External sphincter muscle of female urethra

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External sphincter muscle of female urethra
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Sagittal section of the lower part of a female trunk, right segment. (Sphincter not labeled)
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Muscles of the female perineum. (Urethral sphincter not labeled)
Details
Nerve Somatic fibers from S2-S4 through pudendal nerve
Actions Constricts urethra and vagina, maintains urinary continence
Identifiers
Latin musculus sphincter urethrae externus urethrae femininae
TA98 A09.2.03.006F
TA2 2422
FMA 19778
Anatomical terms of muscle

The external sphincter muscle of the female urethra is a muscle which controls urination in females. The muscle fibers arise on either side from the margin of the inferior ramus of the pubis. They are directed across the pubic arch in front of the urethra, and pass around it to blend with the muscular fibers of the opposite side, between the urethra and vagina.

Contents

The term "urethrovaginal sphincter" ("sphincter urethrovaginalis") is sometimes used to describe the component adjacent to the vagina. [1] [2] [3] [4] [5]

The "compressor urethrae" is also considered a distinct, adjacent muscle by some sources, [6] [7] [8] [9]

Function

The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system. The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves S2-S4 then the pudendal nerve to synapse on the muscle. [7] [10]

Voiding urine begins with voluntary relaxation of the external urethral sphincter. This is facilitated by inhibition of the somatic neurons in Onuf's nucleus via signals arising in the pontine micturition center and traveling through the descending reticulospinal tracts.

See also

Related Research Articles

<span class="mw-page-title-main">Urethra</span> Tube that connects the urinary bladder to the external urethral orifice

The urethra is the tube that connects the mammalian urinary bladder to the urinary meatus. In placental mammals, the urethra transports urine through the penis or vulva during urination and semen through the penis during ejaculation.

<span class="mw-page-title-main">Bladder</span> Organ in vertebrates that collects and stores urine from the kidneys before disposal

The bladder is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In placental mammals, urine enters the bladder via the ureters and exits via the urethra. In humans, the bladder is a distensible organ that sits on the pelvic floor. The typical adult human bladder will hold between 300 and 500 ml before the urge to empty occurs, but can hold considerably more.

<span class="mw-page-title-main">Female ejaculation</span> Expulsion of fluid during orgasm

Female ejaculation is characterized as an expulsion of fluid from the Skene's gland at the lower end of the urethra during or before an orgasm. It is also known colloquially as squirting or gushing, although research indicates that female ejaculation and squirting are different phenomena, squirting being attributed to a sudden expulsion of liquid that partly comes from the bladder and contains urine.

<span class="mw-page-title-main">Pudendal nerve</span> Main nerve of the perineum

The pudendal nerve is the main nerve of the perineum. It is a mixed nerve and also conveys sympathetic autonomic fibers. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter.

<span class="mw-page-title-main">Urination</span> Release of urine from the urinary bladder

Urination is the release of urine from the bladder to the outside of the body. Urine is released from the urethra through the penis or vulva in placental mammals and through the cloaca in other vertebrates. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, pissing, and euphemistically going number one. The process of urination is under voluntary control in healthy humans and other animals, but may occur as a reflex in infants, some elderly individuals, and those with neurological injury. It is normal for adult humans to urinate up to seven times during the day.

<span class="mw-page-title-main">Urinary incontinence</span> Uncontrolled leakage of urine

Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis. UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others.

<span class="mw-page-title-main">Onuf's nucleus</span> Group of neurons

Onuf's nucleus is a distinct group of neurons located in the ventral part of the anterior horn of the sacral region of the human spinal cord involved in the maintenance of micturition and defecatory continence, as well as muscular contraction during orgasm. It contains motor neurons, and is the origin of the pudendal nerve. The sacral region of the spinal cord is the fourth segment of vertebrae in the spinal cord which consists of the vertebrae 26-30. While working in New York City in 1899, Bronislaw Onuf-Onufrowicz discovered this group of unique cells and originally identified it as “Group X.” “Group X” was considered distinct by Onufrowicz because the cells were different in size from the surrounding neurons in the anterolateral group, suggesting that they were independent.

<span class="mw-page-title-main">Urogenital diaphragm</span> Layer of the pelvis

Older texts have asserted the existence of a urogenital diaphragm, also called the triangular ligament, which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of the urogenital diaphragm and superior fascia of the urogenital diaphragm.

<span class="mw-page-title-main">External anal sphincter</span> Flat plane of skeletal muscle fibers

The external anal sphincter is an oval tube of skeletal muscle fibers. Distally, it is adherent to the skin surrounding the margin of the anus. It exhibits a resting state of tonical contraction and also contracts during the bulbospongiosus reflex.

<span class="mw-page-title-main">Internal anal sphincter</span> Ring of smooth muscle that surrounds part of the anal canal

The internal anal sphincter, IAS, or sphincter ani internus is a ring of smooth muscle that surrounds about 2.5–4.0 cm of the anal canal. It is about 5 mm thick, and is formed by an aggregation of the smooth (involuntary) circular muscle fibers of the rectum. It terminates distally about 6 mm from the anal orifice.

