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HRM > Female incontinence; 4.15 > Flashcards

Female incontinence; 4.15 Flashcards

1
Q

What kind of androgen receptors are found in the bladder dome?

A

Beta-receptors

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2
Q

What is the effect of having beta-receptors in the bladder dome when sympathetics are active?

A

The bladder relaxes…this is the case while STORING urine

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3
Q

What kind of androgen receptors are found at the bladder neck (internal urinary sphincter)?

A

Alpha-receptors

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4
Q

What is the effect of having alpha-receptors in the bladder neck when sympathetics are firing?

A

The sphincter constricts…this would also be necessary while STORING urine

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5
Q

Where else are alpha-receptors in the urinary system?

A

The urethra…again, sympathetics would cause the urethra to constrict so the bladder won’t leak

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6
Q

Besides sympathetic activity, what else is going on during urine storage?

A

Cholinergics are inhibited

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7
Q

What nerve sends the sympathetic control to the bladder?

A

Hypogastric nerve

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8
Q

What nerve sends the cholinergic activity?

A

Pudendal nerve

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9
Q

What are some lifestyle modifications that can be made to treat stress incontinence?

A

Weight loss
Fluid retention
Smoking cessation

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10
Q

What can be done to strengthen the pelvic floor?

A

Kegel exercises
Electrical stimulation
Biofeedback
Extracorporeal magnetic innervation

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11
Q

What are devices that can be used to occlude the urethra?

A

Pessary

Urethral inserts

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12
Q

What are some meds that can be used to treat stress incontinence, despite not being approved?

A

Intravaginal estrogen
Duloxetine
Alpha-adrenergic drugs

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13
Q

Why is estrogen given intravaginally?

A

Because it would WORSEN the condition if it was given SYSTEMICALLY

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14
Q

What is the problem with duloxetine?

A

Duloxetine has more side effects

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15
Q

Are alpha-adrenergics commonly used?

A

No…alpha-adrenergics are not commonly used

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16
Q

What are some non-medicinal treatment options for urge/overactive bladder?

A

Bladder retaining
Remove worsening drugs if possible
Pelvic floor strengthening

17
Q

What are some medicinal treatments for urge/overactive bladder?

A

Anticholinergics
Beta-agonists
Intravaginal estrogen
Botulinum toxin

18
Q

When are anticholinergics contraindicated?

A

Narrow angle glaucoma
Dementia
GI obstruction
Old frail people

19
Q

What is a risk of using beta-agonists?

A

Urinary retention (worse with concurrent anticholinergic use)

20
Q

Besides meds and lifestyle changes, how else can urge/overactive bladder be treated?

A

Tibial nerve stimulation

Implantable neuromodulators

21
Q

What causes transient incontinence?

A 
DIAPPERS:
Delerium
Infection (acute UTI)
Atrophic vaginitis
Pharmaceuticals
Psychological disorder (depression)
Excessive urine output
Reduced mobility/Reversible urinary retention
Stool impaction

HRM (40 decks)

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