Incontinence/Pelvic Prolapse Flashcards
Two basic types of incontinence
stress: leak w/ increase in intra-abdominal P
urge: dysfunctional neural system, bladder contraction
Alpha-1 receptors are found where in lower urinary tract
sm muscle of urethra
keeps urethral tone
Beta-2 and 3 receptors are found where in lower urinary tract
detrusor wall
allows for relaxation of bladder dome
Parasympathetic/sympathetic cause bladder contraction
parasympathetic
M3 receptors
Which parasympathetic receptors are stimulatory in bladder
M3 receptors
Common medication class used to treat urge incontinence
anti-cholinergics
Most common side effect of anti-cholinergics
dry mouth
salivary glands also have muscarinic receptors
Type of muscle and innervation of
internal urethral sphincter
external urethral sphincter
internal: sm muscle w/ M3 receptors
external: sk muscle w/ somatic innervation
Control of continence normally by what age
2 y/o
Describe
stress incontinence
urge incontinence
stress: small leakage w/ increase in intra-abdominal pressure
urge: leak large amounts of urine w/ urgency before accident
often appears mixed clinically
Probably most common type of incontinence
mix between stress and urge incontinence
What type of incontinence do men typically get 2˚ to BPH
overflow incontinence
causes dribbling when bladder gets too full
inability to empty bladder b/c of urethral compression
Why does menopause lead to urinary incontinence
decrease in estrogen
causes decrease in CT surrounding urethra
internal and external sphincters cannot close as tightly
intra-abdominal pressure may overcome urethral sphincter pressure and cause stress incontinence
Functional incontinence
inability to actually get to toilet
2˚ to injury or inability to ambulate
Post-void residual volume
used to see if how much urinary retention after voiding
