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ureter may be found immediately anterior to the origin of the
Clinical VignetteA clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.
During an abdominal surgical procedure, the surgeon wishes to locate the ureter in order to ensure that it is not injured. The ureter may be found immediately anterior to the origin of the
A. common iliac artery
B. external iliac artery
C. internal iliac artery
D. gonadal artery
E. renal artery
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
Ans is B since ureter leaves the renal pelvis and lies on the posterior abdominal wall as it descends to the pelvis. It crosses the pelvic brim at the level of the bifurcation of the common iliac artery. At this point it crosses anterior to the origin of the external iliac artery to enter the pelvis.
The ureter leaves the renal pelvis and lies on the posterior abdominal wall as it descends to the pelvis. It crosses the pelvic brim at the level of the bifurcation of the common iliac artery. At this point it crosses anterior to the origin of the external iliac artery to enter the pelvis.
The origin of the common iliac artery (choice A) is at the bifurcation of the abdominal aorta, which occurs at the level of the fourth lumbar vertebra in the midline of the abdomen. Both ureters are lateral to the aortic bifurcation.
The origin of the internal iliac artery (choice C) is at the bifurcation of the common iliac artery, which occurs at about the level of the first sacral vertebra. The ureter and the internal iliac artery both enter the pelvis with the ureter on the lateral side of the artery.
The origin of the gonadal artery (choice D) (either the testicular artery or the ovarian artery) is from the abdominal aorta at a variable level, usually between the renal artery and the inferior mesenteric artery. The ureters are lateral to the origin of this artery.
The origin of the renal artery (choice E) is from the abdominal aorta at about the level of the second lumbar vertebra. The renal arteries pass laterally to enter the renal pelvis. At this site, the ureter is posterior to the artery.
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
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