Micturition Flashcards
(44 cards)
Where does sensory feedback from the brain regarding whether or not its socially acceptable to urinate travel along
Pelvic nerves
What are the roots of the pelvic nerves
S2,3,4
Where does micturation centre send impulses if it is socially acceptable to urinate
Through pudendal nerve to sphincter
2 things that the bladder does
Emptying and storage
What happens to the bladder during bladder villing
Relaxed detrusor
Urethra contracted
Pelvic floor contracted
What happens during the emptying phase to the bladder
Detrusor contracts
Urethra relaxes
Pelvic floor relaxes
How many times does the average adult wee per day
4
How much urine is passed a day
1500ml
What causes normal bladder contraction
Ach released from cholinergic nerves
Stimulates muscarinic receptors on the detrusor smooth muscle
What are the receptor abnormalities seen in a ‘weak’ bladder
Receptors are not upregulated
What is the problem with a small thickened bladder
High pressure during storage phase which can transmit up to kidneys killing them
2 categories of lower urinary tract symptoms
- Storage symptoms
- Voiding symptoms
Some examples of storage symptoms (lower urinary tract)
Frequency
Nocturia
Urgency
Urge incontinence
Some examples of voiding/ obstructive symptoms
Hesistancy, straining, poor floow, intermittency, incomplete emptying, terminal dribbling, haematuria
What is overactive bladder syndrome
Urgency, with or without incontinence, usually with frequency and nocturia
Define nocturia
Excessive urination at night
What are the values for mild symptoms on IPSS
0-7
What are values for medium and severe symptoms on IPSS
8-19
20-35
Are men or women more affected by urine problem
Both
What investigations can be done in patients with urine problems
- Inspect fresh urine sample
- Dipstick
- FBC
Uroflowmetry and post void residual volume - Urodynamics
- XB KUB
- Ultrasound
- CT KUB
- Nuclear imaging
What problems with ‘outlet’ can occur
Bladder neck problems Prostate problems Stricture Meatus Foreskin tightening
What problems with the pump can occur
Bladder- OAB, sensory, failure
Cardiac
Medication
What problems with the constituents can occur
UTI
Cancer
Inflammation
Stones
How does caffeine make your bladder act
Releases calcium stores from the golgi apparatus in the bladder wall
Makes bladder contraction more likely
