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Nephrology > Bladder Anatomy and Physiology > Flashcards

Bladder Anatomy and Physiology Flashcards

1
Q

What is the normal capacity of the bladder?

A

400-500mL

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2
Q

What ligaments hold the bladder?

A
  1. Bladder neck by
    - puboprostatic ligament in male
    - pubovesical ligament in female
  2. Median umbilical ligament
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3
Q

What is the remnant of the allantois

A

obliterated urachus

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4
Q

What is the allantois?

A

In embryo, the allantois is a canal that drains the urinary bladder of the fetus and that joins and runs within the umbilical cord.

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5
Q

What type of epitheium is in the bladder?

A

Transitional epithelium

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6
Q

What type of muscle is the bladder made off?

A

Detrusor muscle

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7
Q

What are the layers of the bladder muscle?

A

Detrusor muscle

Longitudinal
Circular
Spiral

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8
Q

How thick is the bladder muscle?

A

Detrusor muscle

5mm

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9
Q

Weakening in which sphincter causes incontinence?

A

Pre-prostatic sphincter (bladder neck) males

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10
Q

What is the arterial blood supply to the bladder?

A

2 arteries:

  1. internal vesicle artery
  2. external vesicle artery

arise from:
internal iliac arteries from the anterior trunk

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11
Q

Venous drainage of bladder?

A

Rich plexus of veins that ultimately empties into the internal iliac veins

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12
Q

Lymphatic drainage of bladder

A

Lymph nodes at:

  • vesicle
  • internal iliac
  • external iliac
  • common iliac lymph nodes
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13
Q

What structures sense bladder filling?

A

Afferent parasympathetic neurons > spinal cord > pontine and micturition centres

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14
Q

Where does the efferent motor bladder innervation arise from?

A

S2-4

S2 3 4 keeps the shit of the floor

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15
Q

What is the main centre for micturition?

A

Pontine micturition centre in the dorsolateral pons

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16
Q

Where is the sacral micturition centre?

A
  1. Intermediolateral nucleus: PS S2-4 –> bladder

2. Onuf’s nucleus: PS S2-4 –> urethra

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17
Q

Which nerve is responsible for urine retention?

A

Hypogastric (sympathetic nerve)

18
Q

Which nerve is responsible for micturition (voiding)?

A

Pelvic nerve (parasympathetic)

19
Q

Which nerve detects stretch?

A

Sensory pelvic nerve (afferent)
- sends impulses to S2-S4
from stretch receptors on the detrusor muscle

20
Q

Which nervous systems are involved in bladder efferent innervation?

A
  1. Parasympatheic
  2. Sympathetic
  3. Somatic
21
Q

Is the pelvic nerve under voluntary of involuntary action?

A

involuntary

22
Q

What nervous system does the pelvic nerve that causes contract belong to?

A

Parasympathetic

23
Q

What neurotransmitter and to which receptor does the pelvic nerve act on?

A 
S2 to S4
Pelvic nerve to detrusor muscle
Involuntary
Parasympathetic
Released ACh
Acts on M3R
Causes relaxation
24
Q

What effects does the hypogastric nerve have on the bladder?

A 
Hypogastric 
Sympathetic
- detrusor muscle: relaxation (b3R)
- internal sphincter: contraction (a1R)
Noradrenaline
25
Q

Where does the hypogastric nerve arise from?

A

T10-L2

26
Q

What nerve controls the external urethral sphincter?

A

Pudendal nerve

27
Q

Where does the pudendal nerve arise from?

A

Onuf’s nucleus
Anterior horn
S2-S4

28
Q

What nerve is blocked during labour and what does this cause?

A

Female pudendal nerve block

Causes relaxation of external sphincter

29
Q

What is the action of the pudendal nerve?

A

voluntary contraction of the external urethral sphincter

30
Q

What nerve is used when we’re forcibly stopping ourselves from peeing?

A

Pudendal nerve on external urethral sphincter

31
Q

What neurotransmitter and receptor does the pudendal nerve act via?

A

ACh

Nicotinic receptor

32
Q

In BPH what drug can be used and whats it MOA?

A

Tamsulosin
alpha1-R blocker in neck of the bladder
of the hypogastric nerve

33
Q

Where is the sacral micturition centre located?

A

Spinal cord
S2-S4
Intermediolateral grey area

34
Q

Where is Onuf’s nucleus located?

A

Spinal cord
S2-4
Anterior horn

35
Q

What is the relevance of Onuf’s nucleus?

A

Continence
Acts via pudendal nerve nerve
- somatic voluntary contraction

36
Q

What is the relevance of the sacral micturition centre

A

Voiding
Acts on the pelvic nerve
- parasympathetic contraction

37
Q

Which spinal cord injury results in incontinence?

A

Sacral spinal cord injury

38
Q

Which nerve(s) are stimulated during retention?

A
  1. Hypogastric T10-L2
    - Relaxation of detrusor muscle b3R NA
    - Contraction of internal sphincter a1R NA
    - Sympathetic
  2. Pudendal (Onuf’s nucleus)
    - contraction of external sphincter NR ACh
    - Somatic
39
Q

Which nerve(s) are stimulated during micturition?

A

Pelvic (sacral micturition centre) S2-S4

40
Q

How do we maintain a urine flow?

A
  1. Pelvic sensory neurons keep firing to sacral micturition centre (S2-S4) - inferomediolateral grey area
  2. this stimulates the pelvic parasympathetic pelvic nerve to keep firing ACh at the M3R
  3. This maintains contraction of the detrusor muscle and thus urination
41
Q

What happens during spinal shock?

A

Period of reduced excitability at and below spinal cord injury

42
Q

What is autonomic dysreflexia?

A

SCI T6 or higher

- exaggerated SNS activity

Nephrology (6 decks)

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