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Block 2 Week 5 > Bladder and Urinary Tract Lecture Sanders > Flashcards

Bladder and Urinary Tract Lecture Sanders Flashcards

1
Q

(blank) moves urine efficiently into the ureter.

A

Pyeloureteric peristalsis

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2
Q

Peristalsis is initiated by (blank) that drive rhythmic electrical and mechanical events from the renal pelvis to the ureter.

A

pacemaker cells

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3
Q

Peristalsis originates at the border where the (blank) and propagates distally to the renal pelvis.

A

calyces attach to the base of the papilla (pelvi-calyceal junction, PCJ)

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4
Q

Electrical activity and contraction frequency (blank) as muscle is taken from more and more distant sites from the base of papillae. This suggests that the dominant pacemaker in the renal pelvis is at the pelvi-calyceal border.

A

decrease

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5
Q

The force of contractions in the renal pelvis and ureter is influenced by the (blank).

A

rate of urine flow

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6
Q

Blocking urine flow increases pressure in the kidney, and can lead to (blank):distension and dilation of the renal pelvis and calyces usually caused by obstruction of the flow of urine from the kidney. Untreated it causes progressive atrophy of the kidney.

A

hydronephrosis

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7
Q

(blank) form when certain chemicals precipitate.

A

Stones

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8
Q

Where do kidney stones typically get stuck?

A

> at the ureteric junction of renal pelvis;
as the ureter passes over the iliac vessels;
at the junction of the ureter and the bladder (vesicoureteric junction).

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9
Q

What are the four main types of kidney stones?

A

calcium-oxalate
struvite
uric acid
cystine

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10
Q

What kidney stones are these:
These are the most common kidney stones. They can be caused by eating too much calcium or vitamin D, some medicines, genetics and other kidney problems.

A

calcim oxalate

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11
Q

What kidney stones are these:
These stones affect women more than men. They can grow very large and may harm the kidneys more than other stones. Having kidney infections often causes struvite stones.

A

struvite

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12
Q

What kidney stones are these:

May be caused by eating too much animal protein or by genetics.

A

uric acid

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13
Q

What kidney stones are these:

These stones are very rare. They are caused by cystinuria, a genetic kidney disease.

A

Cystine

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14
Q

Kidney stones form when a (blank) occurs in the normal balance of water, salts, minerals, and other substances found in urine. Other chemical compounds that can form stones in the urinary tract include uric acid and the amino acid cystine. (blank) through reduced fluid intake and strenuous exercise without adequate fluid replacement increase the risk of kidney stones. Some people are more likely to get kidney stones because of a medical condition or family history, as the tendency to form kidney stones may also be inherited. If other people in your family have had them, you may have them too.

A

change

Dehydration

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15
Q

Who is most likely to get a kidney stone?

A

fat white males who are dehydrated and on drugs with family members that have stones

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16
Q

pacemaker cells at the renal pelvis make what happen?

A

pyelouretal peristalsis

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17
Q 
Ureteral peristalsis originates
from the (blank) where urine produced in the kidney is collected: the renal pelvis is (blank) to generate  pacemaker activity which propagates to the ureter thus determining the propulsion of boluses of urine toward the bladder.
A

renal pelvis

spontaneously actived

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18
Q

The ureter is normally (blank) although latent pacemakers exist at all levels of the pyeloureteral tract which can be excited to fire action potentials and contractions by depolarizing stimuli. Excitation of latent pacemakers by noxious/irritant stimuli can produce antiperistaltic waves of contraction producing urine (blank) toward the kidney.

A

quiescent

reflux

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19
Q

Is the ureter electrically active?

A

NO

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20
Q

(blank) aid in urine flow from renal pelvis to bladder. This involves what kind of muscles?

A

Peristaltic contractions

Circular muscles that relax and contract

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21
Q

In humans does the contraction occur during depolarization or repolarization?

A

repolarization (its delayed)

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22
Q

The bladder is a storage vessel and able to expand, and becomes more (blank) so that pressure will not rise.

A

compliant

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23
Q

What is impermeable to most things?

A

urothelium

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24
Q

What are the two division of the peripheral nervous system?

A

ANS, enteric

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25
Q

(blank) is the Main neural pathways taking sensory information to the central nervous system and bringing secretomotor output to epithelial and muscle tissues. Cell bodies in spinal cord or peripheral ganglia (like the prevertebral ganglia).

