Bladder

Question 0

What are the measurements of the bladder wall?

Answer 0

Typically <3 mm in a distended bladder

Question 1

Which ligament is the bladder connected to?

Answer 1

Median umbilical ligament (fetal urachus)

Question 2

What are the 3 layers of the bladder wall?

Answer 2

Inner mucosal lining
Middle muscular layer
Outer fibrous adventitia

Question 3

What are the 3 regions of the bladder?

Answer 3

Superior apex
Inferior neck (urethra)
Middle trigone (detrusor muscle)

Question 4

Where is the trigone located?

Answer 4

Posterior wall

Question 5

How much fluid can the urinary bladder hold?

Answer 5

600-800 ml capacity

Question 6

How to measure bladder volume

Answer 6

Length x width x height x 0.5233

Question 7

Where do the ureters lie?

Answer 7

Anterior surface of psoas muscle

Cross anterior to the Common Iliac vessels

Question 8

What is the Urachus?

Answer 8

Median Umbilical Ligament
Holds the bladder to the anterior abdominal wall
Apical extension

Question 9

Cystitis etiology

Answer 9

Infection due to UTI or ecoli

Question 10

Clinical findings of cystitis

Answer 10

Increased WBC 
Urinary frequency
Urgency 
Hematuria
Dysuria

Question 11

Sonographic appearance of cystitis

Answer 11

Diffusely thick wall >6 mm

Internal echoes from debris

Question 12

What is bladder diverticulum?

Answer 12

Out pouching on bladder wall

May be congenital or acquired

Question 13

Complications of bladder diverticulum

Answer 13

Infection (cysts) due to urinary stasis in diverticula

Question 14

What is papilloma?

Answer 14

Benign bladder wall tumor
Precursor to malignancy

Can cause hydro by ureter obstruction

Question 15

Clinical presentation of papilloma

Answer 15

Asymptomatic

Painless Hematuria

Question 16

Ultrasound appearance of papilloma

Answer 16

Focal thickening of bladder wall

Hyperechoic > hypoechoic

Question 17

What is Transitional Cell Carcinoma (TCC)?

Answer 17

Most common type of bladder cancer

Question 18

Clinical presentation of TCC

Answer 18

Weight loss

Gross Hematuria

Question 19

Sonographic appearance of TCC

Answer 19

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

Question 20

What is Squamous Cell Carcinoma SCC?

Answer 20

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

Question 21

Where are uretroceles usually located?

Answer 21

The lower end of the ureter

Question 22

What is a Urachal cyst?

Answer 22

A cystic dilation of the urachus which is a fibrous cord extending from the umbilicus to the apex of bladder

Question 23

Sonographic location of Urachal cyst

Answer 23

Superior and anterior to the bladder

Question 24

Causes of bladder outlet obstruction

Answer 24

Prostate carcinoma, TCC, BPH, neurogenic bladder dysfunction, ectopic uretroceles, bladder stones and blood clots