Urinary Bladder And Urethra

Question 1

The urinary bladder is highly distensible? T or F

Answer 1

T

Question 2

The urinary bladder is a temporary reservoir for ——

Answer 2

Urine

Question 3

When the urinary bladder is empty, the adult urinary bladder lies in the ———, (posterior/anterior?) and slightly (superior/inferior?)to the ——

Answer 3

When empty, the adult urinary bladder lies in the lesser pelvis, posterior and slightly superior to the pubic bones

Question 4

The urinary bladder is separated from these pubic bones by the potential ——- space and lies inferior to the ——— where it rests on the ———

Answer 4

It is separated from these bones by the potential retropubic space and lies inferior to the peritoneum where it rests on the pelvic floor

Question 5

In infants and children, the urinary bladder is in the —— even when empty
• It enters the greater pelvis by the age of —- yrs
• Comes to lie in the lesser pelvis after ——

Answer 5

In infants and children, the urinary bladder is in the abdomen even when empty
• It enters the greater pelvis by the age of 6 yrs
• Comes to lie in the lesser pelvis after puberty

Question 6

In infants and children, the urinary bladder is in the —— even when empty
• It enters the greater pelvis by the age of —- yrs
• Comes to lie in the lesser pelvis after ——

Answer 6

In infants and children, the urinary bladder is in the abdomen even when empty
• It enters the greater pelvis by the age of 6 yrs
• Comes to lie in the lesser pelvis after puberty

Question 7

In adults, as the urinary bladder fills, it ascends and enters the ———
• A full bladder may ascend to the level of the ——-
• When empty, the bladder is somewhat ——— in shape
Has 4 surfaces:

Answer 7

In adults, as the urinaryCont’d bladder fills, it ascends and enters the greater pelvis
• A full bladder may ascend to the level of the umbilicus
• When empty, the bladder is somewhat tetrahedral in shape
Has 4 surfaces:
• Superior surface
• 2 inferolateral surfaces
• Posterior surface

Question 8

List the parts of the urinary bladder

Answer 8

Apex
Fundus(base)
Body
Neck
Uvula

Question 9

Parts of the urinary bladder
• Apex
– Anterior end
– Points towards the ———-
• The body
– Lies between the —— and
the ——-
• Fundus/Base
– Formed by ——which is somewhat convex
• The fundus is related to:
– —— in males
– ——- in females
• Neck of bladder
– Where —— and ——- surfaces meet
• The uvula
– Is a slight projection of the —— of the bladder
– Usually more prominent in which person

Answer 9

• Apex
– Anterior end
– Points towards the superior edge of the pubic symphysis
• The body
– Lies between the apex and
the fundus • Fundus/Base
– Formed by posterior wall which is somewhat convex

Cont’d
• The fundus is related to:
– Rectum in males
– Anterior wall of vagina in females
• Neck of bladder
– Where fundus and inferolateral surfaces meet
• The uvula
– Is a slight projection of the trigone of the bladder – Usually more prominent in older men

Question 10

Urinary bladder

The ———- and the —— are at the angles of the trigone of the bladder
• The ureters pass obliquely through the bladder wall in an ——— direction
• An increase in bladder pressure presses the walls of the ureter together
• Therefore preventing what from happening

Answer 10

The ureteric orifices and the internal urethral orifice are at the angles of the trigone of the bladder
• The ureters pass obliquely through the bladder wall in an inferomedial direction
• An increase in bladder pressure presses the walls of the ureter together
• Therefore preventing the pressure in the bladder from forcing urine up the ureters

Question 11

The bladder is enveloped by loose CT- called the —— fascia
• The wall of the bladder is composed chiefly of ——— muscle
• Towards the neck, the muscle fibers form the (involuntary/voluntary ?) —— sphincter
• In males, the muscle fibers in the neck are continuous with the fibromuscular tissue of the ——
• In females, these muscle fibers are continuous with muscle fibers in the wall of the ——-

