Micturition Flashcards
What 3 nerves are involved with micturition
1) Hypogastric n.
2) Pelvic n.
3) Pudendal n.
What type of fibers does the hypogastric n. have?
Sympathetic
What fibers does the pelvic n. have?
Parasympathetic
What fibers does the pudendal n. have?
Somatic
Which 2 nerves are involved with filling of the bladder?
Hypogastric and pudendal n.
Which nerve is involved with peeing?
Pelvic n.
Nerves and target of Pelvic n.
S1-S3; detrusor m.
Nerves and target of hypogastric n.
L1-L4, IUS and Detrusor m.
Nerves and target of Pudendal n.
S1-S3; EUS-somatic
Receptors of Pelvic n.
Muscarinic-ACh
Receptor of pudendal n.
Nicotinic-ACh
Receptors of hypogastric n.
Beta receptors (bladder wall); alpha receptors (neck of bladder)
Function of beta receptors
Relaxation of detrusor m.
Function of alpha receptors
Contraction of bladder sphincter
During the filling phase, the ________ nerve is inhibited
Pelvic n.
What nerve(s) are inhibited during the voiding (peeing) phase
Hypogastric and pudendal
Name the two higher centers of micturition
Pons and cerebrum
UMN signs are shown when….
A lesion is present in the spine between the pons and L7
What are UMN urinary signs
1) Large, turgid bladder
2) Difficulty expressing bladder
3) No voluntary control
When you do IVDD surgery too treat UMN, what must you use to avoid detrusor atony
Catheter
Where on the spinal cord would a lesion cause LMN signs
Sacral spinal cord or related nerves
What are LMN urinary signs
1) Large flaccid bladder
2) Easy to express, impossible to empty
3) No voluntary control
Lesions in the forebrain produce what type of urinary signs
Loss of habits about when and where to urinate
Lesions cranial to sacral segments (L7 to Pons) produce what type of urinary signs
UMN
Lesions at S1-S3 or sacral roots produce what type of urinary signs
LMN
3 TYPES OF TREATMENTS FOR UMN urinary
Catheter to empty bladder, pharmacological drugs, IVDD surgery
Muscarinic agonists are used to treat
Body of bladder
Alpha-antagonists are used to treat
The neck of the bladder (smooth m. relaxant)
Nicotinic cholinergic drugs are used to treat
The apex of the bladder
