35 8 SURGICAL APPLIED ANATOMY. [Chap. xvm. 



obstruction to the escape of urine, increases in 

 size, as do other much exercised muscles, and 

 that increase serves to demonstrate the arrange- 

 ment of the individual bundles. In a fasciculated 

 bladder the muscular bundles present much the appear- 

 ance of some of the columnae carnese in the heart. 

 It will be understood that the bladder wall between 

 the muscular bundles is comparatively thin, and 

 may yield when the viscus is distended. By such 

 distension the mucous membrane becomes bulged out 

 between the unyielding muscle bundles, so that sacculi 

 are formed, and the appearance known as " sacculated 

 bladder " is produced. In these sacculi urine may lodge 

 and decompose, phosphatic deposits may collect, and 

 calculi may develop (encysted calculi). In some cases 

 the parietes yield, especially at one part, and one 

 large saccule is produced. In this way a sacculus may 

 be formed which in time may become almost as large 

 as the bladder itself, and give rise to the erroneous 

 descriptions of " double bladder," etc. The ureters 

 run for three-quarters of an inch in the muscular wall 

 of the viscus, and their oblique course, together with 

 the action of the muscular tissue about them, tends to 

 prevent regurgitation of urine. In cases of retention 

 the ureters become distended ; but this is due rather 

 to accumulation of urine within them than to its 

 reflux from the bladder. 



In cases of great distension of the bladder, the 

 neck of the viscus is opened up by the pressure from 

 within, and the patient exhibits the feature of over- 

 flow of urine. . 



The female bladder is less capacious than that 

 of the male. Its neck is situate a trifle nearer to the 

 symphysis than it is in the male, and lies in a horizontal 

 line continued back from the lower border of the 

 symphysis. There being no prostate, the neck of the 

 bladder is very distensible, and this fact, taken in 



