Ureter

URETER

Q. 1

The narrowest valvular part of ureter is:

 A

At pelvic brim

 B

At ischial spine

 C

Pelvic ureteric junction

 D

At the entry of bladder 

Q. 1

The narrowest valvular part of ureter is:

 A

At pelvic brim

 B

At ischial spine

 C

Pelvic ureteric junction

 D

At the entry of bladder 

Ans. D

Explanation:

At the entry of bladder 


Q. 2

Which among the following is NOT related to left ureter:

 A

Quadratus lumborum

 B

Psoas major

 C

Left gonadal vessels

 D

External iliac artery

Q. 2

Which among the following is NOT related to left ureter:

 A

Quadratus lumborum

 B

Psoas major

 C

Left gonadal vessels

 D

External iliac artery

Ans. A

Explanation:

Relations of ureter:

Posterior relations (common to both sides):

  • Psoas major muscle
  • Genito femoral nerve
  • The beginning of the external iliac artery and the adjacent vein

Anterior relations of the left ureter:

  • Upper left colic and sigmoidal vessels cross it
  • Gonadal vessels
  • Pelvic mesocolon and pelvic colon overlap near the pelvic brim
Anterior relations of right ureter:
  • Descending part of duodenum
  • Right colic, gonadal and ileocolic vessels
  • Root of mesentery of small intestine, with superior mesenteric vessels
  • Terminal ileum

Q. 3

Which of the following is the correct relation of ureter in ureteric tunnel to the following structures:

 A

Medial to cervix

 B

Lateral to ovarian artery

 C

Inferior to uterine artery

 D

Superior to uterine artery

Q. 3

Which of the following is the correct relation of ureter in ureteric tunnel to the following structures:

 A

Medial to cervix

 B

Lateral to ovarian artery

 C

Inferior to uterine artery

 D

Superior to uterine artery

Ans. C

Explanation:

Ureters pass from behind, forward through the ureteric tunnel located in the cardinal ligament to reach the bladder pillars located anterior to the uterus. It passes inferior to the uterine artery.

Cardinal ligament (Mackenrodt’s ligament): Is located at the base of broad ligament and are condensation of subserous areolar tissue and fascia extending from the uterus to the lateral pelvic wall on either sides. These ligaments provides support to the uterus and as well as to supravaginal portion of the cervix and upper vagina.

Q. 4

TRUE about ureter’s entry into the bladder:

1. At medial angle of trigone
2. At lateral angle of trigone
3. Make an angle
4. Is straight
5. Valveless
 A

1,3 & 5

 B

2,3 & 5

 C

1,2 & 4

 D

1,3 & 5

Q. 4

TRUE about ureter’s entry into the bladder:

1. At medial angle of trigone
2. At lateral angle of trigone
3. Make an angle
4. Is straight
5. Valveless
 A

1,3 & 5

 B

2,3 & 5

 C

1,2 & 4

 D

1,3 & 5

Ans. B

Explanation:

The ureters enters the bladder wall obliquely to open into it at an angle of its trigone.

Ureter Entry To Bladder

  • Ureteric orifices are placed at the posterolateral trigonal angle.
  • The ureter pierces the bladder wall obliquely, and this provides valve like action ( but not true valve), which prevents reverse flow of urine towards kidneys as bladder fills.

Q. 5

All of the following are true regarding the anatomical relationships of the kidney and ureter, EXCEPT:

 A

Posterior relationships include the diaphragm, the psoas major and quadratus lumborum muscles

 B

The upper pole of the kidney may be in contact with the pleura in the vertebral coastal trigone

 C

The ureter enters the hilus in front of the renal vein

 D

In the female, the ureter passes through the uterosacral ligament and then the lateral cervical ligament before entering the bladder

Q. 5

All of the following are true regarding the anatomical relationships of the kidney and ureter, EXCEPT:

 A

Posterior relationships include the diaphragm, the psoas major and quadratus lumborum muscles

 B

The upper pole of the kidney may be in contact with the pleura in the vertebral coastal trigone

 C

The ureter enters the hilus in front of the renal vein

 D

In the female, the ureter passes through the uterosacral ligament and then the lateral cervical ligament before entering the bladder

Ans. C

Explanation:

The kidneys lie along the vertebral column on the psoas major muscle. Posterior relationships include the diaphragm, the psoas major and quadratus lumborum muscles, and the branches of the lumbar plexus and the twelfth rib. The upper pole of the kidney may be in contact with the pleura in the vertebral coastal trigone.

The ureter, and the renal vessels and nerves enter the kidney at the hilus. The ureter lies behind the renal vessels.
 
The ureter begins at the renal hilum and descends retroperitoneally, crossing the common iliac artery, running along the lateral wall of the pelvis, then turning medially to the bladder. In the female, the ureter passes through the uterosacral ligament and then the lateral cervical ligament before entering the bladder.
 

Q. 6

The narrowest part of ureter is?

