Neuro And Micturition Flashcards

1
Q

Pelvic nerve?

A

S1-3
PSNS to bladder—urinate
Ach, muscarinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypogastric nerve?

A

L1-4 dogs, L2-5 cats
SNS—store urine
Nor-adrenaline, beta 3 receptors in bladder, alpha 1 receptors in urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pudental nerve?

A

S1-3
Somatic to external urethral sphincter
Voluntary
Ach, nicotinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Passive phase—filling

A

L1-4 (SNS)—hypogastric
Beta receptors in bladder are activated—allow stretching
Alpha 1 receptros are activated (trigone + prox urethra)
Block PSNS flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Active phase—voiding

A

Reflex: stretch receptors —> pelvic n. —> spinal cord —> brain stem —> PSNS outflow (S1-3)

Contraction of bladder wall—mm fibers contract
Pudental n is inhibited, dec urethral sphincter tone (can be over-ridden by cerebrum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of an UMN bladder?

A

Detrusor areflexia, sphincter hyperreflexia
Small bladder —> large distended bladder
DIFFICULT TO EXPRESS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you tx an UMN bladder?

A

Banclofen (antispasmodic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the characteristics of a LMN bladder?

A

Detrusor areflexia, sphincer areflexia
Large bladder
EASILY EXPRESSED
Constant leaking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you tx a LMN bladder?

A

Bethanecol

Express 3-4x/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is detrusor-sphincter dyssenergia?

A

Detrusor contracts + sphincter spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you tx detrusor-sphincter dyssynergia?

A

Phenoxybenzamine (alpha-andrenergic blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is dysautonomia?

A

All ANS signs. Mainly GI + <3 problems.
Cats
Poor px

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is detrusor atony?

A

From overfill. Obstruciton. Large flaccid bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you tx detrusor atony?

A

Manually express

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is urge incontinence/detrusor instability/detrusor hyperreflexia?

A

Contraction during urine storage
Dec detrusor compliance (cystometrography)
Pollakiuria, stranguria, dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you tx urge incontinence?

A

Anticholinergic—oxybutynin, imipramine, dicyclomine

17
Q

What is urinary incontinence?

A

Involuntary escape of urine during storage phase

18
Q

What is the etx of urinary incontinence?

A

Urinary sphincter mechanism incontinence (USMI)

19
Q

What is the signalment/characteristics of USMI?

A

Spayed bitches, large breed dogs, LOW ESTROGEN

20
Q

How do you tx USMI?

A

Estrogen alone/PPA + estrogen
Collagen injections
Ephedrine similar to PPA but CV side effects
Sx—colposuspension + urethropexy

21
Q

How to dx an ectopic ureter and what are the CS?

A

Contrast enhanced CT + cystoscopy

Wet coat, inflamed perineum, excoriations

22
Q

How do you tx an ectopic ureter?

A

Cystoscopic laser ablation