Physiology
The fundus is made up of three layers of crisscrossing smooth muscle, called the detrusor. These three smooth muscle layers extend down the posterior urethra (where there is also skeletal muscle) toward the external sphincter region.
T10 to L1 supplies the sympathetic innervation for the bladder; this causes the detrusor to relax and the bladder neck and posterior urethra to contract. S2-S4 provides the parasympathetic innervation to the bladder and primarily supplies the fundus. The neurotransmitter is acetylcholine; this causes contraction. The sympathetic innervation is active during bladder filling, and the parasympathetic innervation is active during urination. Somatic nerves via the pudendal (from sacral cord) innervate the skeletal muscle component of the external urethral sphincter; this leads to relaxation of the external urethral sphincter (81).
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