 A

At pelvic brim

 B

At ischial spine

 C

Pelvic ureteric junction

 D

At the entry of bladder

Q. 6

The narrowest part of ureter is?

 A

At pelvic brim

 B

At ischial spine

 C

Pelvic ureteric junction

 D

At the entry of bladder

Ans. D

Explanation:

The constrictions of the ureter are three in number as follows : (i) At the junction of pelvis of the ureter with abdominal part of the ureter. (ii) At the pelvic brim. (iii) Where it pierces the bladder. It is narrowest here.
 
Ureter: The ureter is a retroperitoneal, distensible muscular tube that connects the kidney with the bladder. It runs downward and medialward in front of the Psoas major and, entering the pelvic cavity, finally opens into the fundus of the bladder. The slit like lumen of the ureter has a stellate appearance because its mucosa is folded longitudinally.
 
Arteries and veins: The arteries supplying the ureter are branches from the renal, internal spermatic, hypogastric, and inferior vesical.
 
Nerves: The nerves are derived from the inferior mesenteric, spermatic, and pelvic plexuses.
Constrictions – There are three normal anatomical constrictions where a stone from the renal pelvis can become lodged. The sites are;
1) The ureteropelvic junction
2) Site where it crosses the iliac vessels
3) Ureterovesicular junction: Passage of ureter through the bladder wall.

Q. 7

Ureter develops from which of the following embryologic structure?

 A

Mesonephric tubules

 B

Mesonephric duct

 C

Urogenital sinus

 D

Paramesonephric duct

Q. 7

Ureter develops from which of the following embryologic structure?

 A

Mesonephric tubules

 B

Mesonephric duct

 C

Urogenital sinus

 D

Paramesonephric duct

Ans. B

Explanation:

Ureteric bud arise from the mesonephric ducts. The ureter is derived from the part of ureteric bud that lies between the pelvis of the kidney, and the vesico-urethral canal.
 
The permanent kidneys develop from 2 sources, both of which are of mesodermal origin. 1) The metanephric diverticulum (ureteric bud). 2)The metanephric mesoderm.
 
Ref: Human Embryology INDERBIR SINGH 6th Ed Page 269.

 


Q. 8

Ureteric construction is seen at all the following positions, EXCEPT :

 A

Ureteropelvic junction

 B

Ureterovesicle junction

 C

Crossing of iliac artery

 D

Ischial spine

Q. 8

Ureteric construction is seen at all the following positions, EXCEPT :

 A

Ureteropelvic junction

 B

Ureterovesicle junction

 C

Crossing of iliac artery

 D

Ischial spine

Ans. D

Explanation:

D i.e. Ischial spine


Q. 9

True about ureter’s entry into bladder:

 A

At medial angle of trigone

 B

At lateral angle of trigone

 C

Make an angle

 D

b & C

Q. 9

True about ureter’s entry into bladder:

 A

At medial angle of trigone

 B

At lateral angle of trigone

 C

Make an angle

 D

b & C

Ans. D

Explanation:

B i.e. At lateral angle of trigone; C i.e. Make an angle


Q. 10

About ureter – true is:

 A

5 cm long

 B

25 cm long

 C

A and B both

 D

Only B

Q. 10

About ureter – true is:

 A

5 cm long

 B

25 cm long

 C

A and B both

 D

Only B

Ans. D

Explanation:

B i.e. 25 cm long


Q. 11

True about ureter:

 A

Starts at the hilum

 B

Changes its direction at the ischial spine.

 C

Penetrates the bladder wall without any valve.

 D

All

Q. 11

True about ureter:

 A

Starts at the hilum

 B

Changes its direction at the ischial spine.

 C

Penetrates the bladder wall without any valve.

 D

All

Ans. D

Explanation:

A i.e. Starts at hilum; B i.e. Changes its direction at the ischial spine; C i.e. Penetrate the bladder wall without any valve


Q. 12

Ureter derives its blood supply from:

 A

Renal artery

 B

Gonadal vessel

 C

Common iliac artery

 D

All

Q. 12

Ureter derives its blood supply from:

 A

Renal artery

 B

Gonadal vessel

 C

Common iliac artery

 D

All

Ans. D

Explanation:

A i.e. Renal artery; B i.e. Gonadal vessel; C i.e. Common iliac artery


Q. 13

TRUE about ureter is:

 A

Gonadal vessels lie anterior to it

 B

It lies in front of great vessels

 C

About 50 cm. long

 D

Nerve supply from T8-Tio

Q. 13

TRUE about ureter is:

 A

Gonadal vessels lie anterior to it

 B

It lies in front of great vessels

 C

About 50 cm. long

 D

Nerve supply from T8-Tio

Ans. A

Explanation:

A. i.e. Gonadal vessels lie anterior to it


Q. 14

Lt ureter is related to:

 A

Quadratus Lumborm

 B

Lt gonadal vessels

 C

Superior mesenteric vein

 D

All

Q. 14

Lt ureter is related to:

