week 14-26)
colostrum: fluid containing cells/antibodies from mother
> muscle cells hypertrophy to support breast weight |
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Term
| What are indications for a breast massage? |
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Definition
Breast massage indications
> relaxation
> pectoralis work (trigger points)
> adhesions and scar tissues
> fibrocytic breasts (cysts in tissue)
> infection (inflammation/edema)
> severe kyphosis
> scars and congestions (from implants) |
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Term
| What are contraindications to breast massage? |
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Definition
> acute infections ie: mastitis
> cancers: cannot mx if highly metastatic and non terminal
> chemotherapy
> sexual abuse issues
> touching the nipple or areola |
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Term
| When is breast tenderness/pain around the nipple increased? |
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Definition
Breast tenderness increased during the 3rd trimester
> increased number of alveoli and glands |
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Term
| Name the attachments of the breast tissue |
|
Definition
Breast tissue attachments
> Lateral border: latissimus dorsi
> medial border: sternum
> between ribs 3-7
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|
|
Term
|
Definition
Milk is produced 4-5 days after the baby is born
> ducts are filled with colostrum right after birth (antibodies) |
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Term
| A woman after labour or in the early stages of pregnancies would like a breast massage. However, her breast are too tender. What else may be used? |
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Definition
figure 8 cool wrap indicated to ↓ tenderness
Breast massage
> during pregnancy/after birth to relieve congestion and improve lymphatic flow
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|
Term
| What is the functional tissue of the breast? |
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Definition
Parenchyma = functional tissue of breast
> designed to produce milk |
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Term
| What does the retromammary space usually contain? |
|
Definition
Retromammary space
> contains lymphatic fluid
> where implants are placed
> hold posterior suspensory ligaments (deep fascia of breasts to superficial fascia of pectoralis) |
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Term
| Other than having a child with a genetic disorder, conceiving whilte using an IUD, your mother having taken DES during her pregnancy, when are pregnancies considered high risk? |
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Definition
> age 35+ (chromosomal anormaly)
> under 17 (intrauterine growth restriction)
> carrying more than 1 baby (preterm labour)
> diabetes, blod clot disorder
> pelvic inflammatory disease (PID), endometriosis, STD (ie: HIV)c
> history of miscarriage, ectopic pregnancyrt
> 2 or more 2nd trimester abortions |
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Term
| what should you experience in order to call your caregiver (s/s of high risk pregnancies)? |
|
Definition
> vaginal bleeding/spotting
> face/fingers swollen
> leakage of fluid/↑ vaginal discharge
> severe/persistent H/A
> persistent emesis unrelated to morning sickness, chills/fever, dizziness/faintness
> urgent/painful urination, noticeable change in frequency/strength of baby's mvmts |
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Term
| What position should be avoided post-partum? |
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Definition
prone position avoided (including ADL) 4-6 weeks post partum; until cleared by MD
> treat sideline to also treat breast tenderness from lactation
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Term
| What will you focus on during post partum massage? |
|
Definition
> breast tenderness (sideline; figure 8 cold towel or warm if congestion ↓)
> low back (epidural)
> low grade joint play
> fascial work
> postural mm: core strengthening (wait until mm are healed from diastus recti)
> stress reduction (client is exhausted) |
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|
Term
| Will you perform an abdominal massage post partum? |
|
Definition
NO
> abdominal massage is to be avoided 2-4 weeks post partum
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|
|
Term
| What word defines thigh entrapment and congestion of the soft tissue structures around the lateral femoral cutaneous nerve? |
|
Definition
| Meralgia paresthetica: thigh entrapment and congestion of the soft tissue structures around the lateral femoral cutaneous nerve |
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|
Term
| What are s/s of meralgia paresthetica? |
|
Definition
> insidious feeling of burning/itching
> icy numbness/tingling then persistent aching (burning touch/sensitive to light touch)
> unilateral usually with hair loss involved area
> aggravate: standing for long
> relieve: sitting down/lying down with hip flexion
> worsens or clears up on its own |
|
|
Term
|
Definition
| DDX: trochanteric bursitis, hip pointer, trigger point |
|
|
Term
|
Definition
> sensory from motor
> tinels for symptom reproduction
> light air brushing = irritates the symptoms
> sitting = improves symptoms
> standing = aggravates symptoms
> hip flexion = exacerbates symptoms |
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|
Term
|
Definition
> mx: anterolateral thigh, hip and groin
> MFR to above structures (ie: TFL)
> hip flexor "triple attachment release"
> decompression tech: ant/lat thigh
> myofascial lengthening for psoas
> fascial wringing: thigh
> elbow ing. lig. with active med. rot of thigh
> rebalance the pelvis |
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|
Term
| What self-care would you suggest for someone with DDX? |
|
Definition
> no restrictive clothing
> weight loss
> belts
> re-balance the pelvix |
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