Christmas tree appearance of urinary bladder is seen in -

Ans. is 'a' i.e., Neurogenic bladder o Christmas tree appearance of the bladder is seen in neurogenic bladder caused by detrusor hyperreflexia.o Detrusor hyperreflexia is caused by lesions of the spinal cord above the sacral segments but below the pons. Such patients have noperception of bladder filling or emptying and voluntary' voiding is not possible.o Voiding when it does occur is involuntary with simultaneous contractions of the detrusor and external sphincter muscles.o Common neurological condition resulting in detrusor hyperreflexia include :Multiple sclerosisMyelodysplasia,Spinal cord traumaSpinal cord tumours,A-V malformatio nof the spinal cordo Radiologically patients with long terms untreated detrusor hyperreflaxia have characteristic changes of the urinary tact.Bladder is vertically oriented, with an irregular contours, consistent with trabeculation. There are frequently multipel diverticula. Such a bladder is referred to as a Christmas tree. Automatic bladderAutonomous bladderLesion siteAbove T5 or higherCauda equina damage / lower motero neuron damageManifestationSmall spastic bladderLarge flaccid bladderWhy this name ?urge comes again and again due to repeated contractions and hence empties repeatedly after some timeHas no urge sensation and continuous DRIBBLING occurs. So it is like the bladder is working all the time but Brain has no control over it and hence called autonomous bladderRadiological dataChristmas tree appearanceNo VUR but still bladder is large and holds lots of residual urine