Urinary Bladder Discussion

Urinary Bladder from 1919 Edition of Atlas of Human Anatomy
  • Lies inside the pelvic cavity behind pubic symphysis.
  • Parts-
    • Apex- allantoid and uracus through which embryo urinates gets obliterated after birth. The obliterated part is median umbilical fold.
    • Neck related to prostate.
    • Base-
      • Related to body of uterus in female fundus of uterus lies on UB
      • In males- seminal vesicles and vas.
      • The inferolateral surface is not covered by peritoneum. The outlet is covered by pelvic diaphragm. Most important muscle is levator ani. Clinical: supra pubic cystectomy
      • Superior relation in male- coils of intestine
    •  
    • Retropubic space with pad of fat
    • Interior of bladder-
      • 2 ureteric orifices in the supero lateral surfaces
      • Mucosa is not thrown into folds. There is no submucosa, so mucosa is adherent to the muscle layer.
      • Trigone of bladder is developed from the absorption of mesonephric duct.
      • Rest of bladder is developed from endodermal cloaca
      • Trigone of bladder blood supply- inferior vesicle artery
  • Ligaments-
    • True
      • Pubovesicle ligament- pubis to bladder
      • Puboprostatic ligament- pubis to prostate
      • Median umbilical ligament
    • False-(peritoneal folds)
      • Median umbilical fold- just above the uracus
      • Medial umbilical fold- above the obliterated part of umbilical artery on both sides
      • Lateral umbilical fold- folds on the inferior epigastric artery.
  • Blood Supply-
    • Superior vesicle artery
    • Inferior vesicle artery
    • Inferior gluteal artery
    • Obturator artery
  • Lymphatic- internal Iliac
  • Uvula Vesicae-
    • Protruded part near the urethral orifice produced by the medial lobe of the prostate
  • Nerve Supply-
    • Sympathetic- L1, L2- hypogastric plexus
    • Parasympathetic- S2, S3, S4
    • Higher centre for micturition- para central lobule
  • Clinical-
    • Cystitis- inflammation of bladder
    • Transitional cell carcinoma- occupational hazard for people working in alkaline dye factories
    • Suprapubic cystotomy
    • Neurogenic bladder-
      • Brain-spinal cord-bladder (normal path)
      • Signal from bladder goes to spinal cord but not further to brain in case of spinal cord injury.
      • Signal comes back from spinal cord- bladder empties on its own- autonomous bladder.
      • Once spinal edema is gone, bladder functioning returns to normal