Ureter Course and Relations Flashcards

Trace the abdominal and pelvic course of the ureters, including muscular, vascular, reproductive, and bladder relationships.

Card 1 of 30Question

Where does the anatomical course of each ureter begin?

At the ureteropelvic junction, where the renal pelvis narrows to become the ureter.

In This Section

1. Where does the anatomical course of each ureter begin?

At the ureteropelvic junction, where the renal pelvis narrows to become the ureter.

2. What is the general direction of the abdominal ureter?

It descends inferiorly and slightly medially along the posterior abdominal wall toward the pelvic brim.

3. What is the peritoneal relationship of the abdominal ureter?

It is retroperitoneal, lying posterior to the parietal peritoneum.

4. Which muscle forms the principal posterior muscular relation of the abdominal ureter?

The psoas major muscle.

5. Which nerves pass posterior to the abdominal ureter on the surface of psoas major?

The genitofemoral nerve.

6. Which vessels cross anterior to the abdominal ureter during their descent toward the gonads?

The gonadal vessels, including the testicular or ovarian vessels.

7. What is the relationship between the right abdominal ureter and the inferior vena cava?

The right ureter normally descends lateral to the inferior vena cava.

8. Which part of the duodenum lies anterior to the upper right ureter?

The descending, or second, part of the duodenum.

9. Which intestinal mesentery crosses anterior to the right abdominal ureter?

The root of the mesentery of the small intestine.

10. Which colonic structure is an anterior relation of the right abdominal ureter?

The ascending colon and its mesocolic attachments.

11. Which colonic structure lies anterior to the left abdominal ureter?

The descending colon and its mesocolic attachments.

12. Which mesenteric structure crosses anterior to the left ureter near the pelvic brim?

The sigmoid mesocolon.

13. Which major vessels are crossed by the ureters as they enter the pelvis?

The common iliac arteries near their bifurcations or the proximal external iliac arteries.

14. What anatomical landmark marks the transition from the abdominal to the pelvic ureter?

The pelvic brim near the iliac vessel crossing.

15. What is the initial course of the pelvic ureter?

It descends along the lateral pelvic wall anterior to the internal iliac vessels.

16. How does the pelvic ureter change direction as it approaches the urinary bladder?

It turns anteromedially from the lateral pelvic wall toward the bladder base.

17. What is the relationship between the female pelvic ureter and the ovary?

The ureter passes posterior to the ovary in the region of the ovarian fossa.

18. Which reproductive ligament contains the uterine artery where it crosses the female ureter?

The cardinal ligament, also called the transverse cervical ligament.

19. What is the relationship between the female ureter and the uterine artery?

The uterine artery crosses superior to the ureter near the lateral aspect of the cervix.

20. Approximately how far lateral to the cervix does the uterine artery cross the ureter?

Approximately 1.5 to 2 cm, although the distance varies.

21. What is the relationship between the distal female ureter and the vaginal fornix?

The ureter passes close to the lateral vaginal fornix before entering the bladder.

22. Why is the female ureter at risk during hysterectomy?

It lies close to the cervix beneath the uterine artery, where surgical ligation or dissection may injure it.

23. Which reproductive duct crosses superior to the pelvic ureter in males?

The ductus deferens, also called the vas deferens.

24. What is the relationship between the terminal male ureter and the seminal vesicle?

The ureter passes lateral to the seminal vesicle before entering the bladder.

25. How does the ureter traverse the urinary bladder wall?

It passes obliquely through the bladder wall along an intramural course.

26. Where are the ureteric orifices located inside the urinary bladder?

At the two superolateral angles of the bladder trigone.

27. How does the oblique intramural course of the ureter help prevent vesicoureteral reflux?

Increasing bladder pressure compresses the intramural ureter and limits backward urine flow.

28. What are the three traditional anatomical narrowing sites along the ureter?

The ureteropelvic junction, iliac vessel crossing, and ureterovesical junction.

29. What anatomical variation causes a ureter to pass posterior to the inferior vena cava?

A retrocaval ureter, usually affecting the right side and resulting from abnormal inferior vena cava development.

30. Why is identifying the ureter at the pelvic brim useful during pelvic surgery?

Its relationship to the iliac vessels provides a landmark for tracing its pelvic course and avoiding injury.