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Is the process of making urine involuntary of voluntary?
It is involuntry = which means autonomic
Explain how the bladder involves both sympathetic and para-sympathetic nervous system?
Good test question Emma **)
HINT - rememeber that parasympathetic means you are paralayzed and relaxed.
The parasympathetic system controls bladder emptying
The sysmpathetic system controls bladder filling
What are the 3 mean urinary conditions?
- 1. Urinary infection
- 2. Unrinary incontinence
- 3. Urinary retention
What is the bacteria associated with UTI's?
Where in the urinary systems can a UITI develop?
Upper UTI - Body system includes - Ureters and kidney
Lower UTI - Body system includes - Bladder and urethra
What are the 3 etiological (remember this word mean "the origin of something") factors associated with a UTI?
- 1. Host-Agent Interaction
- (in other words I am the host and e.coli is the agent)
- 2.Obstruction and reflex
- (When blockage occurs in Urethra > Urine cant flow out> builds up in bladder breading bacteria> travels back up ureters to kidneys)
- 3. CATHETER INDUCED INFECTION
- i. bacteria was on the surface of a catherter > cathether was inserted > bacteria is now in urinary tract
What are the TWO complications of a UTI?
- 1. Sepsis and Septic shock
- Remember that sepsis is when you have an infection in the blood.
- Septic shock is when the body is over whelmed by infection.
2. PERMENANT KIDNEY DAMAGE
What does UROSEPSIS mean?
A severe illness that occurs when an infection starts in the urinary tract and spreads into the bloodstream.
Decribe the manifestions assoiciated with an upper UTI?
- 1. Fever
- 2. Lathrgic (feeling tired)
- 3. malaise (feeling unwell)
- Remember that these are systemic responses. meaning NON-SPECIFIC
Decribe the manifestions assoiciated with an LOWER UTI?
- 1. Frequency
- 2. Urgence
- 3. Burning unpon urination
Remember this is a specific
reponse and is happening in a local area of the body
What are the different ways you can diagnose a UTI?
- 1. Urine R&M = Routine Microscopy
- this is when we determine the amt of bacteria and WBC aka Leukoctyes
- 2. Urine C&S = Culture and Sensitivity
- Culutre is taking bacteria from urine and growing it and sensitivity is determining the type of bacteria
What are the treatments associated with a UTI?
Treatmens associated with UTI's are based on the type of pathogen and location.
The main treatment is ANTIMICROBIAL (fights micro-organism) and fluids
What is meant by urinary incontinence?
an involuntary loss of urine due to increased bladder pressure or decreased ablity to prevent the escape of urine?
What are the 3 types of incontinence?
- 1. Stress
- 2. Urge
- 3. Overflow
Decribe Stress incontinence?
This happens when you are putting stress on your abdomen. (coughing laughing, running etc.
This is caused by Pelvic floor weakness, poor sphincter support, urethal defiencies, trauma, certain spinal cord lesions, and neurolic disfunction (MS)
Describe URGE incontinence?
Urgency and frequecy with the detrusor muscle. (bladder fills up half way but the detrusor muscle cntract giving you the urge to urinate)
Can be caused by acute or chronic UTI's
Decribe OVERLOW incontinence?
Loss of urine whne bladder pressure exceeds urethral pressure. the bladder will distand and urine will leak out.
This is caused by Nervous system leison, obstruction of bladder neck, chronic urine retention.
What are some diagnose for urinary incontinence?
Incontinence is a symptomand a cause can be found by conducting a history of the person voiding pattern, physical examination, blood test and urine analysis.
What are some treatments for urinary incontinence?
- 1. Stress Incontinence = use excerises to strengthen pelvic floor muscles.
- Use a adrenergic agonist drugs to increase sympathetic relaxation
2. Urge incontinence
= Toiletting at regular times andc ertain medications.
Self-catherterization and Surgery can be used to treat urinary incontience.
The in ability to empty the bladder completely during attemts to void?
What is this called?
This is called Urinary retention
What are the etiological(the origin - where did it come from) factors for urinary retention?
- 2. Prostate hyperplasia (which is enlarged prostate)
- Remember prostate is a round like a donut
3. Urethral Pathology (the study of the urethra) Ex. Infection, tumor, bladder stone, and scaring.
- 5. Neurologic disorder (can stop urine flow)
- 6. Medication (can stop urine flow)
- 7. Post-Op complication
What are some complication associated with urinary retention?
*Remember complications are the very worse outcomes from a disease
- 1. Chronic infection
- 2. Renal calculi aka kidney stone
- 3. Pyeolonephritis = Infection inside the pyrimids of the kidney
- 4. Sepsis - infection of the blood
- 5. Kidney damage
How can bladder retention be diagnosed?
(there are 8)
- 1. Bladder scan
- 2. X-ray
- 3. Ultrasound
- 4. Blood work
- 5. Urine R&M (Routine & Microsocopy)
- 6. Urine C&S (Culture and Sensitivity)
- 7. CT scan (full body scan)
- 8. Cystoscopy (camera goes up urethra)
What are the treaments for urinary retention?
- 1. Remove the blockage
- 2. Retrain the bladder
- 3. Catherization
What is the function of the SOMATOSENSORY system?
Provides the CNS with information about the body in terms of touch, temperature, pain, and body position
How many neurons are involed in the pain pathway?
