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Anatomy · Abdomen and pelvis: ureter
Sample itemA 35-year-old man with renal colic has a stone lodged at the pelvic brim on CT. Which vessel is the ureter crossing at this site?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Bifurcation of the common iliac artery
The ureter has three constrictions: the pelviureteric junction, the pelvic brim where it crosses the bifurcation of the common iliac artery, and the vesicoureteric junction. Stones tend to lodge at these sites.
Option by option
A. Inferior vena cava at the level of L3
The ureter lies lateral to the inferior vena cava and descends on psoas, not crossing it.
B. Bifurcation of the common iliac artery (correct)
Correct. The ureter crosses the common iliac bifurcation at the pelvic brim.
C. Aortic bifurcation at L4
The ureter does not cross the aortic bifurcation; it passes lateral to it, on psoas, before crossing the iliac vessels.
D. Origin of the inferior mesenteric artery
The inferior mesenteric artery lies on the left of the aorta and is not crossed by the ureter at the brim.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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