Bladder Function Flashcards
What are the functions of the bladder and urethra?
Store urine at low pressure (without much sensation).
Empty fully at a socially convenient time.
Reciprocal contraction/relaxation of bladder and urethra.
How much urine can the bladder hold?
upto 500ml
What holds the bladder in place?
Puboprostatic/Pubovesical ligament
Median umbilical ligament (superior).
List the factors contributing to urethral closure.
Muscular occulsion by sphincter.
Transmission of abdominal pressure to proximal urethra.
Muscosal surface tension.
Anatomical configuration at bladder neck.
Submucosal vascular plexus.
Inherent elasticity.
Urethral length.
Where is the micturition centre found?
The dorsolateral region of the pons.
List some neurological diseases which may cause bladder disease?
Spinal cord injury
MS
Parkinson’s.
What is spinal shock?
Hyporeflexia and autonomic dysfunction due to spinal injury.
Causes decreased excitability below the injury and some reflexes will be absent with muscle paralysis.
Decreased autonomic activity causes an acontracile bladder although sphincter amy function.
Can last days to months.
How do you test for the bulbocavernosus reflex to determine if reflexes have recovered in spinal shock?
Why is this reflex significant?
Pinch glans/clitoris or pull catheter and anal sphincter contracts on your finger.
If present, means the sacral micturition centre should be intact.
What is autonomic dysreflexia?
Spinal Cord injury at T6 or higher.
Creates exaggerated sympathetic activity: Increased BP, decreased HR, vasoconstriction.
What is detrusor hyperflexia?
Bladder overreactivity in a patient with an underlying neurological condition such as MS or Parkinsons.
If bladder pressure high can result in upper tract dilatation (hydronephrosis).
Treat with anticholinergic M3 receptor blockers.
Describe chronic retention?
Painless retention of >300ml.
