Bladder Flashcards
What are the 4 types of urinary incontinence?
Stress incontinence, urge incontinence, retention with overflow, anatomical
What is stress incontinance?
Leakage on coughing or straining due to a weak sphincter
What is urge incontinence?
Leakage with urgency due to bladder overactivity
What is retention with overflow?
Continuous dribbling
What is anatomical urinary incontinence?
Continuous dribbling with normal voids; can be congenital or acquired
What is the trigone?
A triangular area located within the fundus of the bladder. It has smooth wall and is developed by the integration of two mesonephric ducts at the base of the bladder
What is the name of the smooth muscle in the bladder wall?
Detrusor muscle
What is the male internal urethral sphincter?
Circular smooth fibres which are under autonomic control
What is the role of the male internal urethral sphincter?
Prevention of seminal regurgitation during ejaculation
What is the female external sphincter?
A functional sphincter formed by the anatomy of the bladder neck and proximal urethra
Is the internal or external urethral sphincter structurally different between the sexes?
Internal
What is the external urethral sphincter?
Skeletal muscle ring
How does the external urethral sphincter vary in males and females?
In males the external sphincteric mechanism is more complex
Is the external or internal urethral sphincter under voluntary control?
External
What vessels supply the bladder?
Internal iliac vessels
What is the sympathetic supply to the bladder?
Hypogastric nerve (T12-L2)
What effect does activation of the hypogastric nerve have on the bladder?
Relaxation of the detrusor muscle, promoting urine retention
What is the parasympathetic supply to the bladder?
The pelvic nerve (S2-S4)
What effect does activation of the pelvic nerve have on the bladder?
Contraction of the detrusor muscle, stimulating micturition
What is the somatic supply to the bladder?
Pudendal nerve (S2-S4)
What effect does activation of the pudendal nerve have on the bladder?
Innervates the external urethral sphincter so voluntary control over micturition
Where are sensory (afferent) nerves found in the bladder?
The bladder wall
What do the afferent nerves of the bladder do?
Signal the need to urinate when the bladder becomes full
What is the bladder stretch reflex?
A primitive spinal reflex in which micturition is stimulated in response to stretch of the bladder wall. This must be overridden by the higher centres of the brain during toilet training in infants.
What areas of the brain coordinate bladder and sphincter function?
Pontine micturition centre and periaqueductal grey
What are the two main types of urinary buffer?
Phosphate and ammonium
What is the aim of urinary buffers?
To add alkalinity to the blood after is it made acidic from carbon dioxide
