Bladder
General
Normal anatomy

Author: Alcides Chaux, M.D. (see Authors page)

Revised: 21 March 2016, last major update June 2011

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Bladder [title] normal anatomy
General
  • Hollow organ that serves as a reservoir for urine
  • Adult bladder can hold up to 400-500 ml of urine without a change in intraluminal pressure
  • In addition, can initiate and sustain a contraction until empty
  • Distended adult bladder may reach level of umbilicus
  • ICD-O-3 coding


Parts of bladder
  • Apex/dome: most anterosuperior point; is covered by peritoneum; site of insertion of median umbilical ligament (obliterated urachus) which anchors the bladder to the abdominal wall
  • Base: posterior surface, is also covered by peritoneum
  • Neck: most distal portion of bladder
  • Trigone: area between ureteral and urethral orifices, continuous with bladder neck


Relationship to other structures
  • Located in part within the abdomen in children, enters pelvis major at age 6, found entirely within pelvis minor (“true” or obstetric pelvis) after puberty
  • Adult bladder rests on rectum and seminal vesicles (males) or cervix and vagina (females); thus, cystectomy for tumor may be combined with removal of prostate and seminal vesicles (males) or hysterectomy and partial vaginectomy (females)
  • Ureters enter the bladder posteroinferiorly and obliquely, travel 1.5-2 cm through the bladder wall (intravesical portion), and open at the ureteral orifices
  • Bladder neck is formed by interlacing and converging fiber of detrusor muscle forming 3 well-defined layers; occasionally contains prostatic ducts (males)
  • Anteroinferiorly and laterally, there is abundant fat and loose connective tissue (space of Retzius)
  • Bladder is relatively free within pelvis (which permits its expansion as it distends), but neck is secured by puboprostatic ligaments (male) and pubovesical ligaments (female)


Blood supply:
  • Superior, middle and inferior vesical arteries, derived from the anterior trunk of the internal iliac artery
  • In addition, minor branches are derived from obturator and inferior gluteal arteries and, in women, uterine and vaginal arteries
  • Venous drainage by a rich vesical venous plexus, which empties into internal iliac veins

Lymphatic drainage:
  • Vesical, internal and external iliac nodes; bladder neck drains to sacral or common iliac nodes

Nerve supply:
  • Sympathetic from T11-L2 nerves, plays no role in micturition
  • Parasympathetic from S2-4, travel to bladder via pelvic nerve and inferior hypogastric plexus, cause contraction of muscularis propria fibers, which puts traction on bladder neck, which opens internal sphincter; important in micturition
Diagrams / Tables

Images hosted on other servers:

Position of bladder in male pelvis


Position of bladder in female pelvis

Interior



Images hosted on Nature.com:
Missing Image

Position of bladder in male pelvis

Gross Description
  • Hollow viscus resembling inverted pyramid when empty, sphere when distended
  • Internal (mucosal) surface is flat when distended but show abundant folds in an empty bladder