Chapter·AnatomyAutonomic nervous system anatomy

Parasympathetic sacral outflowDownloads

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1

A 19-year-old man is brought to the emergency department following a high-speed motor vehicle collision in which he was a restrained passenger. He complains of pelvic pain and urinary retention with overflow incontinence, along with associated lower extremity weakness. Examination shows perineal bruising and there is pain with manual compression of the pelvis. Injury to which of the following structures is most likely responsible for this patient's urinary incontinence?

AIlioinguinal nerve

BObturator nerve

CGenitofemoral nerve

DPelvic splanchnic nerves

ESuperior gluteal nerve

2

A 58-year-old obese male has noticed the gradual development of a soft bulge on his right groin that has been present over the past year and occasionally becomes very tender. He notices that it comes out when he coughs and strains during bowel movements. He is able to push the bulge back in without issue. After examination, you realize that he has an inguinal hernia and recommend open repair with mesh placement. After surgery, the patient returns to clinic and complains of numbness and tingling in the upper part of the scrotum and base of the penis. What nerve was most likely injured during the procedure?

AIlioinguinal nerve

BIliohypogastric nerve

CLateral femoral cutaneous nerve

DObturator nerve

EGenitofemoral nerve

3

One day after undergoing surgery for a traumatic right pelvic fracture, a 73-year-old man has pain over his buttocks and scrotum and urinary incontinence. Physical examination shows right-sided perineal hypesthesia and absence of anal sphincter contraction when the skin around the anus is touched. This patient is most likely to have which of the following additional neurological deficits?

AImpaired hip flexion

BParalysis of hip adductors

CAbsent cremasteric reflex

DImpaired psychogenic erection

EAbsent reflex erection

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