Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GYNECOLOGY > LOWER URINARY TRACT DISORDERS > Flashcards

LOWER URINARY TRACT DISORDERS Flashcards

1
Q

common in women and generally is treated successfully with a range of nonsurgical and surgical treatments

A

Urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

occurs with increases in abdominal pressure (such as coughing, running, lifting) and can be treated with pelvic muscle exercises, vaginal devices, lifestyle changes, and surgery.

A

Stress urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

occurs with a sudden sense of urgency (such as on the way to the bathroom or when washing hands) and can be treated with bladder training, medications, lifestyle changes, and neuromodulation.

A

Urgency urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

most commonly performed surgical procedures for stress urinary incontinence.

A

Minimally invasive synthetic midurethral slings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a bag of smooth muscle that stores urine

A

THE BLADDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

contracts to expel urine under voluntary control

A

THE BLADDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a low-pressure system that expands to accommodate increasing volumes of urine without an appreciable rise in pressure

A

THE BLADDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

appears to be mediated primarily by the sympathetic nervous system

A

THE BLADDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when the bladder has filled to a certain volume, fullness is registered by tension-stretch receptors, which signal the brain to initiate

A

micturition reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

controlled by cortical control mechanisms, depending on the social circumstances and the state of the patient’s nervous system

A

MICTURITION REFLEX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

accomplished by voluntary relaxation of the pelvic floor and urethra, accompanied by sustained contraction of the detrusor muscle, leading to complete bladder emptying.

A

NORMAL VOIDING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

i. sympathetic

ii. parasympathetic divisions of the autonomic nervous system

iii. neurons of the somatic nervous system (external urethral sphincter)

Question: controls bladder emptying

A

parasympathetic divisions of the autonomic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

i. sympathetic

ii. parasympathetic divisions of the autonomic nervous system

iii. neurons of the somatic nervous system (external urethral sphincter)

Question: primarily controls bladder storage

A

sympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

i. sympathetic

ii. parasympathetic divisions of the autonomic nervous system

iii. neurons of the somatic nervous system (external urethral sphincter)

Question: plays only a peripheral role in neurologic control of the lower urinary tract through its innervation of the pelvic floor and external urethral sphincter

A

neurons of the somatic nervous system (external urethral sphincter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The sympathetic nervous system originates in the

A

thoracolumbar spinal cord, principally T11 through L2 or L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

postganglionic neurotransmitter is

A

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of receptor is located principally in the urethra and bladder neck

A

α-receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of receptor is located principally in the bladder body?

A

Beta-receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

controls bladder motor function—bladder contraction and bladder emptying

A

parasympathetic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

parasympathetic nervous system originates in the

A

sacral spinal cord, primarily in S2 to S4, as the somatic innervation of the pelvic floor, urethra, and external anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

the main neurotransmitter used in bladder muscle contraction

A

acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  • the most important facilitative center above the spinal cord
  • serves as the final common pathway for all bladder motor neurons
A

pontine-mesencephalic gray matter of the brainstem
(aka pontine micturition center)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

serves as a major center for coordinating pelvic floor relaxation and the rate, force, and range of detrusor contractions

A

cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Lower urinary tract disorders:
• disorders of storage

A

urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lower urinary tract disorders:
emptying

A

urinary hesitancy and retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lower urinary tract disorders:
sensation

A

urgency or pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Any involuntary leakage of urine

A

Incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Involuntary leakage on effort or exertion, or on sneezing or coughing

A

Stress urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Observation of involuntary leakage from the urethra, synchronous with exertion/effort, or sneezing or coughing

A

Stress urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Involuntary leakage on effort or exertion, or on sneezing or coughing

A

Stress urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Involuntary loss of urine associated with urgency

A

Urgency urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Involuntary loss of urine associated with urgency and also with effort or physical exertion or on sneezing or coughing

A

Mixed incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Continuous involuntary loss of urine

A

Continuous urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Number of voids per day, from waking in the morning until falling asleep at night

A

Frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Micturition occurs more frequently during waking hours than previously deemed normal by women (traditionally defined as more than seven episodes)

A

Increased daytime urinary frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Interruption of sleep one or more times because of the need to micturate (each void is preceded and followed by sleep)

A

Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Involuntary loss of urine that occurs during sleep

A

Nocturnal enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Sudden, compelling desire to pass urine, which is difficult to defer

A

Urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Involuntary loss of urine associated with change of body position, for example, rising from a seated or lying position

A

Postural urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Urinary incontinence where the women has been unaware of how it occurred

A

Insensible urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Involuntary loss of urine with coitus. This symptom might be further divided into that occurring with penetration or intromission and that occurring at organism.

