Bladder innervation, Micturation centre & Reflex and Cystometrogram : Renal physiology USMLE Step 1

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Bladder innervation, Micturation centre & Reflex and Cystometrogram : Renal physiology USMLE Step 1
Bladder Innervation:
The bladder is innervated by both the sympathetic and parasympathetic nervous systems. The sympathetic nerves originate from the lower thoracic and upper lumbar segments of the spinal cord and regulate bladder storage. The parasympathetic nerves originate from the sacral spinal cord and regulate bladder emptying. The somatic nerves control the external urethral sphincter, which is responsible for voluntary control of urination.
Micturition Center and Reflex:
The micturition center is located in the sacral spinal cord and consists of a network of neurons that control bladder emptying. When the bladder is full, sensory signals from stretch receptors in the bladder wall travel to the micturition center, triggering the micturition reflex. The micturition reflex involves the relaxation of the bladder smooth muscle and the contraction of the external urethral sphincter, which allows for the voluntary control of urination.
Cystometrogram:
A cystometrogram is a test used to evaluate bladder function. During this test, a catheter is inserted into the bladder, and the bladder is slowly filled with sterile fluid while the patient reports the sensation of fullness. The volume at which the patient feels the need to urinate is noted. The catheter is then emptied, and the bladder is refilled while pressure readings are taken to evaluate bladder capacity and pressure changes during filling and emptying. This test can help diagnose conditions such as overactive bladder, urinary retention, and bladder outlet obstruction.
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