Anatomy of urinary bladder. surfaces, border of urinary bladder its relation , ligament support, peritoneal relation in male and females, pouches, blood supply of bladder, nerve supply of bladder, true and false ligament of urinary bladder,

1. URINARY
BLADDER
Dr SANA YASEEN
(ANATOMY DPT)

2. INTRODUCTION
• Is a muscular reservoir of urine
• Lies in anterior part of pelvis
• Max capacity of bladder ~ 500ml

3. STRUCTURE
• Empty bladder is tetrahedral in shape,
lies entirely within pelvis with shape like
upside-down pyramid.
• When distended with urine, part of it
extends above the level of pubic
symphysis & comes into contact with
anterior abdominal wall.

5. 1.Apex: directed forward
2.Fundus/ base: directed backward
opp. Apex
3.Neck: is fixed part, it is held only by
lateral ligament of bladder &
tendinous arch of fascia

7. SURFACES: 3
• Superior
• R & L surfaces
BORDERS: 4
• 2 lateral
• Anterior
• posterior
Ureters join bladder at its posterolateral angle called
“TRIGONE”
• The smooth traingular area between openings of
the ureters and urethra on the inside of the bladder
is known as TRIGONE

9. • The muscle of bladder wall is
called DETRUSOR MUSCLE
• It is thickened at the neck to
form involuntary internal urethral
sphincter

12. RELATIONS
SUPERIOR: PERITONEUM (both)
Male:coils of intestine and sigmoid colon
Females: uterus

14. ANTERIOR RELATION:
• Pubic symphysis
• Retropubic fat
EACH SIDE:
• pubic bone
• fascia covering levator ani an levator ani
muscle
• Males: pubo prostatic ligament
• Females: pubovesical ligament

15. FUNDUS:
• Female: cervix & vagina
• Male:
Centrally: rectovesical septum
Laterally: seminal glands
ampulla of ductus
deference
Neck: prostate gland in males

19. LIGAMENTS
TRUE LIGAMENTS: thickening of fascia
1.Lateral true ligament: A pair of ligament
covering levator ani muscle
2.Male: Medial & lateral puboprostatic
ligament
In females: pubovesical ligament, also
known as true ligament.

20. 3.Median umbilical ligament/ urachus: it is
unpaired and presents the fibrosed
remnant of allantois.
4. Posterior ligament of bladder: are
paired, & are condensed pelvic cellular
tissue containing plexus of vein ( which
open into internal iliac veins). These
ligaments extend from each side of base
of bladder to lateral pelvic wall

21. Ligaments in male

22. FALSE LIGAMENTS / FOLDS
OF PERITONEUM:
1.Median umblical fold
2.Medial umblical fold
3.Lateral false ligament
4.Posterior false ligament

23. IN FRONT:
1. MEDIAN UMBLICAL FOLDS:
A peritoneal fold enclosing urachus, also
known as anterior false ligament.
2. A pair of MEDIAL UMBLICAL
LIGAMENTS which are fold over
obliterated umbilical arteries. Also
known as antero-lateral false ligaments

24. • BEHIND:
3. LATERAL FALSE LIGAMENT:
extending from the bladder to lateral
pelvic wall. These form floor of para
vesical fossa & form lateral false
ligament
4. A pair of sacrogenital folds extending
from lateral angle of bladder to 3rd piece
of sacral vertebrae.

25. BLOOD SUPPLY
ARTERIAL SUPPLY:
Is Superior & inferior vesical arteries which are the
branches of anterior trunk of internal iliac artery.
• Superior vesical artery: supply anterosuperior
part of bladder
• inferior vesical arteries: supply fundus & neck
of bladder
• In females, vaginal arteries replace the inferior
vesical arteries & send small branches to
posteroinferior parts of the bladder

27. VENOUS DRAINAGE: vesical venous
plexus
• IN MALES: venous plexus around
bladder & prostate drains into inferior
vesical vein.
• IN FEMALES: venous plexus drains into
vaginal / uterovaginal vein & then to
internal iliac vein
• Also superior vesical vein drains the
bladder
Both vessels drain into internal iliac vein

30. INNERVATIONS
• Vesical plexus of nerves containing
both sympathetic & para sympathetic
components.
• PARA SYMPATHETIC: EFFERENT
(S2-S4) are motor to detrusor muscle
& inhibitory to sphincter vesical

31. • SYMPATHETIC: Efferent (T11-T12)
Are inhibitory to detrusor muscle & motor to
sphincter vesicae
• SOMATIC, PUDENDAL NERVE: (S2-S4).
Supplies the sphincter urethra, which is
voluntary
• SENSORY NERVE: pain sensation caused
by distension/ spasm of bladder wall are
carried mainly by para-sympathtic & partially
by sympathetic nerve via lateral
Spinothalamic tract.