Urinary Incontinence Flashcards

1
Q

Describe the sphincters and nervous systems involved in micturition

A
  • internal sphincter: involuntary
  • external sphincter: voluntary
  • autonomic NS: sympathetic T10-L3 release norepi to relax bladder, parasympathetic S2-S4 release Ach to contract detrusor muscle
  • somatic NS: motor neurons from S2-S4 supply external urethral sphincter
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2
Q

Describe the detrusor muscle and its actions/functions

A
  • smooth muscle
  • contracts & pushes urine out of the bladder (voiding phase)
  • relaxed & allows bladder to fill (storage phase)
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3
Q

Describe the etiology of urinary incontinence

A
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4
Q

Describe the etiology & RF for stress urinary incontinence (SUI)

A
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5
Q

Describe the presentation of stress UI

A
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6
Q

Describe the treatment for stress UI

A
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7
Q

Describe the etiology of urgency urinary incontinence (UUI)

A
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8
Q

Describe the presentation of urgency UI

A
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9
Q

Describe the diagnosis of UUI/OAB

A
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10
Q

Describe the initial management of urgency UI

A
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11
Q

Describe the pharm for urgency UI

A
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12
Q

List some bladder irritants

A
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13
Q

Describe the etiology of overactive bladder syndrome

A
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14
Q

Describe the presentation of overactive bladder syndrome

A
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15
Q

Describe the etiology of mixed UI

A
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16
Q

Describe the etiology of overflow incontinence

A
17
Q

Describe the diagnosis of overflow incontinence

A
18
Q

Describe the treatment for overflow incontinence

A
19
Q

Describe the etiology of neuropathic incontinence

A
20
Q

Describe the presentation of neuropathic incontinence at the different levels of injury/lesion

A
21
Q

List some health complications of urinary incontinence

A
  • risk of death in nursing home
  • MH and social concerns
  • incontinence associated dermatitis (contact)
  • tricky balance between incontinence and retention
22
Q

what are some side effects of anticholinergics?

A

dry mouth, dry eyes, constipation, exacerbation of dementia/cog impairment

23
Q

what physiologic effect does mirabegron (beta agonist) have on the urinary tract?

A

relaxes the bladder/detrusor muscle

24
Q

what PVR would you expect in a patient with overflow incontinence?

A

> 200 ml

25
Q

what PVR would you expect in a patient with urge incontinence?

A

normal <50 ml

26
Q

a male pt has OI secondary to BPH, what are some pharm options?

A

Finasteride (5A reductase inhib), alpha blockers

27
Q

What is a potential derm complication of urinary incontinence?

A

contact dermatitis (incontinence associated dermatitis)

28
Q

why would we pee our pants if we get scared if sympathetic retains urine and parasympathetic releases urine?

A

limbic system throws sympathetic function out of whack