Question

Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis? How could she have got cystitis? Explain the anatomy of the urinary bladder in detail.

Answer 1

Cystitis is the inflammation of the urinary bladder.

The main chances that she has got cystitis will be either of the 3 causes.

• urinary tract infection (UTI),most commonly caused by a type of Escherichia coli (E. coli) bacteria.
• drug intake
• irritating hygiene products

Cystitis can also occur in the conditions like the kidney stones,Diabetes,immunocompramised states etc

ANATOMY OF URINARY BLADDER

The urinary bladder is a muscular organ for the collection pf urine.

Shape: The shape varies according to the amount of urine

when empty,it lies entirely within the pelvis

when full it extends upwards and enters the abdominal cavity

External featrures

1. Apex: it is located superiorly directing forward and the median umbilical ligament attatches to it
2. Base/fundus: located posteriorly. It is triangular-shaped, with the tip of the triangle pointing backwards.
3. Neck : Lowest and the most fixed part
4. 3 surfaces: Superior,right and left inferolateral
5. 4 Borders :two lateral,one anterior and one posterior

Ligaments of the bladder

1. lateral true ligament
2. lateral puboprostatic ligament
3. medial puboprostatic ligament
4. median umbilical ligament
5. posterior ligament

TRIGONE: It is a small triangular area over the lower part of the base.It has a smootg mucosa that has firm attatchment to themuscular coat

The ureters open in the posterolateral angles of the trigone

MUSCULATURE

• detrusor muscle : helps in the contraction of the bladder
• Internal urethral sphincter:

Male – consists of circular smooth fibres - under autonomic control.

Females – functional sphincter

• External urethral sphincter – It is under voluntary control. In males the external sphincteric mechanism correlates with fibers of the rectourethralis muscle and the levator ani muscle.

VASCULAR SUPPLY

arterial supply : from the superior and inferior vesical arteries(branches of internal illiac); Additional supply from obturator and inferior gluteus in males and uterine and vaginal arteries in females.

Venous supply: Vesical venous plexus

Lymphatic drainage: Lymphatics terminate in the external illiac nodes.

NERVE SUPPLY: supplied by the vesical plexus of nerves which contain the fibres from the inferior hypogastric plexus.

parasympathetic efferebt fibres fron S2,S3,S4

Sympathetic efferent fibres:T11 to L2

Somatic pudental nerve(S2-S4)