Bladder, Male Urethra, Prostate Flashcards
Surfaces an borders of the urinary bladder
3 surfaces:
Superior and 2 inferolateral surfaces
4 borders:
2 lateral, anterior and posterior
The Trigone is made of
Posterolateral angles: ureteric orifices
Anteroinferior angle: urethral orifice
Interureteric bar
Superior trigone muscle
Deep detrusor muscle
Relation of the bladder?
Anteriorly:
Retropubic space of Retzius
Posteriorly: separated from rectum by rectovesicle pouch/rectouterine pouch
Relations of apex of bladder?
Faces towards upper part of pubic symphysis, continuing as median umbilical ligament.
The median umbilical fold is formed by
Peritoneum
Base of bladder is separated from rectum by what three things
Rectovesicle pouch anteriorly
Seminal vesicle and vas deferens
Denonvilliers fascia
True ligaments of the bladder
- pubovesical ligament( women)
-puboprostatic ligament(men)
Medial and lateral
-Lateral true ligament in male - posterior vesical ligament male
- median umbilical ligament
False ligaments of the bladder
Median umbilical folds
Medial umbilical folds
Lateral false ligaments
Posterior false ligament
Vesical mucosa
Folds in empty bladder
Location of urethral orifice
Trigonal apex
Referred pain in distended distended pelvis
T11-L2: S2-S4. Felt in lower anterior abdominal wall, perineum, penis
Blood supply to bladdwr
-Inferior vesical arteries, supplemented by obturator and inferior gluteal arteries
In females also vaginal and uterine arteries
Venous drainage and lymphatics of bladder
Vesical venous plexus which drain into internal iliac vein
Lymphatic drainage: external iliac nodes
Innervation of urinary bladder
Autonomic
-parasympathtic efferent
Motor for detrusor inhibitory for internal urethra sphinter
- sympathomimetic efferent
Inhibitory for detrusor motor for internal sphincter
SOMATIC INNERVATION
- pudendal nerve to external urethra sphincter
Afferent nerves In which pain and distension can be felt pass through
Pain: lateral spinothalamic tract
Length of amale urethra
20cm.
Posterior part:4cm
Anterior part:16cm
Parts of the urethra
Posterior part: preprostatic, prostatic, and membranous
Anterior part: bulbar, penile(pendulous)
Characteristic of anterior urethra
Spongy
Parts of the urethra in prostate
Urethra sinuses
Urethral crest
Verumontanum
Protatic utricle
Vascular supply to urethra
Urethral artery, branch of internal pudendal artery
Venous drainage and lymphatica of urethra
Venous drainage: dorsal vein of the penis, prostatic and vesical venous plexuses.
Lymphatic: internal iliac nodes
Nerve supply to urethra
-Prostatic plexus
-Great cavernous nerves: supply preprostatic sphincter. Prevents reflux of sperm into bladder
-Parasympathetic preganglionic fibers
-neurons of Onufs nucleus and perineal branches of pudendal nerve: supply internal sphincter
Length of female urethra
4cm. 6mm in diameter
What gland opens Into the para urethral duct of the female urethra
Skene’s glands
Blood supply to female urethra
Internal pudendal and urethral arteries
Lymphatic drainage of female urethra
Unlike male only internal iliac nodes
Female: both internal and external