Autonomic Control of the Urinary Bladder Flashcards
What in the urinary bladder has parasympathetic innervation?
the detrusor muscle
What in the urinary bladder has sympathetic innervation?
the detrusor muscle, internal sphincter, and parasympathetic ganglia
What in the urinary bladder has somatic innervation?
external urethral sphincter
What does parasympathetic innervation do in the body of the bladder?
contraction of the bladder via muscarinic (M3) acetylcholine receptors
What does sympathetic innervation do in the base of the urinary bladder?
it stimulates contraction via alpha 1 adrenergic receptors
What does sympathetic innervation to the body of the bladder do?
it relaxes the bladder via beta adrenergic agonists
During bladder filling, does sympathetic or parasympathetic innervation predominate?
sympathetic
During bladder filling what does sympathetic innervation do to the internal sphincter?
contracts it via stimulation of alpha 1 adrenergic receptors
During bladder filling, what does sympathetic innervation do to the base of the bladder?
contraction via stimulation of alpha adrenergic receptors
During bladder filling, what does sympathetic innervation do to the body of the bladder?
relaxation via stimulation of beta 2 and 3 adrenergic receptors
During bladder filling, what happens with parasympathetic activity?
outflow from the CNS to the bladder is minimal and the parasympathetic ganglia are inhibited by sympathetic neurons
During micturition (bladder emptying), does sympathetic or parasympathetic innervation predominate?
parasympathetic
During micturition, what does parasympathetic innervation to the body of the bladder do?
contraction via stimulation of the muscarinic acetylcholine receptors
During micturition, what does parasympathetic innervation to the external sphincter of the bladder do?
relaxes it because there is no stimulation to the nicotinic acetylcholine receptors
What are the common causes of urinary incontinence?
hormonal deficiencies, neurological dysfunction, ectopic ureters, and obstructions
What is urinary incontinence?
when the patient either has no control over urination or they do not know that they are urinating
What is the most common cause of urinary incontinence?
hormone responsive urinary incontinence
What drugs are used to treat hormone responsive urinary incontinence?
oral diethylstilbestrol and phenylpropanolamine
What is phenylpropanolamine?
an alpha agonist that is used to increase internal sphincter tone
What are the negative side effects of phenylpropanolamine?
there is an increased risk of stroke
What is oxybutynin?
a muscarinic acetylcholine antagonist that reduces bladder contractility
What is a negative effect of oxybutynin?
dry mouth due to the M3 receptors being blocked
