Osteopathic Approach To GU Patient Flashcards
The sphincter, trigone, and urethral orifice of the bladder are activated by symapthetics at the levels of __ and inhibited by parasympathetics at the level of ___
T12-L2
S2-S3
Which autonomic portion activates the bladder wall? What about inhibits?
Activated by Parasympathetics
Inhibited by sympathetics
What is sympathetic innervation to the kidney and upper ureter and where do they synapse?
T10-L1, synapse in the superior mesenteric ganglion
Fibers for lower ureter synapse in inferior mesenteric ganglion
What are sympathetics to the bladder and where do they synapse?
T12-L2, synapse at inferior mesenteric ganglion
Activation of this parasympathetic nerve contracts the bladder and causes emptying
Pelvic splanchnic (S2-4)
Activation of this sympathetic nerve relaxes the bladder and causes retention
Hypogastric plexus
Alpha adrnergic –> relaxes detrusor
Beta2 adrenergic –> closes internal urethral sphincter
What is the somatic innervation that allows for voluntary contraction to close the external urethral sphincter?
Pudendal n. (S2-4)
What is parasympathetic innervation to the kidney and proximal ureter?
Vagus n
What is parasympathetics to distal ureter and bladder?
Pelvic splanchnic nerves (S2-4)
What are some Ambulatory postural considerations for the renal pt for OS tx?
Diaphragm massages kidneys –> L1-L3 attachment
Psoas spasm can decrease lordosis, compress kidneys from flexed posture, restrict ureters
Lowers ribs, quadratus lumborum –> posterior wall of soma
What are some techniques to stimulate sympathetics for urologic dysfunction?
Rib raising
T10-L2
Inf mesenteric ganglion
What are some lymphatic techniques to tx urologic dysfunction?
Thoracic inlet and diaphragms
Rib raising
Lymphatic pump
What are some ways to stimulate parasympathetics for urologic dysfunction?
OA/A
OM suture
Sacrum/pelvis
Parasympathetics to kidneys should focus on the vagus n. and correct somatic dysfunction at the ___
OA
Parasympathetic tx to the bladder should focus on the pelvic splanchnic n and correct the somatic dysfunction at ___
S2-S4
Sympathetics to kidney and bladder should focus on correcting any somatic dysfunction at ___
T10-L2
Reduce stimulation to renal arteries –> reduce component of HTN
Reduce excessive relaxation of bladder –> complete emptying
Reduce ureterospasm of IUS –> urinary retention
Common dysfunctions in BPH are found at ___
T11-T12
L1
Common areas of dysfunction in nephrolithiasis are found at ___
T12-L2
S2-S4
May consider a Psoas spasm affecting hip motion if ureter involved
Pyelonephritis has the same OS considerations as nephrolithiasis but Frymann associated ___ dysfunctions with renal dysfunction
Cervical
OA/AA connections with vagus
The ureter travels across the ___ fascia and can cause contracture or spasm that may contribute to ureteral dyfunction
Psoas
