Bladder + Bowel Flashcards
What is the path of sympathetic control of the bladder/bowel
Inf mesenteric ganglion-> hypogastric nerve-> pelvic ganglion
What does sympathetic control do for the bowel + bladder
- inn bladder wall + internal sphincter
- relaxes bladder wall
- stims internal urethral spincter
What are the parasympathetic controls
Stimulate bladder wall
inhibit int urethral sphincter
What does the somatic control do
via pudendal n (conscious control)
- Inn external urethral spincter
- somatic control is activated by visceral afferents
what spinal cord lvls inn the bowel
S2,3,4
What does pelvic floor mm spacticity lead to
Anismus
how can diet issues affect bowel
reduced fluids
low fibre
decreased activity
poor diet
What is primary, secondary and tertiary sexual dysfunction
primary- related directly to CNS lesion
Secondary- Related to symptom caused by CNS lesions
Tertiary- related to impact of disease on QOL
examples of primary sexual dysfunction
Probs related to CNS lesion
- Erectile and ejaculatory dysfunction
- lack of lube
- loss of sensation
- decreased libido
- loss of Organsm
What is secondary sexual dysfunction
Result of disease effect on sexual response cycle
- fatigue
- spasticity
- weakness
- tremor
- cognition
Examples of the tertiary effects of sexual dysfunction
anxiety, depression
low self esteem
overworking
what are some good questions to ask about frequency of urination
- do u urinate more than 8 times in a 24hr period
- do u frequently get up 2 or more times at night to go to the bathroom
—more than this is a frequency problem
what is urge incontinace
An immediate instoppable urge to urinate
urge incontinance= didn’t make it
what is urinary hesitancy and reasons for men/women
difficulty starting the flow of urine
men- Prostate enlargement
women- Narrowing of the urethral
when would you first feel urge to urinate and max retain
first urge- 200-400ml
most people max 480ml
What is urine retention and what does it lead to
Bladder becomes too full
–Leads to overflow incontinence
What are common reasons bladder not releasing (3)
- Detrusser sphincter dyssynergia
- incomplete sphincter relaxation
- sphincter paralysis
What causes detrusser sphincter dyssynergia
sphincter mm are damaged
-leakage or stay tight when you are trying to release urine
what is overactive bladder and symptoms
poor bladder control-> release without warning and w/o pts permission
Symptoms-
- Urinary frequency
- Urinary urgency
- Urge incontince
What are the 3 neurological disease pattens
- Cotical disease
- C1-t11 spinal cord
- Spinal cord disease below t12
What causes frontal bladder syndrome
higher cortical structures not functioning properly
What is spinal cord shock and what does it lead to for the bladder
Acute trauma to the spine
reduced relex bladder control-> flaccid distension-> over flow
–Leads to spastic reflex bladder
What is spastic reflex bladder
An UMN type of lesion
- detrusser mm is overactive
- reduced bladder capacity
If large residual volumes of urine remain in bladder what is the pt at risk of developing
Hydrourter
Hydronephrosis
Pylonephritis
renal insufficiency
