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    Micturition Reflex

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    Micturition Reflex

    Uploaded by

    ynk8vqzyrs
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    11 views11 pages

    Micturition Reflex

    Uploaded by

    ynk8vqzyrs

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 11

    MICTURITION REFLEX

    Micturition is the process of passing urine. This is primarily a reflex


    phenomenon, which is mostly integrated in the spinal cord.
    This spinal reflex is influenced by activities of the higher centers.
    Unless the bladder is filled, urine accumulates in urinary bladder without
    much increase in the intravesical pressure, as bladder wall is made up of smooth
    muscles that exhibit the property of plasticity.
    Due to plasticity, tension produced by stretching is not maintained. This
    relationship between the bladder volume and pressure is best studied by cystometry.
    Control of Micturition

    The micturition reflex is controlled by centers in the brainstem.

    1. The facilitatory area is present in pons and the inhibitory area is present in midbrain .

    Therefore, section of neuraxis above pons promotes activity of micturition reflex in which
    less filling of bladder triggers its reflex evacuation, and section above midbrain does not affect it.

    2. Posterior hypothalamus also contains a facilitatory area for micturition.

    3. Cortex has voluntary inhibitory control on micturition. In children, below 3 years of age,
    cortical inhibition is not well-developed; hence they often pass urine without their knowledge.

    4. Control on urination starts to develop at about 2 years of age and completess by 3 years.
    MECHANISM OF
    MICTURITION
    CYSTOMETRY CYSTOMETROGRAM

    Cystometry is the procedure


    to study the relationship between the
    bladder volume and pressure.

    For this purpose, a catheter


    is inserted into the bladder and
    bladder is completely emptied.

    Then, as bladder volume is


    gradually increased by slowly
    pushing water to fill bladder,
    intravesical pressure is recorded at
    different bladder volumes. This
    recording of pressure-volume
    relationship is called cystometrogram
    APPLIED PHYSIOLOGY
    ATONIC BLADDER - EFFECT OF DESTRUCTION OF SENSORY NERVE FIBER

    Atonic bladder is the urinary bladder with loss of tone in detrusor muscle.
    It is also called flaccid neurogenic bladder or hypoactive neurogenic bladder. It is
    caused by destruction of sensory (pelvic) nerve fibers of urinary bladder.
    Now, urine overflows in drops as and when it enters the bladder. It is
    called overflow incontinence or overflow dribbling.
    Conditions of Destruction of Sensory Nerve Fibers
    1. Spinal injury: During the first stage (stage of spinal shock) after injury to sacral
    segments of spinal cord the bladder becomes atonic
    2. Syphilis: Syphilis results in the degenerative nervous disorder called tabes
    dorsalis, which is characterized by the degeneration of dorsal (sensory) nerve roots.
    AUTOMATIC BLADDER

    Automatic bladder is the urinary bladder characterized by hyperactive micturition reflex with loss
    of voluntary control. So, even a small amount of urine collected in the bladder elicits the
    micturition reflex resulting in emptying of bladder.

    During the first stage (stage of spinal shock) after complete transection of spinal cord above
    sacral segments, the urinary bladder loses the tone and becomes atonic resulting in overflow
    incontinence.

    During the second stage after shock period, the micturition reflex returns. There is
    hypertrophy of detrusor muscles so that the capacity of bladder reduces.

    Some patients develop hyperactive micturition reflex.


    UNINHIBITED NEUROGENIC BLADDER

    Uninhibited neurogenic bladder is the urinary bladder with


    frequent and uncontrollable micturition caused by lesion in midbrain. It is also
    called spastic neurogenic bladder or hyperactive neurogenic bladder.

    The lesion in midbrain causes continuous excitation of spinal


    micturition centers resulting in frequent and uncontrollable micturition.
    Even a small quantity of urine collected in bladder will elicit the
    micturition reflex.

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