GI Anatomy 5 Flashcards
What is the retropubic space?
Extraperitoneal space between the pubic symphisis and the bladder
What is the rectovesical pouch?
Extraperitoneal space between the rectum and the bladder in the male
What is the uterovesical pouch?
Extraperitoneal space between the uterus and the bladder in the female
What is the rectouterine pouch (pouch of Douglas)?
Extraperitoneal space between the rectum and the uterus
What is significant clinically about the rectouterine or rectovesical pouch?
Most inferior part of the abdominal cavity where pus collects due to gravity
To the level of what may a severely distended bladder extend?
The level of the umbilicus
What is suprapubic catheterisation and when may it be needed?
Catheterising the bladder through the anterior abdominal wall
May be necessary when the prostate is markedly large and a urethral catheter can’t be passed
What are the 4 surfaces of the bladder?
1) Fundus (superiorly)
2) Base (posteriorly)
3) 2 inferolateral surfaces
Where do the base and the inferolateral surfaces of the bladder meet and what exits the bladder at this point?
Meet at the neck of the bladder which leads to the urethra
What is the median umbilical ligament and how may it be identified?
From the apex of the bladder to the umbilicus, slender fibrous chord which is the obliterated remnant of a foetal structure the urachus. It produces a midline ridge of peritoneum on the anterior abdo wall inferior to the umbilicus
What forms the posterior relation of the bladder in females?
Uterus
Where do the ureters enter the pelvic inlet?
Anterior to the bifurcation of the common iliac, lateral to the base of the bladder
What is the trigone bounded by and what is significant about this part of the bladder wall?
Bounded by the 2 ureteric openings superolaterally and the urethral opening inferiorly
Rugae are absent here
Is the internal urethral sphincter under voluntary or involuntary control and what is it formed by?
Involuntary, formed by the circular arrangement of the detrusor muscle around the neck of the bladder
What is the detrusor muscle?
Network of smooth muscle fibres contained in the bladder wall
In males, which structure separates the bladder neck from the pelvic floor?
The prostate
What is the normal capacity of the bladder?
400-600ml
What is the blood supply to the bladder?
1) Superior aspect - superior vesical artery (from the root of the umbilical artery from the anterior trunk of the internal iliac)
2) Rest of the bladder - inferior vesical artery in men or vaginal artery in women (from the anterior trunk of the internal iliac)
What is the nerve supply to the bladder?
Vesical plexus, originates from the pelvic plexuses (inferior hypogastric plexuses) PS S2-S4, S L1-L3
What effect does PS have on the bladder?
Stimulate bladder contraction
What is the prostatic urethra and what empties into it?
Part of the urethra in the males which runs through the prostate, ejaculatory ducts open up into it
What is the urethral crest in males?
Longitudinal midline fold of mucosa in the prostatic urethra
How do secretions from the prostate reach the urethra?
Through the ejaculatory ducts which open into the prostatic urethra
Where does the prostatic venous plexus lie?
Plexus of veins that lies between the fibrous capsule and thick sheath derived from the pelvic fascia surrounding the prostate