420 THE UEINAEY ULADDEE. 



and the vngiria in tlie female ; and its smaller end, or svmmit, resting" 

 against the lower part of the anterior wall of the abdomen. Imme- 

 diately in front of the base is the thickened portion named the cervix, or 

 iicclo, which bonnds the ontlet of the bladder, and connects it below with 

 the urethra. 



The long axis of the distended bladder is inclined obliquely upwards- 

 and forwards from the base to the summit, in a line directed from the 

 coccyx to a point between the pubes and the umbilicus. In being' 

 gradually distended, the bladder curves slightly forwards, so that it 

 becomes more convex behind than in front, and its upper end is by 

 degrees turned more and more towards the front of the abdomen. 

 Lastly, the bladder, when filled, appears slightly compressed from before 

 backwards, so that its diameter in that direction is less than from side 

 to side. In its ordinary state, the longest diameter in the male is from 

 base to summit ; but in the female its breadth is often greater than 

 its height. The average capacity of the bladder is often stated to be 

 greater in the female than in the male ; and, no doubt, instances of 

 very large female bladders are not unfrequent, but these have pro- 

 bably been the result of unusual distension : in the natural condition,, 

 according to Luschka and Henle, the female bladder is decidedly 

 smaller than that of the male. 



Connections. — IThile freely movable in all other directions upon 

 surrounding parts, the bladder is fixed below to the walls of the pelvis 

 by the neck, and by fibrous bands given off from the recto-vesical 

 fascia, named the tnie Jiriamenfs of the bladder. It is supported, 

 moreover, by strong areolar connections with the rectum or vagina, 

 according to the sex, in a slighter degree by the two ureters, the 

 obliterated hypogastric arteries and the uraohus, by numerous blood- 

 vessels, and, lastly, by a partial covering of the peritoneum, which, in 

 being reflected from this organ in different directions, forms duplica- 

 tures, named t\i& false ligaments of the bladder. 



The anterior surface is entirely destitute of peritoneum, and is in 

 apposition with the triangular ligament of the urethra, the subpubic- 

 ligament, the symphysis and body of the pubes, and, if the organ be 

 full, the lower part of the anterior wall of the abdomen. It is con- 

 nected to these parts by loose areolar tissue, and to the back of the 

 pubes by two strong bands of the vesical fascia, named the anterior 

 true ligaments. This surface of the bladder may be punctured above 

 the pubes without wounding the peritoneum. 



The posierior surface is entirely free, and covered everywhere by 

 the peritoneum, which in the male is prolonged also for a short 

 distance upon the base of the bladder. In the male, this surface 

 is in contact with the rectum, and in the female with the uterus, some 

 convolutions of the small intestine descending between it and those 

 parts, unless the bladder be very full. Beneath the peritoneum, in the 

 male, a part of the vas deferens is found on each side of the lower por- 

 tion of this surface. 



The summit (sometimes named the superior fundus) is connected to 

 the anterior abdominal wall by a tapering median cord, named the 

 iirachus, which is composed of fibro-areolar tissue, mixed at its base 

 ■with some muscular fibres which are prolonged upon it from the bladder. 

 This cord, becoming narrower as it ascends, passes upwards from the 

 apex of the bladder between the linea alba and the peritoneum, to reach 



