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,
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,
rectus sheath, the sheath covering rectus muscle of anterior abdominal wall, formation of the sheath, the muscles involved in ts formation, and the contents the sheath is covering
rectus sheath, the sheath covering rectus muscle of anterior abdominal wall, formation of the sheath, the muscles involved in ts formation, and the contents the sheath is covering
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
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He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
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3. • IT IS A HOLLOW MUSCULOMEMBRANOUS SAC WHICH ACTS AS A
RESORVOIR FOR THE URINE.
• IT IS THE MOST ANTERIOR ELEMENT OF THE PELVIC VISCERA.
• IT IS A SUBPERITONEAL ORGAN AND HAS PARIETAL PERITONEUM
ONLY ON ITS SUPERIOR SURFACE.
• URINE ENTERS THE BLADDER VIA URETERS AND EXITS VIA THE
URETHRA.
URINARY BLADDER
4. ANATOMICAL LOCATION
▸When "Empty" , the adult urinary bladder is located in the "Lesser
pelvis" lying partially superior to and partially postetior to the pubic
Bones.
▸As the bladder fills it enters the "Greater Pelvis".
▸In some individuals, a full bladder may ascend to the level of the
"Umbilicus".
▸In infants and young children,the urinary bladder is in the abdomen
even when empty.
▸The Bladder usually enters the Greater Pelvis by 6 Years of age.
5. SURFACES OF THE URINARY BLADDER
▸Superior surface.
▸Right inferolateral surface.
▸Left inferateral surface
▸Posterior surface.
6.
7. BODY OF URINARY BLADDER
▸It is lined by Transitional epithelium,
▸It holds the urine, before it is voided.
▸It can hold 400ml to 1000ml of the urine.
▸It is located between the apex and the fundus.
8.
9. FUNDUS OF THE URINARY BLADDER
▸It is base of the bladder.
▸It has the shape of inverted triangle.
▸It faces postero-inferiorly and , is formed by the posterior
wall of bladder.
▸Trigone of the urinary bladder is found on the fundus.
10.
11. TRIGONE OF URINARY BLADDER
▸It is smooth triangular part of urinary bladder.
▸Mucosal lining of trigone is smooth and firmly attached to the
underlying wall of the bladder.
▸Formed by Right and left ureteral orifices.
▸Once the trigone of urinary bladder is stretched to a certain
degree, siganl is sent to the brain that bladder needs to be
emptied.
12.
13.
14. URETERAL ORIFICES
▸These are Slit like openings through which ureters enter the
bladder on the posterolateral angles of the trigone of urinary
bladder.
15. MERCIER'S BAR
▸It is a mucous membane present between the two ureteral
orifices.
▸It is also called "InterUreteral Fold"
16. NECK OF URINARY BLADDER
▸It is the lowest portion of the bladder through which the
"Urethra" arrises.
17. INTERNAL URETHRAL SPHINCTER
▸It is comprised of smooth muscle that is located at the
junction of urethra and the urinary bladder.
▸It is innervated by S2-S4 nerves of the pelvic plexus.
▸It's function is to constrict the internal urethra ,preventing the
urine leakage and also prevents the Retrograde ejaculation (
Ejaculatory Reflex ) of semen into the bladder.
18.
19.
20. DETRUSOR MUSCLE
▸It is also referred as " Muscularis Propria".
▸It is smooth muscle , found around the wall of bladder.
▸It is comprised of inner and outer longitudinal, and middle
circular layer.
▸This muscle is relaxing during accomulation of urine in the
bladder, and contracts only during urination to void and
empty the bladder.
21.
22. POSTERIOR RELATIONS OF URINARY
BLADDERIn males :-
▸ Vas deferan
▸ Seminal Vesicle
▸ Rectum
▸ RetroVesical Fascia
▸ Peritoneum
In famales :-
▸ Vagina
▸ Part of Uterus
23. RELATIONS CONTINUED
Superior Relations in male:-
▸Peritoneum
▸Coils of ileum
▸Sigmoid colon
Superior Relations in female:-
▸Uterus
Lateral Relations :-
▸Obturator internus
▸Levator ani
24.
25.
26.
27. ARTERIAL SUPPLY
▸Branches of internal iliac arteries.
▸Superior vesical arteries supply anterosuperior parts of the bladder.
▸In males, inferior vesical arteries supply the fundus and neck of the
bladder.
▸In females, vaginal arteries replace the inferior vesical arteries and
send small branches to posteroinferior parts of the bladder.
▸Obturator and inferior gluteal arteries also supply small branches to
the bladder.
28.
29. VENOUS DRAINAGE
▸The veins draining from the bladder correspond to the
arteries.
▸Veins from the Vesical venous plexus drain into the internal
iliac veins.
30. INNERVATION OF URINARY BLADDER
▸Pelvic Nerve (Parasympathetic nerve) comes from the sacral region of
spinal cord. It is not under our control. It causes contraction of the
Detrusor muscle.
▸Pudendal nerve (Somatic nerve) causes contraction of External
Sphincter. We are firing pudendal nerve when we are trying to hold our
urine.
▸Hypogastric nerve (Sympathetic nerve) causes relaxation of Detrusor
muscle and contraction of Internal sphincter.
▸Afferent Pelvic nerve that is sensory and comes from the detrusor
muscle. It is stimulated when the bladder is stretched.
31. LYMPHATIC DRAINAGE OF BLADDER
▸In both sexes, lymphatic vessels leave the superior surface
of the bladder and pass to the "External iliac lymph nodes".
▸Those from fundus pass to the "Internal iliac lymph nodes".
▸Some vessels from the neck of bladder drain into the
"Sacral" to "Common iliac lymph nodes".
