THE URINARY BLADDER 



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below the level of this excavation it is connected to the front of the cervix uteri 

 and the upper part of the anterior wall of the vagina by areolar tissue. When 

 the bladder is empty the uterus rests upon its superior surface. The female bladder 

 is said by some to be more capacious than that of the male, but probably the 

 opposite is the case. 



Sacrum 



Coccyx 



Rectovaginal 

 excavation 

 External uterine 

 orifice 



Anal canal 



Uterovesical 

 excavation 



Urethra 



FIG. 1139. Median sagittal section of female pelvis. 



Ligaments. The bladder is connected to the pelvic wall by the fascia endo- 

 pelvina. In front this fascial attachment is strengthened by a few muscular fibers, 

 the Pubovesicales, which extend from the back of the pubic bones to the front 

 of the bladder; behind, other muscular fibers run from the fundus of the bladder 

 to the sides of the rectum, in the sacrogenital folds, and constitute the Rectovesicales. 



The vertex of the bladder is joined to the umbilicus by the remains of the urachus 

 which forms the middle umbilical ligament, a fibromuscular cord, broad at its 

 attachment to the bladder but narrowing as it ascends. 



From the superior surface of the bladder the peritoneum is carried off in a series 

 of folds which are sometimes termed the false ligaments of the bladder. Anteriorly 

 there are three folds: the middle umbilical fold on the middle umbilical ligament, 

 and two lateral umbilical folds on the obliterated hypogastric arteries. The reflec- 

 tions of the peritoneum on to the side walls of the pelvis form the lateral false 

 ligaments, while the sacrogenital folds constitute posterior false ligaments. 



Interior of the Bladder (Fig. 1140). The mucous membrane lining the bladder 

 is, over the greater part of the viscus, loosely attached to the muscular coat, and 

 %ppears wrinkled or folded when the bladder is contracted : in the distended condi- 

 tion of the bladder the folds are effaced. Over a small triangular area, termed the 

 trigonum vesicae, immediately above and behind the internal orifice of the urethra, 

 the mucous membrane is firmly bound to the muscular coat, and is always smooth. 





