the

URINARY BLADDER CADAVERIC DISSECTION - Human Anatomy Cadaveric Dissection Videos

[Music]

so this is spring cadaver I'm on the

right side camera person is on the left

side we have completely taken all the

structures of the pelvis and this

structure that we see in front of us

this is the urinary bladder

this is apex of the bladder and we can

see this ligament arising from the apex

this is the median umbilical ligament

which is a remnant of the erectus which

is derived from the allen toy and this

goes and gets attached to the umbilicus

on the inner surface of the a abdominal

wall we see these two ligaments on

either side these are the medial

umbilical ligaments which are the

obliterated distal portions of the

umbilical artery which is a branch from

the anterior division of the internal

iliac these also go to the umbilicus in

life these structures are located on the

inner surface of the a tree abdominal

wall and there's a depression on either

side of the median umbilical ligament

here and here these are called the super

of a cynical fossa which can be a

potential site of herniation to continue

we have opened out the space between the

bladder and the pubic symphysis this is

known as the previous cycle space this

is filled with endo pelvic fissure this

space is also referred to as the cave of

radius in life this is filled with

recycled venous plexus which becomes

continuous with the prosthetic venous

plexus normally the bladder is below the

level of the pubic bone intra pelvic

organ but when the bladder gets

distended and for some reason we cannot

pass the catheter through the urinary

passage we have to do what is known as a

suprapubic cystoscopy

and we do the suprapubic just talk to me

through this route where my instrument

is pointing to continue with the parts

of the bladder this surface of the

bladder was covered by peritoneum and

this is the Dome of the bladder and this

peritoneum which we have removed

continues and gets reflected onto the

rectum which is this structure here the

place where the peritoneum gets

reflected from the bladder to the rectum

that is known as the rec to recycle

pouch in females Sutras is lying on the

Dome of the bladder so therefore there

will be a Vista Co you trained publish

any portion after that is extra pet

oniel and we will come to that in a

little

while we will pick up the better to show

you this portion Knox ocean is known as

the fundus it is extra paid to name the

fundus of the bladder is also called the

pace of the bladder because it is

opposite the apex it is also the

posterior surface of the bladder this is

the structure which is in relation to

the rectum separated by the recto of a

cycle set and it contains three

structures in the main and we can see

the two structures here one of them is

the doctors difference which is going

inside and then we have the ureter which

is also going and there will be a

structure which is not visible but

further lower down and that'll be the

seminal vesicle so this are the three

structures which are separating the

posterior surface or the base of the

bladder from the rectum and the rector

of a cycle septum and to show it more

clearly I will lift up the bladder and

we can see this is the doctors

difference here on this side and the

doctors difference on this side and we

can see the doctors difference here

becomes a little dilated this is known

as the ampule of the doctors difference

which will then unite with the duct from

the seminal blade and form the gamma D

regulatory duct which will go through

the prostate and open as the common

ejaculatory duct into the prostate in

your instrument this is a post-operative

case so therefore this whole area was

highly fibrosis but we can see a few of

the blood vessels which are coming to

the bladder from the proximal portion of

the umbilical artery and these are the

severe recycle arteries on this side and

these are some remnants of the severe

recycle artery on this side they are the

ones we supply the dome of the bladder

the ductus deferens it's supplied by

branch from the inferior recycle artery

and these are known as differential

arteries ninfea recycle artery is also

approached from the anterior division of

the internal iliac now let's take a look

at the interior of the bladder and for

that we have sliced open the bladder on

its anterior surface and I have tilted

the bladder back and we have opened the

letter

this is the interior of the matter we

can see first of all the bladder mucosa

it is sewn into slight folds after that

this is the thickness of the bladder

wall this contains a smooth muscle which

is referred to as the detrusor muscle

this detrusor muscle is under

parasympathetic control parasympathetic

causes contraction and sympathetic

causes relaxation of the bladder and if

we look very closely here we can see a

triangular shaped structure here this is

the Trigon of the bladder this tricone

is located in the floor of the bladder

what are the components of this Trico

you can see this structure which I have

lifted up here and when I pull we can

see it is exerting attraction on the

ureter on this side similarly when I

pull here we can see it is exerting

traction on the ureter on this side so

these are the openings of the two

ureters the ureters went into the

bladder to enter in a bevelled fashion

the purpose being to prevent vistacool

euroleague reflux in normal

circumstances therefore it acts as a

valvular mechanism with this valve Aloma

cancer fails then we get what I

mentioned as the visco urinary reflux

for the same reason this you drove a

cycle Junction is also a potential site

of European constriction where a small

stone more than 0.5 centimeters can get

impacted in which case there will be

hydro ureter and hydronephrosis this is

an axial CT scan at the level of the hip

joint to show a right you Egypt calculus

and right hydro ureter if we look

further closely we will see a rich

joining the two openings of the ureters

this is referred to as the inter

ureteric bar lower down we can see yet

another opening here that is the opening

of the urethra that is the internal

urethral meatus

which is also encircled by smooth muscle

which is the internal urethral sphincter

this is relaxed by the spatter

sympathetic and contracted by the

sympathetic

so therefore parasympathetic is for

micturition purpose this try goal of the

bladder is derived separately from the

rest of the bladder

bladder is derived from inter term of

the urogenital sinus why the tricone is

derived from the me suit

wolffian dumped mucosa of the trigon is

very sensitive when we are doing a you

know trance copy examination of the

bladder and we reach the internal

urethral meatus at that position we

cannot see normally the two openings of

the ureter however when we advance the

urine through scope even further then we

can see these two openings that is the

normal situation however when the

patient has got benign hypertrophy of

the prostate then the internal urethral

orifice is pushed up by means of the

median lobe of the prostate and that is

referred to as the uvula of the bladder

and in which case we get a condition

known as Marion's sine positive

what is this Merion sign positive it

means that in the same system urethral

scopic view we can see all the three

orifices simultaneously so when a

patient has got enlarged prostate the

median lobe is enlarged there is a

depression behind the median lobe of the

prostate and that is known as the post

prostatic pouch

whenever the patient lies down there is

irritation of the post prostatic pouch

the trigana of the bladder by means of

residual urine and that is what produces

nocturia

and frequency in a patient with benign

hypertrophy of the prostate again come

to the posterior surface or the base of

the bladder to show the unique

relationship of the ductus deferens and

the ureter so I have pulled it up to

show you the normal relationship and we

can see that the ureters are crossed

over by the ductus deferens on either

side this is because during embryonic

life the testes descends down and the

kidneys ascent up and so therefore this

is the place where the ductus deferens

crosses the ureter this can rarely be a

site of constriction of the ureter where

again a stone can get impacted so these

are the points that are already

mentioned to you about the better and

the related structures in the pelvis