神经源性膀胱(台湾)创新.pptVIP

Neurogenic bladder Preface Neurogenic voiding dysfunction (neurogenic bladder), neuropathic bladder/neuropathic urethra Innervation Autonomic: Para.(S2~4)-pelvic n.-bladder(detrusor contracture) Sym.(T11~L2)-paravertebral chain-hypogastric n.-bladder/urethra(detrusor relaxation) Somatic: cortex-(S2~4)-pudendal n.-external sphincter Physiology 排尿：pelvic floor musculacture, external sphincter relax? urethral?Detrusor contracture?Trigone(防止VUR)?bladder pressure ?neck open? 解畢：Detrusor relax, bladder neck close, external sphincter tone 排尿途中：external sphincter contracture?detrusor relax Cause in