Micturition

Question 1

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

Answer 1

smooth msucle
enhanced
inhibited

Question 2

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

Answer 2

increase in hydrostatic pressure

subsequent ureter dilation

Question 3

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

Answer 3

increased hydrostatic pressure in the kidney

Question 4

describe the ureterorenal reflex

Answer 4

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

Question 5

sites of UPJ obstruction

Answer 5

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

Question 6

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

Answer 6

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

Question 7

during micturition, the detrusor muscle ______

Answer 7

contracts

Question 8

Internal sphincter is _____

and located within the _____

Answer 8

involuntary

bladder neck

Question 9

external sphincter is______ and located within the _____

Answer 9

voluntary

urogenital diaphragm

Question 10

bladder afferent innervation

Answer 10

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

Question 11

bladder fullness is sensed by

Answer 11

alpha-delta fibers

Question 12

bladder pain is sensed by

Answer 12

C fibers (unmyelinated)

Question 13

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

Answer 13

parasympathetic

ACh signals M3 receptor (stimulates detrusor muscle)

Question 14

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

Answer 14

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

Question 15

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

Answer 15

somatic
external sphincter
voluntary control

Question 16

parasympathetic activity predominates while the bladder is

Answer 16

emptying

Question 17

sympathetic activity predominates when the bladder is

Answer 17

filling

Question 18

nicotinic receptors in the bladder are located at the ends of

Answer 18

somatic neurons at the external sphincter

Question 19

muscarinic receptors are associated with what activity in the bladder

Answer 19

parasympathetic
emptying
M3 receptor
ACh NT

Question 20

Adrenergic receptors in the bladder are associated with

Answer 20

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

urine retention/filling

Question 21

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

Answer 21

on/off

Question 22

storage reflexes for urine are organized in the

Answer 22

spinal cord

Question 23

voiding reflexes are organized in the

Answer 23

brain

Question 24

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

Answer 24

sympathetic pathways

results in detrusor muscle relaxation

Question 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 ______

Answer 25

activates parasympathetic reflexes - stimulates parasympathetics
inhibits sympathetics and somatic outflow
Results in detrusor muscle contraction and sphincter relaxations

Question 26

brainstem center responsible for controlling and coordinating activity of the sacral micturition center by activating external sphincter relaxation and sacral parasympathetic outflow

Answer 26

pontine micturition center

“Barrington’s Nucleus”

Question 27

brainstem control center that recieves afferent bladder signals and passes on to higher brain centers, is the primary excitatory input to the PMC

Answer 27

periaqueductal gray

Question 28

higher brain centers can suppress what passing on its input to the PMC

Answer 28

the PAG

to prevent incontinence