1896 



HUMAN ANATOMY. 





'^' 



Renal 

 papilla 



Reflection 

 of calyx 

 onto renal 

 papilla 



Pelvis 



behind the descending part of the duodenum, lies to the right of the inferior vena 

 cava, which it approaches and even touches in its descent, and is covered by the 

 attachment of the mesentery. Above the left ureter may be covered by the pancreas 

 when that organ is unusually broad, and below it is crossed by the attachment of the 

 sigmoid flexure. 



The pelvic portion (pars pelvina) — from 12-13 ^^- (5 in.) in length — lies 

 against the lateral wall of the pelvis, close beneath the serous membrane embedded 

 within the subperitoneal tissue, and curves downward and forward to about the level 

 of the ischial spine, where it turns inward upon the visceral layer of the pelvic fascia 

 to reach the dorsal wall of the bladder (Fig. 1619). In its descent it lies in front of 

 the internal iliac artery as far as the greater sciatic notch (Merkel), crosses the ob- 

 literated hypogastric artery and the obturator nerve and vessels to their inner side, 

 and, as it traverses the pelvic floor, is surrounded by the tributaries from the vesical 

 plexus to the internal iliac vein and may lie upon the middle and inferior vesical 



arteries. The ureter is crossed 

 Fig. 1 61 5. on its inner side by the vas defer- 



ens, and pierces the bladder-wall 

 immediately in front, or under 

 cover of the anterior part, of the 

 seminal vesicle or of the ampulla 

 (Fraenkel '). The space between 

 the ureter and the seminal vesi- 

 cle, which when the bladder is 

 empty may be considerable, is 

 filled by areolar tissue containing 

 veins and fat. The relations of 

 the ureter to the bladder are pe- 

 culiar, since, in addition to pene- 

 trating the latter so obliquely that 

 the last 18 mm. (i/^ in.) of the 

 renal duct are embedded within 

 the vesical wall, the muscular tis- 

 sue of the latter is seemingly pro- 

 longed (page 1897) over the ure- 

 ter outside the bladder for some 

 5 mm. as a distinct sheath (Wal- 

 deyer). The ureteral orifices on 

 the inner surface of the vesical 

 wall are slit-like and valvular in 

 form and, in the contracted condi- 

 tion of the bladder, about 2.5 cm. 

 apart, thisdistance being increased 

 twofold or even more when that 

 organ becomes distended. 

 The female ureter (Fig. 1622) calls for special description on account of the 

 relations of its pelvic portion to the generative organs. On gaining the lateral wall 

 of the pelvis, the ureter descends in close proximity to the unattached border of the 

 ovary and constitutes the postero-inferior boundary of the ovarian fossa (page 1986 j. 

 On the pelvic floor the ureter enters the base of the broad ligament, within which 

 duplicature it is crossed by the uterine artery, passes between the veins of the vesico- 

 vaginal plexus, and continues downward and forward in the vicinity of the uterine 

 cervix to the vagina; its terminal segment lies embedded within the connective tissue 

 between the cervix and bladder, close to the anterior vaginal wall for a distance of 

 from 1-1.5 cm., where, bending somewhat inward, it reaches the posterior vesical 

 wall, which it pierces obliquely in the manner above described. 



Structure. — The wall of all parts of the renal duct is the same in its general 

 construction and includes three layers, (i) the mucous membrane, (2) the mus- 

 cular tunic, and (3) the outer fibrous coat; the mucosa and the muscular layer are 



1 Die Samenblasen der Menschen, Berlin, 1901. 



Renal 

 blood- 

 vessels 



Ureter 



Sagittal section throujjh sinus of child's kidney, showing lower 

 part of pelvis and commencement of ureter. X lo. 



