Normal Micturition Flashcards Preview

Week 64: Prostate Cancer and BPH > Normal Micturition > Flashcards

Flashcards in Normal Micturition Deck (8)
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1

What nerves are involved in
1. Sympathetics
2. Parasympathetics
3. Somatic

1. T11-L2
2. S2-4
3. S2-4

2

How does the sympathetic reflex in the bladder work (storage)

Stimulation of alpha adrenergic receptors at bladder neck increasing resistance
Activation of beta3 receptors in detrusor inhibiting contraction
Direct inhibition of detrusor motor neurons in sacral spinal cord

3

Pontine micturition center

Receives afferent input from lower urinary tract
Receives input from forebrain, cerebellum and hypothalamus
Cortical inputs are inhibitory
Cerebellum involved in coordination of detrusor contraction and relaxation of bladder neck and external voluntary sphincter

4

3 types of UMN lesions

Cerebral injury (stroke, tumour, brain injury) causing detrusor overactivity
Basal ganglia disease (PD) causing detrusor overactivity, slow relaxation of external sphincter
Suprasacral spinal cord damage causing detrusor overactivity with sphincter dyssynergia

5

2 types of LMN lesions

Sacral spinal cord damage
Peripheral nerve damage

6

DIAPERS for causes of transient/reversible incontinence

Delirium/ confusional state
Infection
Atrophic vaginitis/urethritis
Pharmacologic
Excess urine output
Restricted mobility
Stool impaction

7

Investigations for urinary incontinence

Voiding diary
Urinalysis
Urine cytology with irritative symptoms
Postvoid residual by ultrasound
Renal ultrasound in specific cases

8

Anticholinergic side effects

Dry mouth
Dry eyes
Blurred vision
Constipation
UGI distress
Headache, flushing
Confusion
(rarely) SVT