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SM Renal > Anatomy: Urinary continence and renal system pain > Flashcards

Anatomy: Urinary continence and renal system pain Flashcards

1
Q

What are the 2 types of sensory nerve fibres and what do they do

A

Somatic sensory - sensations from the body wall to the CNS

Visceral Afferent - sensations from the organs to the CNS

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2
Q

What are the 3 types of motor fibres and what do they do

A

somatic motor - motor responses to our body wall from CNS (stimulate skeletal muscles to contract)
Paraysympathetic
Sympathetic

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3
Q

What nerves are responsible for ureteric peristalsis and bladder contraction

A

Autonomics (sympathetic and parasympathetic)

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4
Q

What nerve fibres control the urethral sphincter

A

somatic motor for external

Autonomics for internal (Male only)

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5
Q

What nerve fibres transmit pain from structures in the renal system

A

Visceral afferents

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6
Q

What nerve fibre transmits pain from the distal urethra

A

somatic sensory

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7
Q

Why does the testis also have some somatic sensory innervation

A

Due to its close proximity with the scrotum (body wall structure)

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8
Q

What nerve fibres are responsible for urinary continence

A

Autonomics
Somatic motor
Visceral afferent

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9
Q

How many spinal nerves do we have

A

31 pairs

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10
Q

What is the only way in which any type of nerve fibre can communicate with the CNS

A

being carried within Cranial nerves or spinal nerves

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11
Q

What is the distance that a somatic motor and a somatic sensory nerve will travel

A

The entire length of the spinal and cranial nerves

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12
Q

What is the distance that an autonomic or visceral afferent nerve will travel within the cranial nerve or spinal nerve

A

Just a short part of the nerve

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13
Q

How do sympathetic nerve fibres leave the CNS

A

Only within the spinal nerves between the spinal cord levels T1-L2 (thoracolumbar outflow)

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14
Q

How do sympathetic nerve fibres reach smooth muscle/ glands of the body wall

A

within the spinal nerves

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15
Q

How do sympathetic nerve fibres reach the smooth smooth muscle/ glands of the body (other than the body wall)

A

iwhtin nerves caled splanchnic nerves

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16
Q

What are the cardiopulmonary splanchnic nerves

A

Those which supply the viscera –> heart and respiratory structures)

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17
Q

What are the abdominopelvic splanchnic nerves

A

Those which supply the viscera of the abdomen and pelvic cavity

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18
Q

How do the sympathetic nerve fibres reach the head

A

They follow the path of the arteries (internal and external carotid plexus) to reach the viscera within the head

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19
Q

What happens once the sympathetics have left the spinal nerves

A

They enter the sympathetic chain

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20
Q

How do the sympathetic nerves leave the sympathetic chain

A

Via anterior rami

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21
Q

What are the little connections that are found between the sympathetic chain and the spinal nerves

A

Rami communicans

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22
Q

Where doe the sympathetic nerves fibres that innervate the renal system leave the spinal cord

A

Between T10 and L2

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23
Q

Where are the abdominal sympathetic ganglia located

A

Around the abdominal aorta

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24
Q

Do the sympathetic nerve fibres synapse in the sympathetic chain

A

NO - they pass through it and then leave as abdominopelvic splanchnic nerves

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25
Q

Where do the postsynaptic sympathetic nerve fibres pass from and where are they heading

A

the ganglia onto the surface of the arteries which are heading towards the organs they need to innervate

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26
Q

What is the name given to the collection of nerve fibres found on the outside of the arteries called

A

periarterial plexus

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27
Q

On what cranial nerves do the parasympathetic nerve fibres leave the CNS

A

CN 3,7,9 and 10

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28
Q

On what spinal nerves do the parasympathetic nerve fibres leave the CNS

A

S2,3,4

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29
Q

What is the difference between the abdominopelvic splanchnic nerves and the pelvic splanchnic nerves

A

Parasympathetics form the pelvic splanchnic nerves

Sympathetics form the abdominopelvic splanchnic nerves

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30
Q

What are the parasympathetic nerve fibres which innervate the kidneys and ureter carried in

A

The vagus nerve

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31
Q

What are the parasympathetic nerve fibres than innervate the baller carried in

A

The pelvic splanchnic nerves

32
Q

What parts of the renal system do the somatic fibres go to

A

Those within the perineum e.g. urethra (distal to the pelvic floor) and its sphincter (external urethral sphincter and elevator anti)

33
Q

What nerve supplies the structures within the perineum

A

The pudendal nerves (from S2,3,4)

34
Q

What nerves cause bladder contraction

A

parasympathetic fibres ( from S2,3,4 via the pelvic splanchnic nerves)

