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Mar 06, 2016 · Typically, a ureter exits each renal pelvis at approximately L2 to L3 and parallels the spine overlying the transverse processes. As the ureters enter the pelvis, they course first laterally, then curve toward the bladder trigone, entering at an angle that is variable but often approximates 45 degrees.
The course of each ureter should be traced to look for the presence of calculi. The ureters pass down the lateral margins of the transverse processes of the lumbar vertebrae as is illustrated in Fig. 11. Particular attention should be paid to the pelvicoureteric junction and the vesicoureteric junction, as these are two sites of normal anatomical narrowing within the ureter and hence are …
On a radiograph the ureter can be seen lying along the tips of the transverse processes and then in front of the sacroiliac joint. At operation it can be distinguished from nerves and vessels as a whitish non-pulsatile cord which is adherent to the peritoneum (moves with the peritoneum as the latter is pushed forward) and showing peristaltic activity when gently pinched with a forceps.
Purpose: The aim of this prospective study was to assess the diagnostic benefit of taking a kidney-ureter-bladder (KUB) radiograph in an upright position during routine intravenous urography (IVU). Materials and methods: Between February 2005 and September 2007, 170 consecutive patients were included in the study. A basal IVU exam consisted of pre-contrast …
The ureters begin at the ureteropelvic junction (UPJ) of the kidneys, which lie posteriorly to the renal vein and artery in the hilum[1]. The ureters then travel inferiorly inside the abdominal cavity. They pass over (anterior to) the psoas muscle and enter the bladder on the posterior bladder aspect in the trigone.
If your provider suspects you have an obstructed ureter, some of these tests and scans might be used to reach a diagnosis:Blood and urine tests. ... Ultrasound. ... Bladder catheterization. ... Renal nuclear scan. ... Cystoscopy. ... Computerized tomography (CT) scan. ... Magnetic resonance imaging (MRI).Jan 21, 2022
The ureter is a tube that carries urine from the kidney to the urinary bladder. There are two ureters, one attached to each kidney. The upper half of the ureter is located in the abdomen and the lower half is located in the pelvic area.
The ureteric orifice should be identified. Having identified the mid-point of the trigone, the ultrasound probe should be moved slowly laterally towards the pelvic side wall in order to identify the ureters.Nov 26, 2018
The ureters begin at the ureteropelvic junction (UPJ) of the kidneys, which lie posteriorly to the renal vein and artery in the hilum. The ureters then travel inferiorly inside the abdominal cavity. They pass over (anterior to) the psoas muscle and enter the bladder on the posterior bladder aspect in the trigone.Sep 8, 2021
The ureters are collapsible S-shaped channels, each about 25 cm in length. They are widest at the renal pelvis and narrow progressively as they enter the urinary bladder in the concavity of the true pelvis.
Where do the ureters enter the bladder? At the posterior wall at the lateral margins of the superior part of its base and pass obliquely through the wall to their respective internal orifices. The openings are about 1 inch apart when the bladder is empty and about 2 inches apart when the bladder is distended.
The upper ureter extends from the renal pelvis to the upper border of the sacrum. The middle ureter continues from the upper to lower borders of the sacrum. The distal ureter continues from the lower border of the sacrum to the bladder.Sep 8, 2021
the intima, the media, and the superficial layer.
Ultrasound can detect cysts, tumors, abscesses, obstructions, fluid collection, and infection within or around the kidneys. Calculi (stones) of the kidneys and ureters may be detected by ultrasound.
Bladder ultrasound can give information about the bladder wall, diverticula (pouches) of the bladder, bladder stones, and large tumors in the bladder. Kidney ultrasound can show if the kidneys are in the right place or if they have blockages, kidney stones, or tumors.
3:164:29Ultrasound Tutorial: Kidney & Bladder / Urinary Tract | Radiology Nation ...YouTubeStart of suggested clipEnd of suggested clipSuch as a thickened irregular bladder wall rotating the probe 90 degrees clockwise. Will image theMoreSuch as a thickened irregular bladder wall rotating the probe 90 degrees clockwise. Will image the bladder in its long axis. Number two sweep out past the lateral walls of the bladder.
The proximal ureter refers to the segment from the UPJ to the superior margin of the sacrum, the midureter is the segment that overlies the sacrum (also referred to as the sacral ureter), and the distal ureter is the short segment between the inferior margin of the sacrum and the ureteral orifice (Fig. 19-4).
The ureters are muscular tubes with an internal lining of urothelium (previously called transitional epithelium ). During development, each ureter begins as a ureteric bud arising from the mesonephric duct near the cloaca. The ureteric bud elongates in a cephalad direction until it reaches the metanephric blastema, which is induced to form a kidney.
Excretion of contrast into the ureters usually starts by about 2 minutes after injection. The high attenuation of excreted contrast defines the ureteral lumen well but can obscure the thin ureteral wall.
