Step I bladder and spinal cord lesions

[menniscus]

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I need help! i am stuck with the conus medullaris and cauda equina related to the bladder disfx...I was wondering if anyone could put some light in that... I read in too many places about both issues...
the problem is that medscape says that in conus medullaris you have a atonic bladder ... so I have thought that the PANS within S2-S4 had a reflex like the knee jerk reflex but with the bladder.. so I guess if we have a conus medullaris.. we should get a reflex hypertonic bladder.. not the opposite??

Thanks in advance!! i really need some help...

 

[megaman123]

I am not really sure what you are asking... caudal equina syndrome is damage to the peripheral nerves going to those different region below the umbilicus. Damage to the peripheral nerves will cause an atonic bladder (regardless of reflex arc), because it is a LMN lesion. Majority of the time you get hypertonicity only with UMN lesions.

 

[menniscus]

I am not really sure what you are asking... caudal equina syndrome is damage to the peripheral nerves going to those different region below the umbilicus. Damage to the peripheral nerves will cause an atonic bladder (regardless of reflex arc), because it is a LMN lesion. Majority of the time you get hypertonicity only with UMN lesions.

thanks so much!! and what about conus medullaris? how is the bladder going to be?

 

[megaman123]

Depends at what part and the level of the spinal cord, but I honestly think that may beyond your scope for Step 1. For what it's worth at the conus medullaris it will most likely be atonic.