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REN > L17: Control Of Bladder Emptying > Flashcards

L17: Control Of Bladder Emptying Flashcards

1
Q

Where does urine from to after the collecting duct

A

Minor calyx

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2
Q

Where does urine flow to after the minor calyx

A

Major calyx

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3
Q

Where does urine flow to after the major calyx

A

Renal pelvis

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4
Q

Where does urine flow to after the renal pelvis

A

Ureter

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5
Q

What can obstruct the ureter

A

Kidney stones
Tumours
Fibrosis

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6
Q

What is the treatment for kidney stones in the ureter

A

Removal

Extracorporeal shock wave lithotripsy

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7
Q

What are the layers of the urinary bladder form inside to outside

A

Urothelium
Lamina propia
Detrusor smooth muscle
Serosa

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8
Q

What type of junctions does the urothelium have

A

Tight junctions

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9
Q

What does the urothelium have tight junctions

A

So fluid cannot pass into it

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10
Q

What does the lamina propia contain

A

Blood vessels
Lymphatics
Nerves
Intersitial cells of CAJAL

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11
Q

What does the sensory nerves in the lamina propia detect

A

Chemical

Stretch

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12
Q

What nervous system is the detrusor smooth muscle innervated by

A

Parasympathetic

Sympathetic

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13
Q

What neurotransmitter does the parasympathetic post ganglionic neurones release

A

Acetylcholine

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14
Q

What neurotransmitter does the post ganglionic sympathetic neurone release

A

Noradrenaline

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15
Q

Which receptors does acetylcholine act on the detrusor smooth muscle

A

Muscarinic 3 receptor

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16
Q

Which receptors does noradrenaline act on the detrusor smooth muscle

A

Beta 3 receptor

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17
Q

What does parasympathetic innervation to the detrusor muscle to do

A

Contraction to expel urine out

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18
Q

What does the sympathetic nervous system cause the detrusor muscle to do

A

Relaxation to store urine

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19
Q

What does continence mean

A

To not urinate

20
Q

What does void mean

A

Empty the bladder and urinate

21
Q

What happens to the pressure inside the bladder when we are continent

A

Decreases

22
Q

What happens to the sphincters during continence

A

Activated/contract

23
Q

What happens to the pressure inside the bladder when we void

A

Increase due to a contraction of the muscle

24
Q

What happens to the sphincters when we void

A

Relax

25
Q

Which floor does the bladder sit on top of

A

The pelvic floor

26
Q

What is the pelvic floor made of

A

Levator ani

Coccygeous

27
Q

What is the levator ani made of

A

Pubococcygous
Iliococcygeous
puborectalis

28
Q

When can the pelvic floor weaken

A

In childbirth

29
Q

What are the types of innervation of the urethra

A

Somatic

Autonomic

30
Q

Which part of the urethra does the somatic system innervate

A

External urethral sphincter that has Striated skeletal muscle

31
Q

Which layer of the urethra does the autonomic nervous system innervate

A

Smooth muscle

32
Q

Describe the process that occurs during continence

A

1) somatic NS innervated the external urethral sphincter so it is contracted
2) sympathetic NA is activated which contracts the internal urethral sphincter (inside the bladder)
3) parasympathetic NS is inactive

33
Q

Describe what happens during voiding

A

1) somatic and sympathetic NS are inactivated

2) parasympathetic NS is activated which causes the detrusor muscle to contract and void

34
Q

What type of innervation does the pudenal nerve have

A

Somatic

35
Q

What does the pudenal nerve supply

A

The external urethral sphincter

36
Q

What type of innervation does the Pelvic nerve have

A

Parasympathetic

37
Q

What does the pelvic nerve supply

A

The detrusor smooth muscle

38
Q

What type of innervation does the hypogastric nerve have

A

Sympathetic

39
Q

What does the hypogastric nerve supply

A

Internal urethral sphincter

Detrusor smooth muscle

40
Q

Where does the sensory nerves send the signal to

A

Pontine micturition centre

41
Q

When does stress in continence

A

When the abdominal pressure increases when you cough or sneeze

42
Q

Why does stress incontinence occur in females after childbirth

A

Anterior vaginal walls is damages so posterior wall of urethra collapses open

43
Q

What is the treatment for stress incontinence

A

Surgical by addition support to the anterior vaginal wall

Pelvic floor exercises

44
Q

What are the pharmacological interventions for an overactive bladder

A

Antimuscarinic drug
Botulinum toxin to stop PNS
B3 adrenoceptor agonist

45
Q

What is the treatment for benign prostatic hyperplasia

A

Surgical: reduce size
Medical: alpha adrenoceptor antagonist

REN (19 decks)

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