Paravesical ) | 
ligaments of the bladder, and are described as pubo-prostatic or anterior ligaments, 
reaching the bladder from the pubis in front, and lateral ligaments, reaching the 
bladder from the fascial lining of the side wall of the pelvis. 
In addition to the urachus and the peritoneal and true ligaments already 
mentioned, the bladder is supported and fixed in position, in the region of its 
Vesical artery First sacral vertebra 
External iliac vessels x | 
Obturator nerye Ny 
Obliterated hypogastric \ 
artery > 
Vas deferens 
\ \ 
artery. 
Ureter 
Plica Ridge due to 
wmnbilicalis » . ; . “ pera eee 
lateralis ) i AZ ; .\ |) —from hypo- 
gastric 
Obturator ) plexus 
vessels | 
fossa J 
Plica ) 
vesicalis » 
transversa ) 
Recto- 
vesical 
pouch 
Symphysis 
pubis 
Prostate ’ 
Opening of ureter into bladder | eer 
Portions of vasa deferentia cut in section 
Fic. 749.— MESIAL SECTION OF THE PELVIS IN AN ADULT MALE. 
‘he coils of small intestine which lay within the pelvis have been lifted out in order to give a view of the side 
1 y I g 
wall of the pelvie cavity. The peritoneum is coloured blue. The separation of the prostate from the 
bladder is indicated somewhat diagrammatically. 
basal surface, by the dense fibrous and unstriped muscular tissue which sur- 
rounds the seminal vesicles, the terminal portions of the vasa deferentia, and the 
ureters. 
Laterally the strands of connective tissue and the bundles of muscle fibres forming this sup- 
port pass backwards to gain attachment to the fascia in connexion with the rectum, and the 
front of the sacrum. Muscle fibres connected with the bladder wall are also found within the 
pubo-prostatic ligaments, through which they are attached to the pubis. 
In the female the basal part of the bladder wall is supported and held in place 
by its connexion with the anterior wall of the vagina. The region of the urethral 
orifice is the most firmly fixed part of the bladder wall in both sexes. 
Structure of the Bladder.—The wall of the bladder from without inwards is com- 
posed of a serous, a muscular, a submucous, and a muceus coat. The serous coat (tunica 
serosa), formed by peritoneum, is incomplete, and covers only the upper and posterior 
parts of the distended bladder (Fig. 742). 
The muscular coat (tunica muscularis) is composed of three imperfectly separatec 
strata, called external, middle, and internal. he external stratum (stratum externum), 
in the middle line of the organ, is made up of longitudinally-directed bundles of muscle 
fibres. These have an attachment in front to the lower part of the back of the symphysis 
pubis, where they constitute the musculus pubo-vesicalis. Further from the middle line 
(on the sides of the bladder) the fibres composing the external stratum run more obliquely, 
and frequently cross each other. The middle stratum (stratum medium) is composed of 
THE BLADDER. 1101 
Position of internal iliae 
-Vas deferens 
