URETER

URETER

The ureter is a muscular tube that connects the kidney to the urinary bladder. It plays a crucial role in the excretory system of the body.

Origin

• The ureter originates from the renal pelvis of the kidney.
• It is formed from the fusion of the calyces of the kidney.

Pathway

• The ureter descends through the renal fascia and then through the extraperitoneal tissue.
• It passes through the pelvic brim and enters the pelvis.
• It then passes through the ureteric hiatus of the pelvic wall.
• Finally, it opens into the urinary bladder through the ureteric orifice.

Structure

• The ureter has three layers:
  • The mucous membrane
  • The muscular layer (smooth muscle)
  • The adventitia

Blood Supply

• The ureter receives blood supply from the renal arteries and the common iliac arteries.
• The blood supply is provided by branches of the renal and iliac arteries.

Nerve Supply

• The ureter receives nerve supply from the renal and iliac plexuses.
• The nerve supply is provided by branches of the renal and iliac nerves.

Muscle Action Sequence

• The ureter contracts when the bladder is empty and relaxes when the bladder is full.
• The contraction of the ureter helps to propel the urine from the kidney to the bladder.

Lymph Drainage

• The lymphatic vessels of the ureter drain into the renal and iliac lymph nodes.
• The lymphatic vessels then drain into the lumbar and para-aortic lymph nodes.

Functions

• The primary function of the ureter is to transport urine from the kidney to the urinary bladder.
• The ureter also helps to regulate the flow of urine by contracting and relaxing.

Clinical Significance

• The ureter is a common site for kidney stones and tumors.
• The ureter can also be affected by conditions such as ureteral obstruction and ureteral dilation.

Describe the extent and parts of ureter

Ureter is a muscular tube that carries urine from the kidney to the urinary bladder. It is about 25 cm long and has three main parts:

• Renal part: This is the upper part of the ureter that connects it to the kidney.
• Pelvic part: This is the lower part of the ureter that connects it to the urinary bladder.
• Abdominal part: This is the middle part of the ureter that lies in the abdominal cavity.

Describe the course and relations

The ureter courses from the kidney to the urinary bladder. It passes through the following structures:

• Renal hilum: The ureter passes through the renal hilum, which is the part of the kidney where the renal vessels and nerves enter and exit.
• Perirenal fat: The ureter lies in the perirenal fat, which is the fatty tissue that surrounds the kidney.
• Pararenal space: The ureter passes through the pararenal space, which is the space between the perirenal fat and the abdominal muscles.
• Psoas major muscle: The ureter lies on the psoas major muscle, which is a long muscle that runs from the lumbar spine to the femur.
• Obturator internus muscle: The ureter lies on the obturator internus muscle, which is a small muscle that arises from the pelvic bone.
• Urinary bladder: The ureter passes through the wall of the urinary bladder to empty urine into the bladder.

Describe the applied anatomy

The ureter has several important anatomical landmarks that are relevant to surgical procedures:

• Ureteric orifice: This is the opening of the ureter into the urinary bladder.
• Ureterovesical junction: This is the area where the ureter meets the urinary bladder.
• Ureteric fold: This is a fold of tissue that surrounds the ureter as it passes through the urinary bladder.