Ureter

Question 1

What is the ureter?

Answer 1

Narrow, thick-walled muscular tubes
Convey urine from kidneys to bladder

Question 2

Location of the ureter

Answer 2

Deep in the peritoneum
Closely applied to posterior abdominal wall in upper part and lateral pelvic wall in lower part

Question 3

Dimensions of the ureter

Answer 3

25cm long
3mm diameter
Slightly constricted in five places

Question 4

Course of the ureter

Answer 4

Begins within the renal sinus as a funnel shaped dilatation, called the renal pelvis. The pelvis issues from the hilus of the kidney, descends along its medial margin, or partly behind it
The ureter passes downwards and slightly medially on the tips of transverse processes and the psoas major muscle, and enters the pelvis by crossing in front of the termination of the common iliac artery
In the lesser or true pelvis, the ureter at first runs downwards, and slightly backwards and laterally, following the anterior margin of the greater sciatic notch
Opposite the ischial spine, it turns forwards and medially to reach the base of the urinary bladder

Question 5

Constrictions of the ureter

Answer 5

At the pelviureteric junction
At the brim of the lesser pelvis
Point of crossing of ureter by ductus deferens or broad ligament of uterus
During its oblique passage through the bladder wall
At its opening in lateral angle of trigone

Question 6

Anterior relations of the ureter outside the kidney

Answer 6

Right side: Renal vessels and second part of duodenum
Left side: Renal vessels, pancreas, peritoneum and jejunum

Question 7

Posterior relations of the ureter outside the kidney

Answer 7

Psoas major

Question 8

Anterior relations of abdominal part of ureter on the right side

Answer 8

Third part of duodenum
Peritoneum
Right colic, ileocolic and gonadal vessels
Root of mesentery
Terminal part of ileum

Question 9

Anterior relations of abdominal part of ureter on left side

Answer 9

Peritoneum
Gonadal artery
Left colic vessels
Sigmoid colon and mesocolon

Question 10

Posterior relations of abdominal part of ureter

Answer 10

Psoas major
Tips of transverse processes
Genifemoral nerve

Question 11

Medial relations of abdominal part of ureter

Answer 11

Right side: IVC
Left side: Left gonadal vein
Medially: Inferior Mesenteric Vein

Question 12

Course of pelvic part of ureter

Answer 12

Backwards and downwards

Question 13

Posterior relations of pelvic part of ureter

Answer 13

Backward and downward

Question 14

Posterior relation of pelvic part of ureter

Answer 14

Internal iliac vessels
Lumbosacral trunk
Sacroiliac joint

Question 15

Lateral relations of pelvic part of ureter

Answer 15

Fascia covering the obturator internus
Superior vesical artery
Obturator nerve and vessels
Inferior vesical vein
Middle rectal artery
In the female, it forms the posterior boundary of the ovarian fossa

Question 16

Relations of downward and forward course of ureter in males

Answer 16

Ductus deferens crosses the ureter superiorly from lateral to medial side
Seminal vesicle lies below and behind the ureter
Vesical veins surround the terminal part of ureter

Question 17

Relations of downward and forward course of ureter in females

Answer 17

The ureter lies in the extraperitoneal connective tissue in the lower and medial part of the broad ligament of the uterus
Uterine artery lies first above and in front of the ureter for a distance of about 2.5 cm and then crosses it superiorly from lateral to medial side
The ureter lies about 2 cm lateral to the supravaginal portion of the cervix. It runs slightly above the lateral fornix of the vagina
The terminal portion of the ureter lies anterior to the vagina

Question 18

Blood supply of ureter

Answer 18

Upper part: Branches from the renal artery
Middle part: Branches from the aorta
Pelvic part: Branches from the vesical, middle rectal, or uterine vessels

Question 19

Nerve supply of ureter

Answer 19

Sympathetic: T10 to L1 segments
Parasympathetic: S2 to S4 nerves
Reach the ureter through the renal, aortic andhypogastric plexuses.
All the nerves appear to be sensory in function

Question 20

What is ureter colic?

Answer 20

Severe pain due to a ureteric stone or calculus which causes spasm of the ureter
Pain starts in the loin and radiates down the groin, the scrotum or the labium majus and the inner side of the thigh