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Updated: Jul 6 2021

Bladder / Urethra Anatomy

Images
https://upload.medbullets.com/topic/112038/images/urinary_system.jpg
https://upload.medbullets.com/topic/112038/images/bladder_innervation.jpg
  • Introduction
    • The urinary organs consist of
      • ureters (pelvic portion)
        • carries urine from the kidney into the bladder
      • urinary bladder
        • the site of temporary urine storage
      • urethra
        • the conduction site of urine from the urinary bladder to the external world
  • Ureters
    • Muscular tubes that carries urine from the kidney into the bladder
      • they are retroperitoneal structures that pass beneath the
        • uterine artery (in females)
          • clinical correlate
            • uterine or ovarian vessel ligation in gynecologic procedures may damage the ureter
        • vas deferens (in males)
    • Blood supply consists of branches from
      • renal arteries (most proximal)
      • testicular arteries (in men) and ovarian arteries (in women)
      • the descending aorta
      • internal iliac arteries
      • superior vesical arteries
      • uterine arteries (in women)
      • vaginal arteries (in women) and inferior vesical arteries (in men) (most distal)
  • Urinary Bladder
    • A temporary reservoir of urine
    • Innervation
      • parasympathetic fibers
        • conveyed from the sacral spinal cord via the pelvic splanchnic nerves and inferior hypogastric plexus
        • provide motor innervation to the detrusor muscle
        • inhibits contraction of the internal urethral sphincter in men
      • sympathetic fibers
        • conveyed from the lower thoracic and upper lumbar spinal cord via the hypogastric plexus and nerves
        • promotes contraction of the internal urethral sphincter
  • Urethra
    • A muscular tube that allows urine to travel from the urinary bladder to the external world
      • the urethra also provides an exit path for semen
      • the female urethra is much shorter (~4 cm) than the male urethra (~18-22 cm)
        • this is a reason as to why women are more prone to developing urinary tract infections than men
    • Urethral injury
      • posterior urethra
        • the weakest point is in the bulbomembranous junction
        • prone to injury in pelvic fractures (e.g., from a motor vehicle accident)
          • can result in urine or blood being found in the retropubic space
      • anterior urethra
        • injury to the anterior urethra can result from
          • straddle injuries
          • instrumentation
          • pelvic fracture (in conjunction)
          • direct blow
        • injury can result in urine or blood being found in the
          • deep fascia of Buck
          • superficial perineal space
            • when the deep fascia of Buck is torn
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