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Ureter
Urinary tract la.png
Ureter (Anatomical View)
Urinary system.svg
Ureter (Schematic View)
1. Human urinary system: 2. Kidney, 3. Renal pelvis, 4. Ureter, 5. Urinary bladder, 6. Urethra. (Left side with frontal section), 7. Adrenal gland
Vessels:
8. Renal artery and vein, 9. Inferior vena cava, 10. Abdominal aorta, 11. Common iliac artery and vein
With transparency:
12. Liver, 13. Large intestine, 14. Pelvis
Details
Latin Ureter
Precursor Ureteric bud
Superior vesical artery, Vaginal artery, Ureteral branches of renal artery
Identifiers
Gray's p.1225
MeSH A05.810.776
Dorlands
/Elsevier
Ureter
TA A08.2.01.001
FMA 9704
Anatomical terminology

In human anatomy, the ureters are tubes made of smooth muscle fibers that propel urine from the kidneys to the urinary bladder. In the adult, the ureters are usually 25–30 cm (10–12 in) long and ~3–4 mm in diameter. Histologically, the ureter contains transitional epithelium and an additional smooth muscle layer in the more distal one-third to assist with peristalsis.

Structure[edit]

In humans, the ureters arise from the pelvis of each kidney, and descend on top of the psoas major muscle to reach the brim of the pelvis. Here, they cross in front of the common iliac arteries. They then pass down along the sides of the pelvis, and finally curve forwards and enter the bladder from its left and right sides at the back of the bladder.[1]:324–326 This is classically depicted as running "posteroinferiorly on the lateral walls of the pelvis and then curve anteriormedially to enter the bladder". The junction between the pelvis of the kidney and the ureters is known as the pelvoureteric junction and the junction between the ureter and the bladder as the vesicoureteric junction. At the entrance to the bladder, the ureters are surrounded by valves known as ureterovesical valves, which prevent the backflow of urine.[citation needed]

In females, the ureters pass through the mesometrium and under the uterine arteries on the way to the urinary bladder. An effective phrase for remembering this anatomical relationship is "water (ureters) under the bridge (uterine arteries or vas deferens).

Blood supply[edit]

The ureters receive a segmental arterial supply, which varies along its course.[1]:324–326

  1. The upper part of the ureter closest to the kidney is supplied by the renal arteries
  2. The middle part of the ureter is supplied by the common iliac arteries, direct branches from the abdominal aorta, and gonadal arteries (the testicular artery in men or ovarian artery in women)
  3. The lower part of the ureter closest to the bladder is supplied by branches from the internal iliac arteries,[1]:324–326 as well as[citation needed]:
  • Superior vesical artery
  • Uterine artery (in women only)
  • Middle rectal artery
  • Vaginal arteries (in women only)
  • Inferior vesical artery (in men only)

Within the periureteral adventitia these arteries extensively anastomose thus permitting surgical mobilization of the ureter without compromising the vascular supply as long as the adventitia is not stripped. Lymphatic and venous drainage mostly parallels that of the arterial supply.[2]

Innervation[edit]

The ureters are richly innervated by nerves that travel alongside the blood vessels. The primary sensation to the ureters is provided by nerves that come from T12-L2 segments of the spinal cord. Thus pain may be referred to the dermatomes of T12-L2, namely the back and sides of the abdomen, the scrotum (males) or labia majora (females) and upper part of the front of the thigh.[1]:324–326

Histology[edit]

The ureter is surrounded by urothelium, a type of transitional epithelium that is capable of responding to stretches in the ureters. The transitional epithelium may appear as a columnar epithelia when relaxed, and squamous epithelia when distended. Below the epithelium, a Lamina Propria exists. The Lamina Propria is made up of loose connective tissue with many elastic fibers interspersed with blood vessels, veins and lymphatics. The ureter is surrounded by two muscular layers, an inner longitudinal layer of muscle, and an outer circular or spiral layer of muscle.[3]:324

In other animals[edit]

Ureters are also found in all other amniote species, although different ducts fulfill the same role in amphibians and fish.[4]

Function[edit]

The ureters are a component of the urinary system. Urine, produced by the kidneys, travels along the ureters to the bladder.

Clinical significance[edit]

Cancer of the ureters is known as ureteral cancer.

The ureters are also known for being extremely hard to work around during surgery and account for 80 percent of failed kidney transplants.[citation needed]

Injury[edit]

Injuries to the ureter with certain forms of trauma including penetrating abdominal injuries and injuries at high speeds followed by an abrupt stop (e.g., a high speed car accident).[5] The ureter is injured in 0.2 per 1,000 cases of vaginal hysterectomies and 1.3 per 1,000 cases of abdominal hysterectomies,[6] near the infundibulopelvic (suspensory) ligament or where the ureter courses posterior to the uterine vessels.[7]

Kidney stones[edit]

A kidney stone can move from the kidney and become lodged inside the ureter, which can block the flow of urine, as well as cause a sharp cramp in the back, side, or lower abdomen.[8] The affected kidney could then develop hydronephrosis, should a part of the kidney become swollen due to blocked flow of urine.[9] There are three sites where a kidney stone will commonly become stuck:

  • at the ureteric junction of renal pelvis;
  • as the ureter passes over the iliac vessels;
  • where the ureter enters into the urinary bladder (vesicoureteric junction).

