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GERR > Physiology - Control of micturition > Flashcards

Physiology - Control of micturition Flashcards

1
Q

micturition

A

the process by which the bladder is emptied when it becomes full

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2
Q

what type of spinal reflexes are stimulated by bladder filling

a.somatic
b.autonomic
c.central

A

b.autonomic

(parasympathetic and sympathetic)

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3
Q

what type of muscle is the internal urethral sphincter made up of

a.smooth
b.skeletal

A

a.smooth

involuntary action

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4
Q

what type of muscle is the external urethral sphincter made up of?

a.smooth
b.skeletal

A

b.skeletal

voluntary action

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5
Q

how many layers make up the bladder wall

a.1
b.2
c.3
d.4

A

d.4

mucosa
submucosa
detrusor
serosa

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6
Q

what type of epithelium is found on the bladder mucosa

a.stratified squamous
b.simple columnar
c.simple cuboidal
d. transitional
e.pseudostratified columnar

A

d. transitional

allows for stretch

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7
Q

which layer of the bladder wall is a thin layer of CT , containing nerves and ICCs

a.mucosa
b.submucosa
c.detrusor
d.serosa

A

b.submucosa

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8
Q

what are the 2 roles of ICCs found in the detrusor

A

interact with nerves
interact with smooth muscle to imitate contraction

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9
Q

which 3 nerve bundles supply the bladder

A

pelvic
hypogastric
pudendal

sensory afferents in alll bundles

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10
Q

Which nerves bundles give efferent nerves to the detrusor?

a.pelvic and hypogastric
b.pelvic and pudendal
c.hypogastric and pudendal
d.sympathetic and parasympathetic

A

a.pelvic and hypogastric

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11
Q

which nerve bundle is made up of parasympathetic efferent fibres from the sacral spinal cord (s2 and s4)

a.pelvic
b.hypogastric
c.pudendal

A

a.pelvic

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12
Q

from which part of the spinal cord do the pelvic nerves originate

a.sacral
b.lumbar
c.cervical
d.thoracic

A

a.sacral

s2 and s4

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13
Q

which nerve bundle is made up of sympathetic efferent fibres from the lumbar spinal cord (t11 - s2)

a.pelvic
b.hypogastric
c.pudendal

A

b.hypogastric

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14
Q

what stimulus stimulates the pelvic efferents to act on the detrusor

a.bladder stretch

b.internal sphincter pressure

A

a.bladder stretch

parasympathetic pelvic nerves are excitatory
so detrusor contracts
voiding

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15
Q

what stimulus stimulates the hypogastric efferents to act on the detrusor

a.bladder stretch

b.internal sphincter pressure

A

b.internal sphincter pressure

sympathetic hypogastric nerves are inhibitory
so detrusor relaxes
filling

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16
Q

what effect does pelvic nerve stimulation have on the detrusor

a.contraction
b.relaxation

A

a. contraction

pelvic nerves are parasympathetic so are excitatory to smooth muscle
contraction and voiding

17
Q

what effect does hypogastric nerve stimulation have on the detrusor

a.contraction
b.relaxation

A

b.relaxation

hypogastric nerves are sympathetic so are inhibitory to smooth muscle
relaxation and filling

18
Q

which efferents innervate the internal urethral sphincter

a.hypogastric
b.pelvic
c. pudendal

A

a.hypogastric

sympathetic efferents from lumbar spinal cord
noradrenaline
contracts the smooth muscle
filling

19
Q

which efferents innervate the external urethral sphincter

a.hypogastric
b.pelvic
c. pudendal

A

c. pudendal

somatic efferents
signals coming down from brain at all time

20
Q

what type of efferents make up the pudendal nerves that supply the external urethral sphincter

a.sympathetic
b.parasympathetic
c. somatic

A

c. somatic

signals from brain and PONS to bladder external sphincter

Act contracts this skeletal muscle (voluntary control)

21
Q

which reflex arc is stimulated by stretch on the bladder wall

a.parasympathetic
b.sympathetic
c.somatic

A

a.parasympathetic

causes detrusor contraction and voiding as soon as stretch is detected

parasympathetic nerves also synapse to pons allowing conscious control (inhibits micturition reflex)

22
Q

which reflex arc is stimulated by pressure on the internal sphincter

a.parasympathetic
b.sympathetic
c.somatic

A

b.sympathetic

relaxes detrusor and contracts internal sphincter

23
Q

which nerves are activated by the PONS to contract the external sphincter

a.parasympathetic
b.sympathetic
c.somatic

A

c.somatic

pudendal nerves

24
Q

When the bladder signals to the PONS it is nearly full the PONS pauses its inhibition of the parasympathetic reflex arc in order for voiding to occur. Which nerves are inhibited by the PONS causing relaxation of the internal sphincter

a.parasympathetic
b.sympathetic
c.somatic

A

b.sympathetic

25
Q

stopping of which signals by the PONS causes the external urethral sphincter to relax in order for voiding to occur

a.parasympathetic
b.sympathetic
c.somatic

A

c.somatic

26
Q

what are the 4 types of incontinence

A

stress
urge (detrusor over activity)
overflow
neurogenic

27
Q

patient has increased frequency snd urgency of urination, following frequent UTIs patient also has diabetes and drinks 5 cups of coffee per day . which type of incontinence would be most likely

a.stress
b.urge
c.overflow
d.neurogenic

A

b.urge

28
Q

patient has increased frequency snd urgency of urination, following frequent UTIs patient also has diabetes and drinks 5 cups of coffee per day . which treatment would be most appropriate

a.bladder training and anti muscarinics

b.pelvic muscle exercises, weight loss and surgery

c.M3 agonists, catheterisation

d.catheterization, botox, capsaicin

A

a.bladder training and anti muscarinics

urge incontinence

29
Q

patient has bladder leakage upon coughing and sneezing and is a mother to 3 children . which treatment would be most appropriate

a.bladder training and anti muscarinics

b.pelvic muscle exercises, weight loss and surgery

c.M3 agonists, catheterisation

d.catheterization, botox, capsaicin

A

b.pelvic muscle exercises, weight loss and surgery

stress incontinence

30
Q

patient has bladder leakage upon coughing and sneezing and is a mother to 3 childrenwhich type of incontinence would be most likely

a.stress
b.urge
c.overflow
d.neurogenic

A

a.stress

external pressure on bladder / multiple childbirths

31
Q

patient has a large dilated bladder which does not empty after recently giving birth which type of incontinence would be most likely

a.stress
b.urge
c.overflow
d.neurogenic

A

c.overflow

sensory nerve disruption
chronic obstruction of the bladder

32
Q

patient has incontinence and large dilated bladder which does not empty after recently giving birth . which treatment most appropriate

a.bladder training and anti muscarinics

b.pelvic muscle exercises, weight loss and surgery

c.M3 agonists, catheterisation

d.catheterization, botox, capsaicin

A

c.M3 agonists, catheterisation

33
Q

patient has incontinence following a spinal cord injury causing involuntary voiding . which treatment most appropriate

a.bladder training and anti muscarinics

b.pelvic muscle exercises, weight loss and surgery

c.M3 agonists, catheterisation

d.catheterization, botox, capsaicin

A

d.catheterization, botox, capsaicin

neurogenic incontinence

34
Q

patient has incontinence following a spinal cord injury causing involuntary voiding which type of incontinence would be most likely

a.stress
b.urge
c.overflow
d.neurogenic

A

d.neurogenic

GERR (53 decks)

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