W12 Urine transport Flashcards

1
Q

what are the three main components of the urinary tract

A

ureters
urinary bladder
urethra

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2
Q

what is the role of the micturition reflex

A

coordinates the process of urination

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3
Q

describe the 4 main stages in the micturition reflex

A

sensory fibers in the pelvic nerve sense stretch due to bladder filling

parasympathetic fibers control muscle contraction

interneurons communicate signals up to hypothalamus with relays into the cortex

voluntary relaxation of external sphincter results in urination

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4
Q

what do stretch receptors do as the urinary bladder fills

A

stimulate pelvic nerve

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5
Q

where does the stimulus from the pelvic nerve travel too

A

stimulates ganglionic neurons in wall of bladder

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6
Q

what does the postganglionic neuron in intramural ganglion do

A

stimulates detrusor muscle contraction

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7
Q

what relays sensation to thalamus and deliver sensation to cerebra cortex

A

interneuron

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8
Q

what results from the relaxation

A

relaxation of internal urethral sphincter

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9
Q

what two age ranges affect the micturition reflex

A

babys as they do not have the connections between the bladder and the hypothalamus are not mature

elderly reflex becomes impaired leading to incontinence.

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10
Q

what can loss of control micturition reflex be caused by

A

a stroke
alzheimer’s disease
CNS problems affecting cerebral cortex or hypothalamus
enlarged prostate

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11
Q

what is incontinence

A

involuntary loss of urine that is enough to cause a social or hygiene concern

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12
Q

what is chance of incontinence in female vs male

A

x4 in woman

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13
Q

what can stress incontinence be caused by

A

coughing
sneezing
laughing
carrying heavy weights

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14
Q

what is stress incontinence

A

anything that puts pressure on the bladder

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15
Q

when does stress incontinence occur

A

when the urethra moves out of the normal position (prolapses) after weakening of the pelvic floor muscles.

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16
Q

In woman what are some other causes of stress incontinence

A

childbirth
hysterectomy
menopause

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17
Q

what is urge incontinence

A

strong urge to pass frequent small amounts of urine.

18
Q

what is urge incontinence caused by

A

muscle of the bladder wall known as the detrusor being overactive meaning it contracts to squeeze out urine before the bladder is completely full

19
Q

what is mixed incontinence

A

some woman get both urge and stress and they can be liked but not always

20
Q

what is overflow incontinence

A

when urine held by the bladder builds up to the point where the bladder can no longer expand.

21
Q

what is overflow incontinence also known as

A

chronic urinary retention

22
Q

what is overflow incontinence caused by

A

obstruction in urinary tract or damage to the nerves that supply the bladder

23
Q

what might obstruction be due to

A

stones
constipation
benign pro static hypertrophy

24
Q

what conservative treatments can be used to help

A

pelvic floor muscle training

bladder training
- scheduled toileting every 2-4 hours

frequently empty the bladd and thereforre keep the patient dry

25
Q

what is duloxetine used for

A

moderate to severe stress urinary incontinence

26
Q

what can duloxetine help with

A

increasing the muscle tone of the urethra which should help keep it closed

27
Q

what are sub indications of duloxetine

A

depression and neuropathic pain

28
Q

what are some possible side effects of duloxetine

A

nausea
dry mouth
fatigue

29
Q

what do antimuscarinic drugs do

A

reduce contractions of bladder and increase bladder activity (urge incontinence)

30
Q

what effect does antimuscarinic drugs have

A

reduce symptoms of urgency and increase bladder capacity

31
Q

what are some examples of antimuscarinic drugs

A

Oxybutynin (DITROPAN)
Tolterodine (DETRUSITOL)
Solifenacin (VESICARE)

32
Q

what are some side effects of antimuscarnic side effects

A
dry mouth 
constipation
blurred vision
dry eyes
fatigue
drowsiness
confusion
difficulty in micturtion
angle close glaucoma
arrythmias and tachycardia
33
Q

what forms of incontinence can be treated surgically

A

all 3

34
Q

when should surgical correction be considered

A

only after all conservative options have been exhausted

35
Q

what complications can occur

A

infection
bleeding
continued incontinence
inability to urinate

36
Q

where is the prostate located

A

surrounds the urethra

37
Q

what is the enlargement of the prostate known as

A

benign prostatic hyperplasia BPH

38
Q

what is the problem with prostate enlargement

A

it presses down on the urethra and cause urination and bladder problems

39
Q

when does the likely hood of prostate enlargement increase

A

as age increase

40
Q

what is the role of alpha 1 blockers

A

they are a class of medication used to treat high blood pressure and allow easier urination as it relaxes the muscle of the bladded,neck and prostate.

41
Q

what is the role of finasteride and dutasteride

A

lower levels of hormones produced by the prostate, reducing the size of the prostate gland increasing urine flow rate and decrease symptoms of BPH it may take 3-6 months for improvement in symptoms.