Ureters Flashcards
Prevent urine reflux
Ureterovesical valve of Sampson
Anatomic relations:
Males?
Females?
Males: posterior to DUCTUS DEFERENS
Females: posterior & inferior to uterine artery which lies in the transverse cervical ligament (CARDINAL LIGAMENT OF MACKENRODT) & lie 1-2cm lateral to the cervix
May inadvertently ligate the ureter along with the uterine artery near the cervix
Hysterectomy
3 normal constrictions (where kidney stones most commonly cause obstruction
Ureteropelvic junction
As it crosses the pelvic inlet
Ureterovesical junction (along the intramural portion of the ureter)
Ureter opens at a site other than the urinary trigone
Often occurs with duplication of renal pelvis & ureter
Males: urine leakage from urethra or seminal vesicle
Females: urine leakage from urethra, vestibule of the vagina or vagina
Ectopic opening
Obstruction by renal calculi
Most often at the 3 normal sites of constrictions
Causes unilateral hydronephrosis
Most common (40%)
Radiopaque
Acidic urine (<6.0) or neutral (7.0)
Colorless, small squares crossed by intersecting diagonal lines
Associated diseases:
- absorptive
- hypercalcemia
- Vitamin D intoxication
- hyperparathyroidism
- milk-alkali syndrome
- renal tubular acidosis
- ethylene glycol
- poisoning
- diabetes
- liver disease
Calcium oxalate
2nd most common (15%)
Radiopaque
Alkaline urine (>7.4)
Colorless, rectangular, prism-shaped
Associated diseases:
- UTI
- urea-splitting bacteria (Pseudomonas sp, proteus vulgaris, providencis sp, klebsiella, staphylococcus sp)
Magnesium ammonium sulfate (struvite or triple phosphate)
3rd most common (5%)
Radioluscent
Acidic urine (
Uric acid
Least common (1%)
Faintly radiopaque
Acidic urine (
️Cysteine
Begin at ureteropelvic junction
Retroperitoneal
In the abdomen: anterior to PSOAS MAJOR, where they cross the pelvic inlet to enter the minor (true) pelvis
In the minor pelvis: anterior to COMMON ILIAC ARTERY & VEIN
End at URETEROVESICAL JUNCTION, buried in the wall of urinary bladder (intramural portion of the ureter)
- defines the upper limit of bladder trigone
- function as a check valve (ureterovesical valve of Sampson) - prevent urine reflux
Ureters
