so in this video I'm going to talk about
the position of the urinary bladder
inside the body so the bladder is a
pelvic organ it's retroperitoneal by
position and it is normally in in an
empty state it is present behind the
symphysis pubis so in front of you is a
Hemi section through the male pelvis
showing us the bladder and other
structures present in the pelvic cavity
and here you can see this is the
symphysis pubis and this is the lower
part of the anterior abdominal wall with
all the skin subcutaneous fat fascia and
then muscles and then the plutonium okay
all right here is the apex and this is
the ligament I was talking about
originating from the apex or attached on
the apex and reaches up to the umbilicus
this is the median umbilical ligament or
Eureka's or Eureka's okay so in normal
circumstances in an adult the urinary
bladder partially full or empty is mine
inside the pelvic cavity or true pelvis
while in an infant this bladder whether
it's empty or is filled it's lying
inside the abdominal cavity because in
the infant the pelvic region is still
growing and it's a small narrow space so
the urinary bladder is an abdominal
organ in infants and that explains why
the because due to the pressure and
negative pressure of the abdominal
cavity when a Venna when an infant is
peeing he has has a very fast stream
away like you know that rushes out
because of the pressure from the other
internal organs while in adults the the
bladder descends down and settles in to
its normal and advocate position that is
in the true pelvis or the lesser pelvis
okay now what happens I told you that
the the bladder has a capacity of up to
500 milliliters of urine in one point of
time it can hold okay as the bladder is
filling I want you to imagine I always
give this example you imagine the
bladder like a Sun rising over the
horizon okay so it's raw it is rising
slowly so the fundus of the bladder as
it is getting full you know the cavity
is getting full it's getting distended
urine is constantly collecting so it
just you know it rises up and and I have
mentioned that the superior surface or
the fundus of the bladder is covered by
the peritoneum from the top okay the
peritoneum is not wrapped around the
bladder it's just covering the soupy air
surface so as the the bladder is getting
full it is rising like a Sun on the
horizon and it's entering it's crossing
the symphysis pubis and just peeps out
of the pelvic cavity into the abdominal
cavity what is happening at is it it is
getting full it's getting distended and
distended it's it's you know peeling off
the parietal peritoneum or the abdominal
peritoneum and it's you know occupying
this area behind the peritoneum or
outside the peritoneal cavity okay it
always stays outside the Britannian we
have to keep in mind sometimes what
happens in small children and also in
adults there is extraordinary retention
of urine like in cases of BPH like
benign prostatic hyperplasia or any any
situation that leads to obstruction
urethral obstruction of some sort so
there would be chronic retention of
urine and minute reaches like it's
getting more and more it spilling of the
the petunia layer from the anti
abdominal wall and it's becoming an
abdominal organ so they perform
assistance taught me like they they
insert a needle to relieve the pressure
so how do they do that they cross
through the skin the the campers and
superficial fasciae both elements the
the Scarpas and campers and then the
Linea Alba which is the you know the
bloodless line the way a vascular line
present in the mid of the abdominal wall
that is like below the umbilicus and
then the you know the fasciae
transversal ascends and they reach to
this level which is the bladder wall so
that that needle has entered the swollen
or you know distended bladder wall after
crossing all these structures and the
the urine can be aspirated out to
relieve the pressure and and prevent the
bladder from rupturing okay so it's
important to understand by the way a
full bladder can up can reach up to the
level of umbilicus although it's a it's
a pubic or a pelvic organ it's lying
behind the pimple symphysis pubis but it
when it gets starts getting distended it
can't stand up to so much that it
reaches the umbilicus okay but there are
chances of rupture in case or if
somebody has blown blown or blown
someone's abdomen in the region of the
standard bladder so then tear
bladder wall will rupture and the urine
can get collected here in the
subcutaneous tissue which is fashio and
that you know Atkin can can call
problems