THE BLADDER. 



c 



1903 



the urachus, but lies farther above and behind, since the antero-inferior wall always remains 

 shorter than the postero-superior. The condition of the rectum and the pressure exerted by 

 the abdominal viscera influence in no slight degree the form and position of the distended 

 bladder, since, when these factors are both unfavorable to unhampered expansion, the inferior 

 surface and fundus are depressed to a greater degree than when the bowel is empty and the 

 superior surface is little impressed by the overlying organs, the entire bladder assummg a more 

 vertical position and the ovoid form being modified (Merkel). Under pathological conditions 

 the bladder may suffer such enormous expansion that it reaches as high as or even above the 

 umbilicus and occupies a large part of the abdominal cavity. Owing to its intimate attachment, 

 the part of the inferior surface united to the prostate and the pelvic floor undergoes least change 

 both as to form and relations. 



Fig. t6iq. 



External iliac 

 artery 



External iliac 

 vein 



Deep epigastric 

 artery 



Spermatic vessels 



Internal abdominal 

 ring 



Obliterated 

 hypogastric artery 



Urachus 



Suspensory us« 

 ligament of penis — lAx 



Internal urethral orifice 



\\\ 

 Fatty tissue. ^ 

 contai 



Pectinate septum 



Spongy urethra 



Navicular fossa. 



ining veins //^«V^'^ltT7V' 



Internal iliac 

 vessels 



Ureter, pelvic 

 portion 



Vas deferens 



Ureter, entering- 

 bladder 



Seminal vesicle 



// Rprtnin 



Ejaculatory duct 



Prostatic urethra 

 and utricle 



Prostate 



Membranous urethra 

 Bulb of cavernous body 



Bulbous urethra 



Scrotum 

 Dissection of sagittally cut pelvis, showing relations of organs after fixation by formalin injection. 



The capacity of the bladder during; Hfe so obviously depends upon individual 

 peculiarities and habit that it is impossible to more than indicate approximately the 

 quantity of fluid that ordinarily induces a desire for the evacuation of the vesical 

 contents. This quantity — the physiological capacity of the bladder — may perhaps be 

 said to vary from 175-250 cc. (6-9 fl. oz. ), 700 cc. (24 fl. oz. ) representing the 

 maximum for the normal organ (Disse). Under pathological conditions, "as in 

 paralysis of the vesical wall, the bladder may contain from 3-4 litres without rupture. 

 As a means of determining its capacity during life, estimates based upon artificial 

 distention of the bladder after death are worthless, since the maximum resistance 



