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urinarybladderandurethra-110317021330-phpapp02.pptx

The urinary bladder is a musculomembranous sac located in the pelvis that stores urine. In males, it is anterior to the rectum, and in females it is anterior to the vagina and inferior to the uterus. The bladder expands superiorly into the abdomen when full. The urethra drains the bladder, differing in length and path between males and females. In males it is longer and passes through the prostate, while in females it is shorter and passes through the pelvic floor. The bladder and urethra receive blood supply from branches of the internal iliac arteries and are innervated by autonomic nerves from the pelvic plexus.

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Anatomy of Urinary Bladder and Urethra
Urinary Bladder • Urinary bladder is a musculomembranous sac which acts as a reservoir for the urine. • The bladder is the most anterior element of the pelvic viscera. • It is entirely situated in the pelvic cavity when empty, it expands superiorly into the abdomen when full.
Urinary Bladder • The empty bladder is shaped like a three- sided pyramid. • It has an apex, a base, a superior surface, and two inferolateral surfaces.
Urinary Bladder • The apex of the bladder is directed toward the top of the pubic symphysis; a structure known as the median umbilical ligament (a remnant of the embryologic urachus that contributes to the formation of the bladder) continues from it superiorly up the anterior abdominal wall to the umbilicus.
Urinary Bladder • The base of the bladder is shaped like an inverted triangle and faces posteroinferiorly. The two ureters enter the bladder at each of the upper corners of the base, and the urethra drains inferiorly from the lower corner of the base. • The smooth triangular area between the openings of the ureters and urethra on the inside of the bladder is known as the trigone
Urinary Bladder • The inferolateral surfaces of the bladder are cradled between the levator ani muscles of the pelvic diaphragm and the adjacent obturator internus muscles above the attachment of the pelvic diaphragm. • The superior surface is slightly domed when the bladder is empty. • It balloons upward as the bladder fills.
Neck of bladder • The neck of the bladder surrounds the origin of the urethra at the point where the two inferolateral surfaces and the base intersect. • The neck is the most inferior part of the bladder and also the most 'fixed' part.
Urinary Bladder: Location • Posterior to pubic symphysis • In females is anterior to vagina & inferior to uterus
Urinary Bladder: Location • Posterior to pubic symphysis • In males lies anterior to rectum
Blood Supply of Urinary Bladder • Its blood supply from the superior and inferior vesicular arteries. These arteries are tributaries of the internal iliac arteries.
Innervations of Urinary Bladder • The pelvic plexus is supplying the urinary bladder with autonomic nerves. • The sympathetic innervation is directed to the blood vessels, urethral openings, and the trigone. The last thoracic and L1,2 nerves create the necessary innervation to the bladder. • Parasympathetic innervation is derived from S2,3 and 4 nerves. These are aimed at serving the detrusor muscle. • The pelvic spinal nerves are responsible for responding to the sensory response of a full bladder, which responds to the impulses sent via the central nervous system.
Urethra • The urethra begins at the base of the bladder and ends with an external opening in the perineum. • The urethra differs significantly in women and men.
Urethra In women • The urethra is short, being about 4 cm long. • It travels a slightly curved course as it passes inferiorly through the pelvic floor into the perineum, where it passes through the deep perineal pouch and perineal membrane before opening in the vestibule that lies between the labia minora.
Urethra In men • The urethra is long, about 20 cm, and bends twice along its course. • Beginning at the base of the bladder and passing inferiorly through the prostate, it passes through the deep perineal pouch and perineal membrane and immediately enters the root of the penis. • The urethra exits the deep perineal pouch, it bends forward to course anteriorly in the root of the penis. • When the penis is flaccid, the urethra makes another bend, this time inferiorly, when passing from the root to the body of the penis. During erection, the bend between the root and body of the penis disappears.
Urethra • The urethra in men is divided into: preprostatic, prostatic, membranous, and spongy (penile) parts.
Parts of the Urethra Preprostatic part • The preprostatic part of the urethra is about 1 cm long. • It extends from the base of the bladder to the prostate, and is associated with a circular cuff of smooth muscle fibers (the internal urethral sphincter). Contraction of this sphincter prevents retrograde movement of semen into the bladder during ejaculation. Prostatic part • The prostatic part of the urethra is 3-4 cm long and is surrounded by the prostate. In this region, the lumen of the urethra is marked by a longitudinal midline fold of mucosa (the urethral crest). (Read more)
Parts of the Urethra Membranous part • The membranous part of the urethra is narrow and passes through the deep perineal pouch. • During its transit through this pouch, the urethra, in both men and women, is surrounded by skeletal muscle of the external urethral sphincter. Spongy (Penile) urethra • The spongy urethra is surrounded by erectile tissue (the corpus spongiosum) of the penis. • It is enlarged to form a bulb at the base of the penis and again at the end of the penis to form the navicular fossa). • The external urethral orifice is the sagittal slit at the end of the penis.
urinarybladderandurethra-110317021330-phpapp02.pptx
urinarybladderandurethra-110317021330-phpapp02.pptx