Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MET2 > 32 - Micturition > Flashcards

32 - Micturition Flashcards

1
Q

Where is the micturation centre and what is it’s function

A

Back of the neck (pons)

Ask if socially acceptable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the sensory feedback in micturition, What nerve?

A

Bladder to MC via stretch receptors

S2,3,4 branch of pelvic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Somatic to sphincter pathway and nerve?

A 
Micturition centre to external sphincter
Via somatic nerves
Pudendal nerve = S2,3,4
Relaxes external sphincter to open
Sympathetic inhibited (hypogastric nerve)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Parasympathetic to detrusor

A

Feedback loop and parasympathetic supply to detrusor muscle
Contracts
Pelvic nerves S2,3,4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How much does a normal adult micturate

A

4 times/24 hours

1.5L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What stimulates bladder contraction

A

Ach released from nerve endings and that stimulates muscarinic receptors on the detrusor smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drug for overactive bladder

A

Anti-muscarinic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effects of anti-muscarinic drugs

A

Dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Storage symptoms of LUTI

A

Frequency, nocturia, urgency, urge incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Voiding symptoms of LUTI

A

Hesitancy, poor flow, incomplete emptying, terminal dribbling, haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Overactive bladder syndrome

A

Urgency, with or without incontinence, usually with increased frequency and nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnosing BPH

A

International prostate symptom score (I-PSS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the IPSS

A

Questions about symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mild I-PSS

A

(I-PSS)

Reassure, watch and wait, reassess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Moderate I-PSS

A

(8-19)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Severe IPSS

A

20-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Low vs high QoL score

A

Low - watch and wait

High - Lifestyle and education, medication, surgery

18
Q

Investigations for urinary issues

A

Urine sample, uroflowmetry and post void residual volume

Urodynamics (pressure/flow studies) - flow decreases with age

19
Q

Obstruction disorders

A

BPH, Lithiasis, strictures, cancer

20
Q

Incontinence disorders

A

Stress, urge, mixed urinary incontinence

21
Q

Functional disorders

A

Stroke, spinal cord injury, neurological disease

22
Q

Medical disorders

A

Cardiac, hepatic and renal failure

23
Q

What is BPH

A

Prostate gland enlarges
Thickened bladder that can fail
End-fill over activity (generating large amounts of pressure and small flow)

24
Q

Conservative treatments for BPH

A

Fluid type, amount, food, smoking
Don’t drink to little (can irritate bladder)
Voiding diary

25
Q

Caffeine effect on bladder

A

Caffeine releases calcium stores from the golgi apparatus in the bladder wall, making bladder contraction more likely

26
Q

What is a bladder drill

A

Store for 3-4 hours then pee

27
Q

Medical therapy for BPH

A
  • A blockers: Stretchers for smaller prostates
  • 5-a reductase inhibitors : shrinkers (bigger prostates)
  • PDE5 inhibitors
28
Q

What surgery options for BPH

A

TURP
HoLEP/greenlight
UroLift

29
Q

What is TURP

A

The gold standard, electric loop carves out prostate chips

- ED issues

30
Q

HoLEP/greenlight

A

Modern laser operation, better at tissue removal

- No ED

31
Q

UroLift

A

Staples prostate

32
Q

What is stress urinary incontinence and how do you treat

A

Increased abdomen pressure
leaking on effort or exertion
- Surgery

33
Q

Urge UI

A

Leakage and urgency

- Treat with medication

34
Q

Anticholinergics

A

Oxybutynin
Solifenacin
Tolterodine
Fesoterodine

35
Q

MoA of anticholinergics

A

Block ACH in parasympathetic nerves

blocks elsewhere too like salivary gland

36
Q

B3 Adrenergics MoA + SE

A

Activates receptors on the detrusor to relax

  • Upregulated int OAB
  • Hypertension
37
Q

B3 adrenergic drug

A

Mirabegron

38
Q

Botulinum Toxin A MoA

A

Fuses synaptic vesicles with the motor end plate

- Used for over active bladder

39
Q

lesion above the pontine micturation centre?

A

Safe

CVA, Parkinsons MS

40
Q

Lesion below T-12

A

Safe
as bladder and sphincter are flaccid + low pressure
(trauma, tumours,spina bifida)

41
Q

Lesions between pontine mucturation centre => T12

A

Unsafe
uncoordinated + so high pressures in the resting bladder result
(RTA, Tumours, MS)

MET2 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions