Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

A patient whose spinal cord injury is above the sacral reflex arc generally has what type of neurogenic bladder?

1. Flaccid bladder

2. Reflex bladder

3. Hypotonic bladder

4. Neurogenic bladder

The correct answer is: Reflex bladder

A patient with a spinal cord injury above the sacral reflex arc typically presents with a reflex bladder. This occurs because the injury interrupts the normal communication pathways between the brain and the sacral region of the spinal cord, which typically coordinates voluntary bladder control. Although the higher brain centers may no longer send signals to the bladder, the sacral reflex arc remains intact and can still initiate bladder contractions in response to filling. As a result, when urine fills the bladder, the stretch receptors activate, leading to involuntary bladder contractions and the sensation of needing to void, even though the patient may not have the ability to control this urge consciously. This often results in a situation where the bladder can empty reflexively when full, a characteristic that defines reflex bladder function in individuals with these types of injuries. Understanding this concept is crucial for managing patients with neurogenic bladder effectively, as reflex bladder can lead to issues such as urinary incontinence if not properly monitored and treated.