Answer 11

The bladder is enveloped by loose CT- vesical fascia
• The wall of the bladder is composed chiefly of detrusor muscle
• Towards the neck, the muscle fibers form the involuntary internal sphincter
• In males, the muscle fibers in the neck are continuous with the fibromuscular tissue of the prostate
• In females, these muscle fibers are continuous with muscle fibers in the wall of the urethra

Question 12

The bladder bed is formed on each side by the —— and the ——- and ——, posteriorly by the —— or ——
• The vesicouterine pouch of peritoneum between the bladder and uterus, is empty except when the uterus is———-; in this case it may contain a ——-

Answer 12

The bladder bed is formed on each side by the pubic bones and the obturator internus and levator ani and posteriorly by the rectum or vagina
• The vesicouterine pouch of peritoneum between the bladder and uterus, is empty except when the uterus is inclined posteriorly (retroverted); in this case it may contain a loop of intestine

Question 13

• The ———- pouch of peritoneum between the bladder and uterus, is empty except when the uterus is inclined posteriorly (retroverted); in this case it may contain a loop of intestine

Answer 13

• The vesicouterine pouch of peritoneum between the bladder and uterus, is empty except when the uterus is inclined posteriorly (retroverted); in this case it may contain a loop of intestine

Question 14

Blood supply of the bladder
Arterial supply- branches of ———artery
They include

Answer 14

Superiorvesical
Inferior vesical
Vagina arteries
Obturator and inferior gluteal arteries

Question 15

Blood supply of the bladder
Arterial supply- branches of internal iliac artery
􏰀 Superior vesical artery
• supplies the —— surface
􏰀 Inferior vesical (found in males/females?);
• supply——-
􏰀 Vagina arteries (found in males/females)
• supplies which parts
􏰀 Obturator and inferior gluteal arteries
▪ Supply small branches to the ——-

Answer 15

Blood supply of the bladder
Arterial supply- branches of internal iliac artery
􏰀 Superior vesical artery
• Anterosuperior surface
􏰀 Inferior vesical (males);
• Neck and fundus
􏰀 Vagina arteries (females)
• neck, fundus and posteroinferior parts 􏰀 Obturator and inferior gluteal arteries
▪ Supply small branches to the bladder

Question 16

Venous drainage
• The names of the veins correspond to the arteries and are tributaries of the —— veins
• In males, the vesical venous plexus combines with the prostatic venous plexus and envelopes the :——
• The vesical venous plexus mainly drains through the
——— vein and then into the ———veins;
❑ However, it may drain through the sacral veins into the internal vertebral venous plexuses

Answer 16

Venous drainage
• The names of the veins correspond to the arteries and are tributaries of the internal iliac veins
• In males, the vesical venous plexus combines with the prostatic venous plexus and envelopes the :
❑ Fundus of the bladder and prostrate
❑ Seminal vesicles
❑ Ductus deferens
❑ Inferior ends of the ureters
• The vesical venous plexus mainly drains through the
inferior vesical veins into the internal iliac veins;
❑ However, it may drain through the sacral veins into the internal vertebral venous plexuses

Question 17

In females, the vesical venous plexus envelops the ——— and the —— and receives blood from the ————and communicates with the ——- venous plexus

Answer 17

In females, the vesical venous plexus envelops the pelvic part of the urethra and the neck of the bladder and receives blood from the dorsal vein of the clitoris and communicates with the vaginal or uterovaginal venous plexus

Question 18

Lymphatic drainage
• In both sexes lymphatic vessels from the:
❑ Superior surface of the bladder pass to the —— lymph nodes
❑ Fundus of bladder pass to the ——-lymph nodes
❑ Neck of bladder pass into the —— or ———lymph nodes

Answer 18

Lymphatic drainage
• In both sexes lymphatic vessels from the:
❑ Superior surface of the bladder pass to the
external iliac lymph nodes
❑ Fundus of bladder pass to the internal iliac lymph nodes
❑ Neck of bladder pass into the sacral or common iliac lymph nodes

Question 19

Innervation of bladder
• Parasympathetic fibers to the bladder are derived from the ——nerves
• They are motor to the ——— and inhibitory to the ——
• When the visceral afferent fibers are stimulated by stretching, the bladder (relax/contracts ?) reflexively the internal sphincter (relaxes/contracts?) and what happens to the urine

