beginning ending

URETER - an expansile muscular tube responsible for urine collection (superiorly) as renal pelvis which continues as ureter at pelvi-ureteric junction (inferiorly) embedding in the wall of UB before entering lateral angles of its cavity (intramural part) 25 30 cm (10 inches) Sites of constriction 1. Pelvi-ureteric junction. 2. Point of crossing the pelvic brim or the iliac vessels (halfway point between the abdominal and pelvic ureter). 3. Intramural part of the ureter (inside the wall of the urinary bladder)

MALE URETHRA FEMALE URETHRA a muscular duct that conducts urine from the bladder (and semen from the ductus deferens) to the exterior - at the neck of the urinary bladder - as the internal urethral opening - externally in the urogenital triangle of the perineum - as the external urethral opening 20 cm (or 8 inches) 4 cm - S shaped - extending from the internal to the external - subdivided into 3 parts: urethral orifices prostatic, membranous, spongy / penile - wider and more dilatable than male urethra. begins at the neck of the bladder begins from the bladder neck at the internal - then extends through the prostate, pelvic urethral orifice diaphragm, sphincter urethrae, root & body of penis - descends downwards and forwards, traversing the deep and superficial perineal pouches end at the tip of the glans penis as external urethral ends by the external urethral orifice into the orifice vestibule of the vagina between the clitoris and the vagina opening Relations : Upper part -surrounded by the sphincter urethrae. - connected to inferior part of pubic bone by pubovesical ligament anteriorly separated from symphysis pubis by fat posteriorly : adherent to the anterior wall of the vagina

supply & drainage

* segmental arterial supply abdominal art by nearby arteries abdominal aorta, renal artery, gonadal, common iliac ven renal, gonadal and internal iliac veins

pelvic inferior vesical (in males) or uterine & vaginal arteries (in females) vena comitants corresponding the arteries *male urethra!
part arterial supply venous d. lymphatic nerve s.

nerve supply

Sympathetic: the preganglionic nerve cells lie in the T12- L2 spinal cord segments Parasympathetic: from S2,3,4 nerves and reach the ureter through pelvic splanchnic nerves.. para-aortic lymph nodes

lymph

PROSTATIC MEMBRANOUS SPONGY inferior vesical, artery of bulb of penis urethral artery, deep & dorsal artery of penis middle rectal prostatic plexus internal pudendal vein internal iliac vein internal iliac nodes 1. deep & superficial inguinal nodes prostatic plexus branches of pudendal nerves

DIVISION OF URETER RENAL PELVIS ABDOMINAL URETER - funnel-shaped upper - renal pelvis + abdominal expansionof the ureter part - dilated into 2-3 major calyces - it is the upper half of ureter - may lie completely outside that courses in the abdomen the kidney / buried inside the substance of renal hilum courses * for abdominal ureter ureter descends vertically on the psoas major muscle then crosses the bifurcation of the common iliac artery over the sacroiliac joints to enter the pelvis

PELVIC URETER - 1-2 cm length, oblique part inside the wall of the bladder

right ant

left

relation

post med

peritoneum - duodenum sigmoid colon - terminal ileum apex of pelvic root of mesentery mesocolon 4 Vessels 3 vessels - right colic - left colic - ileocolic - superior - inferior mesenteric mesenteric - gonadal vessels - gonadal vessels -psoas major -genitofemoral nerve inferior mesenteric IVC vessels

1. After crossing the end of the common iliac artery, it enters the pelvis. 2. On the side wall of the pelvis: - lies in front of internal iliac artery and behind the ovary - It crosses the obturator nerve, vessels and obliterated umbilical artery (medial umbilical ligament) 3. At the level of the ischial spine: it passes forwards & medially above the pelvic floor to reach the postero-superior angle of the bladder. 4. Intramural part of the ureter: - 1-2 cm long - oblique part inside the wall of the bladder In males: - vas deferens crosses above it then descends medial to the ureter - seminal vesicle lies inferior to the ureter In females: - lies in the base of broad ligament of uterus - lies 1-2cm lateral to the cervix of the uterus very near to the lateral fornix of the vagina - Here the uterine artery crosses over the ureter

DIVISION OF MALE URETHRA PROSTATIC PART length - 3 cm (1.5 inch) long - fusiform in shape most! starts course ends the widest & most dilatable part from internal urethral orifice at apex of trigone of bladder traverses the prostate at external urethral sphincter muscle proximal part is surrounded by the internal urethral sphincter helps to close this opening during ejaculation to prevent regurgitation of the seminal fluid to the UB

MEMBRANOUS PART - 1 cm (0.5 inch) long - lies in the deep perineal pouch & surrounded by the external urethral sphincter the shortest, narrowest & least dilatable part at the apex of prostate passes through pelvic diaphragm and sphincter urethrae (deep perineal pouch) at bulb of penis

SPONGY PART - 10 to 16 cm (6 inches) long. - lies in the corpus spongiosum of penis extends from bulbs to body to glans of penis

its wall is thin so it is most liable to rupture during instrumentation (catheter)

ending at external urethral orifice (narrowest part of the male urethra) It shows 2 dilatations: 1. in the bulb (intrabulbar fossa) 2. in the glans (fossa navicularis).

Internal features of prostatic urethra (posterior wall) Name Description urethral crest (verumontanum) median ridge (or elevation) seminal colliculus - ovoid enlargement of the crest - located approximately at junction of middle & lower 1/3 of prostatic part prostatic utricle at summit of colliculus prostatic sinus - groove on each side of crest - most prostatic ducts open into it openings of ejaculatory ducts on each side of opening of prostatic utricle