Bladder + Bowel

Question 1

What is the path of sympathetic control of the bladder/bowel

Answer 1

Inf mesenteric ganglion-> hypogastric nerve-> pelvic ganglion

Question 2

What does sympathetic control do for the bowel + bladder

Answer 2

• inn bladder wall + internal sphincter
• relaxes bladder wall
• stims internal urethral spincter

Question 3

What are the parasympathetic controls

Answer 3

Stimulate bladder wall

inhibit int urethral sphincter

Question 4

What does the somatic control do

Answer 4

via pudendal n (conscious control)

• Inn external urethral spincter
• somatic control is activated by visceral afferents

Question 5

what spinal cord lvls inn the bowel

Answer 5

S2,3,4

Question 6

What does pelvic floor mm spacticity lead to

Answer 6

Anismus

Question 7

how can diet issues affect bowel

Answer 7

reduced fluids
low fibre
decreased activity
poor diet

Question 8

What is primary, secondary and tertiary sexual dysfunction

Answer 8

primary- related directly to CNS lesion

Secondary- Related to symptom caused by CNS lesions

Tertiary- related to impact of disease on QOL

Question 9

examples of primary sexual dysfunction

Answer 9

Probs related to CNS lesion

• Erectile and ejaculatory dysfunction
• lack of lube
• loss of sensation
• decreased libido
• loss of Organsm

Question 10

What is secondary sexual dysfunction

Answer 10

Result of disease effect on sexual response cycle

• fatigue
• spasticity
• weakness
• tremor
• cognition

Question 11

Examples of the tertiary effects of sexual dysfunction

Answer 11

anxiety, depression
low self esteem
overworking

Question 12

what are some good questions to ask about frequency of urination

Answer 12

• 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

Question 13

what is urge incontinace

Answer 13

An immediate instoppable urge to urinate

urge incontinance= didn’t make it

Question 14

what is urinary hesitancy and reasons for men/women

Answer 14

difficulty starting the flow of urine

men- Prostate enlargement
women- Narrowing of the urethral

Question 15

when would you first feel urge to urinate and max retain

Answer 15

first urge- 200-400ml

most people max 480ml

Question 16

What is urine retention and what does it lead to

Answer 16

Bladder becomes too full

–Leads to overflow incontinence

Question 17

What are common reasons bladder not releasing (3)

Answer 17

• Detrusser sphincter dyssynergia
• incomplete sphincter relaxation
• sphincter paralysis

Question 18

What causes detrusser sphincter dyssynergia

Answer 18

sphincter mm are damaged

-leakage or stay tight when you are trying to release urine

Question 19

what is overactive bladder and symptoms

Answer 19

poor bladder control-> release without warning and w/o pts permission

Symptoms-

1. Urinary frequency
2. Urinary urgency
3. Urge incontince

Question 20

What are the 3 neurological disease pattens

Answer 20

1. Cotical disease
2. C1-t11 spinal cord
3. Spinal cord disease below t12

Question 21

What causes frontal bladder syndrome

Answer 21

higher cortical structures not functioning properly

Question 22

What is spinal cord shock and what does it lead to for the bladder

Answer 22

Acute trauma to the spine

reduced relex bladder control-> flaccid distension-> over flow

–Leads to spastic reflex bladder

Question 23

What is spastic reflex bladder

Answer 23

An UMN type of lesion

• detrusser mm is overactive
• reduced bladder capacity

Question 24

If large residual volumes of urine remain in bladder what is the pt at risk of developing

Answer 24

Hydrourter
Hydronephrosis
Pylonephritis
renal insufficiency