Urinary Bladder

Upper Surface Inferolateral surface Inferolateral surface Apex Neck

URINARY BLADDER SHAPE: It has the shape of three-sided pyramid placed on one of its angles, with the apex of pyramid is directed forward & its base is directed backward SITE: It lies behind the body of pubis & is separated from it by the retropubic space

MALE PELVIS

MALE PELVIS

BASE OF MALE BLADDER

FEMALE PELVIS

FEMALE PELVIS

URINARY BLADDER RETROPUBIC SPACE: It is a space filled with extraperitoneal fatty tissue continuous with that of lower part of anterior abdominal wall It accomodates distention of urinary bladder In case of rupture of urinary bladder, urine may escape upward into the anterior abdominal wall

URINARY BLADDER APEX: Is directed forward Is related to upper border of symphysis pubis Is connected to umbilicus by the median umbilical ligament (obliterated part of urachus)

URINARY BLADDER BASE (POSTERIOR SURFACE): In male: In female: Is directed backward Its superolateral angles receive the ureters In male: Its upper part is covered by peritoneum It is related to vasa deferentia & seminal vesicles separating it from rectum In female: It has no peritoneal covering It is related to vagina

URINARY BLADDER SUPERIOR SURFACE: Is covered by peritoneum in both sexes In male: it is related to sigmoid colon & loops of ileum In female: it is related to the uterus separating it from sigmoid colon & loops of ileum

URINARY BLADDER INFEROLATERAL SURFACES: Are related to retropubic fat separating them from: Body of pubis Levator ani Obturator internus

URINARY BLADDER NECK: In male: In female: Is the lowest & most fixed part Lies behind symphysis pubis Is continuous with urethra In male: It rests on upper surface of prostate Anteriorly: it is attached to puboprostatic ligament Posteriorly: it is related to beginning of ejaculatory ducts In female: Anteriorly: it is attached to pubovesical ligament Posteriorly: it is related to anterior wall of vagina

URINARY BLADDER LIGAMENTS: Median umbilical ligament Puboprostatic (pubovesical) ligament: Forms the floor of retropubic space In male: is called “puboprostatic” & extends from body of pubis to prostatic fascia & neck of bladder In female: is called “pubovesical” & extends from body of pubis to neck of bladder

INTERIOR OF URINARY BLADDER

INTERIOR OF URINARY BLADDER The mucous membrane forms folds (rugae) that disappear when the bladder is distended TRIGONE: A triangular area in the base of bladder, bounded by the 2 ureteric orifices & the internal urethral orifice Its mucous membrane is elastic, more vascular & more sensitive UVULA VESICA: is an elevation immediately behind internal urethral orifice produced by the underlying median lobe of prostate

URINARY BLADDER Distended Empty

URINARY BLADDER CAPACITY: Is about 300 ml with a maximum capacity of 500 ml Distended bladder: Is circular in shape Bulges upward into abdominal cavity Removes peritoneum form lower part of anterior abdominal wall & becomes into direct contact with it

URINARY BLADDER IN CHILD It is an abdominal organ even when empty It begins to enter the enlarging pelvis at six years of age It is not entirely a pelvic organ till after puberty Median sagittal section of a new-born female child

URINARY BLADDER ARTERIAL SUPPLY: Superior & inferior vesical arteries VENOUS DRAINAGE: Veins from the vesical venous plexus that drain into the internal iliac vein LYMPHATIC DRAINAGE: Into internal & external iliac lymph nodes

URINARY BLADDER NERVE SUPPLY Parasympathetic fibers: from S2,3,4 motor to detrusor muscle (muscle coat of bladder) & inhibitory to internal urethral sphincter, produce micturation.Pelvic splanchic nerve and inferior hypogastric nerve. Sympathetic fibers: from first & second lumbar ganglia : by hypogastric plexuses Ascending sensory fibers: carry sensation of fullness (distention) & pain sensation