Urinary Incontinence Flashcards

1
Q

definition of urinary incontinence

A

involuntary leakage of urine

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2
Q

when urine is collecting in the bladder what is shut

A
  • the internal urethral sphincter which is under involuntary control
  • the external urethral sphincter which is skeletal muscle under voluntary control
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3
Q

as the bladder is filling there are

A
  • specialised sense receptors in the bladder wall which sense this filling and send afferent impulses to the level of S2-S3 and to the pointine storage and pointing micturition centre
  • This increases the parasympathetic innervation and reduces the sympathetic innervation causing the internal and external urethral sphincters to relax and it also reduces the motor innervation to the external urethral sphincter causing it to relax which is called the micturition reflex
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4
Q

the pons is the region of the

A

brain that is trained to voluntary control urination the pointing stage centre can override the micturition reflex and the pointing micturition centre allows the micturition reflex to occur

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5
Q

types of urinary incontinence

A
  1. urge
  2. stress
  3. overflow
  4. mixed
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6
Q

urge incontinence

A

is the sudden urge to urinate followed by immediate involuntary urination caused by an overactive bladder

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7
Q

urge incontinece is usually caused by

A

an uninhibited detrusor muscle which contracts randomly

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8
Q

treatment of urge incontinence

A

avoid caffeine, bladder retraining, anti-muscarinic medication (oxybuticin), neuromodualtion (pacemaker for the bladder0

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9
Q

diagnosis of urge incotiennence

A

urodynamics

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10
Q

stress incotinence

A

urine leaks out when intra-abdominal pressure rises there is NO contraction of the detrusor muscle

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11
Q

stress incontinence usually occurs during

A

coughing, sneezing and laughing

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12
Q

stress incontinene is usually caused by

A

damage to the pelvic floor or the urethra during childbirth

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13
Q

stress incontinence diagnosed using

A

urodynamics

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14
Q

classically in stress incontinene

A

when you press the bladder urine leaks out

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15
Q

treatment of stress intoinence

A

weight loss stop smoking and kegel exercises

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16
Q

overflow incontinence

A

usually caused by a problem with emptying the bladder i.e. any bladder outlet obstruciton

17
Q

in overflow incontinence

A

urine fills up within the bladder and leaks through the sphincters

18
Q

the leakage o urine in overflow incontiencne causes

A

a weak or intermittent stream and can cause hesitancy because of the blockage

19
Q

what else can cause urianry inconitiennce by damage nerve s involved with micturition reflex

A

diabetes, MS, parkinsons, bladder cancer

20
Q

management of overflow incontience

A

assess kidney function, treat the obstruction and catheterise

21
Q

mixed incontinence is a mixture of

A

urge and stress incontinencne