 A

Quadratus Lumborm

 B

Lt gonadal vessels

 C

Superior mesenteric vein

 D

All

Ans. B

Explanation:

. B. i.e. Lt. gonadal vessels


Q. 15

All of the following structures cross the Right Ureter Anteriorly, Except:

 A

Terminal ileum

 B

Vas deferens

 C

Genitofemoral nerve

 D

Right Colic and ileo colic vessels

Q. 15

All of the following structures cross the Right Ureter Anteriorly, Except:

 A

Terminal ileum

 B

Vas deferens

 C

Genitofemoral nerve

 D

Right Colic and ileo colic vessels

Ans. C

Explanation:

C i.e. Genitofemoral nerve 

Ureter is supplied by renal, gonadal (testicular or ovarian), Colic, aorta, iliac (common & internal), vesicle (superior & inferior) middle rectal & uterine arteries.


Q. 16

Blood supply of Lt ureter are:

 A

Uterine artery

 B

Inferior vesicle artery

 C

Testicular artery

 D

All

Q. 16

Blood supply of Lt ureter are:

 A

Uterine artery

 B

Inferior vesicle artery

 C

Testicular artery

 D

All

Ans. D

Explanation:

A. i.e. Uterine A.; B. i.e. Inferior Vesicle A.; C. i.e. Testicular A


Q. 17

Epithelium of ureter develops from?

 A

Mesonephros

 B

Metanephros

 C

Pronephros

 D

Paramesonephric duct

Q. 17

Epithelium of ureter develops from?

 A

Mesonephros

 B

Metanephros

 C

Pronephros

 D

Paramesonephric duct

Ans. A

Explanation:

A i.e., Mesonephros


Q. 18

The ureter is lined by….epithelium ‑

 A

Stratified squamous

 B

Cuboidal

 C

Cilliated columnar

 D

Transitional

Q. 18

The ureter is lined by….epithelium ‑

 A

Stratified squamous

 B

Cuboidal

 C

Cilliated columnar

 D

Transitional

Ans. D

Explanation:

D i.e. Transitional


Q. 19

The narrowest part of the ureter is at the

 A

Uretero-pelvic junction

 B

Iliac vessel crossing

 C

Pelvic ureter

 D

Uretero-vesical junction

Q. 19

The narrowest part of the ureter is at the

 A

Uretero-pelvic junction

 B

Iliac vessel crossing

 C

Pelvic ureter

 D

Uretero-vesical junction

Ans. D

Explanation:

Ans. is ‘d’ i.e. Uretero-vesical junction 


Q. 20

Length of ureter is:         

 A

15 cm

 B

20 cm

 C

25 cm

 D

30 cm

Q. 20

Length of ureter is:         

 A

15 cm

 B

20 cm

 C

25 cm

 D

30 cm

Ans. C

Explanation:

 25 cm


Q. 21

Constrictions in ureter are seen at all of the following sites EXCEPT:  

 A

At the pelviureteric junction

 B

At the brim of lesser pelvis

 C

At the crossing by external iliac artery

 D

Passage through bladder wall

Q. 21

Constrictions in ureter are seen at all of the following sites EXCEPT:  

 A

At the pelviureteric junction

 B

At the brim of lesser pelvis

 C

At the crossing by external iliac artery

 D

Passage through bladder wall

Ans. C

Explanation:

Ureters is slightly constricted at 5 places. One site is at the point of crossing of ureter by ductus deferens or broad ligament of uterus.


Q. 22

True about ureters are all except: 

 A

Constricted at three places

 B

It is 25cm long

 C

Testicular vessels lie anteriorly to the ureters

 D

It is lined by cuboidal epithelium

Q. 22

True about ureters are all except: 

 A

Constricted at three places

 B

It is 25cm long

 C

Testicular vessels lie anteriorly to the ureters

 D

It is lined by cuboidal epithelium

Ans. D

Explanation:

The ureter emerges from the hilum of the kidney and runs vertically downward behind the parietal peritoneum (adherent to it) on the psoas muscle, which separates it from the tips of the transverse processes of the lumbar vertebrae. It enters the pelvis by crossing the bifurcation of the common iliac artery in front of the sacroiliac joint . The ureter then runs down the lateral wall of the pelvis to the region of the ischial spine and turns forward to enter the lateral angle of the bladder.

Relations, Right Ureter

Anteriorly: The duodenum, the terminal part of the ileum, the right colic and ileocolic vessels, the right testicular or ovarian vessels, and the root of the mesentery of the small intestine.

Posteriorly: The right psoas muscle, which separates it from the lumbar transverse processes, and the bifurcation of the right common iliac artery.

Relations, Left Ureter

Anteriorly: The sigmoid colon and sigmoid mesocolon, the left colic vessels, and the left testicular or ovarian vessels. Posteriorly: The left psoas muscle, which separates it from the lumbar transverse processes, and the bifurcation of the left common iliac artery.



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