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Block 10 Ellen > L8: incontinence and urinary renention > Flashcards

L8: incontinence and urinary renention Flashcards

1
Q

2 functions of the urinary bladder

A

collection and low pressure storage of urine

expulsion of urine

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2
Q

3 histological layers of the bladder

A

outer adventitial connective tissue layer
middle smooth muscle coat (detrusor)
innermost transitional cell epithelial

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3
Q

parasympathetic nerve roots for micturition are at?

A

S2-S4

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4
Q

3 nerves to the bladder

A

pelvic
pudendal
hypogastric

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5
Q

which nerve to the bladder is parasympathetic

A

pelvic nerve

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6
Q

what does the pelvic nerve control

A

contractions of the bladder (M3 receptors)

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7
Q

which nerve to the bladder is sympathetic

A

hypogastric

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8
Q

what does the hypogastric nerve control

A

internal sphincter

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9
Q

what does the pudendal nerve control

A

external sphincter

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10
Q

what brain centre controls voiding

A

pontine micturition centre in the brain

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11
Q

what needs to be coordinated in voiding

A

detrusor contraction and urethral relaxation

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12
Q

is any residual urine in bladder

A

NO

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13
Q

in cytometry to measure bladder pressure where do the catheters need to go

A

one in bladder

one in rectum

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14
Q

cytometry equation to work out bladder pressure

A

bladder pressure - abdominal pressure

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15
Q

LUTS=

A

lower urinary tract symptoms

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16
Q

BPH=

A

benign prostatic hyperplasia

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17
Q

BPE=

A

benign prostatic enlargement

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18
Q

BOO=

A

bladder outflow obstruction

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19
Q

name 5 symptoms of voiding issues

A 
weak or intermittent stream
straining 
hesitancy 
terminal dribbling 
incomplete emptying
20
Q

what did voiding issues used to be called

A

obstructive

21
Q

what did storage issues used to be called

A

irritative

22
Q

name 5 symptoms of storage issues

A

urgency
frequency
incontinence
nocturia

23
Q

post micturition symptom=

A

terminal dribbling

24
Q

3 causes of voiding difficulty

A
  • increased outflow resistance
  • detrusor muscle failure
  • BPH
25
Q

where can the obstruction be to cause increased outflow resistance (3)

A

bladder neck
prostate
urethral stricture

26
Q

what can cause detrusor muscle failure

A

Bladder outflow obstruction (BOO)

27
Q

what is acute urinary retention

A

painful inability to void which is relieved by drainage

28
Q

volume to classify as urinary retention

A

500-800cc

29
Q

if more than 800cc urine retained=

A

acute on chronic retention

30
Q

who is BOO and retention uncommon in

A

women

31
Q

causes of retention in women

A

urethral obstruction

neurological (spinal injury)

32
Q

2 drug therapies for BOO

A

alpha blockers

5-alpha reductase inhibitors

33
Q

how can detrusor failure present

A

in voiding difficulties

34
Q

if the bladder is palpable above the pubic synthesis how much urine is retained

A

> 500ml

35
Q

what does dribble indicate about the bladder in detrusor failure

A

that function is not completely lost

36
Q

urinary incontinence=

A

involuntary loss of urine

37
Q

4 types of urine incontinence

A

stress
urge
mixed
overflow

38
Q

what is stress incontinence

A

weakness of the urinary outlet

39
Q

urge incontinence=

A

failure of bladder to store urine due to high bladder pressure

40
Q

mixed incontinence=

A

weakness of urinary outlet and bladder storage

41
Q

overflow incontinence=

A

an overfull bladder that overflows

42
Q

when would stress incontinence happen

A

by increasing abdominal pressure (cough0

43
Q

name 5 risk factors for incontinence

A
  • pregnancy/childbirth
  • age/menopause
  • obesity
  • constipation
  • chronic cough
44
Q

4 treatments for female urinary incontinence

A

-lifestyle changes
-behaviour therapy
-Drugs
surgical options

45
Q

drugs for urinary incontinence

A

alpha- adrenergic agonists

Tricyclic antidepressants

46
Q

2 surgical options for incontinence

A
  • elevation or support of the bladder neck

- enhance urethral resistance

47
Q

3 treatments for an overactive bladder

A

treat underlying cause
behavioural therapy
anticholinergics

Block 10 Ellen (9 decks)

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