Chapter 35 Disorders of the Bladder and Lower Urinary Tract Flashcards
what system is responsible for the involuntary control of the bladder
the autonomic nervous system
what system is responsible for the voluntary control of the bladder
the somatic nervous system
which system is responsible for promoting the emptying of the bladder and how does it do it?
the parasympathetic nervous system – it contracts the bladder to empty it
which system is responsible for relaxing the bladder and allowing it to fill?
the sympathetic nervous system
Is the urine storage system high pressure or low pressure? Why?
low pressure because the ureters are working 24/7 365 days passing urine into the bladder which then fills and empties
what are types of alterations in bladder function?
urinary obstructions, urinary incontinence, urinary retention or stasis
What causes alterations in bladder function?
structural changes of the bladder, urethra, or surrounding organs, impairment of neurologic control of the bladder
What are the causes of urinary obstruction with retention or stasis of urine?
prostate enlargement, urethral stricture (scarring that causes narrowing of the urethra
what are the clinical manifestations of urinary obstruction with retention or stasis?
bladder distension and hypertrophy, hesitancy, straining, small and weak stream, increase in frequency, feeling like you didn’t empty all of the bladder
what is the treatment for urinary obstruction with retention or stasis?
catheterization and removal of the obstruction
What are 2 types of neurogenic bladder disorders?
spastic bladder dysfunction and flaccid bladder dysfunction
Neurogenic bladder disorders are classified as failure to ___ urine or a failure to ____ the bladder
store
empty
What are the causes of neurogenic bladder disorders?
stroke
advanced age
Parkinson’s
spinal cord injury
diabetic neuropathies
MS
What is spastic bladder dysfunction?
failure to store urine
What is the patho for spastic bladder dysfunction?
neurologic lesions allow neurons in the micturition center to function reflexively without control from CNS
what is flaccid bladder dysfunction?
bladder emptying is impaired
what is the patho for flaccid bladder dysfunction?
neurologic disorders that affect motor neurons that control the detrusor muscles contracting and emptying the bladder
What are the goals of treatment for neurogenic bladder disorders?
preventing distension, preventing UTIs, preventing renal damage, reducing the undesirable effects of the disorders such as voiding uncontrollably, constant urges to void…
What is the treatment for neurogenic bladder disorders?
catheterization, bladder retaining, pharmacologic manipulation, surgical procedures
What is urinary incontinence?
involuntary loss or leakage or urine
What is stress incontinence?
involuntary loss of urine when there is an increase in intraabdominal pressure like during coughing, laughing, sneezing, or lifting - usually also involves sphincter weakness – think new moms
What is urge incontinence?
involuntary loss of urine associated with strong desire to void
What is overflow incontinence?
involuntary loss of urine when intravehicular pressure exceeds the maximal urethral pressure due to bladder distension – muscles aren’t working and the bladder keeps filling and eventually it gets really full and the urine starts to leak out
What is the treatment for urinary incontinence?
management, behavioral or pharm methods, exercises like Kegels to strengthen the pelvic muscles, surgical correction, indwelling catheters, self catheterization
