location, length, and relation of right an left ureter, raletion of male an female ureter, n physiological site of ureteric constriction, bloo supply an inerve supply of ureter, clinical sinificance of ureter with hysteriectpomy

1. URETERS
DR SANA YASEEN
ANATOMY DEPARTMENT

2. INTRODUCTION
Are paired, narrow, fibromuscular tube. Which
conveys urine from kidney to posterior part of bladder
It is the most superficial structure
Sticks to posterior surface of the peritoneum

4. Gross features
Total length: 25 cm
Dia: 3mm (3 constriction)
ureter
Abdominal/upper
half
12.5cm
Pelvic / lower half 12.5 cm

5. SITES OF CONSTRICTIONs
1. Tip of transverse process of L1. pelvic urethral junction
2. At pelvic brim & junctional region between pelvic and
abdominal part – sacroiliac joint
3. At point of piercing the wall of the urinary bladder – medial
to ischial spine

7. COURSE OF URETER: ( in abdomen)

8. Origin: hilum of the kidney
Course:
runs vertically down behind parietal peritoneum on psoas major
muscle. Crosses bifurcation of common iliac artery in front of
sacroiliac joint and enter pelvic.
then runs downward lateral wall of pelvis to region of ischial
spine.
Then course varies in male and female.

9. In males
it runs
posterior to
ductus
deference and
turns forward
to enter the
lateral angle of
bladder .

10. In females:
from ischial spine it
turns forward and
medially beneath
base of broad
ligament where it is
crossed by uterine
artery. Then ureter
runs forward, lateral
to lateral fornix of
vagina to enter
bladder.

12. RELATIONS
In renal pelvis
In abdomen
In pelvic cavity

13. RENAL PELVIS :
In sinus: branch of renal vessel in front and back
Out side kidney:
RIGHT LEFT
ANTERIOR o Renal vessel
o 2nd part of duodenum
o Renal vessels
o Pancrease
o Peritoneum
o Jejunum
POSTERIOR o Psoas major o Psoas major

14. ABDOMINAL: URETER PROPER
RIGHT LEFT
ANTERIOR o 3rd part of
duodenum
o Peritoneum
o R-colic vessels
o Roof of mesentry
o Terminal part of
ileum
o Peritoneum
o Gonadal artery
o L-colic vessels
o Sigmoid colon
o Sigmoid
mesocolon

15. PELVIC PART OF URETER
◦ DOWNWARD COURSE
POSTERIORLY LATERALLY
1. Internal iliac artery
2. Anterior trunk of internal
artery
3. Internal iliac vein
4. Lumbosacral trunk
5. Sacroiliac joint
1. Fascia covering obturator
internus
2. Superior vesical vein
3. Obturator nerve, vessels
4. Middle rectal artery
In female:
Forms posterior boundary of
ovarian fossa

16. FORWARD COURSE
MALE FEMALE
ANTERIOR Ductus deference o Broad ligament of
uterus
o Uterine artery
crosses over
BELOW & BEHIND Seminal vesical Supra vaginal portion of
cervix
TERMINAL PART Surrounding :
Vesical vein
Posterior :
Vagina

17. INTRAVESICAL PART:
is oblique course of
ureter & has valvular
action, prevents
regurgitation of urine
from bladder to ureter.

18. BLOOD SUPPLY
Upper part:
Branch of renal artery
Branch of gonadal / colic artery
Middle part :
Branch from aorta/ iliac vessel
Pelvic part:
branch from vesical, middle rectal/ uterine
vessels
Branches from
vesical, middle
rectal, uterine
vessels

19. NERVE SUPPLY:
Sensory sensation:
Sympathetic: T10-L1
Parasympathetic : S2-S4