8 - Gynae - Disorders of the Urinary Tract - Anatomy and Fx of Female Lower Urinary Tract

Question 1

voluntary control of urine release by ? and ?
what 2 things does normal filling fx depend on?
what 2 things does the voiding phase depend on?

Answer 1

bladder and urethra
adequate bladder capacity and a competent urethral sphincter
detrusor contractility and coordinated urethral relaxation

Question 2

Bladder - walls are what? - normal storage amount? how long urethra? wall of urethra is muscular and external orifice in ? just above the vaginal ?

Answer 2

SM (detrusor)
500ml
4cm
vestibule - introitus

Question 3

Neural control of bladder

• parasym nn ? voiding and symph nn ? voiding
• describe start voiding reflex?
• ? para fibres pass back to ? and cause contraction, and also enable opening of ??
• during this, the Symp motor fibres to detrusor are ?
• micturition reflex is controlled by ? - cerebral cortex modifies reflex to ? or ? pelvic floor and ? muscle of urethra

Answer 3

aid, prevent
voiding reflex = afferent fibres, responding to distension of bladder wall 
efferent, detrusor, bladder neck
inhibited
pons
relax or contract
striated

Question 4

Continence - dependent on ? in urethra being greater than ?

• bladder ? influenced by ? pressure and ext (intra abdo) pressure
• urethral pressure influenced by inherent ? ? ? and by ext pressure eg pelvic ? and ? ? pressure
• detrusor mm is ? - as bladder fills > ? ? in pressure
• incr in abdo pressure eg coughing transmitted ? to bladder and urethra - so causes ? alteration in pressure difference.

Answer 4

pressure - bladder
pressure - detrusor
urethral muscle tone 
floor - intra abdo
expandable
no increase
equally
no

Question 5

Micturition - when what is larger than what? achieved voluntarily by ? dropping ? pressure (partly by pelvic floor relaxation) and incr ? pressure due to detrusor ?

Answer 5

when bladder press > urethral pressure
simultaneously 
urethral 
bladder
contraction

Question 6

Incontinence - what are the main causes?
-rarer causes include urine bypassing sphincter via what? or pressure of urine overwhelming the sphincter due to ? of bladder due to ? causes or ? obstruction (overflow incontinence)

Answer 6

uncontrolled incr in detrusor pressure
increased IAP
fistula, overfilling, neurogenic, outlet