Unit 1: Chapter 35

Question 1

UTIs

Answer 1

Classified according to cause (congenital or acquired), degree (partial or complete), duration (acute of chronic) and level (upper or lower)

Question 2

Lower Urinary Tract Obstruction and Stasis

Answer 2

Urine is produced normally but the kidneys but is retained int he bladder
Can lead to Vesicoureteral reflux and cause kidney damage

Question 3

Congenital Obstructions of Lower Urinary Tract

Answer 3

External meatus in boys and just inside the external urinary meatus in girls
Or damage to sacral nerve in spoon bifida and meningomyelocele

Question 4

Acquired Obstructions of Lower Tract

Answer 4

Males: external compression of the urethra cause by enlarged prostate
Both: gonorrhea , bladder tumors

Question 5

Neurogenic Bladder Disorders

Answer 5

Commonly manifested in 1 of 2 ways
1. Failure to store urine (spatic)
Results from neurogeniclesion located above the level of the sacral micturition reflexes
2. Failure to empty urine (flaccid) results from lesions at the level of the sacral micturition reflexes or the peripheral nerves that innervate the bladder.

Question 6

Bladder Dysfunction Caused by Spinal Injury

Answer 6

After spinal cord injury, spinal shock develops which the bladder becomes atomic.
After the acute stage of spinal injury, micturtion respsonse changes from a long tract reflex to a segmental reflex .
Stimulation created by the bladder stretch receptors produce freq spontaous contractions of the detrusor muscle due to the sacral relfex arc remaining intact.
Cuases hperactive bladder, voiding is interrupted, involuntary or incomplete

Question 7

Autonomic Hyperreflexia

Answer 7

This condition accompanies spastic bladder of spinal cord injuries at the cervical level
This interrupts NCS control of sympathetic reflex
Causes severe hypertension, bradycardia and sweating can be triggered by insertion of a catheter or overdistenion of bladder

Question 8

Urinary incontinence

Answer 8

Involuntary loss or leakage of urine
Common in older adults, women twice ad often as men
Causes: stress, overactive bladder, urge, overflow incontinence

Question 9

Stress Incontinence

Answer 9

Involuntary loss of urine during coughing, laughing, sneezing or lifting that increase intra abdominal pressure commonly because of pelvic floor muscle dysfunction.

Question 10

Overactive Bladder

Answer 10

Used to describe the clinical syndrome that describes not only urge incontinence it also frequency, dysuria and nocturnal.
Associated with urge incontinence
Symptoms caused by invocatory bladder contractions during filling.
CNS functions as on-off switching for voluntary control of bladder so damage can inhibit CNS fucntion owing to uncontrolled voiding reflexes.

Question 11

Functional Incontinence

Answer 11

Caused by factors outside the lower urinary tractsuch as inability to locate, reach or recieve assistant in reaching an appropriate place to void.
Occurs when a person cannot find or reach the BR
Diuretic may cause rapid filling, with decreased mobility, incontinence .
Night sedation may cause a person tosleep through the signal of needing to void, thus bed wetting.

Question 12

Spastic Bladder

Answer 12

Failure to store urine
Condition that cause reflex bladder spasm an and decrease in bladder volume.
Caused by conditions that produces partial or extensive neural damage about the micturition reflex center in the sacral cord
Most common: spinal cord injuries at

Question 13

Bladder Dysfunction Caused by Periperhal Neuropathies

Answer 13

Bladder agony dysfunction is frequent with DM.
Effects the sensory axons of the urinary bladder without involvement of the pudendal nerve.
Leads to large residual volume after micturition sometime complicated by infection

Question 14

Cancer of the Bladder

Answer 14

Most frequent form of Urinary tract cancer.
Most common is derived from the transitional rot helium cells that line the bladder
(Referred to as: urothelial carcinoma)
Tumors range from low grade noninvasive to high grade tumors that invade the bladder wall and metastasize frequently.

Question 15

Cancer of the Bladder Cause

Answer 15

Carcinogens that are excreted in the urine and stored in the bladder
Includes breakdown products of aromatic amines used in the dye industry and products used to make rubber, textiles, pain, chemical and petroleum and smoking.

Question 16

Bladder Cancer Mainfestations

Answer 16

Painless hematuria
Presenting sigh: gross hematuria
Frequent, urgency and dysuria accompany the hematuria.

Question 17

Periodic Urine Cytology

Answer 17

Recommended for people who are high risk for bladder cancer