Bladder

Question 1

Normal adult bladder capacity

Answer 1

400–600 mL

Question 2

Mechanism of accommodation of bladder

Answer 2

Accommodated by distensible walls and rugae that disappear when full

Question 3

Two major roles of the bladder

Answer 3

Temporary storage of urine, Expulsion of urine

Question 4

Location of the bladder

Answer 4

Immediately behind the pubic bones within the lesser pelvis

Question 5

Bladder shape when empty

Answer 5

Pyramidal in shape

Question 6

Parts of the bladder

Answer 6

Apex, base (fundus), superior & inferolateral surfaces, neck

Question 7

Bladder shape when full

Answer 7

Ovoid; superior surface bulges into abdominal cavity

Question 8

Ligament connecting bladder apex to umbilicus

Answer 8

Median umbilical ligament; remnant of urachus

Question 9

Base/fundus of bladder: shape and anatomical significance

Answer 9

Triangular; ureters enter superolaterally, urethra exits inferiorly

Question 10

Base/fundus of bladder corresponds to ____ internally

Answer 10

Trigone

Question 11

The inferolateral surfaces of bladder rest on ___ and ____

Answer 11

Levator ani and obturator internus muscles

Question 12

Which part of bladder is covered by peritoneum?

Answer 12

Superior surface

Question 13

Which part of bladder is the most fixed part?

Answer 13

Neck of bladder

Question 14

What is trigone of bladder?

Answer 14

Smooth triangular area at the base of the bladder between ureteric orifices (superior angles) and internal urethral opening (inferior angle)

Question 15

Small elevation in the bladder situated immediately behind the urethral orifice

Answer 15

Uvula vesicae

Question 16

What causes presence of uvula vesicae?

Answer 16

Underlying median lobe of prostate

Question 17

Internal urethral sphincter surrounds ____ while external urethral sphincter surrounds _____

Answer 17

Neck of bladder; part of urethra in deep membranous pouch: membranous urethra in males and middle part of urethra in females

Question 18

What forms the internal urethral sphincter?

Answer 18

Circular fibers of detrusor muscle thickened around the neck of bladder

Question 19

Another name for internal urethral sphincter and external urethral sphincter respectively

Answer 19

Sphincter vesicae, Sphincter urethrae

Question 20

Detrusor muscle layers of bladder

Answer 20

Inner longitudinal, middle circular, outer longitudinal

Question 21

Detrusor muscle layers are well organized at the ___ of bladder

Answer 21

Neck

Question 22

Arterial blood supply of the bladder

Answer 22

Superior vesical (from umbilical) and inferior vesical arteries (from internal iliac)

Question 23

Venous drainage of the bladder

Answer 23

Vesical venous plexus; drains into internal iliac vein

Question 24

Lymphatic drainage of bladder

Answer 24

Internal & external iliac nodes

Question 25

Nerve supply of external urethral sphincter; autonomic or somatic?

Answer 25

Pudendal nerve (S2-S4); Somatic

Question 26

Sympathetic nerve supply of bladder and actions

Answer 26

T11–L2; contracts internal sphincter → for urine storage; inhibit detrusor contraction

Question 27

Parasympathetic nerve supply of bladder and actions

Answer 27

S2–S4 pelvic splanchnic nerves; contracts detrusor, inhibit internal sphincter contraction → for urine voiding

Question 28

Voluntary control of urination: nerve and actions

Answer 28

Nerve: Pudendal S2–S4; controls external urethral sphincter around membranous urethra (male) or middle urethra (female)

Question 29

Which nerve acts on sphincter vesicae?

Answer 29

IUS = Sympathetic: T11-L2

Question 30

Which nerve acts on sphincter urethrae?

Answer 30

EUS = Somatic: Perineal branch of pudendal nerve (S2-S4)

Question 31

Which nerve acts on detrusor muscle?

Answer 31

Parasympathetic: S2-S4 Pelvic splanchnic nerves

Question 32

Which autonomic nerves inhibit detrusor muscle contraction?

Answer 32

Sympathetic: T11-L2

Question 33

Bladder wall layers

Answer 33

Mucosa (transitional epithelium + lamina propria), lamina muscularis (isolated bundles of smooth muscles), tunica muscularis (3 interlacing layers collectively called detrusor), adventitia/serosa

Question 34

Which part of bladder has serosa?

Answer 34

Upper or superior surface of bladder

Question 35

Which part of bladder has adventitia?

Answer 35

Inferior and lateral surfaces of bladder

Question 36

Which part of bladder is continuous with urethra and internal urethral sphincter (sphincter urethrae)?

Answer 36

Neck of bladder

Question 37

Which bladder nerve control stores and voids urine respectively?

Answer 37

Sympathetic “store” (T11-L2): IUS contracts, detrusor relaxes; Parasympathetic “pee” (S2-S4 pelvic splanchnic): detrusor contracts, IUS relaxes

Question 38

External urethral sphincter has ___ muscle while IUS has __ muscle

Answer 38

EUS: Striated voluntary; IUS: Smooth involuntary (contracts via sympathetic)

Question 39

Bladder apex orientation

Answer 39

Points anteriorly behind pubic symphysis

Question 40

Bladder emptying mechanism

Answer 40

Detrusor contracts; internal & external sphincters relax

Question 41

Uvula vesicae clinical significance

Answer 41

Prominent in males due to median lobe of prostate; may obstruct catheter passage