Kidneys and adrenal glands

Question 1

describe the location of the kidneys

Answer 1

Lie in retro-peritoneum, one on either side of upper lumbar vertebrae.
Mostly covered by costal margin
Right is lower than the left, due to presence of liver on RHS
Hilum of kidney lies in transpyloric plane 5cm from midline

Question 2

What is the kidney surrounded by?

Answer 2

Has a fibrous capsule covered in perinephric fat - this is covered by a renal fascia (created by splitting of tranversalis fascia)

Question 3

What are the posterior relations of the kidney?

Answer 3

4 MUSCLES of posterior abdominal wall:
diaphragm
quadratus laborum
transversus abdominis
psoas major

Question 4

What are the anterior relations of the right kidney?

Answer 4

Liver
Duodenum (2nd part)
Intestines (hepatic flexure of colon)

Question 5

What are the anterior relations of the left kidney?

Answer 5

stomach
spleen
pancreas
intestine (splenic flexure of colon)

Question 6

What are the components of the hilum of the kidney?

Answer 6

Renal vein
Renal artery
Renal pelvis / upper ureter (most posterior)

Question 7

How are the medullary pyramids related to the renal pelvis?

Answer 7

Apex of pyramid projects into the minor calx as renal papilla. 1-3 papilla per minor calyx. Minor calyces combine to form 2-3 major calyces which open into the renal pelvis

Question 8

Blood Supply of kineys?

Answer 8

Renal artery –> divides into anterior and posterior branches at hilum –> 5 segmental arteries, 1 to each lobe –> Interlobar arteries (1 fpr each pyramid and ajoining cortex)–> arcuate arteries –> interlobular arteries –> afferent arterioles –> glomerular capillaries –> peritubular capillaries –> efferent arteriole

Question 9

How many lobes does the kidney have?

Answer 9

5 - apical, upper, middle, lower, posterior

Question 10

Suprarenal / adrenal gland location
Shape of each
Relations of each

Answer 10

Sits on top of kidneys, embedded in perinephric fat.
R- tetrahedral, lies behind liver (bare area) and IVC
L - crescent-shaped, lies behind stomach and pancreas

Question 11

Blood supply of adrenal gland

Answer 11

Supplied by 3 arteries - branches of aorta, renal artery, inferior phrenic artery.
Drained by 1 vein = adrenal vein. R adrenal vein joins IVC L joins L renal vein