Uterine And Bladder Prolapse - Harvard Health
Anatomy of the female pelvis with relations of the urinary bladder to the female genital organs. It shows the surgical anatomy: vesico-uterine space. The uterus sits in the middle of the pelvis, behind the bladder and in front of the rectum. The actual position of the uterus within the pelvis varies. In both conditions the position of the bladder varies with the condition of the . In the female, the bladder is in relation behind with the uterus and the upper part.
Obturator and inferior gluteal arteries.
Uterine and vaginal arteries in the female. They create a complex plexus on the inferolateral surfaces near the prostate referred to as vesical venous plexus. This plexus enters backwards in the posterior ligaments of the urinary bladder to drain into the internal iliac veins.
In the male together with the prostatic venous plexus. In the female with the veins at the base of broad ligament. Lymphatic Drainage The lymphatics of the bladder drain mainly into the external iliac lymph nodes.
Urinary bladder - Wikipedia
Some lymph vessels also drain into the internal iliac lymph nodes consisting of nodes in the obturator fossa. Parasympathetic fibres nervi erigentes are originated from S2, S3, S4 spinal micturition center sections of the spinal cord.
Sympathetic fibres are originated from T11, T12 thoracic and L1, L2 lumbar sections of the spinal cord. Somatic fibres pudendal nerve are originated from S2, S3, S4 spinal sections. The sympathetic innervation accounts for the filling of the bladder and parasympathetic innervation for the emptying of the bladder. The somatic innervation is accountable for voluntary constraint of micturition.
Some fibres also run with all the sympathetic fibres. The division of sympathetic fibres presacral neurectomy will not relieve bladder pain because pain fibres are carried by both sympathetic and parasympathetic fibres. Fibres concerned with pain. Fibres concerned with conscious knowledge of filling of the bladder.
The pain fibres run in the anterolateral white Pillars of the spinal cord. The fibres concerned with the recognition of filling of the bladder is located in the posterior Pillars of the spinal cord. Medically, this accounts for the reality that consciousness of the bladder being filled up and want to micturate stay normal after bilateral anterolateral cordotomy for the alleviation of pain.
Clinical Significance Trabeculated Bladder It results because of chronic obstruction to the outflow of the pee by enlarged prostate or stricture of the urethra.
- Urinary Bladder
- The Uterus
- Bladder, Bowel and Uterus
The bladder becomes distended and its musculature hypertrophies. Drainage functions, treatment of intravesical circumstances, viz. The bladder is distended if not the case of retention of urine with about ml of fluid. Consequently, the anterior aspect of bladder comes in direct contact together with the anterior abdominal wall. The bladder can be now approached via anterior abdominal wall without entering into the peritoneal cavity. Neurogenic Bladder Micturition is basically a reflex action affecting the sensory and motor sympathetic and parasympathetic nerve pathways being mediated by the lower micturition center S2, S3, S4.
The voluntary control over this reflex is used by the higher center cerebral cortex via upper motor neurons of pyramidal tract.
Any defect in this nervous mechanics of micturition results in neurogenic bladder. The neurogenic bladder lacks the normal nerve charge of micturition. The types of neurogenic bladder are: It results from complete transection of the cord above the lower micturition center S2, S3, S4 affecting pyramidal tracts upper motor neurons medically it presents as: The Latin phrase for "urinary bladder" is vesica urinaria, and the term vesical or prefix vesico - appear in connection with associated structures such as vesical veins.
The modern Latin word for "bladder" - cystis - appears in associated terms such as cystitis inflammation of the bladder. Microanatomy[ edit ] The outside of the bladder is protected by a serous membrane.
Layers of the urinary bladder wall and cross section of the detrusor muscle. Anatomy of the male bladder, showing transitional epithelium and part of the wall in a histological cut-out. Detrusor muscle[ edit ] The detrusor muscle is a layer of the urinary bladder wall made of smooth muscle fibers arranged in spiral, longitudinal, and circular bundles. Stretch receptors in the bladder signal the parasympathetic nervous system to stimulate the muscarinic receptors in the detrusor to contract the muscle when the bladder is extended.
The main receptor activated is the M3 receptoralthough M2 receptors are also involved and whilst outnumbering the M3 receptors they are not so responsive. It can also contract for a long time whilst voidingand it stays relaxed whilst the bladder is filling.
Easy Notes On 【Urinary Bladder】Learn in Just 4 Minutes!
The lower part of the bladder is supplied by the inferior vesical artery in males and by the vaginal artery in females, both of which are branches of the internal iliac arteries. These then form three sets of vessels: Interior of the Bladder Fig. Stretching behind the latter openings is a slightly curved ridge, the torus uretericus, forming the base of the trigone and produced by an underlying bundle of non-striped muscular fibers.
When the bladder is illuminated the torus uretericus appears as a pale band and forms an important guide during the operation of introducing a catheter into the ureter. In the contracted bladder they are about 2. The serous coat tunica serosa is a partial one, and is derived from the peritoneum.Relations of the Female & Male Bladder
It invests the superior surface and the upper parts of the lateral surfaces, and is reflected from these on to the abdominal and pelvic walls. The muscular coat tunica muscularis consists of three layers of unstriped muscular fibers: The fibers of the external layer arise from the posterior surface of the body of the pubis in both sexes musculi pubovesicalesand in the male from the adjacent part of the prostate and its capsule.
They pass, in a more or less longitudinal manner, up the inferior surface of the bladder, over its vertex, and then descend along its fundus to become attached to the prostate in the male, and to the front of the vagina in the female. At the sides of the bladder the fibers are arranged obliquely and intersect one another. The fibers of the middle circular layer are very thinly and irregularly scattered on the body of the organ, and, although to some extent placed transversely to the long axis of the bladder, are for the most part arranged obliquely.
The internal longitudinal layer is thin, and its fasciculi have a reticular arrangement, but with a tendency to assume for the most part a longitudinal direction. Two bands of oblique fibers, originating behind the orifices of the ureters, converge to the back part of the prostate, and are inserted by means of a fibrous process, into the middle lobe of that organ. They are the muscles of the ureters, described by Sir C. Bell, who supposed that during the contraction of the bladder they serve to retain the oblique direction of the ureters, and so prevent the reflux of the urine into them.
The submucous coat tela submucosa consists of a layer of areolar tissue, connecting together the muscular and mucous coats, and intimately united to the latter.
The mucous coat tunica mucosa is thin, smooth, and of a pale rose color. It is continuous above through the ureters with the lining membrane of the renal tubules, and below with that of the urethra. The epithelium covering it is of the transitional variety, consisting of a superficial layer of polyhedral flattened cells, each with one, two, or three nuclei; beneath these is a stratum of large club-shaped cells, with their narrow extremities directed downward and wedged in between smaller spindle-shaped cells, containing oval nuclei Fig.
The epithelium varies according as the bladder is distended or contracted. In the former condition the superficial cells are flattened and those of the other layers are shortened; in the latter they present the appearance described above. There are no true glands in the mucous membrane of the bladder, though certain mucous follicles which exist, especially near the neck of the bladder, have been regarded as such. The obturator and inferior gluteal arteries also supply small visceral branches to the bladder, and in the female additional branches are derived from the uterine and vaginal arteries.