Sacral nerve stimulation, also known as sacral neuromodulation, is a procedure in which the sacral nerve at the base of the

spine is stimulated by a mild electrical current from an implanted device * What are the normal results from sacral nerve stimulation? Patients report improvement in the number of urinations, the volume of urine produced, lessened urgency, and higher overall quality of life after treatment with SNS. * What is the function of sacral nerve ? Autonomic Nerve function in the body.

Sacral nerves The brain tells the bladder and bowel what to do by sending electrical signals to the muscles in the pelvic floor, the sphincters, the urethra as well as the bladder and rectal area. Two important sacral nerves that affect the functioning of the bladder and bowel are the pudendal nerve and the pelvic splanchnic nerve. The messages or impulses sent by the brain to the pelvic area are carried by a system of special fibres called nerves. These signals start in the brain, go through the spinal cord and continue to the nerves located in the sacral area of the back before being sent to the pelvic area. Which nerves? There are 31 pairs of these nerves in the lower back. Some of these sacral nerves go to the rectum, the bladder's detrusor muscle, levator ani muscle, and external sphincter muscles, controlling their activities. Two important sacral nerves to the functioning of the bladder and bowel are the pudendal nerve and the pelvic splanchnic nerve. Through a series of reflexes and signals the nerves and the bladder and bowel coordinate with the pelvic floor muscles and external urinary and anal sphincters. This coordination ensures that the sphincters remain closed, opening only during micturition (a term for urination) or defecation. In other words, as the bladder (or rectum) fills, the pressure inside it increases. The nerves sense this pressure and tell the brain about it. The brain then sends signals via the nerves to keep the external sphincter closed. Normally, this prevents leakage. This is called the guarding reflex. When you are ready to go to the toilet, the brain tells the nerves to signal the bladder (or rectum) to empty. You relax the muscles surrounding the urethra (or anus). The bladder (or rectum) empties and urine (or faeces) is expelled. Sensory signals The nerve pathways are also shared with fibres that carry sensory signals, such as pain or fullness. Pain that originates in the pelvic area is transmitted along these pathways to the sacral area, up the spinal cord and back to the brain. The same happens as the bladder (or rectum) fills. This sensation of filling is registered by the nerves, which transmit the information to the brain. The nerves also tell the brain whether it's gas or stool that's filling the rectal canal.

OUR LADY OF FATIMA UNIVERSITY College of Nursing Regalado Fairview, Quezon City

HOSPITAL OF AFFILIATION: Philippine Orthopedic Center AREA/WARD: Orthopedic Ward DATE OF CLINICAL EXPOSURE: January 30, 2012 (ORIENTATION) DAY AND TIME OF DUTY EXPOSURE: Monday/7am

NARRATIVE REPORT

30th of January 2012, the date we oriented in Philippine Orthopedic Center. In our general meeting we tackled some topic regarded by Musculoskeletal System. Specifically its all about the muscles, bones, tendons, tissues, and ligaments. Those topic that we discussed would help us to improve our knowledge and skills especially in actual momentum of ourselves. On actual perspective, being duty in Philippine Orthopedic Center, we need to be coherent and conscious about what were going to do in casting and traction care. Every single of action will be finalized and drastically thinking, because casting and traction can be invasive procedure when you did it falsely. But we started the orientation by naming each University that will be duty in Philippine Orthopedic Center. There are Thomasians, students from Manila Doctors, and also other provinces like students from Batangas University. And last but not the least are students from OUR LADY OF FATIMA UNIVERSITY, considered us. If im not mistaken my Alma Mater has more nursing student that will be duty in Philippine Orthopedic Center for about 3-4 groups.