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Central Regulation of Autonomic Functions$
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Ida J. Llewellyn-Smith and Anthony J. M. Verberne

Print publication date: 2011

Print ISBN-13: 9780195306637

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780195306637.001.0001

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Autonomic Regulation of the Urinary Bladder and Urethra

Autonomic Regulation of the Urinary Bladder and Urethra

(p.345) 19 Autonomic Regulation of the Urinary Bladder and Urethra
Central Regulation of Autonomic Functions

William C. de Groat

Oxford University Press

Storage and elimination of urine is dependent upon the coordinated activity of two functional units in the lower urinary tract: (1) the urinary bladder and (2) the urethra. These structures are in turn controlled by three sets of peripheral nerves and complex neural circuitry in the brain and spinal cord. Micturition is an unusual visceral function because it is controlled by involuntary (reflex) mechanisms in neonates but is regulated voluntarily in adults. This distinguishes micturition from most other visceral functions, which are under involuntary control. This chapter discusses the organization of the neural pathways involved in reflex and voluntary control of micturition, including the anatomy, electrophysiology and pharmacology of inhibitory and excitatory neurotransmission. Pathophysiological mechanisms that underlie the development of lower urinary tract dysfunction in neurological diseases or after neural injury are also discussed.

Keywords:   urinary bladder, urethra, micturition, spinal cord, neurotransmission, brain, lower urinary tract, peripheral nerves, neurological diseases, neural injury

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