Kidney Flashcards
What is the function of the kidney?
to remove water, salts, and products of protein metabolism from the blood
Describe the kidney’s location.
- posterior-most organ in the abdomen
- bean-shaped retroperitoneal organ
- extends from T12 to L3
- right kidney lies slightly lower than the left due to the large size of the right lobe of the liver
- kidneys lie anterior to the psoas major and lateral to the vertebral column within the paravertebral grooves
What is the relationship between the kidney and psoas major?
Because the kidney rests on top of the psoas, a strained psoas major muscle is sometimes mistaken for kidney pain
What are the surfaces of the kidney?
- anterior
- posterior
What are the borders of the kidney?
- medial
- lateral
What are the poles of the kidney?
- superior
- inferior
Where is the hilum of the kidney located?
a vertical fissure located on the medial surface
What does the hilum of the kidney transmit?
- renal vein (anteriorly)
- renal artery (between renal vein and ureter)
- ureter (posteriorly)
- autonomic and sensory nerves
What is the renal pelvis?
the expanded superior end of the ureter within the hilum
What is the renal sinus?
a recess located within the hilum, which is filled with fat
What is the renal pedicle?
the structures which enter the hilum are known collectively by this term
What is the renal cortex?
the outer portion of the kidney
What are the renal columns?
projections of the cortex into the medulla between the renal pyramids
What is the renal medulla?
- the inner portion of the kidney
- includes 8-12 renal pyramids
What is a renal pyramid?
terminates in an apex known as the renal papilla
What are the minor calices?
cup shaped structures into which the renal papillae fit
What are the major calices?
- 2 to 3 major channels into which the minor calices empty
- the major calices empty into the renal pelvis
What is the blood supply to the kidney?
- Artery: renal artery (from the abdominal aorta)
- Extrahilar arteries
- Vein: renal vein (drains to the inferior vena cava)
What are the extrahilar arteries?
accessory arteries which may originate from the abdominal aorta above or below the renal artery
What does the left renal vein drain?
- left kidney
- suprarenal gland
- gonad
- diaphragm
- body wall
Describe anatomical nutcracker.
- left renal vein and third part of the duodenum may be compressed between aorta behind and superior mesenteric artery in front
- this may lead to left side kidney failure and vomiting if the third part of the duodenum is compressed
- causes:
1. compressive abdominal trauma
2. application of body cast (cast syndrome)
3. aortic aneurysm (abdominal, AAA)
What is the innervation of the kidney?
Renal plexus, formed by fibers from the:
- celiac plexus
- aortic plexus
- direct branches from the thoracic and lumbar splanchnic nerves
What are the layers covering the kidney?
- renal capsule (innermost layer)
- perinephric fat (immediately outside renal capsule)
- renal fascia (anterior and posterior layer)
- paranephric fat (outermost layer)
What is the function of fat around the kidneys?
- protection
- insulation
- support
What is the renal fascia?
a membranous layer of extraperitoneal tissue which splits to enclose the kidney
What is gout caused by?
- Adkin’s diet
- eating meat, drinking beer
- due to uric acid
- not related to kidney stones
What are renal calculi?
- kidney stones may be composed of:
1. calcium oxalate
2. calcium phosphate
3. uric acid - Produce a dull ache in the kidney. When they enter the ureter, they cause severe pain.
- May become lodged at one of three constrictions of the ureter, restricting urinary flow.
- Risk factors:
1. being male
2. low fluid intake/dehydration
3. southern USA - Extracorporeal shock-wave lithotripsy (ESWL) may be used to break them up.
Describe nephroptosis.
- the kidney becomes hypermobile and moves downward within the renal fascia
- may descend into the pelvis
- it sometimes turns upside down, twisting blood vessels and the ureter
- more common in very thin people
