Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal and Urology > Structure and Function of Lower Urinary Tract > Flashcards

Structure and Function of Lower Urinary Tract Flashcards

1
Q

layers of bladder wall

A

transitional epithelium (aka urothelium)
lamina propria
submucosa
detrusor muscle
adventitia/serosa

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

do males or females have thicker detrusor muscles

A

males

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

how does the brain know the bladder is getting full

A

as the tight junctions between cells stretch signals are sent to the brain of the bladder filling
afferent neurons carry the signal to the dorsal horn of the sacral spinal cord

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

what system innervates the detrusor muscle

A

postganglionic parasympathetic system

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

what cells make up the urothelium

A

multilayered epithelium
apical/umbrella cells

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

what are the functions of the urothelium

A

forms a barrier
does afferent signalling - sends messages to CNS

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

which layer of the bladder are the blood vessels and nerves found

A

lamina propria

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

what is the function of the lamina propria

A

it coordinates the urothelium and the detrusor muscle

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

what type of cells are found in the lamina propria of the bladder

A

myofibroblasts

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

what is the detrusor muscle made from

A

smooth muscle arranged in bundles
it is a functional syncytium (fused cells with multiple nuclei)

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

what makes up the stroma of the bladder

A

collagen and elastin

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

what is the outer layer of the bladder

A

adventitia/serosa

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

what two things form the barrier function of the bladder

A

glycosamino glycans layer
tight junctions

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

what is and isn’t allowed to pass through the barrier layer of the bladder

A

urea, Na+ and K+ can pass passively
water passage is resisted but it is not completely waterproof

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

does bladder pressure increase when the urine increases in volume

A

no as the bladder is high compliant

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

what term describes the bladders ability to expand in response to urine without losing its tension

A

it is highly compliant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

coordination of what two movements are required for volitional voiding

A

detrusor contraction
urethral relaxtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what type of reflex comes under higher centre control in potty training

A

spino-bulbar reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

at what volume of urine does the bladder begin to feel full

A

250ml

20
Q

at what volume of urine does the bladder begin to feel uncomfortabel

A

500ml

21
Q

which nerves control volitional voiding

A

S2, 3 and 4 (Onuf’s nucleus)

22
Q

where is volitional voiding modulated

A

pontine micturition centre

23
Q

what is facilitation

A

contraction of the detrusor and relaxation of sphincter when bladder less than full (e.g. in anxiety states)

24
Q

what is the likely result on voiding in a spinal cord injury

A

the CNS can no longer inhibit the reflex arc
so the bladder is left to empty under its reflex arc

25
Q

how much urine is normal to pass at one time and how many times a day

A

300-400ml
4-5 times per day

26
Q

what does a bladder diary measure

A

input and output
over three consequetive days
frequency
nocturia
hyperhydration
effects of caffiene
alcohol
binge drinking

27
Q

what are the storage lower urinary tract symptoms

A

urgency
frequency
nocturia
urinary incontinence

28
Q

what are the voiding lower urinary tract symptoms

A

hesitancy
poor flow
intermittency
terminal dribbling

29
Q

causes of decreased bladder capacity

A

reduced compliance
reduced functional capacity
neurogenic bladder (e.g. MS)
irritation (due to bladder stones or tumour)

30
Q

if someone wakes up to pee once every night do they have nocturia

A

no needs to be more than once

31
Q

why do those with peripheral oedema often have nocturia and what is the treatment

A

blood fluid can get to kidneys when lying down
given diuretic in afternoon to get rid of excess fluid before sleeping

32
Q

definition of nocturnal polyuria

A

production of more than one third of 24 hour urine output between midnight and 8am

33
Q

causes of poor flow, hesitancy, dribble

A

usually due to bladder outlet obstruction
or underactive or hypocontractile bladder (e.g. due to spinal cord injury)

34
Q

cause of intermittency

A

prostatic enlargement

35
Q

cause of post-void dribble

A

release of urine retained in bulbar/prostatic urethra

36
Q

what is straining

A

the use of abdominal muscles to void

37
Q

types of incontinence

A

urge - involuntary loss of urine associated with strong desire to void, involves detrusor contraction
stress - involuntary loss of urine when intra-abdominal pressure rises without detrusor contraction (e.g. coughing, sneezing, laughing, exerting)

38
Q

which type of incontinence involves detrusor muscle contraction

A

urge incontinence

39
Q

what is IPSS

A

internal prostate symptom score

40
Q

what 8 questions are included in the IPSS

A

frequency
nocturia
weak urinary stream
hesitancy
intermittency
incomplete bladder emptying
urgency
quality of life

41
Q

what is involved in the urodynamic assessment

A

pressure transducers are placed on the bladder and rectum which measures the pressure here in filling and voiding
patient is asked to cough periodically

42
Q

how is detrusor activity calculated in a urodynamic assessment

A

pressure from bladder - pressure from rectum

rectum pressure = abdominal pressure

43
Q

results of a urodynamic assessment for someone with bladder outlet obstruction

A

no unstable contractions during filling
no leak whilst coughing during filling
very high pressure and low flow during voiding

44
Q

what order are symptoms of outflow obstruction likely to arise in

A
  1. storage symptoms
  2. voiding symptoms
  3. decompensation of detrusor (chronic retention, bladder failure and renal failure)
45
Q

management of over active bladdr

A

lifestyle (e.g. cutting back on caffeine)
medication (e.g. anti-muscarinics, selective B3 adrenoreceptor agonist, intradetrusor botox)

46
Q

management of stress incontinence

A

pelvic floor exercises
weight loss
surgery

47
Q

management of bladder outlet obstruction

A

alpha blockers
5ARI
surgery

Renal and Urology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions