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Renal > Urinary Continence and Renal System Pain > Flashcards

Urinary Continence and Renal System Pain Flashcards

1
Q

Give 3 uses of motor function in the renal system?

A

Internal and external urethral sphincters

Bladder wall contraction by detrusor muscles

Ureteric peristalsis

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2
Q

Pain from the kidneys, ureters and bladder is sensed by what type of nerve fibres?

A

Visceral afferents

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3
Q

Urinary continence:

a) does it involve sensory or motor fibres or both?
b) is it voluntary or involuntary?

A

a) Both
b) Voluntary (control of urine from the bladder)

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4
Q

Where and what type of nerve fibres does the lumbosacral plexus supply?

A

Sensory and motor to the perineum and lower limbs

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5
Q

Which urethral sphincter is voluntary?

A

External

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6
Q

What type of nerve fibre is:

A) Afferent?

B) Efferent?

A

A) Sensory

B) Motor

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7
Q

Sensations from our body wall are conveyed to the CNS via what type of nerve fibres?

A

Somatic sensory fibres

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8
Q

Sensations from our organs are conveyed to the CNS by what nerve fibres?

A

Visceral afferents

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9
Q

Motor responses to the body wall are conveyed from the CNS via what nerve fibres?

A

Somatic motor fibres

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10
Q

What do somatic motor fibres do?

A

Stimulate skeletal muscles (voluntary) to contract

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11
Q

Motor responses to our organs are conveyed from the CNS via which nerve fibres?

A

Autonomic: sympathetic and parasympathetic

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12
Q

What do autonomic nerves stimulate?

A

Smooth muscle, cardiac muscle and glands

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13
Q

Any nerve supplying a skeletal muscle is what type of nerve?

A

Somatic motor

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14
Q

What nerve fibres are responsible for bladder contraction and ureteric peristalsis?

A

Sympathetics and parasympathetics (autonomic nerves)

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15
Q

What type of nerve fibres control:

A) The internal urethral sphincter?

B) The external urethral sphincter and levator ani muscle?

A

A) Sympathetic/parasympathetic (autonomics)

B) Somatic motor

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16
Q

Pain from the urethra is sensed by what nerve fibres?

A

Visceral afferent in the pelvis, somatic sensory in the perineum

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17
Q

What type of nerve fibres do the lumbar and sacral plexus’ supply?

A

Somatic motor and sensory

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18
Q

Pain from the testis is sensed by what nerve fibres?

A

Mostly visceral afferents (small part somatic)

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19
Q
A
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20
Q

The only means by which any type of nerve fibre can communicate with the central nervous system is what?

A

By being carried in cranial or spinal nerves

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21
Q

Which types of nerve fibres are carried the entire length of their run (from origin to destination) within cranial or spinal nerves?

A

Somatic sensory and motor

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22
Q

Which types of nerve fibres are only carried by cranial/spinal nerves for a small part of their journey, to get into/out of the CNS?

A

Autonomics (sympathetics and parasympathetics), visceral afferents

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23
Q

Sympathetic fibres leave the CNS where?

A

Within spinal nerves, between spinal cord levels T1-L2

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24
Q

How do sympathetic nerves reach smooth muscle/glands of the body wall?

A

Within spinal nerves

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25
Q

How do sympathetic nerve fibres reach smooth muscle/glands of the body (internal environment)?

A

Within cardiopulmonary or abdominopelvic splanchnic nerves

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26
Q

How do sympathetic nerve fibres reach smooth muscles or glands in the head and neck?

A

By ‘hitching a ride’ with arteries which supply the same structures

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27
Q

What is a ganglion?

A

A collection of nerve cell bodies outwith the CNS (where the synapse takes place)

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28
Q

Where do the sympathetic chains run?

A

The whole length of the vertebral column

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29
Q

Sympathetic nerves travel between the sympathetic chain and where else?

A

The anterior rami of spinal nerves

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30
Q

Where are sympathetic ganglions found?

A

There is one at pretty much every vertebral level

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31
Q

Once sympathetic nerves to the kidneys, ureters and bladder have left the CNS, what happens to them?

A

Enter sympathetic chains but do not synapse

Leave the sympathetic chains within abdominopelvic splanchnic nerves

Synapse at the abdominal sympathetic ganglia which is around the abdominal aorta

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32
Q

Once sympathetic nerve fibres to the kidneys, ureters and bladder have synapsed at the abdominal sympathetic ganglion, where do they go?

A

Pass onto the surface of arteries which are running to the structure they need to innervate

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33
Q

What is the collection of nerve fibres found on the outside of arteries known as?

A

Periarterial plexus

34
Q

Which types of nerve fibres take part in periarterial plexuses?

A

Sympathetics, parasympathetics and visceral afferents

35
Q

Where do parasympathetic nerve fibres leave the CNS?

A

CNs III, VII, IX and X and sacral spinal nerves

36
Q

Do parasympathetics innervate any structures in the body wall?

A

No

37
Q

How do parasympathetics reach the smooth muscles and glands of the head and body?

A

Via cranial nerves

38
Q

How do parasympathetic nerve fibres reach the smooth muscles and glands of the hindgut and pelvic organs?

A

Pelvic splanchic nerves

39
Q

How do parasympathetic nerve fibres reach the kidneys and ureters?

A

Within the vagus nerve (CNX)

40
Q

How do parasympathetic nerve fibres reach the bladder?