The portion of the inferior vena cava (IVC) below the renal vein usually develops from the supracardinal vein, which is posterior to the ureter. If, instead, the infrarenal IVC develops from the right subcardinal or postcardinal veins (these are anterior to the ureter), part of the ureter may become trapped behind the IVC. In the most common form of this variant, the proximal right ureter courses posterior to the IVC at the L4 level, and loops around medial then anterior to the IVC before assuming a normal location for the distal segment. This loop around the IVC is cause for the name circumcaval ureter. This may give the illusion that the ureter is “hung up” on the L4 pedicle (Fig. 19-18). This anatomic variant often presents when a ureteral stone becomes obstructed in the circumcaval segment ( Fig. 19-19 ). This can be confusing on unenhanced CT if a calculus is lodged posterior to the IVC. Following the ureters carefully from kidney to bladder on sequential axial images allows accurate diagnosis.
Below the bladder neck, the prostatic urethra appears almost as an elongated teardrop with a posterior impression representing the verumontanum. The lumen of the prostatic urethra is lined with the same type of urothelium that lines the bladder, ureter, and renal pelvis. The verumontanum contains the urethral outlets for the ejaculatory ducts.
The bladder is often seen on a kidneys, ureter, and bladder radiograph (KUB) as a flattened ellipsoid (when empty) to elongated oval-shaped (when distended) soft-tissue density arising from the middle of the pelvic floor. In women, the uterus can often be seen faintly as it rests over the bladder dome. Looking for the normal bladder on each KUB helps with the detection of unsuspected bladder distension or bladder calcification.
When empty (or nearly empty), the bladder is relatively flat in the craniocaudal direction. A layer of peritoneum rests over the dome of the bladder like a blanket. As it fills, the bladder becomes ellipsoid, lifting the peritoneum from the anterior abdominal wall (like peeking under the blanket).
The most common causes of large bowel obstruction are lesions within the bowel e.g. colorectal carcinoma or a diverticular stricture. However, volvulus is a rarer but no less important cause of acute colonic obstruction. A volvulus occurs when the colon twists on its mesentry and forms a closed loop obstruction.
The KUB (kidneys, ureters and bladder) radiograph is a variant of the abdominal radiograph, which is optimised for the assessment of the renal tracts . The KUB radiograph is increasingly being replaced by low dose CT for the detection of renal calculi and CT is now the first line imaging modality.
Sacroiliitis radiologically manifests as sclerosis of the subchondral bone either side of the sacroiliac joint, erosions and eventual ankylosis of the joint(Fig. 15). Sacroiliitis in combination with an appropriate clinical history or bowel gas pattern, can suggest inflammatory bowel disease.
The ureter is a muscular tube that follows an S -shaped course in the retroperitoneum. The muscle fibers are arranged in three separate layers: inner and outer longitudinal and middle circular. The length of the ureter in the adult is 28 to 34 cm, varying in relation to the height of the person. The average diameter of the ureter is 10 mm in the abdomen and 5 mm in the pelvis. However, three areas of physiologic narrowing in the ureter should not be considered abnormal unless the proximal ureter is significantly dilated: the ureteropelvic junction, the point where the ureter crosses over the iliac vessels, and the ureterovesical junction. Both ureters have the same posterior relations, lying on the medial aspect of the psoas major muscle and traveling downward adjacent to the transverse processes of the lumbar vertebrae. Just proximal to their midpoints, both ureters cross behind the gonadal vessels. The right ureter passes behind the second part of the duodenum, lateral to the IVC, and is crossed by the right colic and ileocolic vessels. The left ureter passes behind the left colic vessels, descends parallel to the aorta, and passes under the pelvic mesocolon. The upper ureter derives its blood supply from a ureteric branch of the renal artery. During their course in the abdomen, the ureters receive blood from the gonadal vessels, aorta, and retroperitoneal vessels. In the pelvis, they receive additional branches from the internal iliac, middle rectal, uterine, vaginal, and vesical arteries. The abdominal portion of the ureter has a medial vascular supply; the pelvic portion receives its vasculature laterally. This should be taken into consideration during partial mobilization of the ureter to preserve as much blood supply as possible. In case of complete mobilization, the adventitia must be carefully preserved ( Fig. 2.67 ).
This intramural segment of the ureter functions as a one-way valve to prevent vesicoureteral reflux with progressive bladder distention. 1 Ureters are muscular tubes, similar to the esophagus. As a “bolus” of urine accumulates in the renal pelvis, pacemaker activity induces a muscular contraction that propagates the bolus of urine down the ureter to the bladder. With changes in urine flow in other species, the length of the “urine bolus” changes while the rate of transport down the ureter remains the same. 3 Passage of “urine boluses” can be appreciated in horses during either cystoscopy or transrectal ultrasonographic examination. During cystoscopy, streams of urine can be seen to intermittently exit each ureter. These urine streams are asynchronous and vary in volume and frequency with changes in urine flow. 5 During transrectal ultrasonography, forceful passage of urine from the ureters into the bladder can be appreciated by swirling of the echogenic urine in the bladder near the trigone.
