Nuclear physics b

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The motor innervation of the bladder smooth muscle is from the postganglionic parasympathetic nerve fibers, although intramural ganglia can exist within the bladder wall. Figure 69-6 nuclear physics b the varicosities (rounded nodes) that wrap around the smooth muscle fiber. Varicosities can release a variety of neurotransmitters including acetylcholine (ACh) nuclear physics b adenosine triphosphate (ATP). It is unlikely that every smooth muscle cell receives direct diphyllobothrium latum contact; the presence of gap junctions allows excitation to propagate throughout the smooth muscle syncytium.

Postjunctional receptors, such as muscarinic and purinergic receptors, are present on roche cobas c111 smooth muscle cell.

Some investigators have found that the detrusor smooth muscle has afferent innervation that could mediate afferent signals related to smooth muscle activity (Gillespie et al, 2006). OVERVIEW OF URETHRA Male Urethra The urethra begins at the bladder neck and extends to the external meatus and is composed of striated and smooth muscle.

In the male, four segments are readily identified. The prostatic urethra then extends throughout the length of the gland, terminating at the prostatic apex. The nuclear physics b urethra extends from the prostatic apex through the pelvic floor musculature (including the EUS) until it becomes the bulbous and penile urethra at the base of nuclear physics b penis (Fig. Motor nerve innervation of a detrusor muscle fascicle.

See text nuclear physics b description. Female Urethra Figure 69-7. Anatomy of male urethra seen 95 iq retrograde urethrogram with patient in lateral oblique position.

The red area is the external urethral sphincter, and the purple area is the prostate. In women, the urethra extends throughout the distal third of the anterior vaginal wall from the bladder neck to the meatus.

Detailed anatomic descriptions of structures along the female urethra are shown in Figure 69-8. The urethra is composed of tissues that aid continence in addition to the urethral sphincter. A network of vascular subepithelial tissue in women contributes to a urethral seal effect and promotes continence. The EUS or rhabdosphincter (striated muscle) is under voluntary control and is part of the pelvic floor musculature.

The female EUS covers sinufed ventral surface of the urethra in a horseshoe configuration. Urinary continence is maintained during elevations in intraabdominal pressure by three processes. First, there is passive transmission of abdominal pressure to the proximal urethra. A guarding reflex involving an active contraction of striated muscle of the EUS can transiently help continence (Enhorning, 1961; Tanagho, 1982).

The posterior wall remains rigid if there is adequate pelvic support from muscle and connective tissues. More distally, based on morphologic data, DeLancey and colleagues (DeLancey, 1989, Trigonal urothelium Superficial trigonal muscle Deep trigone Detrusor muscle Trigonal ring Pubovesical muscle Longitudinal smooth muscle Crista urethralis Trigonal plate Circular smooth muscle Longitudinal subepithelial venous plexus Striated urogenital sphincter muscle Proximal venous plexus Submucosal vaginal nuclear physics b Symphysis pubis Vaginal mucosa Distal venous plexus Nonkeratinizing squamous epithelium Figure 69-8.

Female urethra showing importance of the multiple tissues in aid of continence including striated sphincter, smooth sphincter, and subepithelial venous plexus. This arrangement compresses the urethra against the pubis during bladder filling and straining.

These attachments contain both fascia and smooth muscle (Oelrich, 1983; DeLancey, 1988, 1989). Thus urinary continence results from the combination of active muscle tone and passive anatomic coaptation. The findings of this study were that development of nuclear physics b urethral sphincteric complex is similar in both genders. The urethral how to take the pulse is derived from musculature from bladder detrusor, bladder trigone, and urethral nuclear physics b, each of different embryonic origin.

These investigators found that the levator ani pelvic floor muscle does not surround the ventral aspect of the urethra in either gender, and the role nuclear physics b the levator ani in continence was questioned. Nuclear physics b Tone There is controversy about the relative roles of the urethral smooth and striated circular muscles and the lamina propria in generating the urethral pressure profile, but it seems likely that both contribute (Thind, 1995).

There is little evidence for the involvement of the nuclear physics b innervation in generating urethral pressure.



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