Incontinence and constipation

Question 1

Describe micturition process

Answer 1

Question 2

What systems are involved in micturition?

Answer 2

Question 3

What provides voluntary control of micturition?

Answer 3

Frontal cortex

Question 4

What co-ordinates detrusor contraction with urethral relaxation?

Answer 4

Pontine micturition centre

Question 5

The parasympathetic system mediates what?

Answer 5

Bladder contraction

Question 6

The sympathetic system mediates what>

Answer 6

Bladder filling

Question 7

What causes contraction of external urethral sphincter allowing voluntary control>

Answer 7

Excitation of pudendal nerves

Question 8

Where is the pontine micturition centre located?

Answer 8

Midbrain

Question 9

What is urge incontinence?

Answer 9

Question 10

What is outflow obstruction?

Answer 10

Question 11

What is stress incontinence?

Answer 11

Question 12

What is overflow incontinence?

Answer 12

Question 13

Deficiency of what hormone can cause incontinence?

Answer 13

Oestrogen

Question 14

What medications can cause incontinence?

Answer 14

Question 15

What are the red flags of incontinence?

Answer 15

Question 16

What symptoms suggest voiding problems?

Answer 16

Question 17

What symptoms suggest storage problems?

Answer 17

Question 18

What is the pelvic floor muscle strength assessment?

Answer 18

Question 19

What neurological examination parts should you focus on?

Answer 19

Question 20

Which nerves innervate smooth muscle of the bladder neck and proximal urethra allowing bladder filling?

Answer 20

Sympathetic nerves from T11 to L2

Question 21

Which nerves allow detrusor contraction?

Answer 21

Parasympathetic fibres origination from sacral plexus (S2 to S4)

Question 22

What is uroflowmetry?

Answer 22

Question 23

What is a USS cystodynamogram?

Answer 23

Question 24

What is cystometry?

Answer 24

Question 25

What is ambulatory urodynamics?

Answer 25

Question 26

If there are no detrusor contractions at low volumes on cystometry, what type of incontinence does this suggest?

Answer 26

Urge incontinence

Question 27

If there is no voiding on increase in abdominal pressure e.g. coughing on cystometry, what type of incontinence does this suggest?

Answer 27

Stress incontinence

Question 28

What surgical options are there for stress incontinence?

Answer 28

Question 29

What medical options are there for stress incontinence?

Answer 29

Question 30

What is a colposuspension?

Answer 30

Question 31

What is a sling insertion?

Answer 31

Question 32

Which medications can be given for urge incontinence?

Answer 32

Question 33

What surgical options are there for urge incontinence?

Answer 33

Question 34

How can antimuscarinics affect urination?

Answer 34

Can cause urinary retention

Question 35

What are the medication options for BPH?

Answer 35

Question 36

What are the surgical options for BPH?

Answer 36

Question 37

What do you look for in blood tests with constipation?

Answer 37

Question 38

What laxatives should you offer for opioid induced constipation?

Answer 38