Anatomy - Urinary Continence and Renal System Pain Flashcards
pain from what reproductive organ results in renal pain?
testis
name the 5 types of nerve fibre
somatic sensory visceral afferent somatic motor parasympathetic sympathetic
what nerve fibre:
sensations from the body wall
external environment are conveyed to the CNS by these nerve fibres
somatic sensory
what nerve fibre:
motor responses to our body wall
our external environment are conveyed from the CNS by these nerve fibres
somatic motor
also stimulate skeletal muscle
what nerve fibre:
sensations from our organs
i.e. our internal environment are conveyed to the CNS by these nerve fibres
visceral afferent
what nerve fibres:
motor responses to our organs i.e. our internal environment are conveyed from the CNS by these nerve fibre
parasympathetic and sympathetic
how many pairs of cranial nerves are there?
12 pairs
how many pairs of spinal nerves are there?
31 pairs
sympathetic nerve fibres leave the CNS between what?
T1 and L2
how do sympathetic nerves reach the smooth muscle ‘glands of the body?within nerves called splanchnic nerves
within nerves called splanchnic nerves
how does sympathetic innervation reach the head?
‘hitching a ride’ with the arteries which supply the same structure
at what levels do the sympathetic nerves leave the spinal cord to reach the kidneys, ureters and bladder?
T10-L2
what splanchnic nerves do the sympathetic nerves that innervate the kidneys, ureters and bladder travel in?
abdominopelvic splanchnic nerves
where do the sympathetic nerves that innervate the kidneys, ureters and bladder synapse?
abdominal sympathetic ganglia
postsynaptic sympathetic nerve fibres of the renal system pass from the ganglia onto the surface of the _________ which are heading towards the organs they need to innervate
postsynaptic sympathetic nerve fibres of the renal system pass from the ganglia onto the surface of the ARTERIES which are heading towards the organs they need to innervate
parasympathetic nerve fibres leave the CNS only within _ cranial nerves and the sacral spinal nerves
parasympathetic nerve fibres leave the CNS only within 4 cranial nerves and the sacral spinal nerves
name the 4 cranial nerves that carry parasympathetic innervation to the rest of the body
III, VII, IX and X
parasympathetic nerve fibres which innervate the kidneys & ureter are carried within what nerve?
CNX
parasympathetic nerve fibres which innervate the bladder are carried within the pelvic ___________ nerves
parasympathetic nerve fibres which innervate the bladder are carried within the pelvic SPLANCHNIC nerves
do somatic motor nerve fibres go to the kidneys, ureters and bladder?
no - only do to structures in the perineum - distal urethra and external urethral sphincter and levator ani
pain in the kidney itself is felt where?
posterior flank
pain from calculus obstructing the ureter can be felt where?
radiating from loin to groin
pain from bladder is felt where?
midline suprapubic region
pain from the perineal urethra is felt where?
in the perineum
how do visceral afferent nerve fibres get from the kidneys to the CNS? what spinal cord level?
visceral afferents from the kidneys run alongside sympathetic fibres back to the spinal cord
enter spinal cord at T11-L1
differential diagnosis of loin pain?
herpes zoster
muscular
vertebral
lower lobe pneumonia
how do visceral afferent nerve fibres get from the ureters to the CNS? what spinal cord level?
visceral afferents from the ureters run alongside sympathetic fibres back to the spinal cord
enter the spinal cord between levels T11 and L2
differential diagnosis of groin pain?
hernias
lymphadenopathy
testicular pathology
how do visceral afferent nerve fibres get from the bladder to the CNS? what spinal cord level?
bladder touching the peritoneum = sympathetic fibres entering spinal cord at T11-L2
bladder NOT touching the peritoneum = parasympathetic nerve fibres to S2,3,4
differential diagnosis of suprapubic pain?
handgun organs like signmoid diverticulitis
uterus
how do visceral afferent and somatic sensory nerve fibres get from the urethra to the CNS:
(a) visceral afferent
(b) somatic sensory
(a) visceral afferent - proximal urethra run alongside parasympathetic nerves fibres to S2,3,4
(b) somatic sensory - from remaining urethra in pudendal nerve to S2,3,4
differential diagnosis of perineal pain?
vaginal tear
anal canal fissure
perineal genital ulcers
how do pain fibres get from the testis to the CNS?
visceral afferents run along sympathetic to the spinal cord to T10-11 or localised in the scrotum
differential diagnosis of scrotal pain?
skin lesions
strangulated inguinal hernia
describe the pain:
(a) kidneys
(b) ureters
(c) bladder
(d) urethra
(e) testis
(a) kidneys - dull ache in loin
(b) ureters - loin to groin in obstruction
(c) bladder - dull ache in suprapubic region
(d) urethra - distal is localised and sharp
(e) testis - in scrotum but can radiate to groin and anterior lower abdomen
nerves entering and leaving the spinal cord at what level are important in urine flow?
S2-S4
pelvic splanchnic nerves leave the spinal cord at what level?
S2,3,4
what nerves sense the bladder filling?
visceral afferent nerve fibres
what spinal level sense the bladder filling?
S2,3,4
what is stimulated and what is inhibited to empty the bladder?
detrusor muscle is stimulated and internal sphincter in males is inhibited
the detrusor muscle contracting and the internal urethral sphincter relaxing is para/sympathetic
the detrusor muscle contracting and the internal urethral sphincter relaxing is parasympathetic
name the nerve:
L2,3,4
under the inguinal ligament into the anterior compartment of the thigh
femoral nerve
name the nerve:
L2,3,4
passes through obturator foramen (pelvis) into medial compartment of thigh
obturator
name the nerve:
L4-S3
into posterior compartment of thigh via the gluteal region
sciatic nerve
what does the common fibular nerve split into?
superficial (lateral compartment of leg) and deep (anterior compartment of leg)
what does the sciatic nerve split into?
tibial nerve (muscles of posterior compartment of leg and intrinsic muscle of foot) and common fibular nerve
bladder contraction is due to what nerve fibres?
parasympathetic fibres (S2,3,4)
what fibres stimulate the internal urethral sphincter to contract?
sympathetic fibres (in ejaculation)
what fibres inhibit (relax) the internal urethral sphincter?
parasympathetic fibres
what nerve contracts the external urethral sphincter and what nerve contracts the levator ani?
external urethral sphincter - pudendal nerve - S2,S3,S4
levator ani - S3-S4