Urinary Bladder. Upper Surface Inferolateral surface Apex Neck.
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Transcript of Urinary Bladder. Upper Surface Inferolateral surface Apex Neck.
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Urinary Bladder
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Upper Surface
Inferolateral surfaceInferolateral surface
Apex
Neck
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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
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MALE PELVIS
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MALE PELVIS
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BASE OF MALE BLADDER
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FEMALE PELVIS
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FEMALE PELVIS
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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
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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)
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URINARY BLADDER
BASE (POSTERIOR SURFACE):• Is directed backward• Its superolateral angles receive the ureters• In male: 1. Its upper part is covered by peritoneum2. It is related to vasa deferentia & seminal
vesicles separating it from rectum• In female:1. It has no peritoneal covering2. It is related to vagina
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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
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URINARY BLADDER
INFEROLATERAL SURFACES:
• Are related to retropubic fat separating them from:
1. Body of pubis
2. Levator ani
3. Obturator internus
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URINARY BLADDER
NECK:• Is the lowest & most fixed part• Lies behind symphysis pubis• Is continuous with urethra• In male:1. It rests on upper surface of prostate2. Anteriorly: it is attached to puboprostatic ligament3. Posteriorly: it is related to beginning of ejaculatory
ducts• In female:1. Anteriorly: it is attached to pubovesical ligament2. Posteriorly: it is related to anterior wall of vagina
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URINARY BLADDER
LIGAMENTS:1. Median umbilical ligament2. 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
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INTERIOR OF URINARY BLADDER
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INTERIOR OF URINARY BLADDER• The mucous membrane forms folds (rugae)
that disappear when the bladder is distended• TRIGONE: 1. A triangular area in the base of bladder,
bounded by the 2 ureteric orifices & the internal urethral orifice
2. 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
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URINARY BLADDER
Distended Empty
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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
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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
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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
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URINARY BLADDER• NERVE SUPPLY1. 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.
2. Sympathetic fibers: from first & second lumbar ganglia : by hypogastric plexuses
3. Ascending sensory fibers: carry sensation of fullness (distention) & pain sensation