Anatomy of the kidney and ureter

Abstract 

The surgical trainee must have a competent knowledge of the anatomical relations of the kidneys, their macroscopic internal structure, blood and nerve supply, lymphatic drainage and segmental anatomy. The renal fascia delimits extravasation of blood in kidney rupture. The suprarenal gland lies in its own fascial capsule and remains safely in place in renal mobilization unless adherent in severe inflammatory scarring or neoplastic invasion. The ureter comprises a pelvis and an abdominal pelvic and intravesical portion and has three sites of narrowing (where calculi are most likely to impact). The intravesical part acts as a sphincter mechanism. The pelvic ureter is crossed superficially only by the vas deferens, while it is crossed by the broad ligament and the uterine vessels in the female. At operation, the ureter is identified as it crosses the bifurcation of the common iliac artery, to lie on the internal iliac. This is confirmed by its peristalsis when gently squeezed.

Keywords:  renal and urology , renal hilium and contents , calyces , fascial coats , blood supply , ureter identification , intravesical sphincter.

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