Bladder and Urinary Tract Lecture

Question 1

Pyeloureteric peristalsis

Answer 1

movement of urine efficiently into the ureter; originates from the renal pelvis where urine produced in the kidney collected

Question 2

What causes pyeloureteric peristalsis?

Answer 2

initiation by pacemaker cells, which drive rhythmic electrical and mechanical events from the renal pelvis to the ureter.

Question 3

Main sites where kidney stones get stuck?

Answer 3

1. at the ureteric junction of renal pelvis;
   as the ureter passes over the iliac vessels;
2. at the junction of the ureter and the bladder

Question 4

Blocking urine flow increases pressure in the kidney and can lead to this condition.

Answer 4

hydronephrosis

Question 5

Where is the main site of pacemaker cells in the kidney?

Answer 5

Renal pelvis

Question 6

3 critical regions of bladder function

Answer 6

1. urothelium
2. suburothelium (afferent pathways)
3. muscularis (efferent pathways)

Question 7

Two types of fibers involved in sensory perception

Answer 7

1. A-gamma: mechanosensitive neurons

2. C fibers: mechanically insensitive, participate in nociception

Question 8

3 main mechanisms for regulation of contraction in detrusor muscle cells

Answer 8

1. Entry of Ca+
2. Release of Ca+ from cellular stores
3. Sensitization of contractile apparatus by inhibiting myosin light chain phosphatase

Question 9

The kidney exhibits this quality, which allows for proper filling.

Answer 9

Enhanced compliance! So, very little pressure build up despite a large increase in volume.

Question 10

Characterized by a sudden, uncomfortable need to urinate with or without urine leakage. This can occur frequently during both the daytime and nighttime

Answer 10

Overactive bladder

Question 11

Predominant pharmacological treatment for patients with overactive bladder

Answer 11

Antimuscarinic drugs

Question 12

The main problem with males and urination

Answer 12

An enlarged prostate (benign prostatic hyperplasia)

Question 13

What would occur if bladder compliance was decreased?

Answer 13

Increased pressure build up with increasing volume

Question 14

Occurs when the muscles and tissue that help support the bladder become weak. When there is increased pressure against the bladder and the sphincter does not stay closed, leakage occurs

Answer 14

Stress incontinence

Question 15

Another word for peeing

Answer 15

micturition

Question 16

Nerves involved in the filling phase of the bladder

Answer 16

Hypogastric
Pelvic
Pudendal

Question 17

What happens to the external sphincter during bladder filling?
What about the internal sphincter?
What about detrusor muscle?
What happens to parasympathetic outflow?

Answer 17

Contraction of both sphincters.
Inhibition of detrusor muscle.
Inhibition of parasympathetic outflow.

Question 18

Antimuscarinic drugs can cause this undesired side effect

Answer 18

Constipation

Question 19

The parasympathetic PELVIC nerve essentially does three things. What are they?

Answer 19

1. ACh binds to M3 receptors and stimulates detrusor muscle
2. ATP binds to P2X1
3. NO binds to GC to relax urethral smooth muscles

Question 20

The sympathetic HYPOGASTRIC nerve does two things. What are they?

Answer 20

1. NE binds to alpha 1 to cause smooth muscle contraction

2. NE binds to B3 to inhibit bladder detrusor muscle

Question 21

What does the detrusor muscle do during filling vs. urination?

Answer 21

Relaxes during filling, and contracts during urination.

Question 22

What do the sphincters do during filling vs. urination?

Answer 22

Contract during filling, relax during urination.

Question 23

What does the somatic PUDENDAL nerve do?

Answer 23

stimulates the external urethral sphincter, mediated by ACh-activating nicotinic (N) receptors