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Spinal Cord Injury > Bladder and sexual Dysfunction > Flashcards

Bladder and sexual Dysfunction Flashcards

1
Q

What are complications that may occur if bladder volume is not kept under 500mL?

A
  1. Vesicoureteral reflux
  2. Overflow incontinence
  3. Hydroureter
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2
Q

In SCI patients, what may be the only clinical sign of pregnant lady going into labor?

A

Autonomic dysreflexia

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3
Q

What is the accepted normal bladder capacity

A

300-600 mL

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4
Q

Acute vs subacute CVA: what kind of neurogenic bladder does each get?

A

Acute CVA = flaccid areflexic bladder

Subacute CVA = spastic hyperreflexic bladder

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5
Q

Are people with SCI more likely to have reflexogenic or psychogenic erections?

A

Reflexogenic

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6
Q

What is the crede maneuver?

A

Applying Suprapubic pressure to help with voiding in an areflexic bladder

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7
Q

When patients do intermittent catheterization, what is the bladder volume goal?

A

Keep bladder volume <500mL

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8
Q

When do most women have return of menstruation after SCI

A

6-12 months after injury

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9
Q

What type of injury results in detrusor sphincter dyssynergia

A

Between the sacral (S2-4) and pontine micturition centers

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10
Q

What type of neurogenic bladder do SCI experience during spinal shock?

A

Areflexic bladder

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11
Q

What innervates the internal urethral sphincter

A

T11-L2 hypogastric nerve (sympathetic)

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12
Q

How many mL can bladder hold before first sensation of bladder filling occurs?

A

100mL

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13
Q

What is the main characteristic that differentiates umn vs lmn neurogenic bladder?

A

Umn bladder = spastic bladder

Lmn bladder = flaccid bladder

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14
Q

What level of SCI differentiates umn vs lmn bladder dysfunction

A

Above S2 = umn

Below S2 =lmn

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15
Q

Single worse predictive factor for inability of sperm to penetrate ovum

A

Leukocyte concentration in the semen

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16
Q

Which pathway mediates parasympathetic sacral micturition reflex

A

Pelvic and pudendal nuclei

17
Q

How many mL can bladder hold before a patient experiences bladder fullness and a sense of urgency?

A 
Fullness = 300-400 mL
Urgency = 400-500 mL
18
Q

What is the functional bladder capacity

A

Voided volume + residual volume

19
Q

Loss of control from which central pathway results in detrusor sphincter dyssynergia?

A

Pontine mesencephalic nuclei

20
Q

When can a patient with an indwelling catheter be switched to intermittent catheterization?

A

When patients can tolerate fluid restriction of 2L/day. About 7-15 days after injury.

21
Q

What is detrusor sphincter dyssynergia

A

Detrusor hyperreflexia and sphincter hyperactivity

22
Q

What SCI patient population are unable to get psychogenic erections

A

Patients with Complete UMN lesions

23
Q

What pathway inhibits parasympathetic sacral micturition center

A

Corticopontine mesencephalic nuclei

24
Q

When do you treat asymptomatic bacteriuria in SCI patients?

A

If they are undergoing an invasive procedure, or if culture is positive for urease producing organism

25
Q

Which nerve carries sympathetic innervation to detrusor muscle?

A

Hypogastric nerve

26
Q

Action of alpha-1 and Beta-2 receptors to bladder and urethra

A 
Alpha-1 = contraction of internal sphincter at base of bladder
Beta-2 = detrusor relaxation
27
Q

How do you treat detrusor sphincter dyssynergia

A 
Anticholinergics (such as oxybutyinin)
Alpha blockers (-zosins)
28
Q

What sexual dysfunctions do women have after SCI

A

Decreased libido

Amenorrhea

29
Q

Multiple sclerosis: what type of neurogenic do patients get?

A

Spastic - detrusor hyperreflexia

30
Q

What fibers sense bladder distention?

A

Myelinated A-delta fibers, which stimulates the parasympathetics

31
Q

What %age of patients with complete UMN and complete LMN lesions are able to ejaculate?

A

Complete UMN = 5%

complete LMN = 18%

32
Q

Which pathway coordinates bladder contraction and sphincter relaxation to allow peeing

A

Pontine mesencephalic nuclei

33
Q

What somatic nerve allows voluntary control of external urethral sphincter

A

Pudendal nerve

34
Q

What nerve has parasympathetic innervation to detrusor muscle

A

Pelvic nerve

35
Q

If SCI occurs during pregnancy, how long should she get thromboprophylaxis for?

A

8 weeks

36
Q

Most common upper urinary tract complication in SCI

A

Renal calculi

Spinal Cord Injury (11 decks)

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