Nerve Supply of the Ureters Flashcards

Explore ureteric innervation, including autonomic plexuses, sympathetic and parasympathetic pathways, visceral afferents, and referred pain.

Card 1 of 25Question

What type of nervous system primarily supplies the ureters?

The autonomic nervous system, through sympathetic and parasympathetic fibers.

In This Section

1. What type of nervous system primarily supplies the ureters?

The autonomic nervous system, through sympathetic and parasympathetic fibers.

2. Which autonomic plexus supplies the uppermost portion of the ureter?

The renal plexus.

3. Which autonomic plexus contributes to the innervation of the abdominal ureter?

The abdominal aortic plexus.

4. Which autonomic plexus supplies the ureter near the pelvic brim?

The superior hypogastric plexus and its associated nerve pathways.

5. Which autonomic plexus contributes to the innervation of the distal pelvic ureter?

The inferior hypogastric plexus.

6. From which spinal cord segments does sympathetic innervation of the ureters primarily originate?

The lower thoracic and upper lumbar spinal cord segments, approximately T10 to L2.

7. Which nerves carry preganglionic sympathetic fibers toward the abdominal ureteric plexuses?

The thoracic and lumbar splanchnic nerves.

8. Which autonomic ganglia contribute sympathetic fibers to the upper ureter?

The aorticorenal and associated prevertebral ganglia.

9. Which nerves provide sacral parasympathetic innervation to the distal ureter?

The pelvic splanchnic nerves.

10. From which spinal cord segments do the pelvic splanchnic nerves arise?

The second through fourth sacral spinal cord segments, S2 to S4.

11. Which cranial nerve may contribute parasympathetic fibers to the upper ureter?

The vagus nerve, although its contribution to human ureteric innervation is variable and incompletely established.

12. How do autonomic nerve fibers typically reach the ureteric wall?

Through periureteric nerve plexuses accompanying the ureteric blood vessels.

13. Which tissue in the ureteric wall is a major target of autonomic innervation?

The smooth muscle of the muscularis.

14. What is the principal role of autonomic nerves in ureteric motility?

They modulate the frequency, strength, and propagation of ureteric contractions.

15. Does normal ureteric peristalsis require continuous autonomic nerve stimulation?

No. Ureteric smooth muscle generates intrinsic rhythmic activity that autonomic nerves can modify.

16. Where does the electrical activity initiating upper urinary tract peristalsis commonly originate?

Pacemaker regions associated with the renal calyces and proximal renal pelvis.

17. Which neurotransmitter is released by most postganglionic sympathetic fibers supplying the ureter?

Norepinephrine.

18. Which neurotransmitter is released by parasympathetic postganglionic neurons?

Acetylcholine.

19. Which sensory nerve fibers transmit pain associated with ureteric distension?

Visceral afferent pain fibers traveling mainly alongside sympathetic pathways.

20. Which spinal cord segments commonly receive ureteric visceral pain afferents?

Approximately T11 to L2.

21. Where are the cell bodies of ureteric visceral pain afferent neurons located?

In the dorsal root ganglia of the corresponding spinal nerves.

22. What is the typical referred pain pattern of ureteric colic?

Pain radiating from the flank toward the lower abdomen, groin, and external genitalia.

23. Why can ureteric pain be perceived in regions distant from the ureter?

Visceral and somatic sensory inputs converge on common spinal cord neurons.

24. Why can a distal ureteric stone cause urinary urgency and frequency?

Irritation near the ureterovesical junction can stimulate sensory pathways associated with the bladder.

25. Which sensory stimuli commonly activate ureteric nociceptors during obstruction?

Increased wall tension, smooth muscle spasm, and local inflammatory mediators.