Renal calyces, pelvis, ureter - syntopy
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Anatomy of Renal Calyces, Pelvis, and Ureter[edit | edit source]

Structural Overview[edit | edit source]

  • Renal Cortex and Medulla: The renal cortex extends inward as renal columns, separating the medullary tissue into distinct renal pyramids.
  • Renal Papilla: The apex of each renal pyramid is called the renal papilla, which opens into a minor calyx.
  • Minor and Major Calyces: Several minor calyces (2-3 per pyramid) unite to form major calyces (2-3 per kidney).
  • Renal Pelvis: The major calyces converge into the renal pelvis, which is the funnel-shaped proximal end of the ureter.
  • Ureter: Urine flows from the renal pelvis into the ureter, which transports it to the bladder.

Vasculature[edit | edit source]

  • Ureter - syntopy.png
    Abdominal Ureter:
    • Arterial Supply: Branches from the renal artery, gonadal arteries (testicular/ovarian), and direct ureteric branches from the abdominal aorta.
    • Venous Drainage: Corresponds to arterial supply via veins of the same names.
  • Pelvic Ureter:
    • Arterial Supply: Primarily from the superior and inferior vesical arteries, with contributions from the internal iliac artery and other local branches.
    • Venous Drainage: Mirrors the arterial supply, draining into the internal iliac vein system.

Innervation[edit | edit source]

  • Sympathetic Fibers: Derived from the renal plexus, gonadal plexus, and hypogastric plexus.
  • Parasympathetic Fibers: Primarily from the pelvic splanchnic nerves (S2-S4).
  • Sensory Innervation: Pain fibers (afferents) enter the spinal cord at levels T11-L2, explaining referred pain to the flank, lower abdomen, and groin during ureteral obstruction (e.g., kidney stones).

Syntopy (Relations)[edit | edit source]

  • Renal Pelvis and Proximal Ureter:
    • Anterior: Often related to the gonadal vessels and peritoneum.
    • Posterior: Adjacent to the psoas major muscle and genitofemoral nerve.
  • Abdominal Ureter:
    • Anterior:
      • Right Ureter: Crossed by the duodenum and right colic vessels.
      • Left Ureter: Crossed by the left colic vessels and sigmoid mesocolon.
    • Posterior: Lies on the psoas major muscle, with the lumbar sympathetic trunk medially and the iliac vessels posteriorly.
  • Pelvic Ureter:
    • Anterior:
      • In males: Crossed by the ductus deferens.
      • In females: Crossed by the uterine artery (clinical importance during hysterectomy).
    • Posterior: Related to the internal iliac vessels and sacrum.