Structure and function of lower urinary tract Flashcards
What is the structure of the lower urinary tract?
Includes bladder wall, detrusor muscle, stroma, and urothelium
The lower urinary tract is responsible for urine storage and elimination.
What are lower urinary tract symptoms (LUTS)?
Symptoms related to bladder function, including storage and voiding issues
LUTS can affect quality of life and may indicate underlying conditions.
What is the function of the detrusor muscle?
Responsible for bladder contraction during micturition
The detrusor muscle is smooth muscle arranged in bundles.
What is the role of the urothelium?
Functions as a barrier and involved in afferent signaling
The urothelium is a multilayered epithelium with umbrella cells.
What is the lamina propria?
A layer of connective tissue supporting the urothelium
It is involved in the communication between the urothelium and detrusor.
What is the function of the bladder as a compliant reservoir?
Stores urine while maintaining constant pressure despite volume increase
The bladder’s visco-elastic properties allow for this function.
What triggers afferent neurons to sense bladder fullness?
Increase in wall tension during bladder filling
This signals to the brainstem and higher centers about the bladder state.
What is volitional micturition?
The voluntary act of voiding urine
It involves coordination of detrusor contraction and urethral relaxation.
What is the role of the pontine micturition center?
Modulates the spino-bulbar reflex for micturition
Barrington’s nucleus is a key area for this modulation.
What is the significance of wall tension in micturition?
Rises to trigger afferent signals to the pontine micturition center
This initiates a positive feedback loop for bladder contraction.
What neurotransmitter is primarily involved in excitatory neurotransmission for bladder function?
Acetylcholine (Ach)
Cholinergic signaling is crucial for detrusor contraction.
What role does nitric oxide play in bladder function?
Facilitates relaxation of the bladder neck and external urethral sphincter
This relaxation is essential for normal voiding.
True or False: GABA and glycine are excitatory neurotransmitters in bladder activity.
False
GABA and glycine act as inhibitory neurotransmitters.
What happens during spinal cord injury at S2-S3?
Loss of central inhibition leading to reflex voiding
This affects the pelvic parasympathetic nerves and pudendal nerve.
Fill in the blank: The bladder is highly _______ to accommodate varying volumes of urine.
compliant
Compliance allows for bladder pressure to remain stable.
What are the components of the bladder wall?
- Urothelium
- Detrusor muscle
- Stroma
- Adventitia/Serosa
Each component plays a role in bladder function and structure.
How often does the normal person urinate?
4-5 times per day, depending on input
How much urine does the normal person pass in one void?
300-400mls
What initiates voiding when the bladder contains approximately 300mls?
Social convenience
What is the purpose of a Frequency/Volume Chart?
To collect urinary habits data from the patient
What does a Bladder Diary monitor?
Input and Output
What are STORAGE LUTS?
- Urgency
- Frequency
- Nocturia
- Urinary incontinence (UI)
What are VOIDING LUTS?
- Hesitancy
- Poor flow
- Intermittency
- Terminal dribbling
- Frequency
- Nocturia
What is polyuria and what conditions should be considered?
Increased urinary production; consider DM/DI and excess fluid intake
