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Spinal Cord Bootcamp > Quiz - Bladder Management > Flashcards

Quiz - Bladder Management Flashcards

1
Q

Bladder volume capacity

A

400-500 cc

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2
Q

Sympathetic nervous system

A

fight or flight response, originates from T11-L2, suppresses micturition reflex, inhibits detrusor, stimulates internal sphincter to stay closed

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3
Q

Parasympathetic nervous system

A

rest and digest response, originate from S2-S4, stimulates detrusor

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4
Q

Micturition reflex

A

spinal reflex that causes activation of the detrusor along with simultaneous relaxation of the urethra

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5
Q

Reflexive bladder physiology

A

Spinal reflex is intact which means when the detrusor is stretched, it sends a message to the spinal cord which responds with a reflex to open the bladder. Without signals from the brain, it may happen at an inappropriate time.

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6
Q

Reflexive bladder symptoms

A

Incontinence - large amounts of urine released at unexpected time.

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7
Q

Reflexive bladder management

A

Intermittent catheterization

May also trigger a reflex via pressing, straining, etc.

May wear briefs or condom catheter for protection.

If funding available, consider functional electrical stimulation.

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8
Q

Reflexive bladder complications

A

detrusor sphincter dyssynergia (only affects some people), pressure sores from incontinence, feelings of social isolation

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9
Q

Detrusor sphincter dyssynergia

A

external sphincter contraction occurs simultaneously with detrusor contraction (reflexive bladder only)

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10
Q

Reflexive bladder population (who is affected)

A

UMN SCI typically above T12

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11
Q

Areflexive bladder physiology

A

Spinal reflex is NOT intact which means the detrusor continues to fill and stretch until urine dribbles out.

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12
Q

Areflexive bladder symptoms

A

dribbling incontinence

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13
Q

Areflexive bladder management

A

Routine intermittent catheterization

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14
Q

Areflexive bladder complications

A

renal failure, UTI, impaired muscle tone, pressure sores from incontinence, feelings of social isolation

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15
Q

Areflexive bladder population (who is affected)

A

LMN SCI (typically below T12)

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16
Q

What determines whether the bowel/bladder is reflexive or areflexive?

A

integrity of the sacral arc

17
Q

How does the bowel/bladder function typically immediately following injury?

A

SPINAL SHOCK - no reflex activity for about 6-12 weeks (variable)

18
Q

GOALS FOR BLADDER MANAGEMENT

A
  1. Empty at appropriate times.
  2. Stay dry.
  3. Maintain low-pressure storage (don’t overstretch detrusor).
19
Q

Foley catheter

A

Catheter inserted into bladder via urethra and maintained via balloon

Can stay in place up to 30 days

20
Q

Suprapubic catheter

A

Catheter inserted through abdomen directed to the bladder.

Can be indwelling up to 30 days or more or used for intermittent catheterization.

21
Q

Condom catheter

A

Catheter that has an attachment on the end that fits onto the penis. Also called an external or ‘‘Texas’’ catheter. Does not empty bladder.

22
Q

Urinary leg bag

A

bag used for collecting urine from a Foley, suprapubic, or condom catheter

23
Q

Functional e-stim (FES) for bladder

A

Allows emptying bladder via electrodes surgically implanted electrodes on S2-S4.

Option for complete injuries with reflexive bladder.
Image: Functional e-stim (FES) for bladder

24
Q

Intermittent catheterization (IC)

A

Catheter inserted into bladder via urethra to release urine (does not stay in place like Foley)

25
Q

Steps for intermittent catheterization

A
  1. Clean hands and genital area.
  2. Lubricate catheter.
  3. Insert catheter until urine drains and remove.
  4. MEASURE urine.
26
Q

Benefits of indwelling catheter

A

Easier for nursing. Can stay in place for up to 30 days.

27
Q

Limitations of indwelling catheter

A

Can cause infection and ischemia

28
Q

Benefits of intermittent catheterization

A

Allows catheter free time. Reduces risk of infection. Facilitates return of normal bladder tone.

29
Q

Limitations of intermittent catheterization

A

Must be on a schedule (q 4-6 hours). Must monitor fluid intake. Must be motivated. Requires fine motor control or assistance. Must not be prone to AD.

30
Q

What is the most common and preferred option for individuals with impaired bladder function after SCI?

A

Intermittent catheterization

31
Q

Are some individuals able to urinate voluntarily after SCI?

A

Yes, many people with incomplete injuries may be able to feel and/or void normally through voluntary sphincter control.

32
Q

Equipment to assist with hand function during bladder program

A

Catheter inserter with u-cuff, self-cath mirrors

Spinal Cord Bootcamp (12 decks)

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