A

ANS (involuntary)

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26
Q

(blank) are relay points between the periphery and the central nervous system. Nerve cells in the central nervous system send processes to nerve cell bodies in the ganglia (pre-ganglionic neurons). Cell bodies in ganglia have processes that project to and innervate targets in the periphery (post-gangionic neurons).

A

autonomic ganglia (pre-vertebral ganglia)

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27
Q

(blank) is the nerve taking information from the periphery to more central locations. These nerves provide sensory information from organs to be used in central neural processing.

A

afferent nerve (neuron)

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28
Q

(blank) is the nerve taking information from more central sites: central nervous system or peripheral ganglion and providing control over muscle or epithelial tissues.

A

efferent nerve (neuron)

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29
Q

(blank) is a Substance released from neuron to convey information from neuron to target cell. Main neurotransmitters used in peripheral nervous system are: norepinephrine (NE), acetylcholine (ACh), nitric oxide (NO) and purines (adenosine triphosphate or ATP). Peptide transmitters are also utilized, such as vasoactive intestinal poly peptide (VIP), calcitonin gene related peptide (CGRP), Pituitary adenylate cyclase-activating polypeptide (PACAP), and others.

A

neurotransmitter

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30
Q

(blank) is a protein expressed by pre- or post-junctional cell that has high affinity for a neurotransmitter and can transduce neurotransmitter binding to a cellular action.

A

receptor

31
Q

Where are nerves located in the bladder?

A

suburothelium (submucosa)

32
Q

What has mucosal cells and sensory receptors in the bladder?

A

urothelium

33
Q

What has the sensory transduction in the bladder?

A

suburothelium

34
Q

What part of the bladder has a motor zone?

A

musclaris

35
Q

What is the afferent pathway of the bladder?

A

suburothelium

36
Q

What is the efferent pathway of the bladder?

A

muscularis

37
Q

When bladder is filling, urothelium senses this and releases substances like (blank) to bind to sensory nerve terminals in the suburothelium.

A

ATP

38
Q

When you have ATP secretion into the suburothelium what happens?

A

you will get action potentials in sensory neurons which will spread to CNS which will send efferents to bladder to make it empty

39
Q

During urine storage, what will your vesicle afferent (pelvic nerve) activity levels be like?

A

they will be low

40
Q

During micturition, what will your vesicle afferent (pelvic nerve) activity levels be like?

A

they will be high

41
Q

During urine storage what is happening in the efferent pathways?

A

external sphincter contraction (somatic nerves)
internal sphincter contraction (sympathetic nerves)
Detrusor inhibition (sympathetic nerves)
Sacral parasympathetic outflow inactive
Inhibition of parasympathetic outflow

42
Q

During urine storage, what is happening in the afferent pathway?

A

low level vesicle afferent activity (pelvic nerve)

afferent activity from the external urethral sphincter

43
Q

During urine storage, what is happening in the central pathway?

A

spinal reflexes

44
Q

During micturition, what is happening in the afferent pathway?

A

high-level vesicle afferent activity (pelvic nerve)

45
Q

During micturition, what is happening in the efferent pathway?

A

Inhibition of external sphincter activity
Inhibition of sympathetic outflow
Activation of parasympathetic outflow to the bladder
Activation of parasympathetic outflow to the urethra

46
Q

What central pathways are occuring?

A

spinobulbospinal reflex and spinal reflex

47
Q

What does the hypogastric nerve do?

A

It contracts the bladder outlet and inhibits the detrusor during filling phase

48
Q

What does the pudendal nerve do?

A

external sphincter contraction during urine storage

49
Q

During the storage of urine, distention of the bladder produces low-level (blank), which in turn stimulates the (blank) to the bladder outlet (base and urethra) and pudendal outflow to the external urethral sphincter. These responses occur by (blank) and represent guarding reflexes, which promote continence. Sympathetic firing also inhibits (blank) and modulates transmission in bladder ganglia.
A region in the rostral pons (the pontine storage centre) increases (blank)

A 
vesical afferent firing
sympathetic outflow
spinal reflex pathways
detrusor muscle
external urethral
sphincter activity.
50
Q

(b) Voiding reflexes. During elimination of urine, (blank) bladder afferent firing activates spinobulbospinal reflex pathways passing through the pontine micturition center (PMC), which stimulate the (blank) to the bladder and urethral smooth muscle and inhibit the (blank) to the urethral outlet. Ascending afferent input from the
spinal cord may pass through relay neurones in the periaqueductal grey (PAG) before reaching the PMG.

A

intense
parasympathetic outflow
sympathetic and pudendal outflow

51
Q

Where do the somatic nerves to the bladder come from?

