Nerve supply to musculature of urinary bladder is ?
Symphathetic
Parasympathetic
Both
None
Ans. is 'c' i.e., BothParasympathetic supply is motor to detrusor muscle and inhibitory to sphinchter vesicae. Sympathetic supply is motor to sphincter vesicae and inhibitory to detrusor muscle.Nerve supply of bladderBladder is supplied by both sympathetic and parasympathetic fibers.Parasympathetic : Preganglionic fibers arise from S2 to S4 cord segments, pass pelvic splanchnic nerves. After relay in ganglion cells in pelvic plexus (inferior hypogastric plexus) and in bladder wall, postganglionic fibers supply detrusor muscle. Contraction of detrusor muscle is mediated by cholinergic muscarinic receptors(M3).Preganglionic parasympathetic neurons at S2,and S4cord segments innervating bladder form sacral micturition center.Sympathetic : Preganglionoic fibers arise from lateral horn cells of T1-L2 cord segments and pass lower lumbar splanchnic nerves, superior hypogastric plexus (presacral nerve of Latarjet) to reach inferior hypogastric (pelvic) plexus. After relay in pelvic ganglia, postganglionic sympathetic fibers (i) stimulate sphincter vesicae (internal urethral sphincter) a, adrenoceptors and (ii) cause relaxation of detrusor muscle 132 adrenoceptors. It can also inhibit presynaptically the parasympathetic ganglia a, adrenoceptorsVisceral afferents : (1) pain fibers from bladder pass through both parasympathetic and sympathetic pathway and enter TH-L2 and S2-S4 cord segments, hence referred pain is felt in lower pa of anterior abdominal wall (hypogastrium), upper pa of front of thigh, scrotum or labium majus, penis or clitoris, and perineum. Centrally, spinothalmic pathway conducts pain impulses from bladder.Stretch afferents : arising from stretch receptors in the bladder wall pass pelvic splanchnic nerves, enter S2, S3 and S4 cord segments and establish reflex connections with sacral micturition center, which innervates detrusor.So afferent and efferent limb of this micturition reflex is formed by pelvic splanchnic nerves.Sacral mictruition center and the micturition reflex are controlled by facilitatory and inhibitory centers located in pons and paracentral lobule of frontal lobe of cerebum.