L2 Anatomy of Urinary Bladder (P2 Hard)
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Questions and Answers

Which structure is located at the apex of the urinary bladder?

  • Detrusor muscle
  • Vesical trigone
  • Urachus (correct)
  • Internal urethral orifice

How does the shape of the urinary bladder change when distended?

  • It expands antero-superiorly (correct)
  • It becomes cylindrical
  • It assumes a flat shape
  • It retains a pyramidal shape

What part of the urinary bladder forms its posterior surface?

  • Inferolateral surfaces
  • Apex
  • Neck
  • Base (correct)

Which nerve plexus is associated with the urinary bladder?

<p>Pelvic plexus (C)</p> Signup and view all the answers

What is the triangular area formed by the ureteric and urethral openings within the urinary bladder called?

<p>Vesical trigone (B)</p> Signup and view all the answers

The detrusor muscle has what function in relation to the urinary bladder?

<p>It contracts involuntarily to expel urine (D)</p> Signup and view all the answers

In females, the urinary bladder's position relative to neighboring structures is different compared to males primarily because of what anatomical feature?

<p>Size of the uterus (D)</p> Signup and view all the answers

The arterial supply of the urinary bladder is significant for which reason?

<p>It provides nutrients and oxygen (C)</p> Signup and view all the answers

What is the function of the internal urethral orifice?

<p>Serves as an exit for urine (D)</p> Signup and view all the answers

Which defines the neck of the urinary bladder?

<p>It connects the bladder to the urethra (A)</p> Signup and view all the answers

What is the primary function of the median umbilical ligament?

<p>Connects the bladder to the umbilicus (B)</p> Signup and view all the answers

Which arteries are responsible for supplying the fundus and neck of the urinary bladder in females?

<p>Vaginal Arteries (C)</p> Signup and view all the answers

What is the role of sympathetic fibers in the urinary bladder's nerve supply?

<p>Inhibitory to the sphincter (C)</p> Signup and view all the answers

Where do the veins of the bladder primarily drain into?

<p>Internal iliac veins (D)</p> Signup and view all the answers

Which ligaments are classified as false ligaments associated with the urinary bladder?

<p>Median umbilical fold and two medial umbilical folds (A)</p> Signup and view all the answers

What condition results from lesions to the sacral spinal cord segments or sacral spinal nerve roots?

<p>Atonic bladder (B)</p> Signup and view all the answers

What do the medial pubo-prostatic ligaments connect?

<p>Neck of the bladder to the prostatic sheath (D)</p> Signup and view all the answers

Which structure encloses the vesical venous plexus?

<p>Posterior ligaments (A)</p> Signup and view all the answers

What is the origin of the superior vesicle arteries?

<p>Internal iliac artery (A)</p> Signup and view all the answers

Which part of the urinary bladder's vascular supply is specifically linked to male anatomy?

<p>Inferior vesicle arteries (A)</p> Signup and view all the answers

What is the main consequence of the superior relation of the urinary bladder with the uterus during pregnancy?

<p>Decreased capacity of the bladder (A)</p> Signup and view all the answers

What structures are covered by the peritoneum in males?

<p>Superior surface and upper part of the base (C)</p> Signup and view all the answers

Which type of ligaments connects the neck of the bladder to the tendinous arch of the pelvic fascia in females?

<p>Lateral Pubo-Vesical Ligaments (A)</p> Signup and view all the answers

Which anatomical structure is posterior to the urinary bladder in females?

<p>Cervix (A)</p> Signup and view all the answers

What common clinical issue may arise from the posterior relationship of the urinary bladder with the cervix?

<p>Cervical cancer invasion (D)</p> Signup and view all the answers

In women, which anatomical structure does the peritoneum reflect to after covering the superior surface of the bladder?

<p>Anterior surface of the uterus (B)</p> Signup and view all the answers

What is the clinical significance of the recto-vesical pouch in males?

<p>Potential space for fluid accumulation (C)</p> Signup and view all the answers

Which of the following correctly identifies the role of the lateral true ligaments in the urinary bladder?

<p>Stretch from bladder to pelvic fascia (D)</p> Signup and view all the answers

Which statement about the inferior aspect of the urinary bladder is accurate?

<p>It shares the same structures in both males and females (C)</p> Signup and view all the answers

How does the anatomy of the urinary bladder differ between males and females at the apex?

<p>Both have the umbilical attached to the anterior abdominal wall (C)</p> Signup and view all the answers

Flashcards

What is the function of the urinary bladder?