A

Pelvic splanchnic nerves

41
Q

What are the only parts of the renal system that are supplied by somatic motor fibres?

A

Those within the perineum i.e. the distal urethra and its external sphincter/levator ani

42
Q

Where is pain from the kidneys felt?

A

“loin”: posterior aspect of the flank region, on the affected side

43
Q

Where is pain from the bladder usually felt?

A

Suprapubic region (midline)

44
Q

Pain from a calculus obstructing a ureter can be felt where?

A

Radiating from ‘loin to groin’ on the affected side

45
Q

Pain from the perineal part of the urethra is felt where?

A

Localised to the perineum

46
Q

How do visceral afferent nerve fibres get from the kidneys to the CNS?

A

Run alongside sympathetic fibres to the spinal cord

Enter the spinal cord between T11 and L1

47
Q

Pain from the kidneys is felt in what pattern?

A

Dermatomal ‘T11-L1’ posteriorly

48
Q

What is the main differential diagnosis of loin pain?

A

Muscular

49
Q

How do visceral afferent fibres get from the ureters and the part of the bladder which is touching the peritoneum to the CNS?

Where will pain from the ureters be felt?

A

Run alongside sympathetic fibres back to the spinal cord

Enter between T11 and L2

Pain can be felt anywhere along this path

50
Q

What are some differentials of groin pain?

A

Hernias

Lymphadenopathy

Testicular origin

51
Q
A
52
Q

How do visceral afferent fibres get from the part of the bladder which is not touching the peritoneum and the superior part of the urethra to the CNS?

A

Alongside parasympathetic fibres in spinal cord levels L2, 3, 4

53
Q

What part of the renal system crosses the pelvic pain line?

A

Bladder

54
Q

How are somatic sensory nerve fibres from the distal urethra carried to the CNS?

A

Within the pudendal nerve through S2, 3, 4

55
Q

How do visceral afferent nerve fibres get from the testes to the CNS?

A

Alongside sympathetic fibres to spinal cord levels T10, 11

56
Q

Pain from the testes can be felt where?

A

Suprapubic region and also in the groin

57
Q

Pain from which stuctures of the urinary tract will cause a dull achy pain?

A

Kidneys, bladder

58
Q

Pain from the distal urethra will be what type?

A

Sharp

59
Q

The nerve fibres entering and leaving the spinal cord at what levels are responsible for urinary continence?

A

S2, 3, 4

60
Q

What nerve fibre types from S2, 3, 4 play a role in urinary continence?

A

Parasympathetics, somatic sensory and motor, visceral afferents

61
Q

What nerve carries somatic sensory and motor nerve fibres from S2, 3, 4?

A

Pudendal nerve

62
Q

As the bladder fills, this is sensed by stretch receptors in the detrusor muscles. What nerve fibres are responsible for this?

A

Visceral afferents

63
Q

Once visceral afferent nerve fibres have passed to the CNS to signal that the bladder is full a reflex takes place. What does this reflex involve?

A

Stimulation of the detrusor muscles to contract and inhibition of the internal urethral sphincter (in males)

64
Q

Once it is an appropriate time to pee, there is contraction of various muscles. What nerve fibres allow this:

A) Detrusor muscle?

B) Internal urethral sphincter?

C) External urethral sphincter and levator ani?

D) Anterolateral abdominal wall muscles?

A

A) Parasympathetics

B) Parasympathetics

C) Somatic motor

D) Somatic motor

65
Q

It is the role of what nerve fibres to maintain the bladder in a relaxed state?

A

Sympathetics

66
Q

The sciatic nerve arises from where?

What are its nerve roots?

A

Sacral plexus

L4-S3

67
Q

What nerve roots form the pudendal nerve?

A

S2-4

68
Q

From superior to inferior, give the 6 named nerves of the lumbar plexus?

A

Iliohypogastric nerve

Ilioinguinal nerve

Lateral cutaneous nerve of the thigh

Genitofemoral nerve

Femoral nerve

Obturator nerve

69
Q

What is the corresponding nerve root for the ilioinguinal and iliohypogastric nerves?

A

L1

70
Q

What are the corresponding nerve root values for the lateral cutaneous nerve of the thigh?

A

L2, L3

71
Q

What are the corresponding nerve root values for the genitofemoral nerve?

A

L1, L2

72
Q

What are the corresponding nerve root values for the obturator and femoral nerves?

A

L2-L4

73
Q

Where does the genitofemoral nerve arise from?

Where does it supply?

A

From teh psoas major

Supplies the medial aspect of the thigh

74
Q

Where are the following nerves in relation to the psoas major muscle:

A) Femoral?

B) Obturator?

A

A) Lateral

B) Medial

75
Q

The femoral nerve passes under where to enter where?

A

Under the inguinal ligament to enter the anterior compartment of the thigh

76
Q

The obturator nerve passes through where into where?

A

Through the obturator foramen into the medial compartment of the thigh

77
Q

The sciatic nerve passes via where to reach where?

A

Via the gluteal region to enter the posterior compartment of the thigh

78
Q

The superficial fibular nerve supplies where?

A

Lateral compartment of leg

79
Q

The deep fibular nerve supplies where?

A

Anterior compartment of the leg

80
Q

The tibial nerve supplies where?

A

The posterior compartment of the leg and intrinsic muscles of the foot

Renal (8 decks)

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