Answer 19

Innervation of bladder
• Parasympathetic fibers to the bladder are derived from the pelvic splanchnic nerves
• They are motor to the detrusor muscle and inhibitory to the internal sphincter
• When the visceral afferent fibers are stimulated by stretching, the bladder contracts reflexively the internal sphincter relaxes and urine flows into the urethra
• This is controlled with toilet training

Question 20

• When the visceral afferent fibers are stimulated by stretching, the bladder contracts reflexively the internal sphincter relaxes and urine flows into the urethra
• This is controlled with ——-

Answer 20

• This is controlled with toilet training

Question 21

Sympathetic fibers
• Sympathetic fibers to the bladder are derived from —- through —- nerves.
• The nerves supplying the bladder form the —— nerve plexus which consists of both sympathetic and parasympathetic fibers
• This plexus is continuous with the ——— plexus

Answer 21

Sympathetic fibers
• Sympathetic fibers to the bladder are derived from T11 through L2 nerves.
• The nerves supplying the bladder form the vesical nerve plexus which consists of both sympathetic and parasympathetic fibers
• This plexus is continuous with the inferior hypogastric plexus

Question 22

List 3 Clinical anatomy of the bladder

Answer 22

Clinical anatomy
• Cystocele- Hernia of the bladder
• Suprapubic cystotomy
• Cystoscopy

Question 23

• The —— is a tube that carries the urine from the bladder to the exterior

Answer 23

• The urethra is a tube that carries the urine from the bladder to the exterior

Question 24

Male urethra
• Is a muscular tube
• Measures about — – —cm long
• Conveys urine from the ——orifice of the urinary bladder to the ——orifice at the tip of the ——
• The urethra also provides exit for——

Answer 24

Male urethra
• Is a muscular tube
• Measures about 18 – 20 cm long
• Conveys urine from the internal urethral orifice of the urinary bladder to the external urethral orifice at the tip of the glans penis
• The urethra also provides exit for semen

Question 25

Male urethra

• It is divided into 4 parts for descriptive purposes:
1.
2.
3.
4.

Answer 25

• It is divided into 4 parts for descriptive purposes:
1. Preprostatic urethra
2. Prostatic urethra
3. Membranous urethra
4. Spongy urethra

Question 26

Female urethra
• Measures— cm in length and —mm in diameter
• Extends from the ———— of the urinary bladder to the ———in the —— of the vagina
• Lies anterior to the orifice of the ——
• It passes with the vagina through the ———, ——— sphincter and ——— membrane

Answer 26

Female urethra
• Measures 4 cm in length and 6 mm in diameter
• Extends from the internal urethral orifice of the urinary bladder to the external urethral orifice in the vestibule of the vagina
• Lies anterior to the orifice of the vagina
• It passes with the vagina through the pelvic diaphragm, external urethral sphincter and perineal membrane

Question 27

Blood supply of the male urethra
Arterial supply
– Proximal 2 parts→ ——-
– Distal 2 parts → ——-
• Venous drainage→Follow the ——
• Lymphatic drainage
– Proximal 3 parts → ——lymph nodes
– Distal part → —— lymph nodes

Answer 27

Blood supply of the male urethra
Arterial supply
– Proximal 2 parts→ Prostatic branches of Inferior vesical and middle rectal arteries
– Distal 2 parts → branches of internal pudendal artery
• Venous drainage→Follow the arteries
• Lymphatic drainage
– Proximal 3 parts → internal iliac lymph nodes – Distal part → deep inguinal lymph nodes

Question 28

Blood supply of the female urethra
• Arterial supply→ ———and —— artery
• Venous drainage→ veins accompany the ——
• Lymphatic drainage →—— and -— nodes ; few drain into —— lymph nodes

Answer 28

Blood supply of the female urethra
• Arterial supply→ internal pudendal and vagina artery
• Venous drainage→ veins accompany the arteries
• Lymphatic drainage →Sacral and internal iliac; few drain into inguinal lymph nodes

Question 29

Name a Clinical anatomy of the urethra

Answer 29

Urethral catheterization