Reflux[edit]

Vesicoureteral reflux refers to the reflux of fluid from the bladder to the ureters during urination. This condition can be one cause of chronic urinary tract infections, particularly in children. Vesicoureteral reflux may be treated surgically, and is believed to have a genetic basis.[citation needed]

References[edit]

  1. ^ a b c d Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. ISBN 978-0-8089-2306-0. 
  2. ^ Wein, Alan J. (2011). Campbell-Walsh Urology, 10th. ed. Elsevier. p. 31. 
  3. ^ Lowe, Alan Stevens, James S. (2005). Human histology (3rd ed. ed.). Philadelphia, Toronto: Elsevier Mosby. ISBN 0-3230-3663-5. 
  4. ^ Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia, PA: Holt-Saunders International. p. 378. ISBN 0-03-910284-X. 
  5. ^ Stein DM, Santucci RA (July 2015). "An update on urotrauma". Current opinion in urology 25 (4): 323–30. doi:10.1097/MOU.0000000000000184. PMID 26049876. 
  6. ^ Burks FN, Santucci RA (June 2014). "Management of iatrogenic ureteral injury". Ther Adv Urol 6 (3): 115–24. doi:10.1177/1756287214526767. PMC 4003841. PMID 24883109. 
  7. ^ Santucci, Richard A. "Ureteral Trauma". Medscape. Retrieved 11 April 2012. 
  8. ^ "Symptoms of Kidney Stones". MedicalBug. 1 January 2012. Retrieved 11 April 2012. 
  9. ^ Resnick, Martin I; Lam, Mildred; Zipp, Thomas (4 September 2009). "Kidney Stones". NetWellness. Retrieved 11 April 2012. 

External links[edit]


Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Ureter — Please support Wikipedia.
This page uses Creative Commons Licensed content from Wikipedia. A portion of the proceeds from advertising on Digplanet goes to supporting Wikipedia.

1660 news items

 
WhaTech
Fri, 03 Jul 2015 10:26:15 -0700

This report provides comprehensive information on the therapeutic development for Ureter Cancer, complete with comparative analysis at various stages, therapeutics assessment by drug target, mechanism of action (MoA), route of administration (RoA) and ...

Martinsville Bulletin

Martinsville Bulletin
Sat, 01 Aug 2015 21:07:30 -0700

France received a second donor kidney in 2006, he said, but that kidney failed four years later when the ureter – the tube that connects the kidney to the bladder – collapsed. He went back on dialysis for five more years. Doctors did not expect that he ...
 
WebMD
Wed, 29 Jul 2015 11:00:00 -0700

Dr. David Hoenig is a specialist in kidney stone treatment and chief of urology at North Shore-LIJ's Arthur Smith Institute for Urology, in New Hyde Park, N.Y. He said that when stones become lodged in the ureter -- the channel between the bladder and ...

The Harlan Daily Enterprise

The Harlan Daily Enterprise
Wed, 29 Jul 2015 11:45:00 -0700

Urinary tract stones begin to form in the kidney, but may enlarge in a ureter or the bladder where they may become lodged leading to symptoms. Tiny stones may never be noticed as they could just as easily cause no symptoms as they pass. Larger stones ...
 
Times of India
Thu, 23 Jul 2015 14:32:29 -0700

Resitha then approached another gynaecologist, who found that the patient was suffering from urinoma (in which urine collects adjacent to kidneys or ureter) due to an injury sustained from the earlier surgery. This injury necessitated two more ...

FOXSports.com

FOXSports.com
Sat, 25 Jul 2015 10:02:47 -0700

If you're curious what a 'testicular contusion' is, Burns clarified to Hass a bit what the A's medical staff told him: "They said it's swelling in the ureter tube that goes up to your bladder to your kidney. That was what was causing me the most pain ...

Worcester Telegram

Worcester Telegram
Sun, 26 Jul 2015 15:57:55 -0700

He said that while his wife died of adenocarcinoma of the ureter, she had survived 43 years after she was treated for Hodgkins Lymphoma as a teenager. The fatal cancer was likely caused by the radiation she received for Hodgkins, the doctor said.

Express.co.uk

Express.co.uk
Wed, 15 Jul 2015 09:18:45 -0700

Passing a kidney stone is extremely painful (the medical term for this is renal colic) and more severe problems can occur if the stone gets stuck or lodged on its way out of the body (via the ureter, the tube connecting the kidney to the bladder, or ...
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