Unit 6 - Micturition and Colonic Function Flashcards Preview

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Flashcards in Unit 6 - Micturition and Colonic Function Deck (47)
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1

what is micturition?

process by which urinary bladder empties when full
1. progressive filling until tension in walls rises above threshold
2. triggering reflex that empties bladder

2

structure of bladder

smooth muscle chamber composed of:
-rough/folded body (where urine collects)
-neck/posterior urethra (funnel-shaped extension of body that connects to urethra and includes the internal sphincter
-smooth trigone area on posterior wall of bladder between orifices of ureters

3

what is detrusor muscle?

smooth muscle that composes body of bladder
-contraction is major step in bladder emptying

4

what do the trigone and internal sphincter do?

relax during bladder emptying
-made of smooth muscle

5

what happens beyond the posterior urethra?

urethra passes thru urogenital diaphragm containing external sphincter
-stretch signals from posteiror urethra are strong and trigger bladder emptying reflexes, but usually inhibited and control is learned during childhood

6

what does the pontine micturition center do? the suprapontine centers?

control detrusor muscle and urinary sphincters
-in turn, suprapontine centers control pontine micturition center providing voluntary control

7

if bladder is being filled, what happens to...
-detrussor muscle
-internal sphincter
-external sphincter

DM: relaxed and controlled by sympathetic beta2
IS: contracted and controlled by sympathetic alpha1
ES: contracted and voluntarily controlled

8

if bladder is being emptied, what happens to...
-detrussor muscle
-internal sphincter
-external sphincter

DM: contracted and controlled by parasympathetic muscarinic
IS: relaxed and controlled by parasympathetic muscarinic
ES: relaxed and voluntarily controlled

9

what are some abnormalities of micturition?

1. atonic bladder and intontinence caused by destruction of sensory nerve fibers (crush injuries)
2. automatic bladder caused by spinal cord damage above sacral region
3. uninhibited neurogenic bladder caused by lack of inhibitory signals from brain

10

what does the colon secrete and not secrete?

doesn't secrete digestive enzymes, but produces mucus to bind feces and aid movement thru colon and protect its lining

11

what happens when ileocecal valve is open/relaxed?

liquid moves from SI into cecum, usually 2 L/day
-gastroileal reflex intensifies peristalsis in ileum to empty contents

12

what happens if there's a faulty gastroileal reflex?

reflux of bacteria into ileum, also in IBD

13

what are the different parts of the colon used for?

ascending: extraction of water and electrolytes, but dwell time of chyme is comparatively short
transverse: remove electrolytes and water, with long (24h) dwell time
descending: stores stool
sigmoid:move stool between descending and rectum

14

what are the different parts of the rectum/anus used for?

rectum: usually empty until mass movement
rectal sac: last 8 inches of colon, stores stool until eliminated thru anus
anal canal: last 2-3 inches of colon
anus: exterior opening to colon guarded by internal and external sphincters

15

what are the different "stages" of feces as they progress thru the colon?

cecum: fluid
ascending: semi-fluid
transverse: mush
descending: semi-mush
sigmoid: semi-solid
anus: solid

16

what does constipation result from?

poor motility, so greater absorption of liquids, and harder feces

17

what does dietary fiber usually do?

promote normal colonic function
-increased colonic intraluminal bulk
-enhanced transit thru colon

18

what is osmotic VS secretory diarrhea?

osmotic: non-absorbable solutes in lumen (ex: lactase deficiency)
secretory: excessive secretion of fluids by crypt cells due to bacterial overgrowth

19

what does distension/pressure/irritation of cecum do?

inhibit ileal peristalsis and excite sphincter contraction to delay emptying

20

what is appendicities?

medical emergency acutely presenting as severe gastric pain followed by vomiting, then fever
-due to obstruction of appendix lumen by calcified fecal matter
-if untreated, causes ischemia, tissue necrosis, peritonitis, septicemia, and death

21

what is the surface epithelium of colon?

columnar with many mucus-secreting goblet cells and columnar absorptive cells, which comprise 95% of cells
-epithelial cells are polarized and have ion channels, carriers, and pumps on luminal or basolateral membrane to regulate transport of large amounts of electrolytes and water

22

what does the colon absorb and secrete? where do major changes occur?

absorbs: Na+, Cl-, H2O
secrete: K+, HCO3
mostly in ascending and transverse colon, removing 1.9 L/day so 0.1 L/day is left in feces

23

what is the main mechanism for Na+ absorption and HCO3 secretion?

parallel Na+/H+ and Cl-/HCO3- exchangers (electroneutral)
-creates osmotic gradient across intestinal mucosa for absorption of water

24

what is the driving force of K+ secretion in colon?

lumen-negative transepithelial voltage
-colon is net secretor of k+
-passive K+ secretion thru tight junctions that occurs throughout colon
-also active K+ secretion throughout colon intensified by aldosterone and cAMP

25

what is the importance of the tighter junctions in colon VS SI?

greater resistance to fluid flow ("tighter") throughout paracellular pathway than SI
-prevents back-diffusion of ions to allow more complete absorption of Na+ ions compared to SI
-enhanced by aldosterone

26

what happens if there are no ICCs in SI or colon?

no slow waves

27

how is motility in colon characterized?

slow segmental propulsion, segmental mixing, and mass movements

28

what are haustrations?

specialized for slow segmental propulsion and mixing to allow time for electrolyte and fluid absorption to solidify chyme
-formed by large circular muscle constrictions and constriction of taenia coli

29

how often do haustrations reach peak intensity?

in 30 seconds (disappearsi n next minute)

30

what are "mass movements"?

1-3 times a day, usually after breakfast, peristaltic movements are created that force chyme/feces to rectum
-haustrations disappear and persist for 10-30 minutes
-signal urge to defecate
-increased incidence during gastrocolic reflex (after a meal)

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