MICTURITION & urinary incontinence

Question 1

Answer 1

Question 2

Answer 2

Question 3

The bladder has 3 major functional muscular units that play a critical role in its normal functions:

Name these three regions?

Answer 3

Detrusor muscle
Internal urethral sphincter

External urethral sphincter

Question 4

this is a detrusor muscle:

• Name the structures M, S and LP
• What type of muscle makes up the layers 1,2 and 3
• how r the arrangments of these muscle layers related to their function?

Answer 4

M= mucosa, S= smooth muscle, LP = Lamina propria

3 layers are external smooth muscle allowing for stretch

The muscle layers are criss‐crossed, with one layer running at right angles to the next. this allows the bladder to be strong irrespective of which direction it is being stretched

Question 5

basic proccess of normal micturition

Answer 5

1. Urine is made in the kidney
2. Urine is stored in the bladder
3. The sphincter muscles relax
4. The bladder muscle (detrusor) contracts
5. The bladder is emptied through the urethra and urine is removed from the body

Question 6

what does the nervous system sense from the bladder

how does para and symp come in play what do they innervate?

Answer 6

filling and pain!

1. parasympathetic> u Pee> detruser contract> urethral sphincters relax
2. sympathetic> u Store> detruser relax (to fill bladder) > urethral sphincters increase their tone to maintain continence.
3. somatic> external urethral sphincter (skeletal muscle)

Question 7

The extent of the bladder contraction is greater in who?

Answer 7

MEN

Question 8

bladder male vs females

Answer 8

Answer 9

Question 10

Types of Incontinence

Answer 10

Question 11

What donwe give for an overactive bladder?

Answer 11

B3 agonist

Question 12

What is the cauda equina?

Answer 12

The cauda equina consists of about 10 pairs of nerve roots, some of which combine to form larger nerves in the lower body—one example of which is the sciatic nerve.

Question 13

Parasympatheic vs somatic

nerve root names

what they innervate?

Answer 13

Parasympathetic >>detrusor

somatic>>EUS

Question 14

Which major divisions of the nervous system innervate the urinary
bladder?

Answer 14

Parasympathetic

Sympathetic

Somatic (external urethral sphincter only)

Question 15

Which functional anatomical units of
efferent fibres innervate?
the urinary bladder do sympathetic

Answer 15

Detrusor, trigone, internal sphincter

Question 16

What somatic nerve supplies the urinary bladder, and what spinal cord
root values are represented within this nerve?

Answer 16

The Pudendal nerve and its associated root values are S2, S3 and S4.

Question 17

Comment on the brain centres responsible for storage of urine.

Answer 17

The Cortical Storage Centres command Pontine Continence centres to increase sympathetic output to the spinal storage centres whilst at the same time reducing the activity of parasympathetic drive to spinal voiding centres.

The Cortical Storage Centres are responsible for executive conscious decisions not to pass urine.

Question 18

What type of neurones in the spinal cord exclusively mediates
continence?

Answer 18

Sympathetic neurins

Question 19

When does bladder pressure increase?

Answer 19

At 500ml!

Question 20

e “stretch-relaxation” phenomeno

Question 21

Where do nerve endings of afferent fibres involved in sensory feedback
of the urinary bladder originate

Answer 21

Throughout the thickness of the wall of the urinary bladder

stretch recepters

Question 22

What sensory information is conveyed to the brain by afferent fibres of the
pelvic nerve?

Answer 22

General Pain

Degree of fullness (i.e. distension) of the urinary bladder

Temperature of the urine

Question 23

Comment on the brain centres responsible for micturition of urine

Answer 23

Cortical tical Micturition Centres command Pontine micturition centres to increase parasympathetic output to the spinal micturition centres whilst at the same time reducing the activity of sympathetic drive to spinal voiding centres. The Cortical Micturition Centres are responsible for executive conscious decisions to pass urine

Question 24

How does the cerebral cortex play amrole in micturation?

Answer 24

The Cerebral Cortex is Responsible for Conscious executive decisions

Question 25

Which region of the PONS is active during micturition?

Question 26

Dermatomes

Answer 26

T4 at nipple

Question 27

Describe the landmarks that define the region of the bladder known as the trigone.

Answer 27

2 x Ureteric orifices top of triangle

internal urethral meatus bottom of triange