Bladder, Bowel, Sexuality

Question 1

what vertebral level of injury is considered a UMN bladder

Answer 1

injury to T12 - L1 and above

Question 2

what is an UMN bladder called

Answer 2

a spastic/reflexic bladder

Question 3

what happens with an UMN bladder

Answer 3

• bladder empties reflexively (hyperreflexic bladder)
• impaired motor control and sphincter function
• incontinence with small volumes of urine
• impaired sensation of fullness
• detruser muscle contracts before bladder is full

Question 4

what is a LMN bladder called

Answer 4

flaccid/areflexive bladder

the reflex is no longer there

Question 5

where is the injury for a LMN bladder

Answer 5

injury to T12- L1 and below

Question 6

what happens with a LMN bladder

Answer 6

there is no reflex action of the detrusor muscle
bladder is full but will not empty
must use a catheter due to risk of overflow into the kidneys

Question 7

what is a suprapubic catheter

Answer 7

surgical procedure that places an opening on the outside of the patients abdomen to allow a catheter to be placed

women tend to use this strategy more often

Question 8

what is a continent stoma

Answer 8

surgical opening on the stomach that has part of the intestine attached to it. the other end is attached to the bladder.
this allows for the pt. to cath themselves through this opening

Question 9

what happens with an UMN bowel

Answer 9

pt. may not feel the need to have a BM
there is no voluntary control
constipation and fecal retention occurs

Question 10

what happens with a LMN bowel

Answer 10

unable to feel the need to have a BM
reflex is damaged or non-existant
constipation with leakage

Question 11

what techniques can be used for UMN bowel

Answer 11

• Dulcolax suppository
• digital stimulation
• bowel meds
• abdominal massages

Question 12

what technique is used for LMN bowel

Answer 12

• manual eactuation
• glycerin suppository and digital stimulation
• metamucil (bowel med)
• bowel care 2x/day to avoid incontinence

Question 13

how often does someone with an UMN/reflexive bowel empty their bowels

Answer 13

3 times/week

Question 14

how often does someone with a LMN/areflexic bowel empty their bowels

Answer 14

2 times/day

Question 15

what can we do if an accident occurs

Answer 15

• let the pt. know that it is expected in the beginning
• clean up the gym or get nursing to help
• provide as much privacy as possible
• remind them about sticking with their bowel care program

Question 16

another name for an UMN erection

Answer 16

reflexogenic erection

Question 17

another name for a LMN erection

Answer 17

psychogenic erection

Question 18

signs and symptoms of AD

Answer 18

headache
bradycardia
flushing
sweating above level of injury
nausea
SBP > 20 mmHg above their normal
blurred vision

Question 19

treatment for AD

Answer 19

inform nurse
check vital signs
loosen any tight clothing
raise head of bed
check foley for kinks in tubing