Bladder Flashcards
What are the measurements of the bladder wall?
Typically <3 mm in a distended bladder
Which ligament is the bladder connected to?
Median umbilical ligament (fetal urachus)
What are the 3 layers of the bladder wall?
Inner mucosal lining
Middle muscular layer
Outer fibrous adventitia
What are the 3 regions of the bladder?
Superior apex Inferior neck (urethra) Middle trigone (detrusor muscle)
Where is the trigone located?
Posterior wall
How much fluid can the urinary bladder hold?
600-800 ml capacity
How to measure bladder volume
Length x width x height x 0.5233
Where do the ureters lie?
Anterior surface of psoas muscle
Cross anterior to the Common Iliac vessels
What is the Urachus?
Median Umbilical Ligament
Holds the bladder to the anterior abdominal wall
Apical extension
Cystitis etiology
Infection due to UTI or ecoli
Clinical findings of cystitis
Increased WBC Urinary frequency Urgency Hematuria Dysuria
Sonographic appearance of cystitis
Diffusely thick wall >6 mm
Internal echoes from debris
What is bladder diverticulum?
Out pouching on bladder wall
May be congenital or acquired
Complications of bladder diverticulum
Infection (cysts) due to urinary stasis in diverticula
What is papilloma?
Benign bladder wall tumor
Precursor to malignancy
Can cause hydro by ureter obstruction
Clinical presentation of papilloma
Asymptomatic
Painless Hematuria
Ultrasound appearance of papilloma
Focal thickening of bladder wall
Hyperechoic > hypoechoic
What is Transitional Cell Carcinoma (TCC)?
Most common type of bladder cancer
Clinical presentation of TCC
Weight loss
Gross Hematuria
Sonographic appearance of TCC
Same as papilloma May be single or multiple Focal thickening of bladder wall Mass protrude into bladder lumen (inwards) Hypoechoic to Hyperechoic to the bladder
What is Squamous Cell Carcinoma SCC?
More aggressive form of bladder wall cancer
Associated with chronic infection, stone and stricture
High incidence of SCC following schistosomiasis
Cannot differentiate Sonographically from TCC
Where are uretroceles usually located?
The lower end of the ureter
What is a Urachal cyst?
A cystic dilation of the urachus which is a fibrous cord extending from the umbilicus to the apex of bladder
Sonographic location of Urachal cyst
Superior and anterior to the bladder
Causes of bladder outlet obstruction
Prostate carcinoma, TCC, BPH, neurogenic bladder dysfunction, ectopic uretroceles, bladder stones and blood clots
