Chapter 35 Flashcards
bladder function
store and empty urine
what is the urine flow?
kidneys -> ureters -> bladder -> sphincter -> urethra
parasympathetic system promotes
bladder emptying
sympathetic system promotes
bladder filling
parasympathetic NS involves issues with
relaxation of internal sphincter
sympathetic NS involves issues with
contraction of internal sphincter
process of urine elimantion
- detrusor muscle contracts to push urine out (sometimes abdominal muscles may be used)
- internal sphincter relaxes
- external sphincter relaxes
urinary obstruction with
retention or stasis of urine
urinary incontinence with
involuntary loss of urine
what are the causes of altered bladder function?
- structural changes in the bladder, urethra or surrounding organs
- impairment of neurological control of bladder function (neurogenic bladder)
obstruction and stasis is classified by
location, cause, duration and degree
obstruction can be in the
bladder neck, urethra, external urethreal meatus, pelvic organ prolapse, prostate
what happens in the early stage of obstruction/stasis?
hypertrophy, spasm, incontinence, urgency, and frequency
what happens in the compensatory stage?
further hypertrophy, increased pressure to overcome resistance but becomes ineffective.
what happens in decompensatory stage?
compensation is o longer effective. pronounced symptoms and overstretched bladder and infections
signs and symptoms of outflow obstruction and urine retention
bladder distention, hesitancy, straining when initating urination, small and weak stream, frequency, feeling of incomplete bladder emptying, overflow incontinence
neural damage can cause interruption of central nervous system control
neurogenic bladder
failure to empty bladder =
flaccid bladder/overstretched
mainfestations of failure to empty bladder
high volume, low pressure, no contraction, and issue with muscle contraction and bladder emptying
failure to store urine is also called
spastic bladder
manifestations of spastic bladder
involuntary contraction, spasms and leaking, neuro lesions (incontinence, interrupted, incomplete voiding)
what are the common causes of neurogenic bladder?
stroke/advanced age, Parkinsons disease, spinal cord injury, injury to sacral cord/spinal roots, radical pelvic surgrey, diabetic neuropathies, MS
name the types of incontinence
- stress
- overactive bladder
- overflow
spincter unable to prevent escape of urine during activity. pelvic floor weakness in women. examples: coughing, sneezing, lifting
stress incontinence
urge with involuntary loss of urine. involuntary bladder contractions during filling while trying to inhibit micturition
overactive bladder
involuntary loss of urine, never feel urge to urinate, bladder never empties, small amounts of urine leak continously.
overflow (reduced urethral function, overactivity/low bladder compliance)
incontinence usually related to
bladder, spincter, pelvic weakness
chronic obstruction leads to compensation by
increases urinary frequency, bladder muscles overstretched and tired, unable to push for long periods of time, and go frequently