35
Q

What do the sympathetic nerve fibres do during ejaculation

A

Stimulate the internal urethral sphincter muscle to contract

36
Q

What do the parasympathetic nerve fibres cause in terms of the internal urethral sphincter

A

the internal urethral sphincter to relax so urine can flow through the urethra

37
Q

What nerve causes the external urethral sphincter to contract in both sexes

A

Somatic motor fibres within the pudendal nerve

38
Q

What nerve causes the levator ani muscle to contract

A

somatic motor fibres within the nerve (S3,4)

39
Q

Where is pain from the kidney often felt

A

In the joint: posterior part of the flank region on the affected side

40
Q

Where is pain from a calculus obstructing the ureter often felt

A

Radiating from loin to groin on the affected side

41
Q

Where is pain form the bladder usually felt

A

Suprapubic region (midline)

42
Q

Where is pain from the perineal part of the urethra usually felt

A

Localised to the perineum

43
Q

Where do the visceral afferent nerve fibres form the kidneys enter the spinal cord

A

between levels T11 and L1

44
Q

What is a differential diagnosis of loin pain

A 
Skin origin (herpes zoster) 
muscular 
vertebrae 
spinal nerve root compression 
lower lobe pneumonia
45
Q

Where do the visceral afferent nerve fibres from the ureters enter the spinal cord

A

between T11 and L2

46
Q

What is the differential diagnosis of groin pain

A

hernias (inguinal or femoral)
lymphadenopathy
testicular pathology

47
Q

Where do the visceral afferents for the bladder go back into the spinal cord

A

T11-L2

48
Q

What is the differential diagnosis of suprapubic pain

A

Hindgut organs e.g sigmoid diverticula

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

49
Q

How do the visceral afferent and somatic sensory nerve fibres get from the urethra to the CNS

A

the visceral afferents from the proximal urethra run alongside the parasympathetic nerve fibres back to spinal cord levels S2,3,4
Somatic sensory nerve fibres from the distal urethra are carried within the pudendal nerve

50
Q

What is the differential diagnosis for pain in the perineal area

A

Vaginal tear
Anal canal fissure
Perineal genital ulcers

51
Q

Where do the visceral afferents from the testis run alongside the sympathetic fibres back to and why

A

the spinal cord to levels T10-11

Due to the embryological descent

52
Q

Why can pain from the testis also present localised to the scrotum and/or groin (L1 region)

A

Due to the close relationship to the scrotal wall

53
Q

Describe the pain from the kidneys

A

Dull

achy type pain

54
Q

Describe the pain from the urethra

A

Relatively sharp pain within the perineum

55
Q

Describe the pain from the testis

A

Often felt in scrotum but can radiate to the groin and the anterior lower abdomen

56
Q

What nerve fibres are key in the control of micturition (urine flow)

A

Those entering and leaving the spinal cord levels S2-S4

57
Q

What nerve fibres sense the bladder stretch

A

visceral afferent

58
Q

What nerve fibres bring about contraction of the detrusor muscle? Sympathetics or parasympathetics

A

parasympathetics

59
Q

How can we voluntarily cause the external sphincter and elevator anti muscles to contract

A

cross your legs

60
Q

Where does the sciatic nerve arise from

A

Sacral plexus (nerve roots L4-S3)

61
Q

What does the iliohypogastric nerve supply and where does it arise

A

skin over the lateral gluteal region

L1

62
Q

What does the ilioingual nerve supply and where does it arise

A

Skin surrounding the perineal area

L1

63
Q

What does the lateral cutaneous nerve of the thigh supply and where does it arise

A

Lateral skin on the thigh

L2,3

64
Q

What does the femoral nerve of the thigh supply and where does it arise

A

Anteiror muscle of the thigh

L2-L4

65
Q

What does the obturator nerve of the thigh supply and where does it arise

A

Medial muscle compartment

L2-L4

66
Q

What does the genitofemroal nerve supply and where does it arise

A

Skin associated with the perineum

L1,2

67
Q

What lies above the femoral nerve

A

inguinal ligament

68
Q

What does the obturator nerve pass through

A

Obturator foramen

69
Q

What does the sciatic nerve split into

A

Tibial and common fibular nerves

70
Q

What does the tibial nerve supply

A

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

71
Q

What does the superficial fibular nerve supply

A

Lateral compartment of the leg

72
Q

What does the deep fibular here supply

A

The anterior compartment of the leg

73
Q

What nerve supplies sensation to the plantar aspect of the foot

A

tibial nerve

74
Q

What nerve supplies the 1st web space of the foot

A

Deep fibular

75
Q

What nerve is formed for the tibial and common fibular nerves

A

sural nerve

76
Q

What does the sural nerve supply

A

Sensation to the lateral aspect of the foot

SM Renal (23 decks)

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