35O Disease of Kidney 



genito-crural nerve, being crossed superficially by the spermatic vessels, 

 which are inclining outwards, towards the internal abdominal ring. 

 Coils of small intestine especially of the ileum lie in front of the 

 right ureter, and the sigmoid flexure is anterior to the left. Entering 

 the true pelvis, the ureter passes over the common iliac artery close 

 to its division, or over the beginning of the trunks into which it 

 divides, and, having passed into the posterior false ligament of the 

 bladder, it enters that viscus by running obliquely through its base. 

 The right ureter descends on the outer side of the vena cava, and, 

 passing very near to the vermiform process, is sometimes glued to it 

 in perityphlitis. In the male the vas deferens curls round between the 

 side of the bladder and the ureter ; in the female the ureter descends by 

 the side of the neck of the uterus and the upper part of the vagina, and 

 in epithelioma of the cervix uteri the ureter may be implicated and ob- 

 structed. Psoas abscess has been known to discharge through the ureter. 



Structure. Inside a fibrous coat are two layers of non-striated 

 muscle, the outer of longitudinal, the inner of circular fibres ; more 

 deeply comes the mucous membrane lined with stratified epithelium. 



The blood supply is from the vessels against wrjich it is placed in 

 its course, namely, renal, spermatic, internal iliac, middle and inferior 

 vesical ; so also with the veins. 



The nerves come from the renal and the hypogastric plexus, and 

 from the filaments about the kidney, spermatic cord and rectum, and 

 indirectly, probably, from the lumbar plexus. 



When a stone is passing down the ureter the pain ma? be intense, 

 localised in part to the region of the ureter, and radiating, after the man- 

 ner of renal colic, down to the bladder and penis, and even into the thigh. 



The supra-renal body (2 drms.) is a ductless gland placed like a 

 cocked-hat upon the top of the kidney. Above the right capsule is the 

 liver ; above the left, and external to it, is the spleen. Posterior to 

 each is the beginning of the vault of the diaphragm. In front of the 

 left are the tail of the pancreas and the stomach. 



Arteries come to the capsule from the aorta (supra-renal) and from 

 the renal, and twigs are derived also from the neighbouring diaphrag- 

 matic branches. 



The right vein enters the vena cava ; the other, like the spermatic, 

 joins the left renal. The nerves come from the solar and renal 

 plexuses ; the lymphatics enter the lumbar glands. 



Degeneration of the supra-renal bodies is associated with bron/ing 

 of the skin and with anaemia (Addison's disease). 



THE ABDOMINAL AORTA 



The abdominal aorta, the continuation of the thoracic, begins at 

 the twelfth dorsal vertebra, and divides into the common iliacs at the 

 left side of the fourth lumbar that is, at a spot just below and to the left 