A

S2-S4 pudental nerve (onuf’s nuclei)

52
Q

Where do sympathetic nerves to the bladder come from?

A

hypgastic nerve from T10-L2 (through IM ganglion)

53
Q

Where do parasympathetic nerves to the bladder come from?

A

pelvic nerve S2-S4 (through pelvic ganglion)

54
Q

(blank) are likely to be the mechanosensitive neurons involved in physiological micturition reflex, whereas (blank) are mechanically insensitive and participate in nociception in pathophysiological conditions.

A

A afferent fibers

C-fiber afferents

55
Q

Where are the receptors that respond to irritants, pH, mechanical, thermal factors on the bladder?

A

receptors on urothelial cells

56
Q

Where do you find nitric oxide; prostaglandins;

nerve growth factor, acetyl choline, substance P on the bladder?

A

in the urothelial cells of bladder

57
Q

Where are the additional chemical receptors on the bladder?

A

on sensory neurons on the sub urothelium

58
Q

The sympathetic hypogastric nerve, emerging from the inferior mesenteric ganglion, stimulates (blank).

A

urethral smooth muscle

59
Q

The parasympathetic pelvic nerve, making synapses onto postganglionic neurons in the pelvic ganglion, stimulates (blank) and inhibits (blank).

A

bladder detrusor muscle and inhibits urethral smooth muscle

60
Q

The somatic pudendal nerve stimulates striated muscle of the (blank).

A

external urethral sphincter

61
Q

What are the spinal cord nerves important for the bladder and urethra?

A

S2-S4 and T11-L2

62
Q

Innervation of the lower urinary tract: The parasympathetic pelvic nerve stimulates the (blank) mediated by muscarinic receptors (M 3 ) being activated by acetylcholine (ACh) and relaxes the urethral smooth muscle, mediated by (blank).

A 
bladder detrusor muscle,
nitric oxide (NO)
63
Q

Innervation of the lower urinary tract:
The sympathetic hypogastric nerve stimulates urethral smooth muscle and (blank), mediated by α1-adrenergic and β3-adrenergic receptors, respectively.

A

inhibits bladder detrusor

64
Q

Innervation of the lower urinary tract:
The somatic pudendal nerve stimulates striated muscle of the (blank), mediated by ACh-activating nicotinic (N) receptors. NE Norepinephrine.

A

external urethral sphincter

65
Q

What are the three main mechanisms of the regulation of contraction in detrusor muscles?

A

1: entry of Calcium (voltage channels)
2: release of calcium from cellular stores
3: Sensitization of contractile
apparatus by inhibiting myosin
light chain phosphatase (MLCP).
(continues the contraction)

66
Q

During the bladder filling, there is normally no significant rise in (blank) until the bladder is near functional capacity.

A

intravesical pressure

67
Q

The bladder does not begin to contract until a certain (blank) is reached to initiate urination (neurogenic).

A

intravesical pressure

68
Q

What is urinary incontinence?

A

loss of bladder control

69
Q

What is this:
Leaks occur during laughing, coughing, sneezing…events that increase abdominal pressure. Most common bladder control problem in younger women.

A

Stress Urinary Incontinence (SUI)

70
Q

What is this:
Frequent feelings of desperate need to urinate. A sudden urge may be triggered by sound of running water, by sipping a drink, or spontaneously. Large amounts of urine may be leaked. Patients feel need to go to the bathroom even when the bladder is mostly empty. The sudden, overwhelming need to urinate is caused by spasms of bladder (detrusor) muscles. Spasms occur as a result of nerve or muscle damage…sometimes from a serious illness, such as stroke, or irritation of the bladder caused by an infection or inflammation.

A

Urge Incontinence (HSIHP)

71
Q

What is this:
urge incontinence. Sudden, frequent need to urinate. Not everyone with overactive bladder has incontinence; many people can “hold it” until they reach a toilet. Rather than leaking urine, the main challenge for these patients is constantly interrupting activities for trips to the bathroom. Some people have symptoms only during the daytime, while others have frequency during the night.

A

Overactive Bladder (OAB)

72
Q

(BLANK) results 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. Pressure from motions like coughing or laughing may be all it takes to leak urine. There are several reasons why these muscles can lose strength: They may be stretched by weight gain, a sports injury, or multiple pregnancies and vaginal childbirths.

A

Stress incontinence

73
Q

(blank) is a problem in which a person lacks bladder control due to a brain, spinal cord,or nerve condition.

A

neurogenic bladder

Block 2 Week 5 (7 decks)

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