The parts of the urinary tract are illustrated above.
The Kidneys are two fist-sized organs located in the back of
the abdominal cavity. The kidneys perform complex functions that are vital
to life. They constantly receive blood from throughout the body and filter
it to remove toxic wastes from the blood and regulate the water volume and
chemical concentrations of the body. In this blood filtering process, the
kidneys use fluid and waste products to form urine.
The Ureters are tubes through which urine leaves the kidneys
and travels to the bladder. The ureters enter the bladder through the
ureterovesical junction, the valve in the muscle wall between the ureter
and the bladder. The function of this one-way valve is to prevent urine from
flowing backward to the kidneys from the bladder (reflux). Under normal
circumstances, this valve prevents kidney damage by preventing reflux.
The Bladder is located in the pelvis and composed of intertwining
layers of muscles. It serves as a reservoir for urine.
The Bladder neck is the outlet of the bladder and is formed by layers
of bladder muscle. When the bladder contracts, these layers of muscle pull
the bladder neck open into a funnel-shape so the urine can flow out easily.
The Urethra is the tube through which urine leaves the bladder
and is discharged outside the body.
The External sphincter is part of the urethra, located below the bladder
neck and surrounded by a circular muscle. The external sphincter muscle can
tighten to prevent the passage of urine, or it can relax and open to allow
urine to flow out of the bladder.
Normal urination, or voiding, depends on an intact nerve
supply. Prior to brain injury when the bladder was filled with urine, the
nerves in the bladder were stimulated and a message was sent along the nerves,
through the spinal cord, to the brain that told you your bladder was "full."
When the message was received by your brain, you felt the sensation of fullness
and realized you needed to urinate.
If you were in a situation where you could not urinate,
the brain sent a message down the spinal cord that told the external sphincter
muscle to tighten and the bladder to remain relaxed. When this message was
received by the external sphincter muscle and the bladder, you could voluntary
stop the bladder from contracting and hold back the flow of urine into the
urethra. When you reached a bathroom and could urinate, the brain sent
a message down the spinal cord telling the external sphincter muscle to relax
and open and the bladder to contract.
Although this may sound like a fairly simple process,
in fact, normal urination is a very complex process that requires an intact
nerve supply, coordination of the voluntary and involuntary nerves, and the
ability to recognize and respond appropriately to bodily changes. |