Christmas tree appearance of urinary bladder is seen in

Ans. is 'a' i.e., Neurogenic bladder Christmas tree appearance of the bladder is seen in neurogenic bladder caused by detrusor hyperreflexia. 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. Voiding when it does occur is involuntary with simultaneous contractions of the detrusor and external sphincter muscles. Common neurological condition resulting in detrusor hyperreflexia include Multiple sclerosis Myelodysplasia, Spinal cord trauma Spinal cord tumours, A-V malformatio not the spinal cord Radiologically, patients with long terms untreated detrusor hyperreflaxia have characteristic changes of the urinary tact. Bladder is veically oriented, with an irregular contours, consistent with trabeculation. There are frequently multipel diveicula, Such a bladder is referred to as a christmas tree. Automatic bladder Autonomous bladder Lesion site Above T5 or higher Cauda equina damage / lower motero neuron Manifestation Small spastic bladder damage Large flaccid bladder Why this name urge comes again and again due to repeated contractions and hence empties repeatedly after some time Has 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 bladder Radiological data Christmas tree appearance No VUR but still bladder is large and holds lots of residual urine