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36 Cards in this Set

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  • Back
Does anything change about urine after it leaves the collecting duct?
What is the ureter's function?
Carries urine from the renal pelvis to the bladder.
Structure of ureter - what are 4 layers from inner->outer?
-Lined w/ transitional epithelium over submucosal layer
-Inner longitudinal muscle layer
-Outer circular muscle layer
What are the contractions of ureteric muscle like?
Peristaltic contractile waves that originate from the proximal portion
How frequent are the peristaltic waves of the ureter?
2-6 /min
What triggers peristaltic contraction of the ureter? (3 things)
-Mechanical stimuli (stretch)
-Chemical stimuli
-Membrane depolarization
Does ureteric peristalsis require innervation?
What types of nerves innervate the ureter?
-Autonomic pain fibers
What is the ureter pathway like as it enters the bladder?
-Enters low/posteriorly
-Crosses obliquely through the detrussor muscle
What covers the uretereal orifice?
A flaplike mucous membrane valve
What is the function of the flaplike valve and oblique pathway of the ureter?
Prevents urine reflux
What are the 2 main parts of the bladder?
What is the muscle of the bladder?
How much can simultaneous contraction of the detrusor increase bladder pressure?
40-60 mm Hg
How long is the bladder neck? What is it made of?
2-3 cm; composed of detrusor muscle and elastic tissue.
What is the function of the bladder neck?
It serves as an internal sphincter to prevent bladder emptying until it reaches a certain critical threshold.
Primary nerve supply to the bladder:
Pelvic nerve
Fibers in the pelvic nerve:
-Sensory nerves
-PNS Motor nerves
What do the sensory fibers of the pelvic nerve detect and how do they respond?
Sense Stretch - initiate bladder emptying reflex.
What muscle do the PNS motor nerves innervate?
What somatic nerves innervate the external sphincter?
What is a cystometagram?
The pressure:volume curve for the bladder.
What is the compliance of the bladder at low volumes?
How do you know the bladder is highly compliant at low volumes?
Because it can hold a lot of volume with minimal changes in pressure.
What happens as the bladder fills with volume?
Its compliance decreases so pressure begins to increase rapidly
What are Micturition waves?
Periods of increased luminal pressure in the bladder that can reach up to 100 cm H2O and last seconds up to a minute.
What are micturition waves initiated by?
Sensation of stretch by stretch receptors in the bladder wall.
Where does the impulse go when stretch receptors sense increasing stretch?
To the sacral spinal cord, then back to the bladder via the PNS pelvic nerve
What happens to the micturition waves as the bladder fills?
They increase in frequency and strength.
What can happen to micturition waves?
They can cease for minutes up to an hour, but will come back!
What happens when micturition waves become powerful enough?
They initiate a reflex through the pudendal nerves to inhibit the external sphincter.
What will happen when the pudendal reflex is stimulated?
Urination - unless your voluntary control is greater.
Is micturition completely reflex?
No; higher cortical centers exert the final control.
How do higher centers have the final control of micturition?
They partially inhibit micturition reflexes by voluntary contraction of the external bladder sphincter.
How is voluntary urination initiated?
1. Abdominal muscles contract
2. Bladder pressure increases
3. Higher centers simultaneously stimulate micturition reflex and inhibit the external sphincter.
So the main function of the micturition reflex is really to:
Empty the bladder.