The ureters are often seen segmentally because of active peristalsis. The ureters should be free of filling defects and smooth. In the abdomen, the ureters lie in the retroperitoneum, passing anterior to the transverse processes of the vertebral bodies. In the pelvis, the ureters course laterally and posteriorly, eventually draining into the posteriorly located vesicoureteral junction. At the vesicoureteral junction, the ureters gently taper. Medial bowing or displacement of the ureter is often abnormal and can be seen secondary to ureter displacement from retroperitoneal masses, lymphadenopathy, and retroperitoneal fibrosis.
The ureters enter the bladder wall obliquely and are covered by a mucosal flap, the vesicoureteral valve, which is an important structure because it normally prevents reflux of urine from the bladder into the ureter and renal pelvis.
The ureters are typically dilated and tortuous. The degree of ureteral pathology is variable and can be segmental. However, the proximal ureter is usually less dilated and appears to have more normal smooth muscle than the distal ureter.34,35 Collagen fibers and connective tissue have been found to be abundant between muscle bundles containing few muscle cells, 36 particularly refluxing ureters. 37 Vesicoureteral reflux is found in 75% of patients with prune-belly syndrome ( Fig. 62-3 ). 38 Obstruction, either at the ureteropelvic or ureterovesical junction, is rare. 11,39
During the test, X-ray images are taken of the structures of your digestive system, including the intestines and stomach. The KUB procedure can help your doctor diagnose certain gastrointestinal conditions, such as: 1 an intestinal blockage 2 foreign objects in the stomach 3 certain tumors 4 kidney stones and certain types of gallstones
Results of a KUB study may show injuries to your stomach or intestines, fluid in your abdominal cavity, or a blockage of your intestines. In addition, results may show the presence of kidney stones or gallstones.
A KUB study is a safe and relatively harmless procedure that can give you and your doctor a look at your kidneys, ureters, and bladder. The study can help your doctor diagnose pain or a condition right away, or it may be a preliminary step toward a diagnosis.
B) Abdominal ureter: Passes downwards and medially to lie on the medial edge of psoas major. Then enters into the pelvis at the bifurcation of the common iliac artery in front of the sacroiliac joint.
Size and Extent: Length: About 25 cm (10 inches) Diameter: About 3 mm. Extent: Pelviureteric junction to urinary bladder.
The pelvic part of the ureter crosses in front of all the nerves and vessels on the lateral pelvic wall with the exception of vas deferens, which crosses in front of it. Near the uterine cervix, the uterine artery is located above and in front of it, an extremely essential surgical association.
In the pelvis, the ureter first runs downward, backward, and laterally along the anterior margin of the greater sciatic notch. Opposite to the ischial spine, it turns forwards and medially to get to the base of the urinary bladder, where it enters the bladder wall obliquely.
Development. Clinical Significance. The Ureter is a narrow, thick-walled, expansile muscular tube that carries the urine from the kidney to the urinary bladder. By the peristaltic contractions of the smooth muscle of the wall of the ureter, the urine is propelled from the kidney to the urinary bladder. Ureter.
Every part is all about precisely the same length, i.e., 12.5 cm (5 inches). The abdominal part of ureter goes from the renal pelvis to the bifurcation of the common iliac artery. The pelvic part of the ureter goes from the pelvic brim (at the level of bifurcation of the common iliac artery) to the base of the urinary bladder.
Throughout its abdominal and upper parts of the pelvic course, the ureter runs deep to the peritoneum and sticks with it closely. During surgery when the ureter is mobilized, the ureter is in danger of injury for it moves with the peritoneum. Deep to the peritoneum in the abdominal part the ureter is crossed by different blood vessels. Because of these vascular Relations an extraperitoneal method of the ureter is favored to that of a transperitoneal method.
It is located partially outside and partly inside the kidney.
The ureters arise in the abdomen as a continuation of the renal pelvis, and terminate in the pelvic cavity – where they empty into the bladder. The anatomical course of the ureters can therefore be divided into abdominal and pelvic components.
The ureters are two thick tubes which act to transport urine from the kidney to the bladder. They are approximately 25cm long and are situated bilaterally, with each ureter draining one kidney. In this article, we shall look at the anatomy of the ureters – their anatomical course, neurovascular supply and clinical correlations.
The anatomical course of the ureters is of surgical importance, as they travel close to other structures in the pelvis. They must be identified during pelvic surgery to ensure that they are not accidentally damaged. As they cross the pelvic brim, the ureters are in close proximity to the ovaries.
A ureteric calculus (or kidney stone), is the presence of a solid stone in the urinary tract, formed from minerals within the urine. These can obstruct urinary flow, causing renal colic (an acute and severe loin pain) and haematuria (blood in the urine).
As they cross the pelvic brim, the ureters are in close proximity to the ovaries. Care must be taken not the damage the ureters during an oophorectomy, especially during the ligation of the ovarian arteries.