Kidneys

Question 1

Urinary system
* Consists of the following structures:

Answer 1

• 2 kidneys
• 2 ureters
• 1 urinary bladder
• 1 urethra

Question 2

Question 3

The kidneys are

Answer 3

Retroperitoneal.

Question 4

Vertebral level of the kidneys:

Answer 4

T12 – L3
(change during respiration: 2-3cm and with posture).

Question 5

Superior parts of kidneys are deep to

Answer 5

ribs 11 & 12.

Question 6

Hilum of left kidney is near

Answer 6

transpyloric plane, approx. 5cm from median plane.

Question 7

Transpyloric plane passes through superior pole of

Answer 7

right kidney (2.5cm lower than left pole).

Question 8

Inferior pole of right kidney is

Answer 8

uperior to iliac crest.

Question 9

Question 10

Kidneys covered by

Answer 10

a renal capsule and 3 layers:

Question 11

3 layers

Answer 11

Perinephric fat
Renal fascia
Paranephric fat

Question 12

Perinephric fat

Answer 12

– surrounds kidney & vessels, extends into renal sinuses

Question 13

Renal fascia

Answer 13

– encloses kidneys, suprarenal glands & perinephric fat (continuous with psoas major, diaphragmatic & transversalis fascia, fascia covering abdominal aorta and inferior vena cava, inferiorly it encloses the ureters).

Question 14

Paranephric fat

Answer 14

– superficial to renal fascia.

Question 15

Question 16

Kidney: External structure

Answer 16

• Surfaces – anterior & posterior.
• Covered by fibrous renal capsule.
• Poles – superior & inferior.
• Supra-renal (adrenal) glands located on superior pole.
• Margins - lateral & medial:
  ➢Renal hilum – structures enter/exit.
  ➢Continuous with renal sinus (perinephric fat)
  ➢renal vein anterior, renal artery middle, renal pelvis posterior.
  ➢Lymphatics & nerves.

Question 17

Question 18

Kidney: Internal structure

Answer 18

Renal cortex
Renal medulla
Renal sinus

Question 19

Renal cortex

Answer 19

– outer layer & extensions into medulla between pyramids: renal columns.

Question 20

Renal medulla:

Answer 20

• Inner layer.
• Forms renal pyramids:
  – apex (papilla) terminates into minor calyx.
• Minor calyx receives urine from papillary ducts.
• Minor calyces join to form major calyx. * Major calyces join to form renal pelvis.

Question 21

Renal sinus – contains:

Answer 21

• Major & minor calyces.
• Renal pelvis (forms ureter).
• Blood vessels, nerves & fat.

Question 22

Question 23

Question 24

Question 25

Question 26

Kidney: Blood supply

Answer 26

• Renal arteries arise from abdominal aorta (lateral branches).
• Originated inferior to superior mesenteric artery: between L1 and L2.
• Left renal artery: higher than the right.
• Right renal artery: longer, passes
  posterior to inferior vena cava.
• Venous drainage: left and right renal veins.
• Left renal vein is longer, crosses midline anterior to abdominal aorta, posterior to superior mesenteric artery.
• Renal arteries divide close to the hilum into five segmental arteries.
• Each one supplies a specific segment of the kidney.

Question 27

Question 28

Question 29

Lymphatic drainage of kidney:

Answer 29

lateral aortic (lumbar) nodes around origin of renal artery.

Question 30

Kidney: Innervation

Answer 30

Sympathetic:
* From T12 level = Least splanchnic nerve, sometimes contribution from L1, synapse in superior mesenteric ganglia

Parasympathetic:
* Vagus nerve

Question 31