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Pathophysiology > module 12 lower urinary tract > Flashcards

module 12 lower urinary tract Flashcards

1
Q

lower urinary tract

A

post-kidney to urethra

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2
Q

Micturition

A

reflex and voluntary

mediated by pons, gravity, peristalsis, and nervous system

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3
Q

structures of lower urinary tract

A

ureters
bladder
urethra
urinary sphincters

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4
Q

ureters

A

collect urine from renal pelvis and transport to bladder

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5
Q

bladder

A

stores and expels urine to urethra

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6
Q

urethra

A

urine exits the body

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7
Q

Pons and micturition

A

relaxation of the interal sphincter and contraction of the bladder to enable urination

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8
Q

cerebral cortex and micturition

A

primarily inhibits via conscious control of the external sphincter

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9
Q

Bladder innervation

A

sympathetic nerves L1-2, allow relaxation and filling
parasympathetic nerves S2-4, bladder contraction and relaxation of the internal sphincter to initiate bladder emptying. Stretch sense

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10
Q

internal sphincter

A

bladder is prevented from emptying until the pressure in the body of the bladder rises about a specific threshold.
- detrusor muscle

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11
Q

external sphincter

A

allows voluntary emptying of the bladder or the prevention of urination.
- ring of skeletal muscle

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12
Q

voiding

A

detrusor muscle to contract and urethral sphincters to relax

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13
Q

continent

A

coordinate urination at a suitable location and time

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14
Q

residual urine

A

less than 50-100 mL following voiding

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15
Q

Urethritis

A

inflammation of the urethra
infection from bladder, STD, or external factors
- cath, poor hygeine, dec. estrogen

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16
Q

Urethritis s/s

A 
pain
burning
incontinence
urethral discharge
abscess
-Men: epididymitis, prostatitis
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17
Q

cystitis

A 
inflammation of the bladder lining 
infection; bacterial, fungal, or parasitic 
chemical irritants
stones
trauma
> women/girls
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18
Q

risk factors for cystitis

A 
urinary stasis
foreign bodies
anatomic factors
dec. immune response
preg
dec. intake
obstruction 
cath's
dec. estrogen 
spermicidal agens
sex 
recurrent UTI
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19
Q

cystitis s/s

A 
frequency
urgency
dysuria
pain
pink or cloudy UA
PEDS
- fever
- irritable
- poor feeding
- vomiting
- diarrhea
- lethargy
GERIATRIC
- delirium
- incontinence
20
Q

Lower urinary tract urolithiasis

A

stones forming anywhere in the urinary tract

may originate in kidney, bladder, or ureters

21
Q

supersaturation and obstruction

A

insolubility fo the urine by stone forming constituents

  • Ca
  • oxalate
  • phosphate
  • uric acid
22
Q

ureteral calculi

A

usually small and pass fine

large stone -> obstruction

23
Q

s/s of ureteral calculi

A 
pain, radiates
hematuria
inc. HR
inc. RR
sweating 
N/V
24
Q

bladder calculi 3 categories

A

migrant
primary
secondary

25
Q

migrant bladder calculi

A

from upper tract

26
Q

primary bladder calculi

A

formation occurs in bladder without underlying pathology

27
Q

secondary bladder calculi

A

associated with conditions

  • bladder outlet obstruction: BPH
  • neurogenic bladder r/t spinal cord injury
  • chronic bladder infections
  • foreign bodies
28
Q

bladder calculi s/s

A

dysuria
suprapubic pain
urinary hesitancy
hematuria

29
Q

hydronephrosis

A

marked dilation of the pelvis and calyces and thinning of the renal parenchyma

30
Q

acute hydronephrosis

A

usually partial obstruction

oliguria

31
Q

chronic hydronephrosis

A

oliguria
anuria
elevated pressure from obstruction -> damage -> ARF

32
Q

chronic hydronephrosis s/s

A

vague intestinal symptoms
N/V
abdominal pain

33
Q

void dysfunction secondary to

A
  • disorder os lower urinary tract
  • pathologies affecting central, autonomic, and peripheral nervous systems
  • control of micturition
34
Q

incontinence

A

involuntary urine loss

never normal

35
Q

urge incontinence

A

involuntary sudden leakage of urine along with or immediately following the sensation of a need to urinate

  • overactive detrusor muscle
  • idiopathic, bladder infection, radiation therapy, tumors/stones, CNS damage
36
Q

stress incontinence

A

occurs when urine is involuntary lost with inc. in intraabdominal pressure

  • precipitated by effort or exertion
  • weakened pelvic muscles or intrinsic urethral sphincter deficiency
37
Q

overactive bladder syndrome

A

inc. daytime frequency and nocturia, though not necessarily with incontinence.

38
Q

neurogenic bladder

A

broad classification of voiding dysfunction

  • cause is a pathology that produces a disruption of nervous communication governing micturition
  • spinal injury
  • MS
  • Parkinsons
  • Storke
  • Neuropathy of DM
39
Q

overflow incontinence

A

bladder becomes so full that it leaks

  • obstruction of the urethra
  • underactive/inactive detrusor muscle
40
Q

functional incontinence

A

r/t physical or environmental limitation resulting in an inability to access a toilet in time

41
Q

enuresis

A

intermittent incontinence while asleep

inappropriate wetting of clothing/bedding

42
Q

types of enuresis

A

primary
secondary
monosymptomatic nocturanal enuresis
nonmonosymptomatic nocturnal enuresis

43
Q

primary enuresis

A

nocturnal enuresis

44
Q

secondary enuresis

A

develops after a period of at least 6 mo. of dryness

45
Q

monosymptomatic nocturnal enuresis

A

nocturnal incontinence but no other signs of lower urinary tract malfunction

46
Q

nonmonosymptomatic nocturnal enuresis

A

urgency, frequency, or daytime incontinence with night incontinence

47
Q

enuresis patho

A

deficiency in ADH (vasopressin)
nocturnal overactivity of the detrusor muscle
immature or abnormal arousal mechanisms
familial pattern

Pathophysiology (80 decks)

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