After a complete spinal cord injury affecting S2-4, a bladder that cannot be emptied is which of the following?

Question

A. Hypertonic and hyperreflexive
B. Flaccid and paralyzed
C. Spastic
D. Autoreflexive
E. None of the above

Answer 1

ANS: B
Rationale: Complete lesions that damage any part of the reflexive bladder emptying circuit, that is, levels S2-S4—or afferents or parasympathetic efferents—produce a flaccid, paralyzed bladder. With an S2-4 lesion, the sympathetic efferents are intact and their signals inhibit contraction of the bladder wall and facilitate closure of the internal spincter. Complete lesions above the sacral cord interrupt descending axons that normally control bladder function but do not interrupt sacral level reflexive control of the bladder. This results in a hypertonic, hyperreflexive bladder with reduced bladder capacity. Hyperreflexive bladder and spastic bladder are synonymous. Autoreflexive is not a neuroscience term.