1274 



THE UEO-GENITAL SYSTEM. 



Apex of bladder 



Lateral border 



Infero-lateral 



with prostate 



Fundus of 

 bladder 



Ureter 



bladder appearing as if it were suddenly constricted to form the urethra. The 

 portion of the bladder wall posterior to the urethral orifice, which is directed in the 

 male towards the anterior wall of the rectum and lies below and in front of the 

 recto-vesical pouch, is called the fundus vesicae or base of the bladder ; it is closely 

 related to the seminal vesicles and ampullae of the ductus deferentes. The corre- 

 sponding part of the bladder in the female rests against the anterior wall of the 

 vagina. The term vertex vesicse, or apex of the bladder, is applied to the portion 

 which lies nearest to the upper border of the symphysis when the organ is empty, 



and rises high above the pubis into 

 the abdominal cavity when the bladder 

 is distended. Connected with the 

 vertex of the bladder is a fibrous cord, 

 the ligamentum umbilicale medium, or 

 urachus, which passes upwards, in the 

 Area continuous median plane, on the posterior aspect 

 of the anterior abdominal wall, and 

 reaches the umbilicus. It represents 

 the passage which in the embryo 

 connects the developing bladder with 

 the allantois. The part of the bladder 

 FIG. 991,-iNFERioR ASPECT OF THE EMPTY MALE connecting the apex with the base, and 



URINARY BLADDER. From a subject in which the not Sharply marked Otl Irom either, IS 



viscera had been hardened in situ. Called the Corpus VCSicas, Or body of 



The prostate has been severed from the bladder, and the the bladder. 



white area in the drawing indicates the position Position Of the Urethral Orifice. 



where the two structures were continuous. TV_ i_ 



During the various changes in shape 



and size which the bladder undergoes, the region of the internal urethral orifice 

 remains almost fixed in position. The urethral orifice lies immediately above the pros- 

 tate, and behind and slightly below the level of the upper margin of the symphysis 

 pubis, from which it is distant about two to two and a half inches. It can be 

 easily reached by a finger introduced into the bladder through the abdominal wall 

 above the symphysis pubis. It is usually placed half an inch to one inch above 

 the level of a plane passing through the lower margin of the symphysis and the 

 lower end of the sacrum, but in some 

 cases it is found to be somewhat lower. 

 In the female it normally occupies a 

 lower level than in the male. The 

 comparatively slight variations in the 

 level of the internal urethral orifice 

 which do occur, depend partly upon 

 the quantity of fluid contained in the 

 bladder, and partly upon the amount 

 of distension of the lower portion of 

 the rectum. When the bladder is 

 very much distended this region lies 

 at a slightly lower level in the pelvis 

 than it does when the organ is empty ; 

 on the other hand, distension of the 

 lower part of the rectum raises, to some 

 extent, the level of the urethral orifice. 

 Since the position of the internal 



Bladder apex 



Infero-lateral 

 area 



Urethra 



Jl 



Ureter 



__ Posterior surface of prostate 



Seminal vesicle 



FIG. 992. THE URINARY BLADDER, PROSTATE, AND 

 SEMINAL VESICLES, VIEWED FROM BELOW. 



urethral orifice varies, in the manner Taken from a subject in which the viscera were hardened 

 ., , .,, '-, -,.,. f in situ. Same specimen as Fig. 993, A. The bladder 



JUSt described With the condition Of con tained but a small amount of fluid.' 



the rectum and of the bladder it 



follows that it lies at its lowest limit when the bladder is full and the rectum empty, 



and at its highest level when the bladder is empty and the rectum distended. 



Inferior Aspect of the Bladder. The lower part of the bladder, which is direct! 

 towards the pelvic floor, changes, as we have seen, but slightly with the varying 

 amount of distension of the viscus. When the organ has been carefully hardened 



