Kidney, suprarenal gland & Ureter Flashcards
Kidney is located opposite —- Vertebrae
T12-L3 vertebrae
Right kidney reach up to —— meanwhile left kidney reaches up to ——, therefore left kidney is higher than right kidney by —- inch
- 11th intercostal space
- 11th rib
- 1/2 an inch
Long axis of the kidney is directed upwards, backward & medial; therefore—–
upper poles of the 2 kidneys are closer to each other than the lower poles
Dimentions of the kidney
4,2,1
* 4 inches long
* 2 inches wide
* 1 inch thick
Site of the hilum of kidney
lies at the Transpyloric plane (L1):
* transpyloric plane crosses lower part of left hilum of left kidney
* transpyloric plane crosses upper part of right hilum of kidney
hilum leads to space inside called
renal sinus
Contents of Hilum of kidney
VAP (from anterior to posterior):
* Renal Vein (most Ant.)
* Renal Artery (middle)
* Pelvis of ureter (most post.)
Posterior relations of the kidney
Same for both kidneys (4 muscles & 4 neuromuscular structures between them and the muscles):
* Diaphragm (medial & lateral Arcuate ligaments): seperates Kidney from costodiaphragmatic recess of pleura, 11th&12th ribs at left kidney, 12th rib at right kidney
* Psoas major: close to medial border of kidney
* Transversus abdominus: close to lateral border of kidney
* Quadratus lumborum: area between transversus abdominis & Psoas Major
4 Neurovascular Structures between kidney & muscles:
* Ilioinguinal N
* Iliohypogastric N
* Subcostal N
* Subcostal vessels
Medial & lateral Arcute ligaments/ Diaphragm seperates kidney from
- Both kidneys: seperates them from Costodiaphragmatic recess of pleura
+
* Left kidney: from 11th & 12th rib
* Right kidney; from 12th Rib
Anterior relations of Right kidney
5 parts of kidney + Ascending br. of right Colic A
* Right Suprarenal gland (upper medial part)
* 2nd part of Duodenum (close to hilum)
* Right lobe of liver (upper lateral part)
* Loops of Jejunum (lower medial part)
* Right colic flexure (lower lateral part)
* Ascending branch of right Colic A (ascends in front of lower end of kidney to reach right Colic Flexure)
Anterior Branches of Left Kidney
*6 part of left kidney + Ascending br. of Sup. left Colic A *
* Left suprarenal Gland (upper medial part)
* Spleen (upper lateral part)
* Body of pancreas & splenic Vessels (quadrilateral area in the middle 1/3)
* Stomach (in a triangular area bounded by suprarenal gland, spleen & Pancreas)
* Jejunum (lower medial Part)
* End of Transverse colon & beginning of descending colon (lower lateral)
* Ascending branch of Sup. left Colic A
Describe peritoneal Relations of Right Kidney
Right Kidney is Anteriorly Covered by Peritoneum at:
* Hepatic Area (upper lateral Part)
* jujenal Area (lower medial)
The rest of the areas (duodenal, right Colic, right Suprarenal) are not Covered
Describe peritoneal Relations of Left Kidney
Left Kidney is Anteriorly Covered by peritoneum at:
* Splenic Area (upper lateral part)
* Gastric Area (quadrilateral part in the middle)
* jujenal Area (lower medial Part)
the rest of the Areas ( left suprarenal, Pancreatic, Colic ) are not covered
Enumerate & describe coverings of Kidney from within outwards
- Renal (true fibrous) Capsule: Closely surrounds kidney & can be stripped off, Continues over renal sinus
- Perirenal fat
-
Renal Fascia (Zukercandle’s fascia):
* Arises from Fascia transversalis
* encloses suprarenal gland by fusing above
* remains seperate below - Pararenal Fat: Condensed retroperitoneal fat Surrounding renal fascia
origin of Renal Artery
from Abdominal Aorta opposite upper border of L2 Vertebra
Compare between Left renal Artery & RIght Renal Artery
- Left renal Artery is shorter than Right renal A
- Left Renal Artery lies behind only its Vein (left renal Vein), Right renal Artery lies behind left renal Vein, IVC, right Renal Vein (veino w Vein ely 8eiro)
Lymphatic Drainage of Kidney
Hilar Lymph node (around Renal A), the to Para-Aortic Lymph node
Nerve supply of Kidney
Sympa & parasympa from Renal Plexus around renal A, derived from Celiac Plexus
Describe surface anatomy of kidney projected at posterior abdominal wall (Morris’ parallelogram)
- upper Horizontal line: T11
- Lower Horizontal Line: L3
- Medial Vertical Line: 1 inch from median Plane
- Lateral vertical Line: 3 inches from Median Plane
Hilum: 2 inches from midline opposite L1 (transpyloric plane)
Surface Anatomy of Kidney projected from Anterior abdominal wall
- upper end: 1 inch from midline
- Hilum: 2 inches from midline
- Lower end: 3 inches from midline
Shape of Suprarenal Gland
- Right Suprarenal Gland: triangular
- Left suprarenal gland: semilunar
Site of Suprarenal gland
- Right Suprarenal gland: on upper pole of right kideny without reaching hilum
- Left Suprarenal gland: on upper pole of left kidney but part of it reaches hilum
Direction of Hilum of Suprarenal gland
- Right Suprarenal gland: hilum directed upwards
- Left suprarenal gland: hilum directed downwards
Anterior relations of Suprarenal gland
- Right Suprarenal gland: IVC, bare area of right lobe of liver
- Left Suprarenal gland: Stomach & lesser sac
Posterior relations of Suprarenal gland
Crus of Diaphragm
Medial relations Suprarenal gland
Coeliac ganglion
Peritoneal Covering of suprarenal gland
- Right Suprarenal gland: bare superior, covered inferior
- Left Suprarenal gland: bare Inferior, covered superior
Venous Drainage of Suprarenal gland
Right Suprarenal gland: right Suprarenal Vein (draining into IVC)
Left Suprarenal gland: left Suprarenal Vein (draining into left Renal V)
Arterial Supply of Suprarenal gland
- Superior Suprarenal A: from phrenic A
- Middle Suprarenal A: from Aorta
- Inferior Suprarenal A: from Renal A
