Kalabhavi Srinivas K.pdf

Proforma
muscular layer and is composed of fibroelastic tissue, which is continuous with the
capsule of the kidney 10 .
Blood supply 3 :
In an adult, the ureter is generally 22 to 30 cms in total length, varying with
body size and habitus. Its origin at UPJ is often vaguely defined in the normal state.
The ureter receives its blood supply from multiple feeding arterial branches along its
course. In the retroperitoneum, the ureter may receive branches from renal artery,
gonadal artery, abdominal aorta & common iliac artery. After entering the pelvis,
additional small branches to the distal ureter may arise from the internal iliac artery
or its branches, especially vesical and uterine arteries, but also from the middle rectal
and vaginal arteries. Arterial branches to the upper ureter approach from the medial
direction, whereas arterial branches within pelvis approach the ureter from a lateral
direction. After reaching the ureter, the arterial vessels course along longitudinally
within the periarterial adventitia in an extensive anatomising plexus. The venous and
lymphatic drainage of the ureter generally parallels the arterial supply.
The normal ureter is not of uniform caliber with 3 distinct narrowing along its
course. The first is at UPJ, second region of narrowing occurs as the ureter crosses
the iliac vessels and the third site is at uretero vesical junction.
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