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URETER
• The ureters are a pair of narrow,thick walled muscular tubes which convey urine from kidneys to the urinary bladder
• Lie deep to peritoneum,closely applied to the posterior abdominal wall in the upper part,and to the
lateral pelvic part in the lower part
DIMENSIONSLength-25 cmDiameter-3mm
COURSEThe ureter begins within the renal
sinus as renal pelvis
The ureter passes downwards and slightly medially on the psoas muscle
enters the pelvis by crossing in front of termination of common iliac artery
After entering the pelvis it reaches the base of bladder
It enters bladder wall obliquely and open into lateral angle of trigone
3 parts:
PELVIS
ABDOMINAL
PELVIC
PELVISFunel shaped
dilatation at upper part
Formed by union of major calyces
Passes downwards and medially through hilum
Capacity – 5 to 7 ml
• Abdominal part
Passes downwards and medially by passing beneath the peritoneum
Enters pelvic cavity by crossing termination of common iliac artery
Posterior Relations
• Psoas major & fascia• Genitofemoral nerve• Tips of transverse
process
Anterior relations
Rt side –Parietal peritoneumRt gonadal vessels2nd & 3rd part of
duedenumRt colic & Ileocolic
vesselsRoot of mesentryTerminal part of ileum
Anterior relations
Lt side –Parietal peritoneumLt gonadal vesselsLt colic & sigmoid
vesselsApex of sigmoid
mesocolon
Pelvic part
First part – downwards beneath
peritoneum along greater sciatic notch & reaches ischial spine
• Second or oblique part - then forward and medially, through extra peritoneal tissue reaches superolateral angle of bladder 5cm from opposite ureter
Third part or Intravesical part –
Pierces musculature of bladder, undergoes oblique course downwards and medially thro bladder and opens into interior of bladder
• NORMAL CONSTRICTIONS
(1) At pelviureteral junction
(2) at brim of lesser pelvis
(3) at passage through bladderwall
Factors preventing reflux of urine
• Oblique direction of intravesical part of ureter• Trigonal muscle which by contraction
maintains the obliquity of ureter• Peristalsis of ureteral muscles at 2 to 5 times
per minute. Urine is collected in bladder in jets, not continually
BLOOD SUPPLYUpper part –renal arteryMiddle part-aortaPelvic part-vesical,middle rectal or uterine vessels
NERVE SUPPLYSympathetic- T10-L1Parasympathetic- S2-S4
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