Urinary Bladder

large muscular bag, reservior of urine lies ant part of pelvic cavity.

Size shape and position:
varies in size , shape and position according to amount of urine contains
when empty lies in pelvis, reaches abdomen when filled with urine.

External features:
when empty:
tetra hedral. has apex, base, three surface, four boarder and one neck.

Ligaments of the bladder:

a. true ligaments:
lateral true ligaments of bladder.
lateral puboprostatic ligament
Medial puboprostatic ligament
median umblical ligaments

b.false ligaments
The median umblical fold
medial umblical fold
lateral false ligaments
Posteriaor false ligaments

Arterial supply:
Superior and inferior vesicular artery
additional supply from obturator and inferior gluteal artery.
acne treatments
Nerve supply:
parasympathetic s234
sympathetic T11-L2
Pudendal nerve s234

The urinary bladder

Urinary Bladder:

Muscular reservior of urine which lies ant to

Ureters

Thick wall muscular tube which convey urine to Urinary bladder from Kidneys.

Lies in posterior abdominal wall.
Measures about 25 cm, 12.5 cm lies in Abdomen and 12.5 cm lies in pelvis.

It has three constrictions.

Course:
Starts from renal pelvis , gradually narrows and lower end of kidneys it become
ureter proper. It runs downwards and slightly medially over psoas major muscle
enters pelvis infront of termination of common internal iliac artery.

In lesser pelvis it runs bownwards and slightly backwards and laterally following
ant margin of greater sciatic notch. Opposite the ischial spine it runs forward
meidally towards urinary bladder.

Normal constriction:
1. At pelvic ureteric junction
2.at the brim of lesser pelvis
3.At its passage through its bladder wall.

Relations:


Blood supply:
It is supplied by three set of arteries:
1.Upper part receives branches from renal artery
2.Middle part receives branchs from the abdominal aorta
3.The pelvic part receives branches from vesical, middle rectal or uterine arteries.

Nerve supply:
Sympathetic N T10-L1
ParaSYMPATHETIC S2-4

Anatomy(Kidneys and Ureters)

KIDNEYS:

Pairs of Excretory organs situated on Both side of vertebral column
on the posterior abdominal wall, behind the peritonium.

Retroperitonial organs:
Kidneys
Supra renal glands
Inferior vena cava
Abdominal aorta
Pancreas
Sympathetic trunk
Ovarian or testicular veins


Main organ of excretion , remove metabolic waste products maintains
water and electrolyte balance.

Each kidney is bean shaped.
It has two pole upper and lower, two border medical and lateral and
two surface anterior and posterior.

Upper pole is broad and lies close contact with supra renal glands. Lower
pole is pointed.

The anterior surface is rough and posterior surface is smooth.

lateral border is convex and medial border is concave and shows depression
in the middle is called hilum. The following structure is seen from ant to post
Renal vein, Renal artery, renal pelvis (VAP)

Expanded upper pole of ureter is called renal pelvis.

Kidneys occupy epigasrium, hypochondrium,lumber,umblical

vertically extends from T12 (upper border) to L3(Middle of the body).
Right kidney is slightly lower than the left.Left kidney is little nearer to
median plane than the right.

Transpyloric plane pass through upper border of rt kidney and lower
border of left kidney.

Each kidneys is about 11,6,3 cm
Measuring about 150 gms in male and 135 gms in female.

long axis is directed downwards and laterally, transverse axis is directed
backwards and laterally.

Relation of Kidneys:



Capsules of Kidneys:

Fibrous capsules
Perirenal Fat
Renal Fasciae
Para renal Fat


Structure of Kidneys.
Outer Cortex. Cortex is further divided into a. cortical lobules or cortical arches
which overlays the base of pyramid and b. Renal columns which dips into between
two cortical lobules.

Inner Medulla. Renal medulla is consist of 9 conical mass of renal pyramids. Their apices
form the renal papillae which indents the renal calices.

Major calices: 2/3 in number
Minor calices: 7/13 in Number

Renal sinus: Space extends from kidneys to renal hilus.

Histologically kidneys consist of 1-3 milions of uriniferous tubules

Each tubules develops from two part 1. Secretory portion from Mesonephric blastoma from mesoderm and 2. Collecting part from ureteric bud.

Arterial supply:

Usually there is one renal artey on each side arising from abdominal aorta.
Acessory renal artey present in 30% case, usually arise from abdomianl aorta

Nerve supply:

sympathetic nerve T10-L1
No Parasympathetic supply

anomalies of Kidneys:

Congenital polycystic kidneys
Horse shoe shape kidneys
Pelvic kidneys
Aplasis/hypoplasia.