The urinary bladder is the organ responsible for storing urine before it is expelled from the body.

Where is the urinary bladder located?

The urinary bladder is located behind the pubic bones and the pubic symphysis, which is the joint connecting the two pubic bones.

How does the shape and size of the urinary bladder change?

The urinary bladder is a flexible organ that can change shape and size. Its size and position are influenced by age, how much urine it holds, and the position of surrounding organs.

Describe the shape of an empty urinary bladder.

An empty bladder is shaped like a pyramid with an apex, base, neck, and two sides.

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What connects to the apex of the bladder?

The apex of the bladder is where the urachus, a fibrous remnant of the fetal allantois, connects.

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Where is the base of the bladder located?

The base of the bladder is its posterior surface, facing the back of the body.

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What openings are located on the base of the bladder?

The base of the bladder houses two openings for the ureters, which carry urine from the kidneys, and one opening for the urethra, which carries urine to the outside.

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What is the vesical trigone?

The vesical trigone is a smooth, triangular area at the base of the bladder formed by the two ureteric openings and the urethral opening.

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What is the neck of the bladder and its significance?

The neck of the bladder is the narrow lower section where the base and the sides meet. It houses the internal urethral opening and plays a crucial role in controlling urine flow.

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What is the detrusor muscle and its function?

The detrusor muscle is a muscular layer that surrounds the neck of the bladder. Its circular arrangement helps create an involuntary internal sphincter that controls urine flow.

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Umbilical Attachment: Bladder

The point where the umbilical cord attaches to the anterior abdominal wall. This is the same in both males and females.

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Base of the Bladder

In males, this area contains the recto-vesical pouch, loops of ileum, seminal vesicles, and vas deferens. In females, it includes the utero-vesical pouch, loops of ileum, and sigmoid colon.

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Neck of the Bladder

In males, the neck sits on the prostate and contains the prostatic venous plexus and ejaculatory duct. In females, the neck is posterior to the vagina.

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Superior Surface of Bladder

The superior surface is covered by peritoneum and contains loops of ileum and sigmoid colon. In males, it reaches the upper base. In females, the peritoneum covers only the anterior part.

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Inferolateral Surface of Bladder

The inferolateral surface is the same in both sexes and contains the obturator internus muscle, levator ani muscle, obturator nerve, obturator artery and vein, and superior vesical artery and vein.

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Peritoneal Covering of the Bladder

In males, the peritoneum covers the superior surface and the upper part of the base, then reflects to the rectum forming the recto-vesical pouch. In females, the peritoneum covers only the anterior part of the superior surface, then reflects to the anterior surface of the uterus forming the utero-vesical pouch.

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Urinary Bladder and Pregnancy: Superior Relation

In pregnant females, the enlarged uterus compresses the urinary bladder, reducing its capacity and leading to increased urgency of urination.

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Urinary Bladder and Pregnancy: Posterior Relation

In cases of cervical cancer, posterior invasion of the bladder can result in occlusion of the urinary bladder.

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True Ligaments of the Bladder

True ligaments anchor the bladder to the pelvic fascia, helping to stabilize it.

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Lateral True Ligaments

The lateral true ligaments stretch from the bladder's lateral wall to the pelvic fascia. They are found in both males and females.

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Medial Pubo-Prostatic Ligaments (Male)

They connect the neck of the bladder and prostatic sheath to the back of the pubic bone. This helps anchor the bladder in place and support its function.

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Medial Pubo-Vesical Ligaments (Female)

These ligaments connect the neck of the bladder to the back of the pubic bone. They help to support and stabilize the bladder.

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Median Umbilical Ligament

It's a fibrous remnant of the urachus, a fetal structure. It stretches from the bladder apex to the umbilicus, helping to keep the bladder in position.

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Posterior Ligaments (Left and Right)

These ligaments are made of loose areolar tissue and extend from the base of the bladder to the pelvic walls. They house the vesical venous plexus, carrying blood away from the bladder.

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Two Medial Umbilical Folds

These are folds of peritoneum, the lining of the abdominal cavity. They cover the obliterated umbilical arteries.

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Superior Vesicle Arteries

These are branches of the internal iliac artery. They provide the main blood supply to the apex and upper part of the bladder.

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Inferior Vesicle Arteries

These arteries supply blood to the base and neck of the bladder in men. They branch off the internal iliac artery.

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Vesical Venous Plexus

These veins form a complex network near the prostate in men, draining blood away from the bladder.

