What technique is used to detect fluid, gaseous distention, stool retention and
masses - ANSWERS-Percussion
Oxford grading scale - ANSWERS-0= none
Flicker 1/5 Trace but instant contraction
Weak 2/5 Weak contraction withot elevation / lifting of examiners finger. Held for
>1 but <3 seconds
Mod 3/5 Held for at least 4-6 seconds and repeated 3x
Firm 4/5 held for at least 7-9 seconds repeated 4-5x
Strong 5/5 Unmistakable strong contraction. Held 10 seconds repeated 4-5x
Most important factor to consider as etiology when assessing a patient for urinary
retention - ANSWERS-Compliance (ability to stretch)
When a patient has >1,000 mL drained, the patient is suspected to have what kind
of what type of UI - ANSWERS-Acute on chronic retention. since the pt has only
mod discomfort with output of >1,000 likely he normally has incomplete
emptying leaving a large residual but now the patient is unable to void at all.
There is now AUR on CUR
In a trial without a catheter, a patient drains 1,000 mL. will he be successful -
ANSWERS-No. he has chronic retention and does not effetively empty. If he is in
,complete retention he likely will not be successful in a TWOC. Either he has lost
bladder contractility or his prostrate is blocking his ability
dysfunctional voiding in children includes UTI's and - ANSWERS-voluntary
contraction of urinary sphincter and pelvic floor during voiding.
What potential complication is associated with sp caths - ANSWERS-track closure
what abo is used for asymptomatic bacteriuria - ANSWERS-none
When catheter has become blocked with blood, what is the first task - ANSWERS-
irrigate
When the catheter has leakage, what should one suspect - ANSWERS-bladder
spasms which means the bladder is starting to contract. Cath may not be
necessary any longer
When should catheters be changed - ANSWERS-only as needed unless the patient
is a frequent blocker. Then a schedule should be kept to keep urine flowing
First thing to teach IC patient - ANSWERS-keep a diary to determin fluid intake
and cath volumes
, Internal anal sphincter is composed of what muscle - ANSWERS-smooth. Controls
continence at rest. Slow twitch, fatigue resistant smooth muscle fibers.
Innervated by the myenteric plexus and branches of the autonomic nervous
system.
External anal sphincter is composed of - ANSWERS-striated voluntary muscle,
fused. with the puborectalis muscle. Innervated by the somatic fibers of the
pudentdal nerve
Pubococcygeus - ANSWERS-lifts the anus, vagina and urethra and pulls them fwd.
3 nervous systems of the bowel - ANSWERS-CNS, brain and spinal cord.
ENS and bowel - ANSWERS-intraintestinal nervous system and primary mediator
in colonic motility. submucosal (Meissners plexus) and myenteric (Auberbach's)
plexus. function is to detect intraluminal substances , irritants, control GI blood
flow and regulate epithelial cell function.
Myenteric plexus controls colonic motility.
CNS - ANSWERS-brain and spinal cord. Primary role is to integrate sensory info
received from the PNS then coordinate voluntary / involuntary activities such as
elimination and defecation.
The PNS consists of all other types of nervous tissue outside of the CNS.
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