You got it
What are the THREE neurons called in the pain path way and describe where they are?
1. First order neuron - located in the peripheral tissues. (eg. anything that is NOT the spinal cord or Brain - fingers, shoulders etc).
2. Second order neurons - located in the spinal cord. (remember the 1 order neurons take from your arm or finger tips to you spinal cord which is the 2nd order neuron)
3. Third order neurons - located in the thalamus and into the cerebral cortex
What is a DERMATOMES?
**possible test question**
Dermatomes is an area of the skin supplied by nerves from a single spinal root
How many pain theory's are there?
(this multiple choice question has been scrambled)
List each pain theory?
- 1. Specificity Theory
- 2. Pattern Theory
- 3. Gate control Theory
- 4. Neuro Matrix Theory
What is the Specificity Theory?
* Pain is regulated by specific receptors that transmit information to the pain center.
What is the Pattern Theory?
- * Pain receptors that share pathways with other sensory modalities (meaning receptors)
- * But the different patterns of activity happening to the receptors determine if it will register as painful or non painful stimuli
What is the Gate control Theory?
(keep in mind this one can be counter reacted by blocking the pain sensation)
Gate control theory says simultaneous firing of the large diameter touch fibers (meaning neurons that sense deep rubbing/messages) has the potential for blocking the small diameter PAIN fibers
What is the Neuro Matrix Theory?
* The Neuro Matrix Theory says neurological network (meaning neurons in the brain) may be triggered by sensory inputs, but may also be generated independently to produce sensation of pain
* this theory also helps to explain Phantom limb or chronic pain
* The brain is remembering pain that is no longer there physically.
Name the THREE types of stimuli that cause PAIN and describe?
- 1. Mechanical - Pressure applied to skin OR contraction / stretching of a muscle
- 2. Thermal - heat or cold
- 3. Chemical - when tissue is injured inflammatory mediators (meaning histamine which causes holes in blood vessels fluid leaks out building up in the tissues which causes pain) lead to swelling which causes pain.
What are the two different types of pain?
Describe fast pain?
Fast pain is when A delta fibers (which are LARGE myelinated nerves) synapse (meet with) spinal neurons and release glutamate
Describe SLOW pain?
Slow pain is when C fibers (small UN-myelinated nerves) synapse (meet with) spinal neurons and release glutamate and substance P (which is a pain chemical within the body)
What is physiology?
This is the function and movement of a body part?
List the the four physiological (movement) steps of pain?
- 1. Transduction
- 2. Transmission
- 3. Perception
- 4. Modulation (Reflex)
Describe the process of Transduction?
(this is the process of receiving the pain message)
- * Starts with painful stimuli (which can be - mechanical, thermal or chemical)
- * Stimulates nociceptors (meaning pain receptors) by the noxious stimuli (meaning harmful stimuli)
- *Noxious stimuli initiates action potential
- * Now the action potential is mediated by neurotransmitters which are epinephrine, prostaglandins, histamine, hydrogen ions and substance P
These are first order neurons
Describe the process of TRANSMISSION
(this is the process of passing the pain message along at the cellular level)
1. The action potential is carried via both Delta A and C fibers
2. Delta A fibers (fast) go to the neospinothalamic tract > which goes to the thalamus > then to the cortical center (**Note - Delta A fibers go DIRECTLY to the Thalamus)
3. Delta C fibers (Slow) go to the paleospinothalamic tract > which goes to the brain stem > then to the thalamus and then to the cortical centers (**Note - Delta C fibers stop at the brain stem first then to the thalamus)
**Transmission is the SECOND order neuron***
Describe the process of the PERCEPTION in the pain process
- 1. thalamus provides the sensation of pain and can distinguish the location of the pain.
- 2. The parietal cortex controls our behavior in response to pain (anxiety or loss of sleep) (Ex. Becoming angry every time you get hurt is an example of a learned behavior)
- 3. The pain goes to the limbic system which is connected to emotions.
Pain Torrence - is the maximum intensity or duration of pain a person is willing to endure
- **Test point**
- Pain threshold is the point at which a person feels pain.
This is the THIRD order neuron
Describe a few points about the MODULATION of pain.
- 1. Neuroanatomic pathways are the mid brain and brain stem.
- 2. Endogenous - anything made within the body and stays inside the body
- Analgesia - pain killer mechanism
So in short Endogenous analgesia mechanism is the body producing something to stop the pain like endorphins
The WITHDRAWAL REFLEX
is the bodies way of telling you to get away from the pain.
What are the SIX types of pain (keeping in mind we are referring to the location and duration of pain)
- 1. Cutaneous
- 2. Deep somatic pain
- 3. Visceral pain
- 4. Referred pain
- 5. Acute pain
- 6. Chronic pain
What is involved in cutaneous pain?
Very superficial cuts or abrasions on the skin
What is Deep somatic pain?
It is pain that is located deep within the bones, muscles and tendons
What is Visceral pain?
Visceral is pain within the organs. It is most commonly produced by disease.
What is referred pain?
Referred pain is pain that is damage in one area, but felt in different area.
What is acute pain?
Acute pain is LOCAL TRAUMA in response to damage.
And is often a warning sign that the damage has occured and the body can start the healing process.
Acute pain is short lived.
What is CHRONIC PAIN?
Chronic pain is the leading cause of disability.
This included things like cancer and back injuries.
It is difficult to treat and last for months to years.