THE DUCT OF THE KIDNEY. 



1269 



Cortical 



Basal part of j, 

 pyramid'7^ 



Papilla 



~ Pelvis 



ureter, in most cases, lies across the external iliac ; but this arrangement is by no 

 means constant. The course and position occupied by the abdominal portion of 

 the ureter is well seen in Fig. 983. 



In X-ray photographs, the shadow cast by the abdominal portion of the ureter when the 

 latter has been rendered opaque, is seen to fall immediately in front of the tips of the transverse 

 processes of the lower lumbar vertebrae. 



The pars pelvina or pelvis minor portion of the ureter is about four and a half or 

 five inches in length ; it passes downwards on the side wall of the pelvis, immedi- 

 ately behind the peritoneum, describing a curve which is convex backwards and 

 laterally (Fig. 988). The most convex portion of this curve lies close to the deepest 

 part of the greater sciatic 



notch (Fig. 988). As it 

 descends upon the side 

 wall of the pelvis the 

 ureter forms the pos- 

 terior boundary of the 

 triangular district known 

 as the obturator triangle. 

 The lower limit of this 

 triangle is formed by the 

 ductus deferens, and the 

 upper and anterior 

 boundary by the external 

 iliac vessels and the 

 pelvic brim (Fig. 988). 



In its course within 

 the pelvis minor the 

 ureter lies in front of the 

 hypogastric artery, and 

 crosses the medial aspect 

 of the obturator nerve 

 and vessels and of the 

 obliterated umbilical 

 artery. About the level 

 of the ischial spine, the 



Ureter is Crossed from Oolumna renalls of 'cortex 



before backwards by the 

 ductus deferens, and 

 from this point onwards 

 it is not so intimately re- 

 lated to the peritoneum The P elvis of the kidne Y and some of its calyces have been laid open as they 



It now bends some- 

 what medially and forwards, to reach the posterior angle of the bladder, and 

 comes into relationship with the upper end of the vesicula seminalis, in front 

 of which it lies. The ductus deferens having crossed the ureter also turns 

 medially, and as it does so it lies at a higher level and on a posterior plane to the 

 ureter. The inferior end of the ureter is surrounded by a dense plexus of veins which 

 brings the vesical plexus into communication with the hypogastric vein. The great 

 nerve cord which connects the hypogastric plexus with the pelvic plexus, also 

 comes into relationship with the lower part of the pelvic portion of the ureter, 

 in the region where the latter is crossed by the ductus deferens (Fig. 988). 



When the right and left ureters reach the bladder they are a little more than 

 two inches apart. They pierce the bladder wall very obliquely, and are embedded 

 within its muscular tissue for nearly three-quarters of an inch of their length. 

 Finally, they open into the bladder by two small slit-like apertures which are 

 of a valvular nature, and prevent a backward passage of fluid from the bladder. 

 It is probable, however, that an exaggerated idea of the valvular nature of 

 the openings of the ureters into the bladder is obtained by an examination 

 of the parts in the dead subject. When the bladder is empty the openings of 



81 & 



--Renal arterj 



- Ureter 



Pars radiata of cortex 



/ 



. LONGITUDINAL SECTION OF THE KIDNEY, OPENING UP THE KIDNEY 



SINUS. 



