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]
- 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.
- Anterior:
- 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.
- Anterior: