URINARY

BLADDER
MOHAMMAD ALDEIRI

Introduction

The urinary bladder is retroperitoneal, same as the ureters.

It is positioned against the pubis between the pelvic diaphragm

and the obturator internus muscles.

The superior surface of the bladder is dome shaped when the

bladder is empty and inflates superiorly into the abdomen when
the bladder is full.

The parts of the bladder

Apex.

Base.

Detrusor muscle.

Neck.

Internal urethral sphincter.

External urethral sphincter.

The apex

The top of the bladder is located at the top of the pubic

symphysis.

The apex continues as the median umbilical ligament, which is

the embryonic remnant of the urachus.

The base

The base of the bladder is located inferiorly and posteriorly.

The ureters enter the bladder at each of the superior corners of

the base.

Internally, the triangular area between the openings of the

ureters is known as the trigone.

The detrusor muscle

The detrusor muscle consists of bundles of smooth muscle

located within the wall of the bladder.

The neck

The most inferior portion of the bladder.

It surrounds the origin of the urethra where the inferolateral

surfaces and base meet.

The neck of the bladder is supported by the pubovesical

ligament, bromuscular bands that attach between the neck and
pubic bones.

The internal urethral sphincter

It is a smooth muscle that involuntarily contracts or relaxes,

which regulates the emptying of the bladder.

The constant muscular tone of the internal urethral sphincter is

through sympathetic innervation.

To urinate, the muscle is relaxed via parasympathetic

innervation.

This is the primary muscle for preventing the release of urine.

The external urethral sphincter

This sphincter is composed of skeletal muscle within the

urogenital diaphragm that voluntarily opens and closes the
urethra to void urine.

The external urethral sphincter is innervated by the pudendal

nerve which means it is under voluntary control.

The inferolateral surfaces of the

bladder

The inferolateral surfaces are related in front to:

The

retropubic pad of fat.

The

pubic bones.

posteriorly, they lie in contact with:

The

obturator internus muscle above.

The

levator ani muscle below.

The inferolateral surfaces of the

bladder
Retropubic fat pad

Blood supply, venous drainage,

and lymph drainage of the
bladder
From the superior and inferior vesical arteries (branches of the

internal iliac artery).

The venous drainage is by the vesical plexus of veins (into the

internal iliac vein).

Lymph drainage is by the internal and external iliac nodes.

Resources

Anne M. R. Agur, Arthur F. Dalley, Grants Atlas of Anatomy,

thirteenth edition. (Lippincott Williams & Wilkins. 2013).

Richard . Snell, Clinical Anatomy by regions, ninth edition.

(Lippincott Williams & Wilkins. 2012).

David Morton, Kurt Albertine, Bo Foreman, the big picture, gross

anatomy. (Mcgraw-Hill, Lange, 2011).

Thank You