Anatomy of urinary incontinance Flashcards
How are somatic motor and sensory nerve taken to the CNS?
within cranial or spinal nerves
What is the sympathetic outflow?
T1-L2 = thoracolumbar
How do sympathetics reach muscles and organs from the CNS?
within splanchinic nerves/sympathetic chains
What is the sympathetic outflow to get to the bladder and ureter?
T10-L2
What is the parasympathetic outflow?
CN 3,7,9 and 10
How do parasympathetics reach the hindgut and pelvic organs?
pelvic splanchnic nerves
How do parasympathetics reach the bladder?
spinal S2,3,4
How do parasympathetics reach the kidneys and ureter?
vagus CN 10
Where does referred pain go from the kidney?
loin
Where does referred pain go from the bladder?
supra pubic region
Where does referred pain go from the ureter?
loin -> groin
Where does referred pain go from the peripheral part of the urethra?
localised in the perineum
Where is pain from the testes felt?
low abdomen or scrotum
Where is pain from the urethra felt?
sharp pain in the peritoneum
Where is pain from the bladder felt?
dull achy suprapubic pain
Where is pain from the ureters felt?
loin to groin
What nerves control the bladder/urine control?
S2, 3, 4
What senses the bladder filling?
stretch receptors at the end of visceral afferent nerves
What do S2, 3, 4 do in response to bladder filling?
stimulate the detrouser muscle
in males - also inhibit the internal spinchter muscle
What does the brain do in response to the detrouser muscle being stimulated?
overrides this reflex and contracts the external spinchter and levator ani muscles
Where do visceral afferents enter the spinal cord for the testes, bladder and kidneys and the ureters?
testes - T10 and L1
bladder and kidneys - T11 and L1
ureters - T12 and L1
List the lumbar plexus in order of L1 -> L4?
iliohypogastric - L1 ilioinguinal - L1 lateral cutaneous nerve of the thigh - L2,L3 genitofemoral nerve - L1, L2 femoral nerve - L2-4 obturator nerve - L2-4
What is a good way to remember the lumbar plexus?
Hi little good fluffy obturator
How do parasympathetics let urine pass?
relax the internal urethral spinchter
How is ureteric peristalsis brought about?
due to automatic action initiated by ureteric cells which have their own auto rhymicity