<span class="mw-page-title-main">External sphincter muscle of male urethra</span>

The external sphincter muscle of the male urethra, also sphincter urethrae membranaceae, sphincter urethrae externus, surrounds the whole length of the membranous urethra, and is enclosed in the fascia of the urogenital diaphragm.

<span class="mw-page-title-main">Stress incontinence</span> Form of urinary incontinence from an inadequate closure of the bladder

Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to inadequate closure of the bladder outlet by the urethral sphincter.

<span class="mw-page-title-main">Perineal membrane</span> Anatomical term

The perineal membrane is an anatomical term for a fibrous membrane in the perineum. The term "inferior fascia of urogenital diaphragm", used in older texts, is considered equivalent to the perineal membrane.

<span class="mw-page-title-main">Bladder sphincter dyssynergia</span> Medical condition

Bladder sphincter dyssynergia is a consequence of a neurological pathology such as spinal injury or multiple sclerosis which disrupts central nervous system regulation of the micturition (urination) reflex resulting in dyscoordination of the detrusor muscles of the bladder and the male or female external urethral sphincter muscles. In normal lower urinary tract function, these two separate muscle structures act in synergistic coordination. But in this neurogenic disorder, the urethral sphincter muscle, instead of relaxing completely during voiding, dyssynergically contracts causing the flow to be interrupted and the bladder pressure to rise.

<span class="mw-page-title-main">Detrusor muscle</span> Muscle of the bladder which expels urine when it contracts

The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract.

<span class="mw-page-title-main">Urethral sphincters</span> Muscles keeping urine in the bladder

The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.

<span class="mw-page-title-main">Internal urethral sphincter</span> Urethral sphincter muscle which constricts the internal urethral orifice

The internal urethral sphincter is a urethral sphincter muscle which constricts the internal urethral orifice. It is located at the junction of the urethra with the urinary bladder and is continuous with the detrusor muscle, but anatomically and functionally fully independent from it. It is composed of smooth muscle, so it is under the control of the autonomic nervous system, specifically the sympathetic nervous system.

In neuroanatomy, the pontine micturition center is a collection of neuronal cell bodies located in the rostral pons in the brainstem involved in the supraspinal regulation of micturition (urination). When activated, the PMC relaxes the urethral sphincter, allowing for micturition to occur. The PMC coordinates with other brain centers, including the medial frontal cortex, insular cortex, hypothalamus and periaqueductal gray (PAG). The PAG acts as a relay station for ascending bladder information from the spinal cord and incoming signals from higher brain areas.

<span class="mw-page-title-main">Overflow incontinence</span> Medical condition

Overflow incontinence is a concept of urinary incontinence, characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition occurs in people who have a blockage of the bladder outlet, or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Overflow incontinence may also be a side effect of certain medications.

<span class="mw-page-title-main">Vaginal support structures</span> Structures that maintain the position of the vagina within the pelvic cavity

The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.

References

PD-icon.svgThis article incorporates text in the public domain from page 431 of the 20th edition of Gray's Anatomy (1918)

  1. Kyung Won, PhD. Chung (2005). Gross Anatomy (Board Review). Hagerstown, MD: Lippincott Williams & Wilkins. p. 262. ISBN   0-7817-5309-0.
  2. Rahn DD, Marinis SI, Schaffer JI, Corton MM (2006). "Anatomical path of the tension-free vaginal tape: reassessing current teachings". Am. J. Obstet. Gynecol. 195 (6): 1809–13. doi:10.1016/j.ajog.2006.07.009. PMID   17132484.
  3. Umek WH, Kearney R, Morgan DM, Ashton-Miller JA, DeLancey JO (2003). "The axial location of structural regions in the urethra: a magnetic resonance study in nulliparous women". Obstet Gynecol. 102 (5 Pt 1): 1039–45. doi:10.1016/j.obstetgynecol.2003.04.001. PMC   1226706 . PMID   14672484.
  4. TA A09.5.03.006F
  5. FMA:30439
  6. Adam Mitchell; Drake, Richard; Gray, Henry David; Wayne Vogl (2005). Gray's anatomy for students. Elsevier/Churchill Livingstone. p. 396. ISBN   0-443-06612-4.
  7. 1 2 Jung J, Ahn HK, and Huh Y (September 2012). "Clinical and Functional Anatomy of the Urethral Sphincter". Int Neurourol J. 16 (3): 102–106. doi:10.5213/inj.2012.16.3.102. PMC   3469827 . PMID   23094214.
  8. TA A09.5.03.005F
  9. FMA:30438
  10. Shah AP, Mevcha A, Wilby D, Alatsatianos A, Hardman JC, Jacques S, Wilton JC (November 2014). "Continence and micturition: An anatomical basis" (PDF). Clin. Anat. 27 (8): 1275–1283. doi:10.1002/ca.22388. PMID   24615792. S2CID   21875132.