Neuroanatomy: neurogenic bladder after cord injury: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Neuroanatomy: neurogenic bladder after cord injury

Sample item

A man with a cervical cord injury regains reflex bladder emptying, but the detrusor and the external sphincter contract at the same time, leaving a large residual volume. What explains this dyssynergia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Cord lesion interrupts pathways from the pontine micturition centre to the sacral cord

The pontine micturition centre coordinates detrusor contraction with sphincter relaxation through descending fibres to the sacral cord. A suprasacral lesion leaves the sacral reflex arc intact but removes this coordination, giving detrusor-sphincter dyssynergia.

Option by option

  • A. Destruction of the sacral parasympathetic nucleus

    Sacral nucleus destruction would give an areflexic, flaccid bladder with overflow.

  • B. Injury to the pudendal nerve

    Pudendal injury paralyses the external sphincter, causing incontinence rather than simultaneous contraction.

  • C. Cord lesion interrupts pathways from the pontine micturition centre to the sacral cord (correct)

    Correct. Loss of pontine coordination while the sacral reflex remains produces detrusor-sphincter dyssynergia.

  • D. Damage to the hypogastric plexus

    Hypogastric plexus injury impairs sympathetic storage and bladder neck closure, not this dyssynergia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Cord lesion interrupts pathways from the pontine micturition centre to the sacral cord. The pontine micturition centre coordinates detrusor contraction with sphincter relaxation through descending fibres to the sacral cord.

Why is "Destruction of the sacral parasympathetic nucleus" not the answer?

Sacral nucleus destruction would give an areflexic, flaccid bladder with overflow.

Why is "Injury to the pudendal nerve" not the answer?

Pudendal injury paralyses the external sphincter, causing incontinence rather than simultaneous contraction.

Why is "Damage to the hypogastric plexus" not the answer?

Hypogastric plexus injury impairs sympathetic storage and bladder neck closure, not this dyssynergia.

What concept does this question test?

It tests Neuroanatomy: neurogenic bladder after cord injury in Anatomy. A suprasacral lesion leaves the sacral reflex arc intact but removes this coordination, giving detrusor-sphincter dyssynergia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroanatomy: neurogenic bladder after cord injury?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.