Anatomy of Urinary Incontinence and Renal Pain Flashcards

1
Q

What conveys sensory nerve fibres from body wall to CNS?

A

somatic sensory

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2
Q

What conveys sensory nerve fibres from organs to CNS?

A

visceral afferent

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3
Q

What conveys motor from CNS to body wall?

A

somatic motor

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4
Q

What conveys motor from CNS to organs?

A

parasympathetic or sympathetic

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5
Q

Sympathetic nerve fibres leave the CNS only within the spinal nerves between spinal cord levels of what, and what is this called?

A

T1-L2 (“thoracolumbar outflow”)

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6
Q

Which cranial nerves are parasympathetic?

A

III, VII, IX & X

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7
Q

Parasympathetic nerve fibres which innervate the kidneys & ureter are carried within which nerves?

A

vagus nerves

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8
Q

Parasympathetic nerve fibres which innervate the bladder are carried within which nerves?

A

the pelvic splanchnic nerves

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9
Q

Where is bladder pain normally felt?

A

suprapubic region (midline)

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10
Q

Pain from a calculus obstructing the ureter can often be felt where?

A

radiating from “loin to groin”, on the affected side

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11
Q

Pain from the kidney itself (e.g. in acute hydronephrosis) is felt where?

A

In the “loin”: posterior aspect of the flank region, on the affected side

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12
Q

Pain from the (perineal part of the) urethra is usually felt where?

A

localized to perineum

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13
Q

Visceral afferents from the KIDNEYS

enter the spinal cord approx. between which vertebra levels?

A

T11 and L1

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14
Q

Give 5 differentials for loin pain.

A
skin origin (e.g. herpes zoster)
muscular 
vertebrae 
spinal nerve root compression
lower lobe pneumonia
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15
Q

Visceral afferents from the URETER

enter the spinal cord approx. between which vertebra levels?

A

T11 and L2

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16
Q

Differentials of groin pain?

A

hernias (inguinal or femoral)
lymphadenopathy
testicular pathology

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17
Q

Visceral afferents from the BLADDER

enter the spinal cord approx. between which vertebra levels?

A

T11 and L2

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18
Q

How Do Visceral Afferent & Somatic Sensory Nerve Fibres get from the Urethra to the CNS?

A

visceral afferents enter back at spinal cords levels S2,S3,S4

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19
Q

Differential diagnosis of perineal pain?

A

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

20
Q

Differential diagnosis of scrotal pain

A

skin lesions

strangulated inguinal hernia

21
Q

How Do Pain Fibres get from the Testis to the CNS?

A

visceral afferents enter back at spinal cords levels T10-11

22
Q

Where can testicular pain also present?

A

localised to the scrotum and/or groin (L1 region)

23
Q

Describe pain from the kidneys themselves.

A

dull, achy type pain in the loin (posterior flank region)

24
Q

Describe pain from the ureters.

A

if obstruction, “loin to groin” pain

25
Q

Describe pain from the bladder.

A

usually dull, achy suprapubic pain

26
Q

Describe urethral pain.

A

distal urethra (that within the perineum) is felt localised and is a relatively sharp pain within the perineum

27
Q

Describe pain from the testis.

A

often felt in scrotum but can radiate to the groin and the anterior lower abdomen (can also initially present in one of the latter two)

28
Q

The nerve fibres entering and leaving spinal cord levels S2-S4 are key in the control of what?

A

micturition (urine flow)

29
Q

As the bladder fills, this is sensed by stretch receptors at the end of which fibres?

A

visceral afferent nerve fibres

30
Q

Describe what happens to the detrusor muscle during micturition.

A

The detrusor muscle contracts (parasympathetic)

31
Q

Describe what happens to the internal urethral sphincter during micturition.

A

relaxes (parasympathetic)

32
Q

Describe what happens to the external urethral sphincter during micturition.

A

relax

33
Q

Describe what happens to the levator ani muscles during micturition.

A

relax

34
Q

Describe what happens to the anterolateral abdominal wall muscles during micturition.

A

contract to increase intra-abdominal pressure and force urine out of the external urethral orifice (somatic motor nerve fibres)

35
Q

Where does the sciatic nerve arise from?

A

the sacral plexus (nerve roots L4-S3)

36
Q

What is the pudendal nerve from?

A

S2,S3,S4

37
Q

Where does the femoral nerve go?

A

anterior compartment of thigh

38
Q

Where does the obturator nerve go?

A

medial compartment of thigh

39
Q

Where does the sciatic nerve go?

A

posterior compartment of thigh via the gluteal region

40
Q

What does the tibial nerve supply?

A

muscles of the posterior part of the leg and the intrinsic muscles of the foot

41
Q

What does the sciatic nerve split into?

A

tibial and common fibular nerves

42
Q

What does the femoral nerve become?

A

saphenous nerve

43
Q

What supplies sensation to plantar aspect of foot?

A

tibial nerve

44
Q

What supplies sensation to the lateral aspect of the foot?

A

sural nerve (formed from the tibial and common fibular nerves)

45
Q

What supplies the “1st web space” in the foot?

A

deep fibular nerve

46
Q

What is pelvic kidney?

A

one kidney fails to ascend

47
Q

What is horseshoe kidney?

A

kidney trapped beneath IMA