1.1 Anatomy

Question 1

At what spinal level is the renal hilum located? Which structures enter and exit the kidney at the hilum?

Answer 1

L1

Renal artery, renal vein, ureters

Question 2

Which rib and spinal level is associated with the superior margin of the kidney?

Which spinal level is asscoiated with the inferior margin of the kidney?

Answer 2

Superior margin: The 12th rib/ T12. The left may be closer to T11 and right closer to T12 (R kidney sits lower in the abdominal cavity).

Inferor margin: L3 (L2-L4 depending on which kidney)

(We have 12 pairs of ribs in total, although only the first 7 pairs are referred to as ‘true’ ribs).

Question 3

Why is the right kidney lower in the abdomen than the left kidney?

Answer 3

The liver is also on the right side and its presence pushes the right kidney lower down

Question 4

What height difference (cm) between your two kidneys is unusual and should be further investigated?

What’s the minimum height for a healthy adult kidney?

Answer 4

More than 2cm

8cm, so anything below should be investigated. May be chronic kidney disease.

Question 5

Do the kidneys sit within the peritoneal cavity or behind it?

Answer 5

Kidneys are retroperitoneal

Question 6

What’s the menumonic to remember retroperitoneal viscera (organs?)

Answer 6

SAD PUCKER

Suprarenal (adrenal) glands, Abdominal aorta & IVC, Duodenum (except the cap- first 2cm)

Pancreas, Ureters, Colon (not transverse), Kidneys, Esophagus, Rectum