10: Urinary incontinence Flashcards Preview

Renal Week 3 2017/18 > 10: Urinary incontinence > Flashcards

Flashcards in 10: Urinary incontinence Deck (41)
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1

What is incontinence?

Involuntary leakage of urine

2

Incontinence is very ___ for the patient.

embarrassing

3

Incontinence is more common in (men / women).

women

4

Why is incontinence more common in women?

They only have one urethral sphincter so rely on pelvic floor

Men have two

5

In micturition, the internal urethral orifice ___ and the bladder ___.

relaxes

contracts

6

During filling, the bladder muscle ___.

During voiding, the bladder muscle ___.

relaxes

contracts

7

What two structures fail to cause incontinence?

Either a

sphincter problem

overactive bladder muscle problem

8

Which receptors detect the filling of the bladder?

Stretch receptors

9

Which spinal nerves control the micturition reflex?

S2,3,4

10

What neuro mechanisms control

a) involuntary voiding

b) voluntary inhibition of voiding?

a) Micturition reflex (parasympathetics of S2,3,4)

b) Pons

11

What urinary problems occur in

a) CNS problems e.g Parkinson's

b) severed spinal cord?

c) problems with the sacral spinal nerves?

a) Micturition reflex persists, so incontinence

b) Detrusor sphincter dyssnergia

c) Retention

12

What is urge incontinence?

Incontinence preceded by URGENCY

i.e desire to void

13

What is stress incontinence?

Involuntary voiding due to raised IAP e.g in coughing, laughing

14

What is overflow incontinence?

Involuntary urination associated with obstruction

15

What are types of incontinence causing

a) bedwetting

b) terminal dribble?

a) Nocturnal enuresis

b) Post-micturition dribble

16

Which neuro disorders increase your chances of incontinence?

Parkinson's

MS

Stroke

17

What are some anatomical causes of incontinence?

Ectopic ureters

Fistulas

Traumatic childbirth

18

Why does smoking cause incontinence?

Cough

19

Why can obesity cause incontinence?

Weakened pelvic floor muscles

20

Which drugs can cause urinary incontinence?

Alpha blockers

cause ureteric relaxation

21

What are some important questions to ask in the history of someone with incontinence?

How often?

Volume?

When (day / night)?

ICE

22

What examinations are done for someone with incontinence?

Abdominal exam

PR exam

PV exam

23

What should be checked on PR exam of someone with urine obstruction?

Prostate gland

Anal tone

24

Which investigation measures urine flow?

Uroflowmetry

25

What does a slow urine flow rate indicate?

Obstruction

Weak detrusor muscle

26

Why do women have a faster flow rate than men?

Shorter urethra

Less resistance

Higher pressure

27

What can a patient keep to track their urinary symptoms?

Diary

28

What investigation allows you to view the anatomy of the bladder?

Cystoscopy

for stricture, stone, tumour, fistula

29

What scan would be used to check the kidneys in the case of hydronephrosis secondary to obstruction?

USS kidneys

30

Anything which increases ____ pressure can cause stress incontinence.

intra-abdominal pressure