Anatomy of the ureter. Which one is TRUE?
A. Along its course, the ureter passes in front of the gonadal vessels and behind the bifurcation of the common iliac vesselsAnswer D
The ureter is up to 30 cm long. From its origin behind the renal artery, each ureter descends over the anterior border of the psoas to the pelvis. In doing so, it passes behind the gonadal vessels but over the bifurcation of the common iliac vessels. In men, the ureter continues along the lateral wall of the pelvis and then turns forward at the ischial spine to enter the bladder just after it is crossed by the vas deferens. In women, the ureter turns forwards and medially at the ischial spine and runs in the base of the broad ligament where it is crossed by the uterine artery. It continues forward passing the lateral fornix of the vagina to enter the bladder. The four layers in the wall of the ureter include the inner transitional cell epithelium, lamina propria, smooth muscle and outer adventitia. The blood supply is from several sources; in the abdomen the ureter receives branches from the renal, gonadal, common iliac arteries and the abdominal aorta. In the pelvis, it is supplied by the internal iliac artery and its branches including the vesicle, uterine, vaginal and middle rectal arteries. There are three main points of narrowing along its course: at the pelvi-ureteric and vesico-ureteric junctions and over the common iliac vessels.