Anatomy of the urinary bladder

Anatomy of the urinary bladder
Anatomical features of the urinary bladder. Functions of the urinary bladder. Blood supply and innervation of the urinary bladder
~ 3 min

The urinary bladder (vesica urinaria) is a urinary organ that is a reservoir for urine.

Urinary bladder (vesica urinaria)
Urinary bladder (vesica urinaria)

Its capacity in an adult person is 600-750 mL, but this measurement varies for each individual.

The urinary bladder is located in the lesser pelvis behind the pubic symphysis and changes its topography depending on the filling.

Male urinary bladder - empty (vesica urinaria)
Male urinary bladder - empty (vesica urinaria)
Male urinary bladder - filled (vesica urinaria)
Male urinary bladder - filled (vesica urinaria)
Female urinary bladder - empty (vesica urinaria)
Female urinary bladder - empty (vesica urinaria)
Female bladder - filled (vesica urinaria)
Female bladder - filled (vesica urinaria)

Holotopy

It is projected onto the pubic region (in an empty state) of the anterior abdominal wall, while the filled bladder may reach the umbilical region.

Skeletotopy

The empty bladder is located at the level of the pubic symphysis, the filled one may reach the 3rd-4th lumbar vertebrae.

Syntopy

In men, the rectum, seminal vesicles, and vas deferens adhere to the bladder posteriorly; the loops of the small intestine adhere to it superiorly, and the prostate gland adheres to it inferiorly. In women, the cervix of the uterus and vagina are located posteriorly to the urinary bladder, and the fundus and body of the uterus are located superiorly to it.

The urogenital diaphragm (diaphragma urogenitale), which is a muscular and fascial structure in the lesser pelvis, adheres to the urinary bladder inferiorly. It is delimited by the pubic symphysis, as well as by the branches of the pubis and ischium bones.

The space between the anterior surface of the urinary bladder and the pubic area is called the prevesical space (spatium prevesicale) or the space of Retzius.

Parts of the urinary bladder

The urinary bladder has the following parts:

1. The apex of the urinary bladder (apex vesicae), which is a narrowed anterosuperior part

Apex of the urinary bladder (apex vesicae)
Apex of the urinary bladder (apex vesicae)
Apex
Apex

2. The body (corpus vesicae), which is the middle, largest part

Body of the urinary bladder (corpus vesicae)
Body of the urinary bladder (corpus vesicae)

3. The fundus (fundus vesicae), which is the inferior, expanded part

Fundus of the urinary bladder (fundus vesicae)
Fundus of the urinary bladder (fundus vesicae)

4. The neck (cervis vesicae), which is the area of transition to the urethra.

Neck of the urinary bladder (cervix vesicae)
Neck of the urinary bladder (cervix vesicae)

The apex of the urinary bladder is attached to the navel with the median umbilical ligament (plica umbilicalis mediana)

Median umbilical ligament (plica umbilicalis mediana)
Median umbilical ligament (plica umbilicalis mediana)

The inferior part of the urinary bladder is supported by the pelvic fascia and the levator ani muscles (m. levator ani)

Levator ani muscle (m. levator ani)
Levator ani muscle (m. levator ani)
Levator ani muscle (m. levator ani)
Levator ani muscle (m. levator ani)

Men also have the pubioprostatic ligament (lig. puboprostaticum), and women have the pubovesical ligament (lig. pubovesicale), which additionally strengthen the urinary bladder.

Men also have the pubioprostatic ligament (lig. puboprostaticum), and women have the pubovesical ligament (lig. pubovesicale), which additionally strengthen the urinary bladder.

Pubovesicalis muscle (m. pubovesicalis)
Pubovesicalis muscle (m. pubovesicalis)

There is dense cellular tissue around the urinary bladder, which also supports the urinary bladder.

Wall of the urinary bladder

The wall of the urinary bladder consists of several layers.

The mucous membrane (tunica mucosa), which is lined with transitional epithelium and has many folds. However, at the fundus of the urinary bladder, there is a region devoid of submucosa, and therefore this region has no folds.

Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)

It is called the trigone of the urinary bladder (trigonum vesicae), or Lieto’s trigone.

