chapter 46

chapter 46

1. micturition: occurs when the brain gives the bladder permission to empty bladder contracts, urinary sphincter relaxes and urine leaves body through urethra

   • bladder: hold the urine, back flow causes infection

2. kidneys: remove waste products from the blood by the nephrons and regulate fluid and electrolyte balance, excretes 1% of urne

   • ureters: attached to kidneys and pelvis, carrying urinary waste to the bladder, obstruction ureters can cause kidney stones
     • urethra: urine from bladder passes through urethra and passes to the outside of the body through the urethral meatus
       • pelvic floor muscles: passed by urethra, muscles stabalize the urethra and contribute to urinary continence

3. acts of urination: involved bladder, urinary sphincter and CNS

   • 2 voiding center in the spinal card, one that coordinates INHIBITION of bladder contraction, one that coordinates bladder contractile
     • urinary retention: inability to partially of completely empty the bladder, small volume voiding, incontinece caused by urinary rentention
       • PVR: amount of urine left in the bladder after voiding

4. urinary incontience: complaint of any involuntary loss of urine, assoc with urinary retention

   • Urinary diversion: surgical procedure that divert urin to the outside of the body through an opening in the abdominal walls(stoma)
     • for pt who had a bladder removed because of cancer of bladder dysfunction
       • continent urinary reservoir: urinary diversion at distal part of ileum
         • orthotopic neobladder: urinary diversion that replace bladder
           • UTI causes: E. coli is the most common pathogen
             • causes: indwelling catheter, instrumentation of urinary tract, urinary retention, urinary the fecal incontinence
               • dysuria: burning of pain when urination
                 • cystis: irritation of bladder

5. CAUTI: catheter-associated UTI, assoc with increased hospitolization cost increases and longer stay

   • ureterostomy: transplanting ureters into a closed off part of the intestinal ileum bringing other end out onto abdominal
     • nephrostomy: small tubes that are tunneled through the skin into renal pelvis placed to drain renal pelvis