Download e-book for iPad: Ciba Foundation Symposium 151 - Neurobiology of Incontinence by CIBA Foundation Symposium

By CIBA Foundation Symposium

ISBN-10: 0470513942

ISBN-13: 9780470513941

ISBN-10: 0471926876

ISBN-13: 9780471926870

Incontinence is a really universal and sometimes devastating challenge, yet person who is going principally unacknowledged. to be able to elucidate the underlying mechanisms of this significant scientific , this symposium introduced jointly neuroscientists engaged on the fundamental biology of the bladder and bowel and clinicians facing many of the manifestations of urinary and fecal incontinence. The ensuing assurance is vast and contains papers at the innervation and practical anatomy of the urinary tract and anorectal quarter, and the imperative neural keep watch over of those parts. different contributions speak about the sensible overview of the anorectum and bladder, pressure incontinence and the neurogenic speculation of incontinence, detrusor-external sphincter dyssynergia, and pharmacological and surgical ways to therapy.

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For example, it exhibits only two modes of operation, namely the storage and elimination of urine. Thus, many of the neural circuits controlling micturition exhibit switch-like or phasic patterns of activity (Fig. l), in contrast to the tonic patterns occurring in autonomic pathways to the cardiovascular organs. In addition, the storage and release of 27 de Groat 28 urine are clearly under voluntary control, unlike many other visceral functions which are purely involuntary. Micturition is therefore dependent on learned behaviour which emerges during maturation of the nervous system as well as on primitive reflexes which are present in the neonate.

Electrical stimulation of this dorsolateral area elicits sphincter contractions and inhibits bladder activity, whereas stimulation of the more medial pontine micturition centre produces the opposite effects: inhibition of sphincter activity and excitation of the bladder. Neurophysiological data are consistent with the concept of a spinobulbospinal micturition reflex pathway. In both cat and rats stimulation of bladder afferents activates neurons in the pons at latencies of 30-40 ms, whereas electrical stimulation in the pons excites sacral preganglionic neurons at latencies of 45-60ms (de Groat 1975).

In addition, the firing of sacral preganglionic neurons elicited by bladder distension in chronic spinal cats after recovery from spinal shock is similar to that occurring in intact cats (de Groat & Ryall 1969, de Groat et a1 1982). However, despite these similarities, electrophysiological studies in rats and cats have shown that the reflex pathways in intact and chronic animals are markedly different. In both species the central delay for the micturition reflex in chronic spinal animals is considerably shorter ( < 5 ms in rats; 15-40ms in cats) than in intact animals (60-75 ms).

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Ciba Foundation Symposium 151 - Neurobiology of Incontinence by CIBA Foundation Symposium


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