crista
Forum Guru
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24-year-old male is thrown from a car that he drove into a tree. He suffers from a T6 spinal crush injury. After he recovers from his acute injury, what is the most appropriate course of action regarding his bladder?
A. The patient should be taught how to self-catherize, because he will never be able to control his bladder.
B. The patient will have a bladder that fills and dribbles urine continually.
C. The bladder is paralyzed, and the patient will have to use abdominal compression and straining to void.
D. The bladder should remain catherized until the patient's micturation reflexes return. The patient can then be taught to cutaneously stimulate the genital area to stimulate a micturation reflex.
E. The patient will have frequent bladder reflux with resulting bladder infections.
answer is D but why? :oops:
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| usmleasr
Forum Guru
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actually...bladder in neuronal injury is divided in to UMN AND LMN type..
UMN is spastic
LMN is flaccid bladder...
in this patient...injury is at level of T6 ....immediately after injury he will go for spinal shock...where even the cord below the level will not function...for reflexes....micturition reflex will return after approximately 2 weeks(usual duration of spinal shock)...note this man will have UMN type (spastic) bladder..and no external pressure will help to evacuate...similarly overflow dribbling is a feature of LMN bladder(flaccid)
hope this helps
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| asmi
Forum Hero
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maY i ask one Q ?
WHERE IS the center micturition reflex located ?
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| usmleasr
Forum Guru
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sacral spinal cord S2,S3,level
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| crista
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thank you; it's clear now.
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| asmi
Forum Hero
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you are excellent usmleasr 
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