| This section describes the ureters and bladder, and their structures.
Bladder & Ureters
Function
- Ureters: A pair of muscular tubes responsible for transporting urine from the kidneys to the bladder.
- Bladder: Hollow muscular organ that functions as a temporary reservoir for urine.
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Location
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Ureters: Originate at the renal hilum of each kidney at the L1spine,extending through the retroperitoneal, abdominal and pelvic cavities and penetrate the posterior wall of the bladder. Each ureter is approximately 30cm in length.
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Location
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Special Features
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Ureter: each has three distinct layers, an inner mucosal, middle muscular, and outer connective tissue. Urine is “milked” from the renal pelvis by stimulation of stretch receptors in the ureter wall resulting in peristaltic like contractions. The slit like opening in the bladder prevents retrograde flow during bladder contractions.
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Special Features
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Bladder: a collection of longitudinal and circular muscles know as the powerful detrusor muscle, rugae are present in the mucosal lining and disappear with bladder filling.
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Trigone : triangular area bounded by the ureteral openings and the entrance to the urethra
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Vascular Supply
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Ureters : superior aspect supplied by the renal artery, middle aspect supplied by the testicular and ovarian arteries, superior vesicle artery supplies the inferior ureter. Inferior vesicle artery (men), or uterine (female) may supply ureters near bladder.
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Venous supply corresponds to the arteries.
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Bladder: superior vesicle artery from the internal iliac and middle rectal arteries supply the posterior surface, inferior vesicle (men) or vaginal artery (female) from internal iliac supply the inferior surface.
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Vesicle plexus ?vesicle veins ?internal iliac veins comprise the venous system.
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Innervation
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Ureter: visceral afferent pain fibers from the upper and mid-ureter travel via renal pelvis to vertebras T12-L2, therefore pain can be referred to lumbar, inguinal and thigh regions.
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Sympathetic innervation occurs via the renal or ureteric plexus to the superior
hypogastric plexus.
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Vagus nerve contributes parasympathetics to the upper and lower portions at S2-S4.
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Bladder: sympathetic (L1-L2) via vesicle plexus, pelvic plexus and hypogastric plexus. * Sympathetic mediation may not depend on direct noradrenergic fibers on the detrusor, but inhibition of the excitatory parasympathetics.
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Parasympathetic (S1-S2) detrusor muscle via the pelvic nerve.
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Visceral afferents along sympathetic and parasympathetic pathways.
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Somatic (motor) via pudendal nerve (S1-S2) to the external sphincter.
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Basic Study Questions
1. What is the detrusor muscle?
2. Where is the trigone?
3. Describe the nerves responsible for bladder innervation.
Additional Study Questions
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About this Page |
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| The author of this section is Ray Pentz who graduated from the University of Pittsburgh with a BSN. He is employed in the Neuro-vascular Intensive Care Unit at UPMC PUH. He is a graduate of the Anesthesia class of 2004
References
- Agar, A., & Lee, M.(1995). Grant's Atlas of Anatomy (17th edition). New York:
DK Publishing, Inc.
- Furman, G.(1999). Anatomy in Outline (14th edition). Philadelphia:
Hanley and Belfus, Inc.
- Gray, H.(2000). Anatomy of the Human Body (20th edition). Philadelphia:
Lea and Febiger.
- Guyton, A., & Hall, J.E. (2000). Textbook of Medical Physiology (10th edition). New York:
W. B. Saunders Company.
- Maribe, E.N. (1998). Human Anatomy and Physiology (4th edition). St. Louis:
The Benjamin/Cummings Publishing Company.
- Pansky, B. (1996). Review of Gross Anatomy (6th edition). Boston:
McGraw Hill.
- Seeley, R., Stephens, T., Tate, P., (2000). Anatomy and Physiology (5th edition). Boston:
McGraw Hill.
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