L2 Anatomy of Urinary Bladder (P1 Mid)
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Questions and Answers

What shape does the urinary bladder take when it is empty?

  • Cuboidal
  • Pyramidal (correct)
  • Cylindrical
  • Spherical

    • Which part of the urinary bladder is attached to the urachus?

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

    • Where are the ureteric openings located in the urinary bladder?

  • Inferior angle
  • Supero-lateral angles (correct)
  • Central cavity
  • Posterior surface

    • What forms the upper limit of the trigone in the urinary bladder?

    <p>Interureteric ridge</p> Signup and view all the answers

    What is the total length of the neck of the bladder?

    <p>3-4 cm</p> Signup and view all the answers

    Which of the following best describes the urinary bladder's position when it is distended?

    <p>Antero-superiorly into the abdominal cavity</p> Signup and view all the answers

    In terms of anatomical relations, which statement is true regarding the urinary bladder?

    <p>Its relations differ between males and females</p> Signup and view all the answers

    Which surface forms the roof of the urinary bladder?

    <p>Superior Surface</p> Signup and view all the answers

    What muscle surrounds the neck of the bladder and acts as an involuntary internal sphincter?

    <p>Detrusor muscle</p> Signup and view all the answers

    Which component is found at the inferior angle of the urinary bladder?

    <p>Urethral orifice</p> Signup and view all the answers

    What structure does the peritoneum cover in males?

    <p>The superior surface and upper part of the base</p> Signup and view all the answers

    What clinical issue can arise from the posterior relation of the urinary bladder with the cervix?

    <p>Occlusion of the urinary bladder due to cancer</p> Signup and view all the answers

    What type of ligaments connect the neck of the bladder to the pelvic fascia in males?

    <p>Lateral Pubo-Prostatic Ligaments</p> Signup and view all the answers

    How does pregnancy affect the urinary bladder in females?

    <p>Decreases the capacity of the bladder</p> Signup and view all the answers

    What is the utero-vesical pouch?

    <p>Peritoneal reflection covering the superior surface in females</p> Signup and view all the answers

    Which muscles are associated with the inferolateral surface of the bladder?

    <p>Obturator internus muscle and Levator ani muscle</p> Signup and view all the answers

    In females, what structure does the peritoneum reflect onto from the bladder?

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

    What is the purpose of the lateral true ligaments?

    <p>To anchor the bladder to the pelvic fascia</p> Signup and view all the answers

    Which of the following describes the superior relation of the urinary bladder in females?

    <p>Is compressed by the enlarged uterus during pregnancy</p> Signup and view all the answers

    What does the recto-vesical pouch contain in males?

    <p>Loops of ileum and seminal vesicles</p> Signup and view all the answers

    What do the medial pubo-prostatic ligaments connect in males?

    <p>Neck of the bladder and prostatic sheath</p> Signup and view all the answers

    Which of the following structures supplies the fundus and neck of the urinary bladder in females?

    <p>Vaginal arteries</p> Signup and view all the answers

    What is the function of the median umbilical ligament?

    <p>Keep the bladder in position anteriorly and superiorly</p> Signup and view all the answers

    Which arteries primarily supply the apex and superior part of the bladder?

    <p>Superior vesicle arteries</p> Signup and view all the answers

    Where does the vesical venous plexus drain into?

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

    What is the role of sympathetic fibers for the bladder?

    <p>Inhibit the muscle wall and motor to the sphincter</p> Signup and view all the answers

    Which structure is a fold of peritoneum over the median umbilical ligament?

    <p>Median umbilical fold</p> Signup and view all the answers

    What does the lymphatic drainage of the bladder primarily drain into?

    <p>Common, external, or internal iliac nodes</p> Signup and view all the answers

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

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

    What do the two posterior false ligaments attach to?

    <p>Front of the sacrum</p> Signup and view all the answers

    Study Notes

    Quranic Verse

    • A verse from Surah Al-Zariyat, verse 21, is quoted:
    • "And in the earth are signs for those who have faith."
    • "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 (ILOs):
      • Describe the shape, size, and parts of the urinary bladder.
      • State the location of the bladder in males and females.
      • Differentiate the bladder's relations 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.

