Bowl Dysfunction with SCI

Question 1

UTI is the most ___ medical complication during the ____ medical rehab period

Answer 1

• Frequent

- Initial

Question 2

During spinal shock the bladder is _____.

Answer 2

• Flaccid
• All mm tone and bladder reflexes are absent
• Need effective drainage system

Question 3

Spinal integration center for urination is the ___ ____ and primary control originates from ___ - ___.

Answer 3

• Conus Medullaris

- S2:S4

Question 4

Post Spinal Shock with lesion within the spinal cord and above the cauda equina

Answer 4

• Relex neurogenic bladder above T12 (UMN)
• Bladder contracts and reflexively empties in response to a certain level of filling pressure
• Reflex arc is intact

Question 5

To stimulate reflex emptying (Post Spinal Shock with lesion within the spinal cord and above the cauda equina)

Answer 5

• Manual stroke, kneading, tapping of supra-pubic region

- Lower abdominal stroking, pinching or pulling of hair

Question 6

Post spinal shock with lesion below spinal cord or within cauda equina results in an_____ or _______ bladder.

Answer 6

• Autonomus

- Non-Reflexive

Question 7

Flaccid Bladder below T12

Answer 7

• No reflex arc

- To empty, increase intra-abdominal pressure (valsalva, manual compression of lower abdomen)

Question 8

Credes Maneuver

Answer 8

• Manual compression of lower abdomen

Question 9

Bladder Training with reflex bladder

Answer 9

• Intermittent catheterization to establish reflex bladder emptying at regualr, predictable intervals in response to certain levels of filling
• Fluid restriction to approx. 2000ml per day in increments
• Initial catherization every 4 hours, it is advisable to first attempt to void with manual stimulation and then cath. Residual can cath every 6 hours
• Train bladder to be emptied at predictable intervals