Neurogenic Detrusor Spasticity (active neuropathic incontinence)

active neuropathic incontinence, Anatomy, conus medullaris damage, cortical inhibitory control, cortical regulatory, Damage at any level above the conus medullaris, Damage to upper motor neurons, expulsion of urine, hyperreflexia, internal urethral sphincter, local reflex arcs, muscle of urinary bladder wall, Neurogenic Detrusor instability, Neurogenic Detrusor Spasticity, pelvic plexus, pelvic plexus (S2-S4), Spinal cord injury above the conus medullaris, spinal levels T11-L2, supraspinal centers in the pons and cortex, upper motor neuron damage, urinary bladder, urinary bladder stretch-contraction reflex arc, visceral motor neurons, visceral sensory (afferent) neurons, voluntary control of micturition bladder stretch-contraction arc Also known as active neuropathic incontinence. The detrusor muscle is the muscle of urinary bladder wall. It is primarily controlled by local reflex arcs, though there is cortical inhibitory control as well. The reflex arcs include visceral sensory (afferent) neurons that detect bladder wall stretch and visceral motor neurons that stimulate detrusor contraction and expulsion of urine. At rest, this reflex is suppressed by upper motor neurons projecting from supraspinalactive neuropathic incontinence, Anatomy, conus medullaris damage, cortical inhibitory control, cortical regulatory, Damage at any level above the conus medullaris, Damage to upper motor neurons, expulsion of urine, hyperreflexia, internal urethral sphincter, local reflex arcs, muscle of urinary bladder wall, Neurogenic Detrusor instability, Neurogenic Detrusor Spasticity, pelvic plexus, pelvic plexus (S2-S4), Spinal cord injury above the conus medullaris, spinal levels T11-L2, supraspinal centers in the pons and cortex, upper motor neuron damage, urinary bladder, urinary bladder stretch-contraction reflex arc, visceral motor neurons, visceral sensory (afferent) neurons, voluntary control of micturition centers in the pons and cortex, allowing voluntary control of micturition. Spinal cord injury above the conus medullaris can damage these cortical regulatory, causing hyperreflexia in response to stretch (following a brief period of bladder areflesxia).
Parasympathetic neurons from the pelvic plexus (S2-S4) provide excitatory motor innervation to the detrusor muscle and inhibitory innervation to the internal urethral sphincter. Sympathetic neurons from spinal levels T11-L2 inhibit the detrusor muscle.

Damage to upper motor neurons that control the urinary bladder stretch-contraction reflex arc causes neurogenic detrusor instability. Damage at any level above the conus medullaris can cause this problem.

Source: USMLE World 2009

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About Blue Star

Medical Student (Future MD)
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