Lecture notes for medical students

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Introduction

3. Introduction
• The bladder is an extraperitoneal muscular
urine reservoir that lies behind the pubic
symphysis in the pelvis.

4. Embryology

5. Embryology
• Urinary bladder is derived from
the urogenital sinus and it is initially
continuous with the allantois.
• The apex of the bladder stretches and is
connected to the umbilicus as a narrow
canal.
• This canal is initially open, but later closes
as the Urachus and forms the median
umbilical ligament.

6. Parts

7. Parts
• Body Detrusor m.
• Dome
• Trigone
• Neck

11. The detrusor muscle

12. The detrusor muscle
• The detrusor muscle is a layer of the urinary
bladder wall made of smooth muscle fibers
arranged in spiral, longitudinal, and circular
bundles

13. The trigone

14. The trigone
• The trigone is a triangular portion of the
bladder floor bordered (ventrally) by the
internal urethral opening or bladder neck
and (dorsolaterally) by the orifices of the
right ureter and left ureter.

15. Transitional epithelium

16. Transitional epithelium
• Ureter, U.bladder and urethra are lined with
transitional epithelium.
• transitional epithelium stratified
ie.multilayered.
• Transitional epithelium cells stretch to
accommodate the volume of urine when
filled.
• Protect deeper tissue from toxic effects of
urine.

17. Internal Sphincter

18. Internal Sphincter
• In males, the bladder neck is contiguous
with the prostate and both serve together as
the internal urethral sphincter.
• In women 3 layers become apparent-
– the sphincter urethrae,
– urethrovaginal muscle
– compressor urethrae.

19. External Sphinctor

20. External Sphinctor
• The external urethral sphincter originates at
the ischiopubic ramus and inserts into the
intermeshing muscle fibers from the other
side.
• the external sphincter is made of skeletal
muscle.
• deep perineal branch of the pudendal nerve

21. Arterial Supply

22. Arterial Supply
• umbilical artery by several superior vesicle
branches.
• inferior vesical arteries, which come as
direct internal iliac branches in males or
from the vaginal arteries in females
• in part from the obturator artery and inferior
gluteal artery .

23. Venous Drainage

24. Venous Drainage
• The venous return of the bladder is a rich
network of vessels that generally parallels
the arteries in both anatomic course and
name.
• The vast majority of venous return from the
bladder drains into the internal iliac
vein.artery and vaginal artery.

25. Lymphatic Drainage

26. Lymphatic Drainage
• The lymphatic drainage of the bladder is
into the obturator, external iliac, internal
iliac (hypogastric), and common iliac lymph
nodes.

27. Nerve Supply

28. Nerve Supply
• Motor
– sympathetic hypogastric plexuses and nerves,
– parasympathetic fibers pelvic splanchnic
nerves and the inferior hypogastric plexus.
– External sphincter supplied by S2–S4 fibres via
the pudendal nerve
• Sensory- via general visceral afferent
fibers(GVA)
– on the superior surface sympathetic efferent
nerves
– Inferior portion of the bladder parasympathetic
efferents.

29. Relations
• The dome and posterior surface of the
bladder are covered by parietal peritoneum
• Anterior to the bladder is the space of
Retzius or retropubic space.
• In males, the seminal vesicles, ductus
deferens, ureters, and rectum border the
inferoposterior aspect of the bladder and
prostate.
• In females, the posterior peritoneal
reflection is continuous with the uterus and
vagina and is referred to as the anterior cul-
de-sac or vesicouterine pouch.

30. Congenital anomalies

31. Congenital anomalies
• Bladder exstrophy(Ectopia vesicae)
• Patent Urachus
• Urachus cyst

32. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

34. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

37. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
=0
• https://www.facebook.com/doctorpradeeppa
nde/?ref=pages_you_manage