The Ureter adrenal glands and urethera in anatomy

1. THE URETER

2. ❖Function :
The ureters convey urine from the kidneys to the bladder .
❖Components
pelvis and abdominal, pelvic
❖ and intravesical parts .
❖25-30 cm long

3. ❑ ureter has a diameter of about 3 mm but is
narrower at the following three sites:
• The junction of the pelvis and ureter .
• The pelvic brim.
• The intravesical ureter .

4. Relations :

6. • Blood supply of the ureter
• upper ureter from the renal arteries.
• The middle part is supplied by the
common iliac arteries, branches from
the abdominal aorta, and the gonadal
arteries.
• The most distal part of the ureter
receives blood from branches of the
internal iliac artery

7. • Radiological features of the ureter
• Plain films of the abdomen
• -The ureter is not visible
• - its course in relation to the skeleton is necessary when looking
for radio-opaque calculi.
• Intravenous urography
• -The ureters are either completely or partly visible when filled with
contrast
• -Prone views aid ureteric filling
• - a compression band across the abdomen during the first part of
the IVU examination
• The ureter enters the posterior part of the bladder, and oblique views
are therefore
• helpful in imaging the ureterovesical junction.
• Ultrasound
• The proximal and distal ureters may be visible on ultrasound

8. Plain X- Ray KUB showing giant right ureteric calculus

9. ✓ Computed tomography
- Ureteric calculi not visible on
radiographs are readily visible on CT
scans .
✓ MR urography
• The ureters may be imaged
using the same water-sensitive
techniques as MR
cholangiography .
• MR contrast urography can be
performed where the ureters are
imaged during the excretory
phase after intravenous
gadolinium.
• MRI tends to be used in cases
where irradiation is undesirable,
such as during pregnancy .
CT Urography
CT Urography with contrast

10. MR Urography

11. THE ADRENAL
GLANDS

12. The adrenal glands lie retroperitoneally above each kidney.
• They are each enclosed within the perirenal fascia but in a
separate compartment from the kidney.
• Each gland is composed of a body and medial and lateral limbs.
body (1) and limbs (2, 3) of the adrenal gland

13. The right adrenal gland
• posterior to the inferior vena cava,
• medial to the right lobe of the liver
• lateral to the right diaphragmatic crus.
• It is lower and more medial in relation to the
spine than the left.
• On cross-section it is linear or V-shaped, with
a larger medial limb and a smaller lateral limb.
• The left adrenal gland
• posterior to the splenic vein
• lateral to the diaphragmatic crus,
• its position is less consistent than that of the right side.
• The left adrenal gland is more semilunar than the right and
it extends down the superomedial border of the kidney
towards the hilum.
• On cross-section it is triangular or Y-shaped.
Relations of adrenal glands

14. Arterial supply
Three arteries supply these glands on
each side, namely:
• The superior adrenal artery from
the inferior phrenic
artery;
• The middle adrenal artery from
the aorta; and
• The inferior adrenal artery from
the renal artery.
Venous drainage
• The right adrenal vein drains to the
IVC and the left adrenal vein drains
to the left renal vein.

15. Radiological features of the adrenal glands :
❑ Plain films of the abdomen
only if calcified
❑ Computed tomography
the adrenal glands can be identified in almost all
subjects.
❑ Magnetic resonance imaging
The adrenals are very well seen on MRI because of
surrounding fat (more easily than with CT).
❑ Ultrasound
In thin individuals the adrenal glands can sometimes
be seen between the kidney and liver on the right
and between the kidney and pancreatic tail on the
left using high resolution scanning.
Calcified adrenal glands

16. Metastases to the Right Adrenal Gland
Adrenal Gland viewed in CT
abdomen
Adrenal Gland viewed in CT
abdomen

17. Urinary Bladder

18. It is divided into four
anatomical parts:
• the apex or dome,
• body,
• fundus,
• and neck.

19. • sphincters are in the urinary
bladder :-
• internal urethral sphincter
regulates involuntary control of
urine flow from the bladder to
the urethra,
• external urethral sphincter
provides voluntary control of
urine flow from the bladder to
the urethra

22. • Blood supply of the bladder :
❖ The bladder is supplied via the internal
iliac artery via vesical arteries
❖ Venous drainage is via a venous plexus to
the internal iliac vein
❖ Lymph drainage : To external iliac and
thence to para-aortic node

23. Venous drainage

24. • Lymphatic drainage

25. THE URETHRA

26. The male urethra runs
from
the internal urethral
sphincter at the neck of
the bladder to the
external urethral orifice
at the tip of the penis.

27. It may be divided into posterior and
anterior parts:
1. The posterior urethra : comprises
the prostatic and membranous
urethra .
2. The anterior part : comprises the
bulbous and penile urethra.

28. • • The prostatic urethra traverses the ventral part of the
prostate and is the widest part
-The lower part of the prostatic urethra is relatively
immobile as the prostate is fixed here by the puboprostatic
ligaments
• membranous urethra it traverses the membranous
urogenital diaphragm, which forms the (voluntary) external
urethral sphincter.
- It is the narrowest part of the urethra . The urethra is
quite immobile at this point.
• bulbous urethra lies in the bulb of the penis It has a
localized dilatation called the intrabulbar fossa. It is
surrounded by the corpus spongiosum
• The penile urethra is long and narrow, except for a localized
dilatation at its termination – the navicular fossa . It is
surrounded by the corpus spongiosum of the penis

29. • The female urethra
• This is 4 cm long.
• It extends from the internal urethral
sphincter at the bladder neck ending
at the external urethral meatus.
Female bladder and sphincters