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Flashcards in Ureters Deck (11):
0

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

1

Prevent urine reflux

Ureterovesical valve of Sampson

2

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

3

May inadvertently ligate the ureter along with the uterine artery near the cervix

Hysterectomy

4

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)

5

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

6

Obstruction by renal calculi



Most often at the 3 normal sites of constrictions

Causes unilateral hydronephrosis

7

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

8

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)

9

3rd most common (5%)

Radioluscent

Acidic urine (

Uric acid

10

Least common (1%)

Faintly radiopaque

Acidic urine (

️Cysteine