The Micturition Reflex | Bladder Nerve Supply | Renal Physiology

✨Micturition Physiology is really complex. In this video I've made an attempt to briefly summarise how the bladder is innervated, how the detrusor and the sphincters co-ordinate and what happens during the micturition reflex. I hope it helps you out!☀️
🌟What's in this video?
0:00 - Intro
0:11 - The functional anatomy of the bladder
1:30 - Bladder nerve supply
2:42 - The micturition reflex
4:56 - A few applied aspects of incontinence
✨ Other videos you may need:
🔅Structure of Smooth Muscle : • Structure of Smooth Mu...
🔅Smooth Muscle Contraction: • Smooth Muscle Contract...
❗️Clarifications:
At 2:00, the M3 receptor should have just been on the detrusor muscle.
At 6:05, the level of damage should have been just above the pons, but below the midbrain because the midbrain has an inhibitory area. So if the level is above the pons, the threshold will be lowered. But if it’s above the midbrain, the threshold will be essentially normal.
(Ref : Ganong's Review of Medical Physiology)
Sorry about that! 😔
✨ Other videos you may need :
• Renal Physiology:
• Renal Physiology
💫 For more videos like this, subscribe to my channel!
Byte Size Med: / @bytesizemed
📚Factual References & for Further Reading:
- Guyton and Hall Textbook of Medical Physiology
- Ganong’s Review of Medical Physiology
- Costanzo’s Textbook of Physiology
- Openstax Anatomy and Physiology
openstax.org/details/books/an...
- Openstax Biology
openstax.org/details/books/bi...
(The last two are links to open-source references. They are NOT affiliate links)
🌤 Note:
These are just a collection of my notes. So use them the way you would use borrowed notes from a friend. 📝
The images in this video are hand-drawn for illustration and explanation only.✍️ Hence, they may not be anatomically accurate. I am just one person making these videos. If there are any errors, that is unintentional. I try super hard to avoid them. Please let me know if you find any, so it gets clarified for other viewers. Science constantly evolves and changes. New discoveries are made everyday. So some of the information in these videos may become outdated. If you notice that, please let me know so I can update them.
⚡️Disclaimer:
These videos are NOT a substitute for a medical textbook. Textbooks are written by experts (which I do not claim to be), edited, proofread and referenced. Please use them.
The information has been sourced from multiple references as mentioned above. I draw all the pictures myself. But if I have inadvertently infringed on any copyright, that is completely unintentional. I only make these videos to impart education. If I have accidentally violated copyright in any way, do let me know so I can make the necessary changes or give credit to anyone who is owed the same.
These videos are NOT intended for patient education. They are NOT a substitute for diagnosis and treatment by a licensed medical professional. Always seek the advice of a qualified health care provider for any questions you may have regarding any medical condition, so that they can address your individual needs.
🔅They are ONLY meant to help students of medicine and health sciences with studying, and should be used for just that purpose and absolutely nothing else.
Byte Size Med. All Rights Reserved.

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[@bytesizemed]

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[@andrecancol]

​@@bytesizemedthanks for this video, My mom has urinary retention after a couple pelvic surgeries and urodynamics shows detusor underactivity meaning it does contract enough to empty her bladder, she does void some but has retention. Do you think sacral nerve stimulation can help her to completely void and no more use of catheters? She is 70

[@Roboticdock]

Very schematic video! The hypogastric and pelvic plexi and somatic innervation of bladder are very well demonstrated. B3 receptor (and therefore, clinical correlate, mirabegron for urge incontinence) are readily concluded. Also, PMC (Barrington nucleus) and prefrontal inhibitory impulse are very well illustrated in a wonderful schematic fashion.

[@salihasaeed6817]

Best physiology video ever 💯. Very helpful to understand abnormalities of micturation.

[@user-xb4uu5rk1b]

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This video is very helpful in understanding the reflex .hats off❤️

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[@thejaswiniravishankar1315]

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[@docadil8071]

ponto-onuf neurons? inhibitory or excitatory? does onuf motor neurons are normally actively maintain tone in EUS?

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[@MrTringuy]

Now for treatments.. For all nerves involved.. Can it Be done

[@mediarabbint9837]

If we try to stop the full bladder , it is by inhibition of parasympathetic system... right?

[@awesomeness7543]

2:07 how does the same receptor cause contraction of one muscle and relaxation of another, M3 receptors are Gq so they should cause smooth muscle contraction

[@KazOoZles1412]

What about staccato voiding?

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[@DocBebo]

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[@richardbrousseau4799]

would like to know if communication problem between brain and internal sphincter could be the reason why even after I had T.U.R.P surgery, I still can't void my bladder ? I will initiate mictions, but will only void between 25 to 50 ml. why can I begin urinating, and then it stop after 25-50ml ???

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[@bytesizemed]

Thank you for your support! Yes, I use an iPad. 😊

[@orthopod47]

There is a doubt . A LESION BETWEEN L3-S1 will cause Automatic bladder or autonomous bladder?

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[@davidschartung6389]

I always thought alpha 1 and M3 receptors both elicit the Gq pathway.. how are they acting oppositely on the internal sphincter?

[@bytesizemed]

Hi! You're right. The M3 receptor should have just been on the detrusor muscle. Thanks for catching that!

[@benjaminazumah9833]

Though alpha 1 and M3 receptors when stimulated both elicit their actions via Gq pathway, the alpha 1 receptor is part of the sympathetic nervous system while the M3 receptor is part of the parasympathetic nervous system hence the difference in their actions on the IUS ( which is opposite).

[@riseup6112]

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[@nolly_]

Is S1 not relevant here? I had a herniation on L5-S1 and now I cant feel/when the bladder is full :(

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We want PHARMACOLOGY

[@mannysingh5879]

Doesn't the detrusor muscle remain relaxed to allow the bladder to store urine under the SNS, and then contract during urination to release urine during the PNS? It's written as "contracts for storage", which may be confusing.

[@bytesizemed]

Hi. Sympathetic : Relaxes detrusor, contracts internal sphincter (storage) Parasympathetic : Contracts detrusor, relaxes internal sphincter (emptying) So the "contracts for storage" that you're referring to was about the sphincter and not the detrusor. Sorry if that was confusing. I hope this helps! 😊

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@@bytesizemed Gotchya thank you!! Great video by the way!

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♥️👏🏻