Problems with the Urination System

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From the course by The University of Chicago

Understanding the Brain: The Neurobiology of Everyday Life

667 ratings

The University of Chicago

Understanding the Brain: The Neurobiology of Everyday Life

667 ratings

Learn how the nervous system produces behavior, how we use our brain every day, and how neuroscience can explain the common problems afflicting people today. We will study functional human neuroanatomy and neuronal communication, and then use this information to understand how we perceive the outside world, move our bodies voluntarily, stay alive, and play well with others.

From the lesson

Homeostasis

Although our bodies are very robust and we can live in a range of environments, our brain requires very specific conditions to function properly. Homeostasis is the active process by which our nervous system regulates internal conditions, such as blood pressure and temperature. This module we will explore what homeostasis does, and how it functions in everyday life.

Problems with the Urination System5:50

Sleep Phenomenology6:33

Sleep Mechanisms6:10

Wrap-Up: Homeostasis2:14

Meet the Instructors

Peggy Mason
Professor
Neurobiology

[MUSIC]

Okay, so lets look at the neuroanatomy of the control of voiding.

The, the boss in this situation is the pontine micturition center.

Micturition is a medical term for, urination.

Same thing.

But, physicians would call micturition instead of urination.

So this is the pontine micturition center, and.

Voiding depends on signals that come from the pontine

micturition center, from the pons, down to the sacral cord where these

parasympathetic neurons are that innervate the, the bladder muscle.

And also, also the, the voluntary motor neurons are.

That innervate the external urethral sphincter.

So that means that, the sacral cord is sitting

very vulnerable, very long way away, and any damage in

this entire zone of the spinal cord has the potential.

So leave these sacral cord neurons on their own.

So spinal cord damage anywhere between the start of the

spinal cord and mid sacral levels has the potential

to prevent, any voluntary voiding.

Now, contrast that with breathing which is, depends on motor neurons in c3-c4.

And so you can see that breathing there's a much smaller area of the spinal cord.

Where you're going to get damage that's

going to affect breathing, then the area of

the spinal cord where you can get damage that affects the ability to void.

So, what happens when the sacral cord is left on its own?

Let's say we had a, a spinal cord injury that cut the cord.

Well, in this situation, what happens is that these.

These movements become reflexive.

They're left on their own, they become reflexive.

And the bladder contracts every, excuse me, every time the volume increases.

The bladder contracts.

But the external urinary sphincter is a voluntary muscle.

And so it will not relax.

And so this is contracting and this is tight.

It's very tight.

Nothing's happening.

And this dyssynergia or this discoordination between the two muscles is

probably the most common initial complication

of spinal cord injury that has

to be taken care of right away and there are no treatments that

solve this, and basically this is typically solved by cathe,

catheterizing the person.

And I should mention that not everyone with spinal

cord injury has this because some people have an

incomplete spinal cord injury that doesn't actually cut the

pathway from the pons down to the sacral cord.

Now I said before hand that, it took even more than just the, the

movements of these two muscles to, to for us and for dogs and cats

to void and the signal that it's okay to void comes from the prefrontal cortex.

From

the cerebral cortex and it's an area in here that says okay,.

This is a safe area.

This is a, an appropriate time and

place in which to void, and the, then engages the pontine micturition center.

And what's, what's very interesting is that

strokes in this area, which do happen,

Not extremely commonly but they do happen, can leave this system intact

but incorrectly triggered so people will void in inappropriate

places or times and in some situations they will be actually,

they won't care that they have voided, they have no.

They have no social embarrassment about it.

other, other, other strokes in this legion will

lead to enuresis which means voiding at night time.

So, serve a pattern that goes back to babyhood.

But will have intact voiding during the day.

So there are places all along here where avoiding

is controlled and it'll produce very different types of effects.

From the, the very disturbing, these are, these are not happy.

Symptoms for people to, to deal with or for

the loved ones of, of the afflicted to deal with.

To just simply, got to take care of it, because it's not going to work.

These spinal cord injuries.

Okay.

So that is what, what we're going to cover with

respect to voiding and now we're going to move on.

To the final segment on sleep and wake.

[MUSIC]

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