A

Coital incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology

A

Overactive bladder syndrome
(OAB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

estimates of urinary incontinence among community-dwelling women range from __

A

2% to 58%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

peak at 5th decade of life and the most common subtype

A

stress incontinence

45
Q

the most dominant subtype in late adulthood

A

mixed urinary incontinence

46
Q

Urinary incontinence Remission rates - equally high and range between

A

3% and 12%

47
Q

proposed that the primary support of the bladder neck and urethra to be an intact vaginal wall at the base of the bladder

A

Hammock Theory

48
Q

hypothesized that stress urinary incontinence occurs as a result of connective tissue laxity in the vagina and its supporting ligaments

A

Integral Theory

49
Q

a syndrome associated with urgency, usually accompanied by frequency, nocturia with (OAB-wet) or without (OAB-dry) urgency urinary incontinence, and in the absence of a urinary tract infection or other obvious pathology

A

overactive bladder (OAB).

50
Q

proposes presence of chemosensitizing agents leading to bladder instability which are believed to be inflammatory substances such as nerve growth factor, prostaglandins, and acetylcholine that increase detrusor muscle sensitivity and neuronal excitability

A

epithelial hypersensitivity theory

51
Q

suggests that the pelvic floor sustains a physical strain during the developmental years

A

myogenic theory

52
Q

the most common incontinence subtype in later adulthood

A

Mixed Urinary Incontinence

53
Q

occur mostly in the distal urethra of women between the ages of 30 and 60 years

A

urethral diverticuli -

54
Q

ectopic ureter is a congenital anomaly where the ureter opens distally into the urethra or more commonly into the vagina

A

ectopic urethra

55
Q

an acquired condition where there are one or more direct communications between the vagina and the following adjacent organs:
a. ureter (ureterovaginal fistula)
b. bladder (vesicovaginal fistula),
c. urethra (urethrovaginal fistula)

A

fistula (traumatic)

56
Q

Most common fistula

A

bladder (vesicovaginal fistula)

57
Q

__ women are at a higher risk of developing stress urinary incontinence, whereas __ women are at a higher risk of developing urgency urinary incontinence

A

white women are at a higher risk of developing stress urinary incontinence, whereas black women are at a higher risk of developing urgency urinary incontinence

58
Q

Risk Factors of Urinary Incontinence

A
59
Q

major risk factor for urinary incontinence and its subtypes

A

Obesity

60
Q

independent risk factor for urgency urinary incontinence

A

Diabetes

61
Q

Reversible Causes of Urinary Incontinence

A

D I A P P E R S

62
Q

Diagnosis:

7-day bladder diary has been replaced with a

A

2- to 3-day diary

63
Q

Medications that May Affect the Function of the Urinary Tract

A

Slide 38

64
Q

intrinsic sphincter deficiency, also known as __

A

stove-pipe urethra

65
Q

the amount of urine remaining in the
bladder within 10 minutes from voiding

A

Postvoid residual (PVR) volume of urine

• Normal values - PVR <50 mL to be within normal
• PVR >150 mL to be abnormally elevated

66
Q

can be administered before (bladder diary), during (urinalysis), or after (pad test) a clinical encounter - to assist the clinician in making a firm diagnosis

A

Simple Bladder Testing

67
Q

The hallmark of advanced bladder testing

A

urodynamics test

68
Q

Advanced Bladder Testing 􏰀 Urodynamics

A

Ppt 51

69
Q

a study that assess voiding function

A

Uroflowmetry

70
Q

several sensory parameters that are measured during the filling phase (with their typical
normal values):

A

• first filling sensation (50 mL
• first desire to void (150 mL)
• strong desire to void (250 mL)
• maximum cystometric capacity (400 mL)

71
Q

performed to assess bladder and urethral function during the filling phase

A

Filling Cystometry (Complex)

72
Q

the intravesical pressure (Pves) is a measure of the detrusor pressure (Pdet) plus the pressure of the abdomen and surrounding organs (Pabd)
• True detrusor pressure is obtained by subtracting the value of the abdominal pressure from the intravesical pressure:

A

Pdet = Pves - Pabd

73
Q

test of urethral integrity which represents the value of the intra-abdominal or intravesical pressure at which point urine loss occurs

