Podcast
Questions and Answers
During a surgery involving the ureters, which approach minimizes the risk of disrupting their blood supply?
During a surgery involving the ureters, which approach minimizes the risk of disrupting their blood supply?
- Aggressively dissecting the ureters to identify all potential anomalies.
- Applying strong traction laterally to expose the ureter fully.
- Leaving the ureters undisturbed unless absolutely necessary. (correct)
- Applying traction away from the blood supply of the ureters.
A patient is experiencing pain related to the ureter that is also felt in the scrotum and inner thigh. Which nerve pathway is primarily responsible for this referred pain?
A patient is experiencing pain related to the ureter that is also felt in the scrotum and inner thigh. Which nerve pathway is primarily responsible for this referred pain?
- Vagus nerve afferents synapsing in the brainstem.
- Afferent fibers traveling with sympathetic nerves entering the spinal cord in the 1st and 2nd lumbar segments. (correct)
- Direct sensory innervation of the scrotum and thigh by the ureter.
- Parasympathetic fibers synapsing in the sacral spinal cord.
Which artery provides the primary blood supply to the middle portion of the ureter?
Which artery provides the primary blood supply to the middle portion of the ureter?
- Renal artery
- Inferior vesical artery
- Superior vesical artery
- Testicular (ovarian) artery (correct)
Where does the upper end of the ureter receive its nerve supply from?
Where does the upper end of the ureter receive its nerve supply from?
Which of the following arteries supplies blood to the ureter within the pelvic region?
Which of the following arteries supplies blood to the ureter within the pelvic region?
A clinician is reviewing a patient's lymphatic drainage pathways. Where would the lymph vessels from the ureter primarily drain into?
A clinician is reviewing a patient's lymphatic drainage pathways. Where would the lymph vessels from the ureter primarily drain into?
Which venous structure drains the upper end of the ureter?
Which venous structure drains the upper end of the ureter?
What is the nerve supply to the ureter in the pelvis?
What is the nerve supply to the ureter in the pelvis?
Which veins drain the middle part of the ureter?
Which veins drain the middle part of the ureter?
Which veins drain the ureter in the pelvis?
Which veins drain the ureter in the pelvis?
Flashcards
Ureter Blood Supply (Arteries - Upper End)
Ureter Blood Supply (Arteries - Upper End)
The upper end is supplied by the renal artery.
Ureter Blood Supply (Arteries - Middle Part)
Ureter Blood Supply (Arteries - Middle Part)
The middle part is supplied by the testicular (ovarian) artery.
Ureter Blood Supply (Arteries - Pelvis)
Ureter Blood Supply (Arteries - Pelvis)
The pelvis is supplied by the superior vesical artery.
Ureter Blood Drainage (Veins - Upper End)
Ureter Blood Drainage (Veins - Upper End)
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Ureter Blood Drainage (Veins - Middle Part)
Ureter Blood Drainage (Veins - Middle Part)
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Ureter Blood Drainage (Veins - Pelvis)
Ureter Blood Drainage (Veins - Pelvis)
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Ureter Lymph Drainage
Ureter Lymph Drainage
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Ureter Nerve Supply (Upper End)
Ureter Nerve Supply (Upper End)
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Ureter Nerve Supply (Middle Part)
Ureter Nerve Supply (Middle Part)
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Ureter Nerve Supply (Pelvis)
Ureter Nerve Supply (Pelvis)
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Study Notes
Blood Supply of the Ureter
- Arterial supply to the upper end of the ureter comes from the renal artery.
- The middle part of the ureter is supplied by the testicular (ovarian) artery.
- The superior vesical artery supplies the ureter in the pelvis.
- Branches of these arteries form a plexus inside the adventitia around the ureter.
- Branches supplying the abdominal half of the ureter approach medially.
- Branches supplying the pelvic half of the ureter approach laterally.
- During surgery, the ureters should be avoided and left undisturbed if possible.
- If traction is necessary, it should be applied gently and toward the blood supply to prevent disruption.
- Venous drainage from the upper end of the ureter is via the renal vein.
- The middle part of the ureter drains into the testicular (ovarian) vein.
- The superior vesical vein drains the ureter in the pelvis.
Lymph Drainage
- Lymph vessels of the ureter drain into the lateral aortic (para-aortic) lymph nodes.
- Lymph also drains into the internal iliac lymph nodes.
Nerve Supply
- The upper end of the ureter is supplied by the renal plexus.
- The middle part of the ureter receives innervation from the testicular (ovarian) plexus.
- In the pelvis, the superior vesical plexus (from the inferior hypogastric plexus) provides nerve supply.
- Afferent fibers travel with sympathetic nerves and enter the spinal cord in the 1st and 2nd lumbar segments.
- Ureteral pain can be felt at the scrotum or the inner side of the thigh.
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