Anatomy - Urinary Continence and Renal System Pain

Question 1

pain from what reproductive organ results in renal pain?

Answer 1

testis

Question 2

name the 5 types of nerve fibre

Answer 2

somatic sensory
visceral afferent
somatic motor
parasympathetic 
sympathetic

Question 3

what nerve fibre:

sensations from the body wall

external environment are conveyed to the CNS by these nerve fibres

Answer 3

somatic sensory

Question 4

what nerve fibre:

motor responses to our body wall

our external environment are conveyed from the CNS by these nerve fibres

Answer 4

somatic motor

also stimulate skeletal muscle

Question 5

what nerve fibre:

sensations from our organs

i.e. our internal environment are conveyed to the CNS by these nerve fibres

Answer 5

visceral afferent

Question 6

what nerve fibres:

motor responses to our organs i.e. our internal environment are conveyed from the CNS by these nerve fibre

Answer 6

parasympathetic and sympathetic

Question 7

how many pairs of cranial nerves are there?

Answer 7

12 pairs

Question 8

how many pairs of spinal nerves are there?

Answer 8

31 pairs

Question 9

sympathetic nerve fibres leave the CNS between what?

Answer 9

T1 and L2

Question 10

how do sympathetic nerves reach the smooth muscle ‘glands of the body?within nerves called splanchnic nerves

Answer 10

within nerves called splanchnic nerves

Question 11

how does sympathetic innervation reach the head?

Answer 11

‘hitching a ride’ with the arteries which supply the same structure

Question 12

at what levels do the sympathetic nerves leave the spinal cord to reach the kidneys, ureters and bladder?

Answer 12

T10-L2

Question 13

what splanchnic nerves do the sympathetic nerves that innervate the kidneys, ureters and bladder travel in?

Answer 13

abdominopelvic splanchnic nerves

Question 14

where do the sympathetic nerves that innervate the kidneys, ureters and bladder synapse?

Answer 14

abdominal sympathetic ganglia

Question 15

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

Answer 15

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

Question 16

parasympathetic nerve fibres leave the CNS only within _ cranial nerves and the sacral spinal nerves

Answer 16

parasympathetic nerve fibres leave the CNS only within 4 cranial nerves and the sacral spinal nerves

Question 17

name the 4 cranial nerves that carry parasympathetic innervation to the rest of the body

Answer 17

III, VII, IX and X

Question 18

parasympathetic nerve fibres which innervate the kidneys & ureter are carried within what nerve?

Answer 18

CNX

Question 19

parasympathetic nerve fibres which innervate the bladder are carried within the pelvic ___________ nerves

Answer 19

parasympathetic nerve fibres which innervate the bladder are carried within the pelvic SPLANCHNIC nerves

Question 20

do somatic motor nerve fibres go to the kidneys, ureters and bladder?

Answer 20

no - only do to structures in the perineum - distal urethra and external urethral sphincter and levator ani

Question 21

pain in the kidney itself is felt where?

Answer 21

posterior flank

Question 22

pain from calculus obstructing the ureter can be felt where?

Answer 22

radiating from loin to groin

Question 23

pain from bladder is felt where?

Answer 23

midline suprapubic region

Question 24

pain from the perineal urethra is felt where?

Answer 24

in the perineum

Question 25

how do visceral afferent nerve fibres get from the kidneys to the CNS? what spinal cord level?

Answer 25

visceral afferents from the kidneys run alongside sympathetic fibres back to the spinal cord enter spinal cord at T11-L1

Question 26

differential diagnosis of loin pain?

Answer 26

herpes zoster muscular vertebral lower lobe pneumonia

Question 27

how do visceral afferent nerve fibres get from the ureters to the CNS? what spinal cord level?

Answer 27

visceral afferents from the ureters run alongside sympathetic fibres back to the spinal cord enter the spinal cord between levels T11 and L2

Question 28

differential diagnosis of groin pain?

Answer 28

hernias lymphadenopathy testicular pathology

Question 29

how do visceral afferent nerve fibres get from the bladder to the CNS? what spinal cord level?

Answer 29

bladder touching the peritoneum = sympathetic fibres entering spinal cord at T11-L2 bladder NOT touching the peritoneum = parasympathetic nerve fibres to S2,3,4

Question 30

differential diagnosis of suprapubic pain?

Answer 30

handgun organs like signmoid diverticulitis uterus

Question 31

how do visceral afferent and somatic sensory nerve fibres get from the urethra to the CNS: (a) visceral afferent (b) somatic sensory

Answer 31

(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

Question 32

differential diagnosis of perineal pain?

Answer 32

vaginal tear anal canal fissure perineal genital ulcers

Question 33

how do pain fibres get from the testis to the CNS?

Answer 33

visceral afferents run along sympathetic to the spinal cord to T10-11 or localised in the scrotum

Question 34

differential diagnosis of scrotal pain?

Answer 34

skin lesions strangulated inguinal hernia

Question 35

describe the pain: (a) kidneys (b) ureters (c) bladder (d) urethra (e) testis

Answer 35

(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

Question 36

nerves entering and leaving the spinal cord at what level are important in urine flow?

Answer 36

S2-S4

Question 37

pelvic splanchnic nerves leave the spinal cord at what level?

Answer 37

S2,3,4

Question 38

what nerves sense the bladder filling?

Answer 38

visceral afferent nerve fibres

Question 39

what spinal level sense the bladder filling?

Answer 39

S2,3,4

Question 40

what is stimulated and what is inhibited to empty the bladder?

Answer 40

detrusor muscle is stimulated and internal sphincter in males is inhibited

Question 41

the detrusor muscle contracting and the internal urethral sphincter relaxing is para/sympathetic

Answer 41

the detrusor muscle contracting and the internal urethral sphincter relaxing is parasympathetic

Question 42

name the nerve: L2,3,4 under the inguinal ligament into the anterior compartment of the thigh

Answer 42

femoral nerve

Question 43

name the nerve: L2,3,4 passes through obturator foramen (pelvis) into medial compartment of thigh

Answer 43

obturator

Question 44

name the nerve: L4-S3 into posterior compartment of thigh via the gluteal region

Answer 44

sciatic nerve

Question 45

what does the common fibular nerve split into?

Answer 45

superficial (lateral compartment of leg) and deep (anterior compartment of leg)

Question 46

what does the sciatic nerve split into?

Answer 46

tibial nerve (muscles of posterior compartment of leg and intrinsic muscle of foot) and common fibular nerve

Question 47

bladder contraction is due to what nerve fibres?

Answer 47

parasympathetic fibres (S2,3,4)

Question 48

what fibres stimulate the internal urethral sphincter to contract?

Answer 48

sympathetic fibres (in ejaculation)

Question 49

what fibres inhibit (relax) the internal urethral sphincter?

Answer 49

parasympathetic fibres

Question 50

what nerve contracts the external urethral sphincter and what nerve contracts the levator ani?

Answer 50

external urethral sphincter - pudendal nerve - S2,S3,S4 levator ani - S3-S4