Describe general position of kidney
They extend from level of upper border of the 12th thiracic vertebra sup to 3rd lumbar vertebra inf.
Right kidney is 1/2 inch below left
The long axis of kidney is directed……., while its inf pole is positioned……
Superomedially
1 inch above iliac crest
What is the effect of slopping of paravertebral gutter on kidney postion?
Its anterior surface is directed anterolaterally and its posterior surface is directed posteromedially
Describe arrangement of structures in hilum of kidney
Ant: renal vein
Int: renal artery
Post: renal pelvis (pelvis of ureter)
The hilum of kidney leads to….. which is lined by…..and occupied by……
Renal sinus
Renal capsule
Renal pelvis & renal vessels
Describe posterior relations of kidneys
- Diaphragm separating it from costodiaphragmatic pleura, 12th rib on rt & 11 & 12 on left.
- Psoas major (med)
- Quadratus lumborum (int, separated from kid by subcostal n&v, iliohypogastric & ilioinguinal ns)
- Transversus abdominis
Describe relations of ant surface of right kidney
- Right suprarenal
- 2nd part of duodenum
- Right lobe of liver
- Right colic flexure
- Coils of small intestine & ascedning branch of right colic art
1, 2, 4 are devoid of peritoneum
Describe relations of ant surface of left kidney
- Left suprarenal
- Spleen
- Body of Pancreas & splenic vessels
- Stomach
- Left colic flexure & beginning of descending colon
- Coils of jejunum & branches of left colic vessels
Write a short note on coverings of the kidney
- True fibrous capsule
- Perirenal fat (if absorbed results in ptosis)
- Renal fascia (surrounds kidney & suprarenal around perirenal fat, continuous laterally with fascia transversalis, medially with fascia around the renal blood vessels, aorta & IVC, sup cont with diaphragmatic facsia, inf it remains free in front & behind the ureter into the pelvis.
- Pararenal fat
The renal arteries arise from abdominal aorta at level of….., it gives……& then divides into…….
L2
Inferior suprarenal art
5 segmental arteries (end arteries)
……renal vein recieves 2 other veins before draining into……
Left
IVC
Describe lymph drainage & nerve supply of kidneys
N.S.: by renal plexus & lowest splanchnic nerve which are vasomotor in function
LD: lateral aortic LNs
Describe projection of kidney to anterior body surface
- Upper pole, 1 inch from midline opposite upper end of T12
- The hilum is 2 inches from midline approx. at transpyloric p (L1) slightly medial to tip of 9th costal cartilage, so hilum of rt k is below while lt is above that plane
- The lower pole is 3 inches from midline opposite L3 vertebra
Describe projection of kidney on posterior surface of body
Morris parallelogram:
2 vertical lines, one ince & 3 inches from midline
2 horizontal planes are drawn opposite spines of T11 & L3 vertebrae
