CALCULUS IN THE UEETEE. 



429 



where the ureter describes a curve known as the flexura margi- 

 nalis ; the third is where the tube traverses the muscular wall of 

 the bladder. It is not as a rule possible to palpate the abdominal 

 part of the ureter. This part descends vertically from the kidney 

 in the umbilical region about an inch and a half from the mid -line. 

 The junction of the outer and middle thirds of a line joining the 

 anterior superior iliac spines corresponds to the flexura marginalis, 



ureter 1st stage 

 . iliac art 



ext. iliac 

 oblit. hypo 



2nd stage 



recto-vesic. fold 

 perit 

 rectum 



vas 



uterine art. 



bladder 



nt. iliac art. 

 ureter 1st stage 



2nd stage 



utero-sacral 

 fold 



rectum 

 perit. 

 3rd stage 

 vagina 



FIG. 55 DIAGRAMS OF THE PELVIC COURSE OP THE URETER IN THE 

 MALE (A) AND FEMALE (B). (HugJiefi and Keith.} 



or portion of the ureter which crosses the brim of the pelvis in 

 front of the bifurcation of the common iliac artery. It is said 

 that the first part of the pelvic portion of the ureter can be 

 palpated from the rectum in both sexes in the knee-elbow position. 

 In the female the terminal part of the tube passes above the 

 lateral fornix of the vagina, then crosses the side of the latter to 

 enter the bladder at a point corresponding to the middle of the 

 anterior vaginal wall. It can easily be palpated from the vagina. 

 The ureter is retroperitoneal in the whole of its course, and can 



