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Metabolism CC > Micturition > Flashcards

Micturition Flashcards

1
Q

Micturition reflex

A

Afferent impulses from stretch receptors to pons
Pontine micturition centre activate
Parasymp. efferents stimulate detrusor muscle (S2,3,4), opening internal urethral sphincter
Sympathetic efferents inhibited
Pudendal nerve (S2,3,4) -somatic efferents inhibited –> external urethral sphincter relaxes

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2
Q

Normal bladder mode

A

Storage mode

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3
Q

Normal 70kg adult micturition

A

4 times in 24 hours

1.5L

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4
Q

Bladder contraction percentage in 24h

A

0.3%

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5
Q

Bladder contraction

A

ACh release from cholinergic nerves

Stimulation of muscarinic receptors on detrusor muscle

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6
Q

Diagnosis LUTS

A

History
Personal history
Past medical history
Physical exam

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7
Q

Micturition Obstruction disorders

A

BPH
Lithiasis
Strictures
Cancer

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8
Q

Micturition Incontinence disorders

A

Stress
Urge
Mixed urinary incontinence

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9
Q

Micturition functional disorders

A

Stroke
Spinal cord injury
Neurologic disease

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10
Q

Micturition medical disrders

A

Organ failure- renal, hepatic, cardiac

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11
Q

BPH

A

Hypertrophied detrusor muscle

Prostate larger + hypertrophied –> obstructs urinary flow

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12
Q

Caffeine

A

Releases calcium stores from Golgi apparatus in bladder wall

–> bladder contraction more likely

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13
Q

Alpha blockers

A

“stretchers”
Finasteride
Dutasteride

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14
Q

5 alpha reductase inhibitors

A

“shrinkers”
Tamsulosin
Doxazosin

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15
Q

Other drugs

A

PDE5 inhibitors

Antimuscarinics

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16
Q

TURP

A

Transurethral resection of prostate

Erection issues

17
Q

HoLEP/Greenlight

A

Laser
Better at tissue removal
Less erection issues

18
Q

UroLift

A

Newest technique
Mechanical
Preserves erections
Makes passageway for urine by holding prostate away from it

19
Q

Anticholinergics

A

Oxybutyrin
Block ACh in PaNS nerves
Incontinence

20
Q

Beta3- adrenergics

A

Incontinence

Mirabegron

21
Q

Botulinum toxin A

A

Incontinence

Fuses synaptic vesicles with motor end plate

22
Q

Neurogenic bladder

A

Lesions above pontine micturition centre are safe
Lesions bellow T12 are safe
Lesions in between are unsafe –> high pressure in bladder

Metabolism CC (29 decks)

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