Urinary bladder (dave's notes)

Question 1

Describe the muscle and membrane makeup of the urinary bladder

Answer 1

Smooth muscle arranged in whorls and spirals, lined with loose mucous membrane, surfaced with transitional epithelium

Question 2

What shape is the bladder?

Answer 2

The distended bladder is globular/ovoid and internally smooth. The undistended bladder is described as XXXX., with internal folds.

Question 3

What does the apex of the bladder point to? What is attached here?

Answer 3

The sharp apex of the bladder points to the pubic symphasis. It has the remains of urachus attached to it, forming the median umbilical ligament.

Question 4

Where is the base of the bladder?

Answer 4

The triangular base of the bladder faces backwards (in front of rectum/vagina) and is the posterior surface.

Question 5

What are the relations of the bladder in the male?

Answer 5

Only the upper part (above the rectovesical pouch) is covered by peritoneum. The ductus deferens medial and the seminal vesicles laterally, attached to this surface. The ureter is at the upper outer corner.

Question 6

What are the relations of the bladder in the female?

Answer 6

The base is firmly connected with the anterior vaginal wall and uterine cervix, with no peritoneal covering.

Question 7

Describe the inferolateral surface of the bladder

Answer 7

TWO inferolateral surfaces slope downwards and forwards, cradled by levator ani.The surfaces meet behind the pubic bones, forming the retropubic space

Question 8

What does the retropubic space contain?

Answer 8

Condensations forming pubovesical (+/-) puboprostatic ligaments

Question 9

What is the lowest part of the bladder? What does it lie against?

Answer 9

The neck. In the male it lies against the prostate, in the female against pelvis fascia.

Question 10

Describe the superior surface of the bladder

Answer 10

The superior surfaces is covered by peritoneum which sweeps upwards on the anterior abdominal wall.

Question 11

What is the trigone?

Answer 11

A triangular shape between the urethral and ureteric orifices (2.5-5cm apart depending on distension)

Question 12

Give three facts relating to the trigone

Answer 12

It is the least mobile part of the bladder
The ureters enter it obliquely
It may have an indentation from the prostate (uvula vesicle)

Question 13

Describe the blood supply of the bladder

Answer 13

Principally from the superior and inferior vesicle arteries, plus obturator, inferior gluteal, uterine, and vaginal (IIA)

Question 14

Describe the venous drainage of the bladder

Answer 14

Veins do not follow attires but instead form a plexus draining backwards across the pelvic floor to the internal iliac vein.

Question 15

Describe the lymphatic drainage of the bladder

Answer 15

Lymphatics follow the arteries back to the internal iliac and external iliac arteries

Question 16

What types of nerves supply the bladder?

Answer 16

Sympathetic, parasympathetic, pain, and sensation.

Question 17

From where is the sympathetic supply of the bladder? What is its function?

Answer 17

From L1,2, via the superior hypogastric plexus. Largely vasomotor but also to trigone and internal sphincter

Question 18

From where is the parasympathetic supply of the bladder? What is its function?

Answer 18

Fibres from the pelvic splanchnic plexus provide the main motor supply

Question 19

How do nerves for normal sensation, and nerves for pain reach the bladder?

Answer 19

Normal sensation via parasympathetic via gracile (???), but pain reaches the spinal cord via both tracts.

Question 20

How do we control the bladder

Answer 20

see physiology

Question 21

The bladder fibres produce a …………. appearance. At the male urethral orifice, the muscle fibres form a ……. and is continuous with the ……… …. (not so in the female). This muscle helps to avoid ……… …………. . The mucous membrane is …… and …, and lined with ………. …….. . There are no …… or ………. ……….. .

Answer 21

Trabeculate
Sphincter
Prostate gland
Retrograde ejaculation
Thick and lax
Transitional epithelium
Glands
Muscularis mucosae

Question 22

From what embryonic origin does the bladder epithelium arise?

Answer 22

From the endoderm of the vsico