632 ABDOMEN 



membrane may extend down over the fundus of the bladder 

 for a very short distance. 



The False Ligaments of the Bladder. As in the male, 

 there are five false ligaments of the bladder, two lateral, two 

 posterior, and one superior. They are all formed by the 

 peritoneum. The two lateral are merely the parts of the 

 peritoneal membrane which connect the lateral borders of 

 the superior surface of the bladder with the side walls of the 

 pelvis; they form the floors of the paravesical fossae. The 

 superior or plica umbilicalis media is the fold of peritoneum 

 which is raised up by the urachus, and the two posterior are 

 the ill-marked folds which pass from the upper part of the 

 base of the bladder to the front of the neck of the uterus ; 

 they form the lateral boundaries of the utero-vesical 

 excavation. 



The True Ligaments of the Bladder. These are five in 

 number, two anterior, two lateral, one superior. The lateral 

 and the anterior ligaments are portions of the visceral layer of 

 pelvic fascia, the lateral pubo-vesical ligaments are merely 

 the lateral parts of the vesical lamella, whilst the anterior 

 or medial pubo-vesical ligaments are thickenings of the 

 anterior part of the same lamella, one on each side of the 

 medial plane. The lateral connect the infero-lateral surfaces 

 of the bladder to the main layer of the visceral pelvic fascia, 

 and indirectly to the side wall of the pelvis. The anterior 

 bind the anterior border of the bladder to the back of the 

 symphysis pubis. It is doubtful if the term ligamentum 

 umbilicale medium is properly applied, but it is sometimes 

 given to the urachus, which connects the apex of the bladder 

 with the anterior abdominal wall. 



Dissection. To examine the interior of the bladder an incision should 

 be made through the anterior border, and through the infero-lateral surfaces 

 immediately below their junction with the superior surface. When this 

 has been done the superior surface should be raised and the anterior 

 border and infero-lateral surfaces should be depressed ; a good view of the 

 interior will then be obtained. The mucous membrane should then be 

 cleaned with a sponge and its general characters and the orifices of the 

 bladder should be studied. 



The Mucous Membrane, the Trigone, and the Orifices of 

 the Bladder. Over the greater part of the inner surface of 

 the empty bladder the mucous membrane is rugose on 

 account of the laxity of its connection with the muscular 

 coat, but in a triangular area on the lower part of the fundus, 



