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[OS 206] 3rd Lecture Exam > [10] Micturition > Flashcards

[10] Micturition Flashcards

1
Q

Components: Bladder

A

Detrusor
Trigone
Ureterovesical Junction

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2
Q

Urethra

A

Bladder Neck
External Sphincter
Prostate

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3
Q

Nervous System Peripheral Nerves

A

Pudendal
Hypogastric
Pelvic

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4
Q

Phases of Micturition

A

Filling/Storage

Voiding

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5
Q

Define: Urodynamics

A

Study of hydrodynamics of urine storage and voiding

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6
Q

Urodynamic Measurement Recordings

A

Intravesical Pressure
Abdominal Pressure
Sphincter Activity
Urine Flow Rate

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7
Q

Normal Filling/Storage

A

No pressure
No leakage
No discomfort

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8
Q

Tracing of Bladder Pressure Is?

A

Flat (? Not too sure)

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9
Q

[Physiology of Normal Filling/Storage]
Detrusor

Compliant:
Control:

A

Compliant: Relaxes, accommodates
Control: No abnormal uncontrolled contractions

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10
Q

[Physiology of Normal Filling/Storage]
Urethra and Sphincter

Competent:
Control:

A

Competent: Closed, contracts
Control: Contracts as needed

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11
Q

[Physiology of Normal Filling/Storage]
Pelvic Floor

Contract:
Control:

A

Contract: To close
Control: Contracts more as needed

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12
Q

Define: Detrusor Compliance

A

Ability to maintain low pressure despite increase of volume during filling

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13
Q

[Anatomic Properties of Detrusor for Compliance]

Smooth Muscles

A

Viscoelastic property

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14
Q

[Anatomic Properties of Detrusor for Compliance]

Submucosa

A

Collagen and Elastin

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15
Q

[Anatomic Properties of Detrusor for Compliance]

Gap Junction Between Muscle Fibers

A

Slow Conduction

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16
Q

[Anatomic Properties of the Outlet for Closure: Competence]
Bladder Neck Factors

Intrinsic Factors

A

Abundant smooth muscle and elastic connective tissue to the passive closure of bladder neck during filling

17
Q

[Anatomic Properties of the Outlet for Closure: Competence]
Bladder Neck Factors

Extrinsic Factors

A

Ligaments keep the neck of the bladder at an angle to the detrusor and provides support to the urethra

18
Q

Urethral Smooth Muscle Layers and Roles

A

Inner Longitudinal Layer: Uncertain Role

Outer Circular Layer: Closure at rest, Urethral Resting Pressure

19
Q

External Urethral Sphincter (Alternate Name)

Type of Fibers
Effect of Stress

A

Rhabdosphincter

Striated Slow Twitch Fibers exert a resting pressure during filling

During stress, cough valsalva, contraction causes rise in urethral pressure

20
Q

Inner Urethral Factor (Alternate Name)

Spongy Tissue Within the Submucosa

A

Collagen and Elastic Fibers

Venous Plexus

21
Q

What is a possible complication in women with regard to the Urethral Seal Effect?

A

It is hormonally regulated and postmenopausal women have thinner seals resulting in urinary leakage

22
Q

What do you call the Pelvic Floor Muscle Group

A

Pubovisceralls

23
Q

Muscles of the Pelvic Floor Muscle Group

A

Puborectalis
Pubovaginalis
Pubococcygeus
Pubourethralis

24
Q

Pelvic Floor Connective Tissue

A

Endopelvic Fascia

25
Q

Normal Voiding Characteristics

A

Adequate Pressure
Good Flow/Stream
No Discomfort

26
Q

[Anatomy and Physiology of Normal Voiding]

Detrusor

A

Contractile

Control: Sustained stimulation to contract until empty

27
Q

[Anatomy and Physiology of Normal Voiding]

Urethra and Sphincter

A

Calms Down: Relaxes and opens

Control: Inherent Contraction Inhibited

28
Q

[Anatomy and Physiology of Normal Voiding]

Pelvic Floor

A

Calms Down: Relaxes and Opens

Control: Inherent Contraction Inhibited

29
Q

[Detrusor Contraction]

Arrangement of smooth muscle fibers allowing sustained and complete emptying

A

Syncitium

30
Q

[Detrusor Contraction]

Contraction of these muscles will close the distal ureter to prevent reflux of urine to the kidney

A

Trigonal Muscles

31
Q

[Coordination of the LUT]

Filling and Voiding:
Detrusor/Bladder
Sphincter/Urethra
Pelvic Floor

A

Detrusor/Bladder -> F: Relax V: Contract

Sphincter/Urethra -> F: Contract V: Relax

Pelvic Floor -> F: Contract V: Relax

32
Q

Micturition Switches

A

Cortical Center
Rostral Pons
Suprasacral Cord
Sacral Cord

Peripheral Nerves

a. Hypogastric
b. Pudendal
c. Pubic

33
Q

[Inherent Actions]

Cortical Center

A

Inhibitory to Pons

34
Q

[Inherent Actions]

Pontine Center

A

Stimulatory to sacral cord

Inhibitory to suprasacral cord

35
Q

[Inherent Actions]

Suprasacral (T10-12) Hypogastric Nerve

A

Stimulates internal urethral sphincter
Inhibits detrusor
Inhibits trigonal muscles

[OS 206] 3rd Lecture Exam (10 decks)

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