Micturition Flashcards

1
Q

uretal peristalsis is performed by ______ muscle in the ureters
Contractions are ______ by parasympathetic stimulation and ______ by sympathetic stimulation

A

smooth msucle
enhanced
inhibited

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2
Q

blockade of urine flow will result in an ______ in hydrostatic pressure in the ureter and subsequent ureter ______

A

increase in hydrostatic pressure

subsequent ureter dilation

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3
Q

a continued blockade of uretal outflow will lead to a _________ hydrostatic pressure in the kidney
and eventually hydronephrosis

A

increased hydrostatic pressure in the kidney

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4
Q

describe the ureterorenal reflex

A

blocked ureter –> pain –> sympathetic reflex tells kidneys to constrict renal arterioles –> decreased urine output

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5
Q

sites of UPJ obstruction

A

Ureterpelvic junction
behind testicular/ovarian av
over external iliac av (pevlic brim)
ureter transverses bladder wall (intramural part)

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6
Q

if the distance the ureter courses through the bladder is too short, contraction of the bladder will not completely occlude the ureter causing

A

urine to go back into the ureter during micturition, increases risk of pyelonephritis
dilates ureters
vesicoureteral reflex

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7
Q

during micturition, the detrusor muscle ______

A

contracts

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8
Q

Internal sphincter is _____

and located within the _____

A

involuntary

bladder neck

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9
Q

external sphincter is______ and located within the _____

A

voluntary

urogenital diaphragm

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10
Q

bladder afferent innervation

A

intravesicle pressure tretch signals (S2-S4) - sacral micturition center

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11
Q

bladder fullness is sensed by

A

alpha-delta fibers

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12
Q

bladder pain is sensed by

A

C fibers (unmyelinated)

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13
Q

pelvic nerve innervation of the bladder is __________ and its associated receptor is ____

A

parasympathetic

ACh signals M3 receptor (stimulates detrusor muscle)

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14
Q

hypogastric innervation of the bladder is ________ and interacts with two receptors: _____ in the bladder wall and _____ in the urethra to do what

A

sympathetic
B3 receptor in the bladder
A1 receptor in the urethra to inhibit detrusor muscle and contract internal sphincter?

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15
Q

pudendal nerve innervation of the bladder is ________ and innervates the __________

A

somatic
external sphincter
voluntary control

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16
Q

parasympathetic activity predominates while the bladder is

17
Q

sympathetic activity predominates when the bladder is

18
Q

nicotinic receptors in the bladder are located at the ends of

A

somatic neurons at the external sphincter

19
Q

muscarinic receptors are associated with what activity in the bladder

A

parasympathetic
emptying
M3 receptor
ACh NT

20
Q

Adrenergic receptors in the bladder are associated with

A

alpha 1 in urethra/bladder neck
B2-3 in the detrusor

urine retention/filling

21
Q

regulation of bladder filling and voiding is an ___ / ____ circuit

22
Q

storage reflexes for urine are organized in the

A

spinal cord

23
Q

voiding reflexes are organized in the

24
Q

when the bladder is filling, it activates _______ pathways and results in detrusor muscle ______

A

sympathetic pathways

results in detrusor muscle relaxation

25
when the bladder is full, it activates ______ reflexes that transmit to spinal cord and then to brain. Stimulates ________ outflow + inhibits _______ Results in detrusor muscle _____ and urethral sphincter ______
activates parasympathetic reflexes - stimulates parasympathetics inhibits sympathetics and somatic outflow Results in detrusor muscle contraction and sphincter relaxations
26
brainstem center responsible for controlling and coordinating activity of the sacral micturition center by activating external sphincter relaxation and sacral parasympathetic outflow
pontine micturition center | "Barrington's Nucleus"
27
brainstem control center that recieves afferent bladder signals and passes on to higher brain centers, is the primary excitatory input to the PMC
periaqueductal gray
28
higher brain centers can suppress what passing on its input to the PMC
the PAG | to prevent incontinence