Renal Flashcards
Ureteric peristalsis
Sympathetic/parasympathetic
Bladder contraction
Sympathetic/parasympathetic
Urethral sphincter control
Sympathetic/parasympathetic (internal sphincter) Somatic motor (external sphincter and levator ani)
pain from the kidneys
visceral afferent
pain from the ureters
visceral afferent
pain from the bladder
visceral afferent
pain from the urethra
visceral afferent (in pelvis) somatic sensory (in perinuem)
pain from the testis?
visceral afferent
Voluntary control of the elimination of urine from the bladder?
sympathetic/parasympathetic/somatic motor/ visceral afferent
perineum and lower limbs
somatic sensory and somatic motor
Parasympathetic nerves which innervate the kidney and ureter?
Carried within vagus nerve
Parasympathetic fibres which innervate the bladder are carried within the..
Pelvic splanchnic nerves
Which fibres stimulate the detrusor muscle to contract?
Parasympathetic fibres from S2, S3, S4 via the pelvic splanchnic nerves stimulate the detrusor muscle to contract
Where would you feel pain from the kidney itself? i.e. hydronephrosis
The pain would be felt in the “loin”
Where would you feel pain from a calculus obstructing the ureter?
Pain can often be felt radiating from “loin to groin” on the affected side
Where is pain from the bladder usually felt?
Pain from the bladder is usually felt in the suprapubic region
Where would you feel pain from the perineal part of the urethra?
Pain is usually quite localised in the perinuem
Differential diagnosis of loin pain?
Kidney Skin origin (e.g. herpes zoster) Muscular Vertebrae Spinal nerve root compression Lower lobe pneumonia
Differential diagnosis of loin pain?
Ureters
Hernia
Testicular pathology
Lymphadenopathy
Differential diagnosis of suprapubic pain?
Bladder
Hindgut organs (e.g. sigmoid diverticula)
Other single, midline pelvic organs whose superior aspect touches the peritoneum e.g. uterus
Nerve fibres in which levels are key in control of micturition?
S2-S4
Rami which form the lumbar plexus, sacral plexus and lumbo-sacral plexus?
ANTERIOR rami form these plexuses :)
Iliohypogastric and ilioinguinal
L1
Lateral cutaneous nerve of thigh?
L2, L3
Genitofemoral nerve?
L1, L2
Femoral nerve
L2-L4
Obturator nerve
L2-L4
Which nerve supplies the anterior compartment of the leg?
Deep fibular supplies the anterior compartment of the leg
Which nerve supplies the lateral compartment of the leg?
The superficial fibular supplies the lateral compartment of the leg
Which nerve supplies the posterior compartment of the leg and the intrinsic muscles of the foot?
Tibial nerve
Nerve sensation to the plantar aspect of the foot?
Tibial nerve
Which nerve supplies the 1st web space?
The deep fibular
Which nerve supplies sensation to the lateral aspect of the foot?
Sural nerve
