Elderly-Continence Flashcards
what impact does continence have
common
stigamtising
disabling
treatable
what are extrinsic causes of incontience
environement fitness physical state co-morbiditis confusion medication
what are instrinsic causes of incontinence
problems with bladder
what is the anatomy of the bladder
for urine storage
involves detrusor muscle relaxation combined with sphincter contraction
detruser is smooth muscle
what is the para innervation of the bladder
parasympathetic-increases strength and contractions
what is the sympathetic innervation
b adrreno causes destrusoer to relax
a adrenal causes contraction of the neck of the bladder and internal urethral spinchter
what is the somatic innveration
contraction of pelvic floor muscle and external urethral sphincter
what is the cns connections
inhibit para tone
what is the pontine micturition
exerts a storage programme of neural connections until a voluntary switch to a voiding programme occurs
what is stress incontinence
bladder outlet is too weak
urine on weak movement
weak pelvic floor muscles
common in woman after having children
what is urinary retention with overflow
bladder outlet is too strong
poor urine floor
older men with BPH
treat with alpha blocker or anti-androgen
what is urge incontience
bladder muscle is too strong contracts at low volumes sudden urge to pass urine can be caused by bladder stones treated with anti muscirinic
what are the main drugs used
antimuscarinics to relax oxybutinin
b 3 adrenocepter agonists to relax
alpha blocker to relax sphincter
anti-andorgen to shrink prostate
what is a neuropathic bladder
an underactive bladder
comlpication of prolonged catheterisation
no awareness of bladder filling so leads too over flow
what us the scheme for assessing incontinence
careful history social history urine output diaries rectal vaginal examiantion urinalysis MSSU bladder scan cystoscopy suggest lifestyle changes
