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Urinary Pathophysiology > Micturition Disorders > Flashcards

Micturition Disorders Flashcards

1
Q

what receptors does the pelvic nerve innervate in the bladder?

A

muscarinic

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2
Q

what is voluntary control of micturitions mediated through?

A

cerebral cortex
cerebellum
pons
spinoreticular tract

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3
Q

what are the two categories of disorders of micturition?

A

neurogenic
nonneurogenic

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4
Q

what are some non-neurogenic disorders?

A

urethral sphincter mechanism incompetence
hormone responsive incontinence
urge incontinence
ectopic ureters
pelvic bladder, urethral dysplasia

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5
Q

who is reflex dyssnergia more common in?

A

large breed male dogs

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6
Q

in a lower motor neuron lesion, the bladder is _____________ and _______________________

A

distended
easy to express

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7
Q

what is the most common cause of detrusor hyperreflexia/instability?

A

bacterial UTI

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8
Q

what are some diagnostics for urinary incontinence?

A

CBC, chemistry, urinalysis
abdominal ultrasound
cystoscopy
contrast radiography
urethral pressure profile

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9
Q

what are some causes of urethral incompetence?

A

puppy piddler
pelvic bladder

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10
Q

what are some treatment options for urethral incompetence?

A

nonmedical management
colposuspension
imbrication techniques
collagen injections
hydraulic occlude
vetfoam urethral bulking agent- gelatin based

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11
Q

what are some causes of urge incontinence?

A

neurogenic
inflamed or irritated bladder
main differential diagnosis is cystitis

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12
Q

what is the definition of ectopic ureters?

A

ureteral opening in any area other than the normal position in the trigone of the bladder

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13
Q

who is ectopic ureters most common in?

A

female large breed dogs
young dogs

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14
Q

what are the clinical signs of ectopic ureters?

A

urinary incontinence most common
less than one year of age typically
uncommonly diagnosed in male dogs: longer urethra

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15
Q

what breeds are predisposed to ectopic ureters?

A

golden retrievers
labrador retrievers
siberian huskies
newfoundlands
english bulldogs

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16
Q

what are some causes of urinary incontinence other than ectopic ureters?

A

stones
vaginal tumors
recessed, infantile, or deep set vulva

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17
Q

what should you ask when getting a history for urinary incontinence?

A

age of onset
sexual status of animal
age of neutering
current medications
history of trauma or previous urinary tract disorders

18
Q

what makes up the storage phase of micturition?

A

bladder: low resistance and high capacity
urethra: high resistance barrier

19
Q

what are some neurogenic disorders?

A

lower motor neuron: atonic bladder
upper motor neuron: automatic bladder
detrusor-urethral dyssynergia

20
Q

what are some disorders of voiding?

A

urethral sphincter mechanism incompetence
ectopic ureters
detrusor instability

21
Q

what are some disorders of storage?

A

functional outflow obstruction
mechanical outflow obstruction
atonic bladder

22
Q

what are some causes of lower motor neuron lesions?

A

trauma or surgery in pelvic region
lesion below L5

23
Q

what do lower motor neuron lesions cause?

A

sphincter and detrusor hyporeflexia

24
Q

in upper motor neuron lesions, the urethral sphincter shows _______________

A

hyper-excitability

25
Q

what happens in reflex dyssnergia?

A

active contraction of detrusor without relaxation of the internal or external urethral sphincters

26
Q

what can an outflow obstruction lead to?

A

paradoxic incontinence

27
Q

is an outflow obstruction easy to catheterize?

A

no

28
Q

who is urethral sphincter mechanism incompetence most common in?

A

middle aged or older neutered or spayed dogs

29
Q

what is the most common cause of detrusor hyperreflexia/instability (urge incontinence)?

A

bacterial UTI

30
Q

what is urethral sphincter mechanism incompetence a common cause of?

A

acquired urinary incontinence

31
Q

what is normal urethral pressure for urethral pressure profilometry?

A

exceeds intravesical pressure during all phases of bladder filling

32
Q

when should you perform a urethral pressure profilometry?

A

when animal fails medical management

33
Q

what are the indications for a urethral pressure profilometry?

A

urethral sphincter mechanism incompetence
suspected increased urethral tone
reflex dyssnergia
ureteral ectopia

34
Q

what are some causes of stress incontinence/urethral incompetance?

A

urethral smooth muscle incompetence or urethral malposition

35
Q

what is detrusor atony from overdistension?

A

separation of tight junctions of the detrusor muscle

36
Q

what are the clinical signs of detrusor atony?

A

dribbling urine
large distended bladder
stranguria/dysuria

37
Q

where are the locations for ectopic ureters?

A

bladder urethral junction
various locations along urethra
rarely within vestibule

38
Q

what breeds are more likely to get ectopic ureters?

A

golden retriever
labrado retriever
siberian husky
newfoundland
english bull dog

39
Q

how can you diagnose ectopic ureterss?

A

abdominal ultrasound
cystoscopy
excretory urography
fluoroscopic urethrography
urethral pressure profile
CT

40
Q

who can have a recessed, infantile, or deep set vulva?

A

conformational predisposition
overweight dogs
dogs spayed young

41
Q

what specific things should you look at with a dog with a micturition disorder?

A

evaluate perineum
palpation of bladder to assess size
rectal exam
digital vaginal exam
observe dog urinate
neurologic exam

42
Q

what should you do during a neurologic exam for a dog with a micturition disorder?

A

perineal reflex
bulbospongiosus reflex

Urinary Pathophysiology (11 decks)

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