Ureters Flashcards
what are the ureters?
two thick tubes which act to transport urine from the kidney to the bladder
how long are the ureters, how are they situated? function?
They are 25cm long, and are situated bilaterally, with one ureter draining each kidney
what do the ureteric walls comprise of? function?
smooth muscle, which contracts to produce peristaltic waves. This propels the urine towards the bladder.
where do the ureters arise? as a continuation of what?
in the abdomen as a continuation of the renal pelvis
where do the ureters terminate? what do they drain into?
They terminate in the pelvic cavity, where they drain into the bladder
what is the anatomical course the ureters are divided into?
the abdominal and pelvic components
where do the ureters arise from?
The ureters arise from the renal pelvis
what is the renal pelvis? where is it located?
a funnel like structure located within the hilum of the kidney
where does the renal pelvis receive urine from?
the major calyces
what is the ureteropelvic junction?
The point at which the renal pelvis narrows to form the ureter is known as the ureteropelvic junction
after the ureteropelvic junction, what happens to the ureters?
the ureters descend down the abdomen, along the anterior surface of the psoas major.
what happens after the ureters travel down the anterior surface of the psoas major?
Here, the ureters are a retroperitoneal structure (located behind the peritoneum)
at the area of the sacroiliac joints, what happens to the ureters?
the ureters cross the pelvic brim, thus entering the pelvic cavity
what also happens when the ureters enter the pelvic cavity?
they also cross the bifurcation of the common iliac arteries
once within the pelvic cavity, what happens to the ureters?
the ureters run down the lateral pelvic walls.
when do the ureters turn and which direction? towards what?
At the level of the ischial spines, they turn anteromedially, moving in a transverse plane towards the bladder
upon reaching the bladder wall, what happens to the ureters?
the ureters pierce its lateral aspect in an oblique manner
what does the ureters piercing the lateral aspect create? what does this prevent?
a one way valve, where high intramural pressure collapses the ureters, preventing the back-flow of urine.
why is the anatomical course of the ureters is of surgical importance?
as they travel close to other structures in the pelvis. They must be identified during pelvic surgery to ensure that they are not accidentally damaged.
what is the important structures in females that lie in close proximity to the ureters?
As the ureters cross the pelvic brim, they are in close proximity to the ovaries
which procedure in females must extra care be taken in?
ovariectomy - care not to damage ureters
especially in ligation of ovarian arteries
when do the ureters come in close contact with the uterine artery?
Approximately 2cm superior to the ischial spine, the ureters run underneath the uterine artery
in which process is the ureter in danger of accidentally damaged?
During a hysterectomy, where the uterus and uterine artery are removed
relationship between the 2: ‘water under the bridge’
which structure lies in close proximity to the ureters in male?
In men, instead of the uterine arteries, the vas deferens cross the ureters anteriorly
how can the arterial supply to the ureters be divided?
into abdominal and pelvic supply
what is the abdominal supply to the ureters?
renal artery and testicular / ovarian artery
what is the pelvic supply to the ureters?
superior and inferior vesical arteries
how is venous drainage to the ureters like?
Venous drainage is carried out by vessels that correspond to the abdominal and pelvic arteries (supply)
how is nervous supply to the ureters delivered?
delivered via the renal, testicular/ovarian and hypogastric plexuses
where do sensory fibres from the ureters enter the spinal cord?
at T11-L2, with ureteric pain referred to those dermatomal areas
what is a ureteric calculus (kidney stone)?
the presence of a solid stone in the urinary tract, formed from minerals within the urine
what can ureteric calculus cause?
They can obstruct urinary flow, causing pain and haematuria (blood in the urine)
what are the locations that the kidney stones are most likely to get stuck in the ureters? why?
There are three locations where the ureters are at their narrowest:
Uretopelvic junction
Pelvic brim
Where the ureter enters the bladder
what is the gold standard investigation for suspected ureteric calculus?
CT scan of the kidneys, ureters and bladder (CT-KUB)
