Urinary Bladder Flashcards Preview

Anatomy (TOPNOTCH SUPPLEMENT) > Urinary Bladder > Flashcards

Flashcards in Urinary Bladder Deck (20):
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Males: UB

Posterior: related to rectovesical pouch, rectum, seminal vesicles, ampulla of ductus deferens

Anterior: related to pubic symphysis & retropubic space of Retzius

Superior: related to peritoneal cavity

Apex: Related to
- MEDIAN UMBILICAL LIGAMENT or URACHUS (remnant of allantois)
- 2 MEDIAL UMBILICAL LIGAMENTS (remnant of R & L umbilical artery)
- 2 LATERAL UMBILICAL LIGAMENTS (R & L inferior epigastric artery & vein)

Neck: related to prostate gland & prostatic urethra

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Females: UB

Posterior: related to anterior vaginal wall

Anterior: related to pubic symphysis & retropubic space of Retzius

Superior: related to vesicouterine pouch (peritoneal cavity) & uterus

Apex: Related to
- MEDIAN UMBILICAL LIGAMENT or URACHUS (remnant of allantois)
- 2 MEDIAL UMBILICAL LIGAMENTS (remnant of R & L umbilical artery)
- 2 LATERAL UMBILICAL LIGAMENTS (R & L inferior epigastric artery & vein)

Neck: related to Urogenital diaphragm

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Internal structure

Mucosa: transitional epithelium

Smooth muscle: DETRUSOR MUSCLE

Trigone: located on posterior surface, defined by openings of ureters superiorly & by urethra inferiorly

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Locations

Infants: within the ABDOMINAL CAVITY

Adults: within the PELVIC INLET, as it fills ➡️ rides out of the MINOR PELVIS, above PELVIC INLET, as high as UMBILICUS

Suprapubic cystostomy: skin ➡️ superficial fascia (CAMPER & SCARPA) ➡️ linea alba ➡️ transversalis fascia ➡️ extraperitoneal fat ➡️ bladder wall without entering the peritoneal cavity to remove the urine from the bladder

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Urine leakage as a result of trauma

Rupture of superior wall (dome)

Rupture of anterior wall

Rupture of urethra above the Urogenital diaphragm

Rupture of urethra just below the Urogenital diaphragm

Rupture of penile urethra

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Rupture of superior wall

Compression on full bladder

Result: Intraperitoneal extravasation of urine

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Rupture of anterior wall

Fractured pelvis that punctures the bladder

Result: extraperitoneal extravasation of urine within retropubic space of Retzius

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Rupture of urethra above the Urogenital diaphragm

Fractured pelvis or improper catheter insertion

Result: extraperitoneal extravasation of urine within retropubic space of Retzius

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Rupture of urethra below the Urogenital diaphragm

Most common type

Straddle injury

Result: extraperitoneal extravasation of urine within superficial perineal space & extends into scrotal, penile & abdominal wall

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Rupture of penile urethra

Crushing injury to penis

Result: extraperitoneal extravasation of urine beneath the deep fascia of Buck

If Buck fascia is not torn --> extravasation is confined in the penis

If torn --> extravasation within superficial perineal space

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Urine leakage as a result of incontinence

Total incontinence

Stress incontinence

Urge incontinence

Overflow incontinence

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Continuous involuntary loss of urine

Cause: ectopic ureter, vesicovaginal fistula

Tx: surgery repair

Total incontinence

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Associate with ⬆️ abdominal pressure (coughing, sneezing, Valsalva, after childbirth)

Tx: ephedrine, Phentolamine or surgery repair

Stress incontinence

13

Associated with intense desire to void

Cause: uncontrolled contraction of DETRUSOR muscle

Tx: oxybutynin or imipramine

Urge incontinence

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Bladder filling overcomes sphincter control

Cause: prostate CA, urethral stricture, atonic neurogenic bladder

Tx: catheterization, surgery

Overflow incontinence

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Types of neurogenic bladder

Hypertonic

Atonic

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Small bladder and DETRUSOR hperreflexia/overactivity

--> thickened walls of the bladder (pine tree bladder)

Urgent, frequent voiding

Upper motor neuron lesions

Tx: Anticholinergics, catheterization, surgery augmentation

Hypertonic

17

Large bladder and detrussor areflexia/underactivity

Urinary retention --> overflow incontinence

Lower motor neuron lesions

Tx: catheterization, surgery urine diversion

Atonic

18

Most common type of tumor in the bladder (>90%)

Painless hematuria

Transitional cell CA

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Urinary bladder prolapses into the anterior vaginal wall

Cystocele