THE HOESE. 



117 



their inferior surface. After the ureters have 

 crossed the spermatic and iliac vessels, they 

 are received within a fold of peritoneum, 

 constituting the false ligaments of the 

 bladder. 



They pierce the muscular coat of the 

 bladder at a distance of about three inches 

 from each other, if the viscus be distended. 

 They pass between the muscular and mucus 

 coats for about an inch, being somewhat 

 diminished in caliber, when they suddenly 

 open into the cavity by an elliptical orifice, 

 so that if the bladder be distended, the sides 

 of the orifice are stretched, and thus closed. 



The ureters are externally covered by a 

 cellulo-muscular coat, consisting of a cellu- 

 lar tissue, with muscular fibres arranged, 

 partly longitudinally and partly circularly, 

 the latter being most internally situated. 

 The ureters are internally lined by mucus 

 membrane, continuous anteriorly with the 

 renal pelvis, and posteriorly with the vesical 

 lining. 



The membrane is loosely attached to the 

 outer coat, and thrown into longitudinal 

 effaceablc folds. 



BLADDER. 



The bladder is dilatable musculo-mem- 

 branous viscus, destined for the temporary 

 retention of urine. It is situated during 

 vacuity entkely within the pelvis, but when 

 distended, even moderately, its fundus en- 

 croaches on the proper abdominal space. 



The bladder is held in situation by the 

 peritoneum coming off from the rectum and 

 sides of the pelvis, so as to form a serous 

 fold, which also encloses the vasa deferentia 

 and vesiculsB seminales. Besides this, the 

 bladder is supplied with true ligaments, as 

 well as bounded posteriorly through the in- 

 tervention of the urethra. 



The shape of the bladder is pyriform, 

 approaching, however, to a sphere when 

 empty or partially distended. 



It presents for consideration a projecting 

 anterior portion or fundus, a middle part or 

 body, and a posterior one, or neck. The 

 fundus is globular and regular, having fixed 

 at its anterior part the two obliterated um- 



bilical arteries, and the remains of the 

 urachus. The body has no precise limits, 

 but may be considered as that portion on 

 which the bulbous portions of the vasa- 

 deferentia rest. It is circular, but if the 

 bladder be much distended, it bends some- 

 what backward and upward. The cervix 

 vesicae is the most constricted part of the 

 organ, and marks the limit between the 

 bladder and urethra. 



The bladder is related by its fundus to 

 the iliac flexures of the colon, inferiorly to 

 the pudic and ischial bones, superiorly to 

 the ureters, vasa deferentia, vesiculee semi- 

 nales, and middle part of the rectum. 



The bladder has three coats. The peri- 

 toneal investment is merely a partial one, 

 as it is reflected from the body on to the 

 sides of the pelvis. It covers the superior 

 surface almost completely, but its extent 

 gradually declines laterally and inferiorly. 

 The attachments contracted by the perito- 

 neum are termed false ones. Thus we 

 have the two umbilical arteries, one on each 

 side, enclosed by peritoneum, forming the 

 two lateral false ligaments. Then the ves- 

 tige of the urachus is similarly enveloped 

 by peritoneum, and constitutes the anterior 

 false ligament. The peritoneum coming 

 off from the rectum on to the superior sur- 

 face of the bladder, gives rise to a pouch, 

 termed the recto-vesical pouch, or cul-de- 

 sac, and laterally to the triangular folds 

 limiting the latter, known as the superior 

 false ligaments. Behind the peritoneal re- 

 flection the bladder is attached to the rec- 

 tum and pelvic parietes, by a continuation 

 of the pelvic fascia, which, leaving the 

 inferior surface of the pelvis at the symphi- 

 sis pubis, comes on to the bladder, forming 

 the inferior true ligaments of the latter ; the 

 fascia is then continuous on to the rectum, 

 blending with the cellular coat. The pelvic 

 fascia is also traced on to the prostate and 

 sides of the bladder, from the posterior part 

 of the obturator foramen, constituting the 

 lateral true ligaments. 



Beneath this fibro-serous coat are muscu- 

 lar fibres, arranged in a peculiar manner. 

 There is an outer longitudinal set, traceable 



