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MET2 > Micturition > Flashcards

Micturition Flashcards

1
Q

Is the female or male bladder at higher pressure and why

A

Male - needs higher pressure to get urine out longer urethra

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2
Q

Is the male or female bladder larger

A

Female

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3
Q

What causes the bladder to reflexively squeeze

A

Sphincter opening

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4
Q

What innervation does the micturition centre sent out

A

Parasympathetic to detrusor
Somatic to sphincter

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5
Q

How are the pelvic nerves involved in the micturition reflex

A

Sensory feedback from bladder to micturition centre
Parasympathetic from micturition centre to detrusor muscle

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6
Q

What spinal routes are the pudendal nerve and pelvic nerves involved in the micturition reflex

A

S2 3 4

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7
Q

2 stages of the bladder cycle

A

Storage phase
Emptying phase

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8
Q

What stage of the bladder cycle is the bladder in the majority of the time

A

Storage phase

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9
Q

How much urine does the average adult pass in a day

A

1.5 litres

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10
Q

Why do emptying phase abnormalities in the bladder cycle not cause permanent damage to ureters and kidneys (except no function at all)

A

Phase is too short

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11
Q

How can chronic retention with overflow cause kidney failure

A

Urine transferred back up into ureters and kidney

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12
Q

What type of receptors are stimulated to contract the detrusor muscle

A

Muscarinic ACh receptors

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13
Q

Storage LUTS

A

Frequency
Nocturnal
Urgency
Urge incontinence

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14
Q

Voiding LUTS

A

Hesitancy
Straining
Poor flow
Intermittency
Incomplete emptying

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15
Q

General LUTS

A

Terminal dribbling
Dysuria
Haematuria

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16
Q

Overactive bladder

A

Urgency usually with frequency and nocturnal, sometimes with incontinence

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17
Q

How does an enlarged bladder sound on percussion

A

Dull

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18
Q

Why does the cardiovascular system affect the urinary system

A

Delivers fluid to urinary tract

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19
Q

What diagnostic tool is used to urinary tract problems

A

IPSS - international prostate symptom score
Input/output charts

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20
Q

What IPSS scores are mile, moderate, and severe

A

Mild - 0-7
Moderate - 8-19
Severe - 20+

21
Q

Urinary tract investigations

A

Inspect urine sample
Urine dipstick
Urine culture and sensitivity
FBC
PSA
uroflowometry
Post voidable residual volume
Urodynamics
XR
Ultrasound
CT
Nuclear imaging

22
Q

How does urinary flow rate change with age

A

Decrease

23
Q

What causes end fill over activity

A

Bladder obstruction

24
Q

3 types of micturition disorders

A

Anatomical
Functional
Medical

25
Q

Causes of obstruction

A

Benign prostatic hypertrophy
Stones
Structures
Valves
Phimosis
Cancer

26
Q

Causes of incontinence

A

Stress
Urge
Mixed urinary incontinence

27
Q

Why does benign prostatic hyperplasia contract the urethra

A

Capsule around prostate gives prostate nowhere else to go

28
Q

Lifestyle changes for LUTS

A

alter fluid type/amount
Bladder drills
Change foods
Stop smoking
Urethral milking
Pads and convenes

29
Q

Why does caffeine increase bladder contraction

A

Releases calcium stored in Golgi apparatus of bladder walls

30
Q

Why do some drinks such as coke and cranberry juice increase urination

A

Acidification irritates bladder

31
Q

Drugs used for LUTS

A

alpha blockers
5 alpha reductase inhibitors
PDE5 inhibitors
Antimuscarinics

32
Q

How do 5 alpha reductase inhibitors reduce constriction of urethra in men

A

Interfere with testosterone metabolism reducing prostatic hyperplasia

33
Q

How do alpha blockers reduce urethra constriction in men

A

Prevent activation of alpha adrenergic receptors in urethra muscle preventing contraction and lumen narrowing

34
Q

What is TURP

A

Electric loop carves out prostatic chips

35
Q

What is HoLEP

A

Laser removal of prostatic tissue

36
Q

What is UroLift

A

Mechanical technique to pull prostate tissue away from urethra

37
Q

What is prostatic artery embolisation

A

Blocking arteries to prostate causing gland to shrink

38
Q

What is rezum

A

Steam therapy

39
Q

Types of urinary incontinence

A

Stress UI
Urge UI
mixed UI

40
Q

How can urge incontinence be medically treated

A

Medication

41
Q

How can stress incontinence be treated

A

Surgery

42
Q

Urinary incontinence non-lifestyle treatments

A

Drugs
Posterior tibial nerve stimulation
Botox
Sacral nerve stimulation
Surgery

43
Q

Drugs for urge incontinence

A

Anticholinergics
Beta3 andrenergics
Botulinum toxin A

44
Q

How can beta3 adrenergics help urge incontinence

A

Beta3 adrenoreceptor upregulates in OAB

45
Q

How can Botox help urge incontinence

A

Fuse synaptic vessels to motor end plate

46
Q

How can anticholinergics help urge incontinence

A

Block ACh in parasympathetic nerves preventing bladder contraction

47
Q

Why can anticholinergics cause dry mouth

A

Block ACh in salivary glands

48
Q

Stress UI treatment

A

Pads
Fluid intake
Treat OAB
Kegal excercises
Vaginal cones
Mid urethral slings
Colposuspension

49
Q

Lesions at what level of the micturition pathway are unsafe and can damage the bladder and kidneys

A

Between pontine micturition centre and T12

MET2 (25 decks)

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