I2I2 



HANDBOOK OF I'lIVSIOI.OOY 



NElIROPHYSIOLOG^■ II 



ETHER 



FIG. 6. Grapli showing A, cysto- 

 mctrogiam in intact state (.V) and that 

 under ether anesthesia; B, cystometro- 

 Rram in intact state and that under 

 pentobarbital anesthesia; C, cysto- 

 metrograni in intact state and that 

 after death. [From Tang & Ruch (32).] 



10 20 30 40 50 60 70 80 90 100 



INTRAVESICAL VOLUME IN C C, 



q: 

 a. 



10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 

 INTRAVESICAL VOLUME IN C.C. 



FIG. 7. A. Cystomctrograms following 

 spinal transection (.S7^) and subsequent 

 sacral rhizotomy (.S'.l). li. Spinal cysto- 

 metrograins showing shift of second 

 curve (SP.) to right of the first (SP,). 

 [From Tang & Ruch (3^).] 



siinihir t(i lliosc of skclcUil iiiuscic. The N'isrous pro]5- 

 crlics explain llio resistance to sudden slretcli, the 

 subsidence of this resistance and a iiysleresis effect. 

 On release of stretch, ihc pressure cui'\e fails 10 re- 

 trace the curve followed on the application of stretch. 

 The failure of two similar applications of stretch, as 

 in fit;ure H, to yield the same curve is a similar 

 j)heiu)iuenon. 



A physical chaniije in the bladder wall which shifts 

 the cystometric curve to the left (hypertonicity) has 

 also been produced experimenially. According to 

 Carpenter & Root's analysis (5), this hypertonicity 

 (fig. 9) occurs after section of the pelvic nerve or, to 

 a lesser degree, of the sacral roots; develops a few 

 days postoperatively; is not due to infcciion; and is 

 accompanied l)\ :i Inpertrophy of ihe bhitkler wall 



(.(I, iiKinilesU'd in weiuhl and hislolosjical ;ippear- 

 ance. The degree of hy[)ertrophy was related to the 

 anu)unt of residual urine and the intravesical pres- 

 sure; these were greater alter iicKic nerve .section 

 which leaxes intact the tonic inner\ation of the ex- 

 ternal sphincter via the pudendal ner\es. 



.Another inid more striking wa\ in which (he jjhys- 

 ical status of the bladder can be altered in the direc- 

 tion of 'hy|)ertonicity" was shown (|uantitatively by 

 \ eeiieiiKi el <il. (34). Thev exteriorized the ureters of 

 dogs, prexenting the bladder from receiving its nor- 

 mal periodic filling and emptying. The cystometro- 

 gram taken 39 days postoperatively showed a sharply 

 ascending .Segment II (fig. 10). Unfortunately, the 

 behavior of the bladder in repealed cysiometrograms 

 was not studied. This and the lime eour.se of recovery 

 from li\ |)ok)nicit\ induced b\ sireteh elearlv deserve 