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Nerve Supply to the Bladder

These nerves are part of the autonomic nervous system and control the bladder muscle. Sympathetic nerves inhibit contraction and stimulate the sphincter, while parasympathetic nerves stimulate contraction and relax the sphincter.

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Atonic Bladder

This condition happens when there's damage to the sacral spinal cord or nerves, leading to loss of bladder control. It can result in urine leakage or inability to empty the bladder.

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Venous Drainage of the Bladder

The veins draining the bladder don't exactly follow the arteries. Instead, they form a network called the vesical venous plexus.

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Study Notes

Quranic Verse

  • The verse is from Surah Al-Dhariyat, Ayah 21
  • The verse states "And in the earth are signs for those who have certainty. And within yourselves, then why do you not see?"

Renal Module

  • Course code: IMP/07/20318
  • Phase I
  • Second year/ semester 3
  • Course duration: 5 weeks

Anatomy of the Urinary Bladder - Learning Outcomes

  • Describe the shape, size, and parts of the urinary bladder.
  • State its location in males and females.
  • Differentiate between the relations of the urinary bladder in males and females.
  • List the arterial supply of the urinary bladder and its significance.
  • Describe the lymphatic drainage of the urinary bladder and ureter.
  • Describe the nerve plexus.

The Urinary Bladder - Structure

  • Reservoir for urine
  • Located posterior to the pubic bones and pubic symphysis
  • Shape varies with age, fullness, and surrounding organs
  • Empty shape: pyramidal
  • Contains an apex, base (fundus), neck, superior surface, and two inferolateral surfaces

The Urinary Bladder - Internal Structures

  • Apex (anterior angle): Attachment site for the urachus.
  • Base (posterior surface/fundus): Includes two ureteric openings, an internal urethral orifice, and the interureteric ridge (forming the upper border of the trigon).
  • Neck: 3-4 cm long, where the base and inferolateral surfaces meet. Contains the internal urethral opening. Contains the internal sphincter muscle.
  • Superior surface: Forms the roof of the bladder.
  • Interferolateral surfaces: Triangular in shape

Bladder Relations (Male and Female)

  • Males: Rectovesical pouch separates the bladder from the rectum.
  • Females: The uterovesical pouch separates the bladder from the uterus.

Bladder Relations (cont.)

  • The relationship between the urinary bladder and uterus in pregnant females may cause increased urinary urgency due to compression.
  • The location of the urinary bladder's inferior surface relating to the uterine cervix may lead to complications in cases of cervical cancer.

Ligaments of the Urinary Bladder

  • True Ligaments: Lateral true ligaments, lateral pubo-prostatic/vesical ligaments, medial pubo-prostatic/vesical ligaments
  • False Ligaments: Median umbilical fold, two medial umbilical folds (over obliterated umbilical arteries), two posterior false ligaments (attach to front of the sacrum).

Arterial Supply of the Urinary Bladder

  • Superior vesical arteries: Supply the apex and superior part. Branch of internal iliac artery.
  • Inferior vesical arteries: Supply the base and neck in males. Branched from internal iliac artery.
  • Vaginal arteries: Supply the fundus and neck (females). Branch of uterine artery.
  • Obturator arteries: Branch of internal iliac artery, providing arterial twigs

Venous Drainage of the Urinary Bladder

  • Veins don't directly follow arteries, forming a plexus near the prostate (male) or the base of the broad ligament of the uterus (female).
  • The plexus drains into the internal iliac veins.

Nerve Supply of the Urinary Bladder

  • Sympathetic fibers: Inhibit bladder muscle, stimulate sphincter. Originate from T11-L2.
  • Parasympathetic fibers: Stimulate bladder muscle, inhibit sphincter. Originate from S2-S4.

Atonic Bladder

  • Damage to sacral spinal cord causes loss of pelvic splanchnic motor innervation.
  • Results in inability to contract detrusor muscles.
  • Continuous dribbling of urine.

Spastic Bladder

  • Damage above sacral cord segments causes loss of sympathetic inhibition during filling.
  • Excessive detrusor muscle contraction.
  • Urge incontinence.

Multiple Choice Questions (MCQs)

  • (Question 1) Pregnancy-related urinary urgency.
  • (Question 2) Arterial Supply of the urinary bladder.

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Description

This quiz explores the anatomy and physiological functions of the urinary bladder, including its structure, location, and relationships in both males and females. Students will learn about the blood supply and nerve plexus associated with the urinary bladder. Ideal for those in the second year of medical studies.

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