Trigone of the urinary bladder (trigonum vesicae)
Trigone of the urinary bladder (trigonum vesicae)
Trigone of the urinary bladder (trigonum vesicae)
Trigone of the urinary bladder (trigonum vesicae)

It forms between the internal urinary meatus and the ureteral orifices.

The muscular coat (tunica muscularis) consists of three layers.

Muscular coat (tunica muscularis)
Muscular coat (tunica muscularis)
Muscular coat (tunica muscularis)
Muscular coat (tunica muscularis)

The internal longitudinal layer (stratum internum longitudinale)

Internal longitudinal layer (stratum longitudinale internum)
Internal longitudinal layer (stratum longitudinale internum)
Internal longitudinal layer (stratum longitudinale internum)
Internal longitudinal layer (stratum longitudinale internum)

The middle circular layer (stratum circulare)

Middle circular layer (stratum circulare)
Middle circular layer (stratum circulare)
Middle circular layer (stratum circulare)
Middle circular layer (stratum circulare)

The external longitudinal layer (stratum externum longitudinale)

External longitudinal layer (stratum longitudinale externum)
External longitudinal layer (stratum longitudinale externum)
External longitudinal layer (stratum longitudinale externum)
External longitudinal layer (stratum longitudinale externum)

The most developed is the circular layer, which forms the internal urethral sphincter (sphincter urethrae internus).

Internal urethral sphincter (sphincter urethrae internus)
Internal urethral sphincter (sphincter urethrae internus)

In general, all the muscular layers of the urinary bladder form the detrusor muscle (m. detrusor vesicae).

Detrusor muscle (m. detrusor vesicae)
Detrusor muscle (m. detrusor vesicae)

The urinary bladder is covered with the peritoneum (tunica serosa) superiorly.

Peritoneum (tunica serosa)
Peritoneum (tunica serosa)

When it is filled, it is located mesoperitoneally, that is, it is covered with the peritoneum on three sides. An empty bladder lies extraperitoneally, that is, the peritoneum covers it only on one side.

Blood supply

Blood supply to the bladder is carried out by branches of the following arteries:

  1. The superior and inferior vesical arteries (aa. vesicales superior et inferior)
  2. The middle rectal artery (aa. rectales media)
  3. Uterine arteries (aa. uterinae)

Venous drainage

Venous blood drains from the bladder in the following structures:

  1. To the venous plexus of the urinary bladder (plexus venosus vesicalis), uterine plexus (plexus uterinus), vaginal plexus (plexus vaginalis), rectal plexus (plexus rectalis)
  2. To the internal iliac vein (v. iliaca interna)

Lymph drainage

Lymph drains into the iliac and internal iliac lymph nodes, from where the lymph goes to the lumbar lymph nodes.

Innervation

Innervation of the urinary bladder is performed by the vesical plexus. It is formed by the inferior hypogastric plexuses and internal sacral nerves.

Dictionary

Anatomy of the urinary bladder

Urinary bladder
vesica urinaria
Urogenital diaphragm
diaphragma urogenitale
Superficial transverse perineal muscle
m.transversus perinei superficialis
Ischiocavernosus muscle
m.ischiocavernosus
Deep transverse perineal muscle
m.transversus perinei profundus
Sphincter muscle of the urethra
m.sphincter urethrae
Prevesical space
spatium prevesicale
Apex of the urinary bladder
apex vesicae
Body of the urinary bladder
corpus vesicae
Fundus of the urinary bladder
fundus vesicae
Neck of the urinary bladder
cervix vesicae
Detrusor muscle
m. detrusor vesicae
Triangle of the urinary bladder
trigonum vesicae
Median umbilical ligament
plica umbilicalis mediana
Levator ani muscle
m.levator ani
Lateral pubovesical ligaments
lig.pubovesicale laterale
Medial pubovesical ligaments
lig. pubovesicale medium
Right and left vesicouterine ligaments
lig.vesicouterinum dextrum et sinistrum
Pubovesical muscle
m.pubovesicalis
Superior and inferior vesical arteries
aa.vesicales superior et inferior
Middle rectal arteries
aa.rectales media
Uterine arteries
aa.uterinae
Venous plexus of the urinary bladder
plexus venosus vesicalis
Uterine plexus
plexus uterinus
Vaginal plexus
plexus vaginalis
Rectal plexus
plexus rectalis
Internal iliac vein
v.iliaca interna
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