Neurogenic Bladder Dysfunction Flashcards
What nerves are associated with the filling phase?
Sympathetic
Thoracolumbar region: hypogastric nerve
Somatic component: pudendal nerve
What nerves are associated with the micturition phase?
Parasympathetic
Cranial-sacral: pelvic nerve
What nerves and receptors are responsible for storage and filling?
Sympathetic
Hypogastric n (L1-L4)
Beta R: relaxes detrusor
Alpha R: constricts internal urethral sphincter
Somatic
Pudendal n (S1-S3)
ACh R: constricts external urethral sphincter
What nerves and receptors are responsible for micturition?
Parasypathetic
Pelvic n (S1-S3)
ACh R: contracts detrusor
What are the characteristics of a LMN bladder?
L4-S3
Hypotonic, flaccid bladder
Very easy to express
Decreased sphincter tone
What are characteristics of an UMN bladder?
T3-L3
Hypertonic, firm bladder
Can be difficult to express
Increased sphincter tone
Function: Pudendal n.
S1-S3
Stimulation constricts external urethral sphincter
Function: Pelvic n.
S1-S3
Constricts external urethral sphincter
Function: Hypogastric n.
L1-L4
Stimulation constricts internal sphincter sphincter
When is diazepam used?
UMN dysfunction to relax external urethral sphincter
What drug is used with UMN dysfunction to relax external urethral sphincter?
Diazepam (Valium)
Striated muscle relaxant
When are phenoxybenzamine and prazosin used?
UMN dysfunction to relax internal urethral sphincter
What drug is used with UMN dysfunction to relax internal urethral sphincter?
Phenoxybenxamine
Prazosin
Alpha Antagonists
When is bethanechol used?
LMN dysfunction to assist with detrusor contraction
What drug is used with LMN dysfunction to assist with detrusor contraction?
Bethanechol
Parasympathomimetic
