module 12 lower urinary tract

Question 1

lower urinary tract

Answer 1

post-kidney to urethra

Question 2

Micturition

Answer 2

reflex and voluntary

mediated by pons, gravity, peristalsis, and nervous system

Question 3

structures of lower urinary tract

Answer 3

ureters
bladder
urethra
urinary sphincters

Question 4

ureters

Answer 4

collect urine from renal pelvis and transport to bladder

Question 5

bladder

Answer 5

stores and expels urine to urethra

Question 6

urethra

Answer 6

urine exits the body

Question 7

Pons and micturition

Answer 7

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

Question 8

cerebral cortex and micturition

Answer 8

primarily inhibits via conscious control of the external sphincter

Question 9

Bladder innervation

Answer 9

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

Question 10

internal sphincter

Answer 10

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

Question 11

external sphincter

Answer 11

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

Question 12

voiding

Answer 12

detrusor muscle to contract and urethral sphincters to relax

Question 13

continent

Answer 13

coordinate urination at a suitable location and time

Question 14

residual urine

Answer 14

less than 50-100 mL following voiding

Question 15

Urethritis

Answer 15

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

Question 16

Urethritis s/s

Answer 16

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

Question 17

cystitis

Answer 17

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

Question 18

risk factors for cystitis

Answer 18

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

Question 19

cystitis s/s

Answer 19

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

Question 20

Lower urinary tract urolithiasis

Answer 20

stones forming anywhere in the urinary tract

may originate in kidney, bladder, or ureters

Question 21

supersaturation and obstruction

Answer 21

insolubility fo the urine by stone forming constituents

• Ca
• oxalate
• phosphate
• uric acid

Question 22

ureteral calculi

Answer 22

usually small and pass fine

large stone -> obstruction

Question 23

s/s of ureteral calculi

Answer 23

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

Question 24

bladder calculi 3 categories

Answer 24

migrant
primary
secondary

Question 25

migrant bladder calculi

Answer 25

from upper tract

Question 26

primary bladder calculi

Answer 26

formation occurs in bladder without underlying pathology

Question 27

secondary bladder calculi

Answer 27

associated with conditions - bladder outlet obstruction: BPH - neurogenic bladder r/t spinal cord injury - chronic bladder infections - foreign bodies

Question 28

bladder calculi s/s

Answer 28

dysuria suprapubic pain urinary hesitancy hematuria

Question 29

hydronephrosis

Answer 29

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

Question 30

acute hydronephrosis

Answer 30

usually partial obstruction | oliguria

Question 31

chronic hydronephrosis

Answer 31

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

Question 32

chronic hydronephrosis s/s

Answer 32

vague intestinal symptoms N/V abdominal pain

Question 33

void dysfunction secondary to

Answer 33

- disorder os lower urinary tract - pathologies affecting central, autonomic, and peripheral nervous systems - control of micturition

Question 34

incontinence

Answer 34

involuntary urine loss | never normal

Question 35

urge incontinence

Answer 35

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

Question 36

stress incontinence

Answer 36

occurs when urine is involuntary lost with inc. in intraabdominal pressure - precipitated by effort or exertion - weakened pelvic muscles or intrinsic urethral sphincter deficiency

Question 37

overactive bladder syndrome

Answer 37

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

Question 38

neurogenic bladder

Answer 38

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

Question 39

overflow incontinence

Answer 39

bladder becomes so full that it leaks - obstruction of the urethra - underactive/inactive detrusor muscle

Question 40

functional incontinence

Answer 40

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

Question 41

enuresis

Answer 41

intermittent incontinence while asleep | inappropriate wetting of clothing/bedding

Question 42

types of enuresis

Answer 42

primary secondary monosymptomatic nocturanal enuresis nonmonosymptomatic nocturnal enuresis

Question 43

primary enuresis

Answer 43

nocturnal enuresis

Question 44

secondary enuresis

Answer 44

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

Question 45

monosymptomatic nocturnal enuresis

Answer 45

nocturnal incontinence but no other signs of lower urinary tract malfunction

Question 46

nonmonosymptomatic nocturnal enuresis

Answer 46

urgency, frequency, or daytime incontinence with night incontinence

Question 47

enuresis patho

Answer 47

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