OAB & Urinary Rentention

Question 1

The main function of bladder is to:

Answer 1

Store and expel urine

Question 2

Which body part contracts to notify the brain that the bladder is filling with urine?

Answer 2

Detrusor muscle

Question 3

When the bladder nears storage capacity, which type of signals are sent from the bladder to the brain?

Answer 3

Afferent

Question 4

The ____ runs form the spinal cord to the appendages and you have to consciously and voluntarily make this system move or work.

Answer 4

Peripheral nervous system

Question 5

The ____ is a large, triangular bone at the base of the spine and at the upper and back part of the pelvic cavity, where it is inserted like a wedge between the two hip bones.

Answer 5

Sacrum

Question 6

_____ is the neurotransmitter in the parasympathetic nervous system that stimulates the muscarinic receptors

Answer 6

Acetylcholine or ACH

Question 7

______ are labeled sacral nerves

Answer 7

Sacral nerves

Question 8

In your own words, explain how normal storage and voiding function works.

Answer 8

As the bladder fills with urine, the destrusor muscle relaxes and the pelvic floor contracts.

Afferent signals are sent fro the bladder to the brain at the unconscious level.

When the conscious decision to void is made, efferent nerve impulses are sent from the brain to the bladder.

The pelvic floor relaxes and the detrusor muscle contracts. Urine is expelled from the body.

Question 9

Which muscarinic receptors are found in the bladder and primarily responsible for voiding behavior?

Answer 9

M2 and M3

Question 10

______ trigger reflex voiding in response to noxious stimuli

Answer 10

C fibers

Question 11

Which statement is incorrect?

• Normal storage relies on efferent signals to the bladder from the pontine micturition center of the brain
• Acetylcholine attaches to M2 and M3 muscarinic receptors, initiating bladder contraction
• under voluntary voiding activity in cerebrum, the external urinary sphincter, pelvic floor muscles, and detrusor muscles relaxes, allowing the bladder to empty completely of urine.
• the average void is approximately 360cc and there is typically less than 100cc left in the bladder after voiding

Answer 11

under voluntary voiding activity in cerebrum, the external urinary sphincter, pelvic floor muscles, and detrusor muscles relaxes, allowing the bladder to empty completely of urine.

Question 12

True/false:

A contraction of the detrusor muscle is what informs the brain that there is a need to void

Answer 12

True

Question 13

T/F

Urine enters the bladder through the urethra

Answer 13

False

Question 14

T/F

The trigone connects the ureteral orifices and the bladder neck

Answer 14

True

Question 15

T/F

Muscles in the external urinary sphincter are under voluntary control

Answer 15

True

Question 16

The main function of the bladder is to store urine? T/f

Answer 16

False

Question 17

When the bladder is filling with urine, afferent signals are sent from the bladder to the brain. T/f

Answer 17

True

Question 18

When the cerebral cortex is the area of the brain responsible for bladder control. T/f

Answer 18

False

Question 19

The release of the ACh in the synapses binds with the M2 and M3 muscarinic receptors in the bladder, which causes a contraction of the detrusor muscle. T/F

Answer 19

True

Question 20

Enteric nerves of the autonomic nervous system are directly responsible for controlling the gastrointestinal system and bowel

Answer 20

True

Question 21

Urgency incontinence

Answer 21

The involuntary loss of urine sometimes associated with a sudden strong desire to void

Question 22

Urgency frequency

Answer 22

An uncontrollable urge to urinate resulting in frequent, small amounts of urine. Posed as often as every 15 minutes

Question 23

Urinary retention

Answer 23

The inability to empty bladder or initiate a void (urine is retained in the bladder)

Question 24

Overactive bladder

Answer 24

Urinary urge incontinence or urgency frequency, occurring either alone or in combination. When the detrusor muscle in the bladder receives a sudden involuntary signals to contact before you are ready to urinate

Question 25

Stress incontinence

Answer 25

The involuntary loss of urine during coughing, sneezing, laughing or other physical activities that increase intra-abdominal pressure.

Question 26

What are symptoms of aob?

Answer 26

Urgency frequency
Urge incontinence
Noctura

Question 27

What % of the us population is thought to have OAB?

Answer 27

16%

Question 28

When is OAB considered a normal condition

Answer 28

It should never be considered a normal condition

Question 29

What is the definition of urgency you frequency?

Answer 29

An uncontrollable urge to urinate that results in frequent, small amounts of urine voided

Question 30

What are the primary symptoms of AOB?

Answer 30

Urgency frequency and urge incontinence

Question 31

What are the two western studies that defined prevelance of OAB?

Answer 31

Milton and Noble

Question 32

What is urodynamics

Answer 32

An assessment of how the bladder and urethra are performing their job of storing and releasing urine

Question 33

T/f OAB medications are classified as antimuscarinic drugs

Answer 33

True

Question 34

What’s nerves signals do OAB medications affect?

Answer 34

Efferent signals

Question 35

Which of the following would be a treatment of last resort for urge incontinence?

Answer 35

Cycstectomy

Question 36

How effective are OAB meds in treating voiding dysfunction?

Answer 36

• 37% of patient did not refill their prescription during 6 month follow up
• 78% were unable to remain on their medication for longer than 150 days

Question 37

What do you see as key side effects of OAB meds?

Answer 37

-side effects from inhibition of M2 and M3 receptors

• blurred vision
• dry mouth
• dry eyes
• constipation
• dyspepsia (stomach and gall bladder)
• tachycardia