A

Valsalva leak point pressure (VLPP)

74
Q

Approximate Normal Values of Female Bladder Function

A

Ppt 70

75
Q

nonsurgical method to restore anatomy and function of genital relaxation

A

pelvic floor exercises were described by Arnold Kegel

76
Q

during a PFMT program - women are encouraged to

A

contract their pelvic floor muscles for 3 seconds, 10 to 15 times per session, and 3 times a day

77
Q

Medications in women who have a coexisting stress and urgency urinary incontinence

A

Imipramine

78
Q

an FDA-approved serotonin and norepinephrine reuptake inhibitor drug to treat depression, chronic pain, and anxiety, but not for stress urinary incontinence.

A

Duloxetine

79
Q

first-line treatment for urgency urinary incontinence, followed by medical interventions

A

Behavioral therapies

80
Q

second class of medications to treat urgency urinary incontinence

A

Beta agonists

Mirabegron, which is a specific beta-3 receptor agonist

81
Q

a medication used to treat nocturia or enuresis = effective mostly through its
central inhibitory action on reducing urine production

A

Desmopressin

82
Q

work centrally to improve sleep, and peripherally on the bladder and urethra to improve bladder storage

A

Imipramine

83
Q

can be helpful, especially in the presence of vascular insufficiency and peripheral edema

A

Furosemide

84
Q

Pharmacologic Therapies Indicated for Overactive Bladder with or without Urgency Incontinence

A

Ppt 97

85
Q

most commonly performed retropubic urethropexies

A

Marshall–Marchetti–Krantz (MMK) and Burch procedures

86
Q

__ was the original mid-urethral sling described by Ulmsten in 1996 - a simple minimally invasive outpatient procedure under local or regional anesthesia

A

Polypropylene tension-free vaginal tape (TVT)

87
Q

commonly performed vaginally, but can be repaired through an abdominal access, either open, laparoscopic, or robotically

A

Genitourinary fistula repair

88
Q

The mechanism of normal bladder emptying is a coordinated effort that is initiated by the individual

A

VOIDING DYSFUNCTION

89
Q

a uroflow when the voiding time is prolonged, the flow pattern is interrupted or the maximum flow rate is diminished

A

VOIDING DYSFUNCTION

90
Q

Desire to void during bladder filling occurs earlier or is more persistent from that previous experienced

A

Increased bladder sensation

91
Q

Definite desire to void occurs later than that previously experienced, despite an awareness that the bladder is filling

A

Reduced bladder sensation

92
Q

Absence of the sensation of bladder filling and a definite desire to void

A

Absent bladder sensation

93
Q

Delay in initiating micturition

A

Hesitancy

94
Q

Need to make an intensive effort (by abdominal straining, Valsalva or suprapubic pressure) to initiate, maintain, or improve urinary
stream

A

Straining to void

95
Q

Urinary stream perceived as slower compared to previous performance or in comparison with others

A

Slow stream

96
Q

Urine flow that stops and starts on one or more occasions during voiding

A

Intermittency

97
Q

Bladder does not feel empty after micturition

A

Feeling of incomplete bladder emptying

98
Q

Involuntary passage of urine following the completion of micturition

A

Postmicturition leakage

99
Q

Urine passage is a spray or split rather than a single discrete stream

A

Spraying of urinary stream

100
Q

Requiring specific positions to be able to micturate spontaneously or to improve bladder emptying, for example, leaning forward or backward on the toilet seat or voiding in a semi-standing position

A

Position-dependent micturition

101
Q

Inability to pass urine despite persistent effort

A

Urinary retention

102
Q

a sudden and often painful inability to void despite the sensation of a full bladder and desire to urinate

A

Acute urinary retention

103
Q

PVR of more than 300 mL persisting for more than 6 months which has been documented in two separate occasions

A

Chronic urinary retention

104
Q

PVR of more than 300 mL persisting for more than 6 months which has been documented in two separate occasions

A

Chronic urinary retention

105
Q

treatment initiation for chronic urinary retention in high-risk patients

A

intermittent catheterization

106
Q

the complaint of suprapubic or retropubic pain, pressure, or discomfort related to the bladder

A

BLADDER PAIN SYNDROME

107
Q

associated with a defective glycosaminoglycan sulfate layer that covers the bladder mucosa

A

Interstitial cystitis

108
Q

a mixture of methenamine, methylene blue, phenyl salicylate, benzoic acid, and
hyoscyamine

A

Prosed DS

GYNECOLOGY (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions