anatomy 3

Question 1

what are the main 2 sensory modalities?

Answer 1

• somatic sensory (from body wall)

- visceral sensory (from organs)

Question 2

what are the main motor modalities?

Answer 2

• somatic motor (to body wall and voluntary/skeletal muscle)

- sympathetic/parasympathetic (to organs/viscera, smooth muscle and glands)

Question 3

pain from the renal system is conveyed via ___

Answer 3

visceral sensory afferents

• pain from urethra - visceral sensory afferent (for pelvic part) and somatic sensory (for perineum part) *

Question 4

how many pairs of cranial nerves and spinal nerves are there?

Answer 4

12 pairs of cranial nerves

31 pairs of spinal nerves

Question 5

region of sympathetic outflow?

Answer 5

thoracolumbar

T1 - L2

Question 6

how to sympathetic nerves reach target organs (smooth muscle, glands, organs)?

Answer 6

via cardiopulmonary or abdominopelvic splanchnic nerves

Question 7

where do sympathetic nerves leave the CNS to innervate the kidneys, ureters & bladder?

Answer 7

T10 - L2
enter the sympathetic chains but don’t synapse here
leave the sympathetic chains in abdominosplachnic nerves
synapse at abdominal sympathetic ganglia at the abdominal aorta

Question 8

parasympathetic outflow

Answer 8

craniosacral

four cranial nerves (III, VII, IX, X) and sacral nerves

Question 9

parasympathetics to kidneys?

parasympathetics to bladder?

Answer 9

kidneys - from vagus nerve (CN X)

bladder - from pelvic splachnic nerves (S2,3,4)

Question 10

pain from kindeys radiates to …

Answer 10

loin region

Question 11

pain from bladder radiates to …

Answer 11

suprapubic regions

Question 12

pain from renal calculi radiates to …

Answer 12

loin to groin

Question 13

pain from perineum part of urethra …

Answer 13

very localised in perineum

Question 14

DDx loin pain?

from kidney pain

Answer 14

skin origin (e.g. herpes zoster)
MUSCULAR - most common !
vertebrae 
spinal nerve root compression
lower lobe pneumonia

Question 15

DDx groin pain

from renal calculi

Answer 15

hernias (inguinal or femoral)
lymphadenopathy
testicular pathology

Question 16

DDx suprapubic pain

from bladder

Answer 16

hindgut organs, e.g. sigmoid diverticula

other single, midline pelvic organs whose superior aspect touches the peritoneum, e.g. uterus

Question 17

DDx perineal pain

from perineal urethra

Answer 17

vaginal tear
anal canal fissure
perineal genital ulcers (e.g. herpes)

Question 18

testicular pain is referred to the ….

Answer 18

abdomen

or the scrotum/groin (well localized)

Question 19

how do somatic motor nerve fibres reach the kidneys, ureters and bladder?

Answer 19

THEY DONT
somatic nerves innervate the ‘soma’ (body wall).
the only renal structure innervated by the somatic nerves is those in the perineum (distal urethra, its external sphincter and the levator ani)

Question 20

describe the process of urinary continence

Answer 20

1. bladder fills and visceral afferents send this info back to CNS via S2,3,4
2. detrusor muscle contracts and internal urethral sphincter (in men) relaxes (both parasympathetic)
3. somatic motor nerves cause contraction of external urethral sphincter, levator ani and abdominal wall muscles.