    Urinary Bladder Structure

    • The bladder is a reservoir for urine.
    • It lies posterior to the pubic bones and symphysis.
    • Size, shape, and position vary according to age, content, and neighboring organs.
    • When empty, it's pyramidal within the lesser pelvis.
    • When full, it expands into the abdominal cavity.
    • The empty bladder has a pyramidal shape.
    • It has an apex, base (posterior surface or fundus), neck, a superior surface, and two inferolateral surfaces.

    Apex, Base, Trigon

    • The apex is the attachment site of the urachus (a fetal structure).
    • The base forms the posterior surface with two ureteric openings at superolateral angles.
    • The internal urethral orifice is at the inferior angle.
    • This area, enclosed by a smooth triangular region, is called the "vesical trigon".
    • The trigon is formed by two ureteric openings and one urethral opening.
    • The interureteric ridge forms its upper limit.

    Neck of the Bladder

    • Approximately 3-4 cm long, located where the base and inferolateral sides meet inferiorly.
    • It contains the internal urethral opening.
    • The detrusor muscle is circular around the neck, functioning as an involuntary internal sphincter.

    Superior, Inferolateral Surfaces

    • The superior surface forms the roof of the bladder.
    • The inferolateral surfaces are triangular in shape.

    Bladder Relations (Male/Female)

    • In males:
    • The bladder is related to the rectovesical pouch, loops of ileum, and the seminal vesicles.
    • Two vas deferens and the prostate are also located near it
    • In females:
    • The bladder is related to the uterovesical pouch, loops of ileum, and the sigmoid colon.
    • The cervix is connected to the posterior aspect of the bladder.

    Peritoneal Covering (Male/Female)

    • (Male) The peritoneum covers the superior surface and upper part of the bladder's base; it then reflects to the rectum, creating the rectovesical pouch.
    • (Female) The peritoneum covers only the anterior part of the bladder's superior surface; it reflects to the uterus, forming the uterovesical pouch.

    Urgency of Urination (Pregnancy)

    • In pregnant females, the uterus' enlargement compresses the bladder, increasing urination urgency.

    Clinical Significance of Cervical Cancer

    • Cervical cancer invasion into the posterior aspect of the bladder can obstruct it.

    Bladder Ligaments

    • True ligaments: Lateral true ligaments (male and female), lateral puboprostatic/pubovesical, medial puboprostatic/pubovesical ligaments.
    • False ligaments: Median and medial umbilical folds and two posterior false ligaments.
    • The median umbilical ligament, derived from the urachus, connects the bladder apex to the umbilicus.

    Arterial Supply

    • Superior vesicle arteries, supplying the apex and upper part (male and female)
    • Inferior vesicle arteries, supplying the bladder base and neck (male only)
    • Vaginal arteries (branches of uterine arteries) supplying the fundus and neck (female only)
    • Obturator arteries (branches of internal iliac artery) with arterial twigs (male and female)

    Venous Drainage

    • Bladder veins form a complex plexus on inferolateral surfaces (near the prostate in males).
    • The vesical venous plexus drains into the internal iliac veins.
    • (Interacts with prostatic venous plexus in males.)
    • (In females, it interacts with the veins at the base of the broad ligament of the uterus).

    Bladder Nerve Supply

    • Sympathetic: T11-12 thoracic spinal segments (inhibitory to the bladder muscle, promote sphincter contraction).
    • Parasympathetic: pelvic splanchnic nerves, S2-S4 (promotes bladder contraction, inhibits sphincter contraction).

    Atonic/Spastic Bladder

    • Atonic bladder: spinal cord lesion results in bladder overfilling due to diminished detrusor muscle contraction.
    • Spastic bladder: injury above the sacral levels results in uncontrolled bladder contractions due to loss of parasympathetic inhibition.

    Multiple Choice Questions (MCQs)

    • A 25-year-old pregnant female experiences increased urinary urgency. The likely cause involves the superior relation of the urinary bladder and the uterus.

    • The superior vesicle arteries are branches of the internal iliac artery, supplying the apex and superior part of the urinary bladder.

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    Description

    This quiz covers the anatomy and function of the urinary bladder as part of the Renal Module for second-year medical students. You will explore topics such as the bladder's shape, size, location, arterial supply, lymphatic drainage, and nervous connections. Test your understanding of the urinary system's structure and its significance.

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