W12 Urine transport

Question 1

what are the three main components of the urinary tract

Answer 1

ureters
urinary bladder
urethra

Question 2

what is the role of the micturition reflex

Answer 2

coordinates the process of urination

Question 3

describe the 4 main stages in the micturition reflex

Answer 3

sensory fibers in the pelvic nerve sense stretch due to bladder filling

parasympathetic fibers control muscle contraction

interneurons communicate signals up to hypothalamus with relays into the cortex

voluntary relaxation of external sphincter results in urination

Question 4

what do stretch receptors do as the urinary bladder fills

Answer 4

stimulate pelvic nerve

Question 5

where does the stimulus from the pelvic nerve travel too

Answer 5

stimulates ganglionic neurons in wall of bladder

Question 6

what does the postganglionic neuron in intramural ganglion do

Answer 6

stimulates detrusor muscle contraction

Question 7

what relays sensation to thalamus and deliver sensation to cerebra cortex

Answer 7

interneuron

Question 8

what results from the relaxation

Answer 8

relaxation of internal urethral sphincter

Question 9

what two age ranges affect the micturition reflex

Answer 9

babys as they do not have the connections between the bladder and the hypothalamus are not mature

elderly reflex becomes impaired leading to incontinence.

Question 10

what can loss of control micturition reflex be caused by

Answer 10

a stroke
alzheimer’s disease
CNS problems affecting cerebral cortex or hypothalamus
enlarged prostate

Question 11

what is incontinence

Answer 11

involuntary loss of urine that is enough to cause a social or hygiene concern

Question 12

what is chance of incontinence in female vs male

Answer 12

x4 in woman

Question 13

what can stress incontinence be caused by

Answer 13

coughing
sneezing
laughing
carrying heavy weights

Question 14

what is stress incontinence

Answer 14

anything that puts pressure on the bladder

Question 15

when does stress incontinence occur

Answer 15

when the urethra moves out of the normal position (prolapses) after weakening of the pelvic floor muscles.

Question 16

In woman what are some other causes of stress incontinence

Answer 16

childbirth
hysterectomy
menopause

Question 17

what is urge incontinence

Answer 17

strong urge to pass frequent small amounts of urine.

Question 18

what is urge incontinence caused by

Answer 18

muscle of the bladder wall known as the detrusor being overactive meaning it contracts to squeeze out urine before the bladder is completely full

Question 19

what is mixed incontinence

Answer 19

some woman get both urge and stress and they can be liked but not always

Question 20

what is overflow incontinence

Answer 20

when urine held by the bladder builds up to the point where the bladder can no longer expand.

Question 21

what is overflow incontinence also known as

Answer 21

chronic urinary retention

Question 22

what is overflow incontinence caused by

Answer 22

obstruction in urinary tract or damage to the nerves that supply the bladder

Question 23

what might obstruction be due to

Answer 23

stones
constipation
benign pro static hypertrophy

Question 24

what conservative treatments can be used to help

Answer 24

pelvic floor muscle training

bladder training
- scheduled toileting every 2-4 hours

frequently empty the bladd and thereforre keep the patient dry

Question 25

what is duloxetine used for

Answer 25

moderate to severe stress urinary incontinence

Question 26

what can duloxetine help with

Answer 26

increasing the muscle tone of the urethra which should help keep it closed

Question 27

what are sub indications of duloxetine

Answer 27

depression and neuropathic pain

Question 28

what are some possible side effects of duloxetine

Answer 28

nausea dry mouth fatigue

Question 29

what do antimuscarinic drugs do

Answer 29

reduce contractions of bladder and increase bladder activity (urge incontinence)

Question 30

what effect does antimuscarinic drugs have

Answer 30

reduce symptoms of urgency and increase bladder capacity

Question 31

what are some examples of antimuscarinic drugs

Answer 31

Oxybutynin (DITROPAN) Tolterodine (DETRUSITOL) Solifenacin (VESICARE)

Question 32

what are some side effects of antimuscarnic side effects

Answer 32

``` dry mouth constipation blurred vision dry eyes fatigue drowsiness confusion difficulty in micturtion angle close glaucoma arrythmias and tachycardia ```

Question 33

what forms of incontinence can be treated surgically

Answer 33

all 3

Question 34

when should surgical correction be considered

Answer 34

only after all conservative options have been exhausted

Question 35

what complications can occur

Answer 35

infection bleeding continued incontinence inability to urinate

Question 36

where is the prostate located

Answer 36

surrounds the urethra

Question 37

what is the enlargement of the prostate known as

Answer 37

benign prostatic hyperplasia BPH

Question 38

what is the problem with prostate enlargement

Answer 38

it presses down on the urethra and cause urination and bladder problems

Question 39

when does the likely hood of prostate enlargement increase

Answer 39

as age increase

Question 40

what is the role of alpha 1 blockers

Answer 40

they are a class of medication used to treat high blood pressure and allow easier urination as it relaxes the muscle of the bladded,neck and prostate.

Question 41

what is the role of finasteride and dutasteride

Answer 41

lower levels of hormones produced by the prostate, reducing the size of the prostate gland increasing urine flow rate and decrease symptoms of BPH it may take 3-6 months for improvement in symptoms.