renal - bladder/ureter

Question 1

parasympathetic innervation to bladder

Answer 1

• (S2,3,4) pelvic nerves

- contracts bladder

Question 2

sympathetic innervation to bladder

Answer 2

• (L1,2,3) hypogastric neres

Question 3

somatic motor innervation to bladder

Answer 3

• (S2,3,4) pudendal nerves

- motor voluntary control of ext. sphincter

Question 4

describe the vesicoureteral reflux

Answer 4

• backward flow of urine into ureters during bladder contraction
• enlarges ureters
• increases chances of kidney infection

Question 5

describe ureterorenal reflex

Answer 5

• Stone blocks ureter, so sensory afferent from ureter causes reflex and constriction of renal arterioles
• decrease fluid flow from the kidney!

Question 6

describe micturition reflex

Answer 6

• initiated by bladder stretch receptors
• pelvic nerves carry sensory to sacral segments of cord and parasympathetics carry it back telling detrusor to tighten and pressure spikes
• as bladder fills reflex gets stronger and occurs at faster rate
• autonomic spinal cord reflex, can be inhibited/facilitated by the brain
• cortical and suprapontine centers in brain can inhibit this reflex

Question 7

describe sympathetic storage reflex

Answer 7

• initiated as bladder distend and afferent activity travels in pelvic nerves to spinal cord
• firing from symp L1,2,3 initiated
• causes decreases in parasympathetic inputs to bladder

Question 8

somati storage reflex (guarding or continence reflex)

Answer 8

• caused by sudden increase in bladder pressure
• pelvic Nerve to sacral spinal cord
• • efferent somatic neurons in nucleus of Onuf are activated and signals sent through motor neurons to external sphincter
• inhibited during micturition so external sphincter will relax

Question 9

describe atonic bladder

Answer 9

• sensory N fibers from bladder tos pinal cord destoryed
• leads to no micturition reflex
• bladder does not empty periodically and overflows (leaks) = overflow incontinence
• can be caused by crush injury to sacral region of spinal cord
• also caused by teritiary syphilis resulting in tabes dorsalis where spinal cord is fine, but dorsal roots interrupted

Question 10

Describe automatic bladder

Answer 10

• caused by spinal cord damage ABOVE sacral region
• typically micturation can occur, but brain can no longer control the reflex, so reflex emptying EVENTUALLY becomes automatic
• bladder overfills until overfill incontinence… eventually micturation reflexes return with time, but no voluntary control
• prone to urinary tract infection from catheters

Question 11

what are the cause and symptoms associated with uninibited neurogenic bladder

Answer 11

• partial damage to spinal cord or brainstem causes interruptions of descending inhibitory signals but leaves facilitory signals intact
• sacral centers continually excited so that even a small amount of bladder elicits uncontrollable micturation