NO 1 - URINARY BLADDER
A ) The bladder has important clinical considerations when it comes to spinal cord lesions.
B ) There are two different clinical syndromes, depending on where the damage has occurred .
1 - Reflex Bladder – Spinal Cord Transection Above T12
In this case, the afferent signals from the bladder wall are unable to reach the brain, and the patient will have no awareness of bladder filling. There is also no descending control over the external urethral sphincter, and it isconstantly relaxed.
There is a functioning spinal reflex, where the parasympathetic system initiates detrusor contraction in response to bladder wall stretch. Thus, the bladder automatically empties as it fills – known as the reflex bladder.
2 Flaccid Bladder – Spinal Cord Transection Below T12
A spinal cord transection at this level will have damaged the parasympathetic outflow to the bladder. The detrusor muscle will be paralysed, unable to contract. The spinal reflex does not function.
In this scenario, the bladder will fill uncontrollably, becoming abnormally distended until overflow incontinence occurs.