structure and function of lower urinary tract Flashcards
What is located anteriorly to the bladder in males?
pubic symphysis
What is located posteriorly to the bladder in males?
rectovesical pouch and rectum
What is located inferiorly to the bladder in males?
obturator internus muscle, levator ani muscle, prostate
What is located superiorly to the bladder in males?
peritoneum
What is located laterally to the bladder in males?
ischioanal fossa
What is located anteriorly to the bladder in females?
pubic symphysis
What is located posteriorly to the bladder in females?
vesicouterine pouch, uterus, cervix, vagina
What is located inferiorly to the bladder in females?
urogenital diaphragm, pelvic fascia, perineal membrane
What is located superiorly to the bladder in females?
uterus, peritoneum
What is located laterally to the bladder in females?
ischioanal fossa
What type of organ is the bladder?
Hollow muscular organ within the pelvis
What is the dome/apex of the bladder?
Located superiorly, pointing towards the pubic symphysis
What connects the bladder to the umbilicus?
median umbilical ligament
What is the body of the bladder?
Located between the apex and the fundus
What is the base of the bladder?
Located posteriorly, triangular-shaped
What forms the neck of the bladder?
Convergence of the fundus and the two inferolateral surfaces
What type of epithelium lines the bladder?
Stratified, transitional epithelium (Urothelium/Uroepithelium)
What is the function of the detrusor muscle?
Facilitates bladder contraction during micturition
What is the stroma of the bladder composed of?
Collagen and elastin
What is the normal function of the bladder?
Reservoir for urine storage
What is the bladder’s barrier function?
Resists water passage but not truly waterproof
What happens to bladder pressure during filling?
Remains constant despite increase in volume
What initiates micturition?
Fullness at approximately 250ml
What is the role of cholinergic neurotransmission in the bladder?
Excitatory neurotransmission for detrusor contraction
What does urge incontinence refer to?
Involuntary loss of urine associated with strong desire to void
What is stress incontinence?
Involuntary loss of urine when intra-abdominal pressure rises without detrusor contraction
What does the International Prostate Symptom Score (IPSS) assess?
Frequency, nocturia, weak urinary stream, hesitancy, intermittency, incomplete bladder emptying, urgency
What is a common symptom of bladder outlet obstruction?
Decreased force of micturition
What is nocturia?
Nocturnal frequency of urination, normal <2x night
What is the normal voiding pattern for urine?
300-400mls per void, 4-5 times per day
What are storage symptoms of bladder dysfunction?
Frequency, urgency, nocturia, incontinence
What is the role of bladder filling sensors?
Detect increase in wall tension and relay data to the brainstem
What is the effect of aging on renal concentrating ability?
Decreases with age, leading to increased urine production at night
What is the role of nitric oxide in bladder function?
Relaxation of bladder neck and external urethral sphincter
What does urodynamic assessment measure?
Pressure from bladder and rectum during filling and voiding
What is the management for an over-active bladder?
Lifestyle changes, anti-muscarinics, Botox
