Incontinence and constipation Flashcards
Describe micturition process
What systems are involved in micturition?
What provides voluntary control of micturition?
Frontal cortex
What co-ordinates detrusor contraction with urethral relaxation?
Pontine micturition centre
The parasympathetic system mediates what?
Bladder contraction
The sympathetic system mediates what>
Bladder filling
What causes contraction of external urethral sphincter allowing voluntary control>
Excitation of pudendal nerves
Where is the pontine micturition centre located?
Midbrain
What is urge incontinence?
What is outflow obstruction?
What is stress incontinence?
What is overflow incontinence?
Deficiency of what hormone can cause incontinence?
Oestrogen
What medications can cause incontinence?
What are the red flags of incontinence?
What symptoms suggest voiding problems?
What symptoms suggest storage problems?
What is the pelvic floor muscle strength assessment?
What neurological examination parts should you focus on?
Which nerves innervate smooth muscle of the bladder neck and proximal urethra allowing bladder filling?
Sympathetic nerves from T11 to L2
Which nerves allow detrusor contraction?
Parasympathetic fibres origination from sacral plexus (S2 to S4)
What is uroflowmetry?
What is a USS cystodynamogram?
What is cystometry?
What is ambulatory urodynamics?
If there are no detrusor contractions at low volumes on cystometry, what type of incontinence does this suggest?
Urge incontinence
If there is no voiding on increase in abdominal pressure e.g. coughing on cystometry, what type of incontinence does this suggest?
Stress incontinence
What surgical options are there for stress incontinence?
What medical options are there for stress incontinence?
What is a colposuspension?
What is a sling insertion?
Which medications can be given for urge incontinence?
What surgical options are there for urge incontinence?
How can antimuscarinics affect urination?
Can cause urinary retention
What are the medication options for BPH?
What are the surgical options for BPH?
What do you look for in blood tests with constipation?
What laxatives should you offer for opioid induced constipation?
