Močový měchýř neurogenní
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
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Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
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Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
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Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
Deprecated: Function split() is deprecated in /home/users/dana/medicinman.cz/web/csf/kf.inc.php on line 67
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Inervace močového měchýře
- Somatická inervace
- N.pudendus - m. sphincter uretrae externus - volní kontrola
- S2-4 (spinální centrum močení)
- Parasympatikus
- M. detrusor
- M. sphincter internus
- Sympatikus
- Relativně malý vliv
- Lokální reflexní oblouk
- Sakrální spinální centrum
- Roztažení moč.m. podráždí stretch receptory ve stěně - reflexní kontrakce m. detrusor - při močení + koordinovaná relaxace sfinkterů
- Mikční reflex inhibován především z center ve frontálním laloku - vědomé ovl.
Neurogenní měchýř
- Různé typy neurologických sfinkterových x
- Inkontinence = neschopnost udržet moč
- Kompletní = absolutní / inkompletní = relativní
- Stresová = jen při zvýšní nitrobřišního tlaku
- Funkční = ok osoba včas nestihne dojít na WC pro motorickou x (immobilita ap.)
- Retence moči
- Především paréza m. detrusor nikoliv spasmus sfinkteru
- Paradoxní ischiurie = únik retinované moči při přeplnění m.m.
- Zůstává však reziduum
- Obtížné spouštění nebo přerušované močení
- Při nedokonalých kontrakcích m. detrusor
- Dyssinergie mezi m. detrusor a sfinktery
Neurologické léze a funkce močového měchýře
Suprapontinní léze - hyperreflektorický m.m. = desinhibiční m.m.
- Iktus, RS, Alzheimerova choroba, Parkinsonova choroba aj
- Snižují / X inhibiční funkci pontinního mikčního centra
- M.m. se vyprazdňuje již při malém objemu
- Zmenšený nebo vymizelý pocit plného m.m. a pouze krátce trvající pocit nucení k mikci
- Hyperaktivita detrusoru, x inhibice, x volní kontrola zevního sfinkteru
- Imperativní mikce = musí rychle vyhovět nutkání a mikci realizovat
- Později vzniká inkontinence v důsledku reflexní kontrakce m.m.
- Koordinace detruzoru a sfinkterů zachována, vyprazdňování kompletní
X mezi pontinním a spinálním centrem = hyperreflektorický m.m.
- X nad S2, RS
- Hyperaktivita m.detrusor, ale často x koordinace se sfinktery - dyssinergie
- Vede k retenci moči
X spinálního centra S2-4, x kořenů pod centrem, x periferních nervů
- X reflexního mechanismu
- X aferentní senzitivní inervace
- Chronická distenze
- X eferentní motorická inervace = autonomní m. m.
- X inervace m. detrusor - m.m. trvale chabý
- Distenze, reziduum a paradoxní ischiurie
- činnost sfinkterů někdy zachována, jindy x
Zdroje informací:
[1] AMBLER, Zdeněk. Základy neurologie. 6. vydání. Praha : Galén, 2006, vydáno v r. 2007, 352 stran. ISBN 80-7262-433-4.
