Kidneys (Daves notes) Flashcards
Describe the location of the kidneys
High up on the posterior abdoinal wall behind the peritoneum, under cover of the costal margin. Lies obliquely with long axis parallel with the lateral border of psoas
Where is the vascular pedicle of the kidney found?
Well back in the paravertebral gutter, with hilum facing forwards and medially
What is the renal pelvis?
The funnel shaped commencement of the ureter, normally most posterior ??
What is the normal size and weight of a kidney?
12x6x33cm and weighs about 130gm
What renal landmark is associated with the transpyloric plane?
The right hilum lies just below and the left just above
Describe the renal coatings
The kidney is encapsulated, with perinephric fat outside, which is more solid than other fat. The renal fascia (Gerotas) surrounds teh prinephric fat and separates the kidney from the suprarenal galnd
What structure is between the right hilum and the peritoneum?
D2
What structure is between the left hilum and the peritoneum?
Tail of pancreas
What structure is between the lateral part of the right lower pole and the peritoneum?
The hepatic flexure
What structure is between the lateral part of the left lower pole and the peritoneum?
The splenic flexure
What structure is between the medial part of the right lower pole and the peritoneum?
This is in contact with peritoneum. The ascending right colic artery also though.
What structure is between the medial part of the left lower pole and the peritoneum?
This is in contact with peritoneum but also the upper left colic artery is found here
What structure is found between the posterior aspect of the right kidney and the peritoneum?
Diaphragm, quadratus lumborum, laterally transversus abdominus
What structure is found between the posterior aspect of the left kidney and the peritoneum?
Diaphragm, quadratus lumborum, laterally transversus abdominus
What structure is found between the upper half of the right kidney and the peritoneum?
The peritoneum of the hepatorenal pouch
What structure is found between the upper half of the left kidney and the peritoneum?
The peritoneum of the lesser sac (part of the stomach bed)
Describe the arterial supply to the kidney
The renal arteries have a supply rate of approximately 1L/minute, each being the sole supply to one of five segments, with no collateral flow
What are the five arterial supply segments of the kidney?
anterior (apical, upper, middle, lower) and posterior
What vascular communication is there between kidney segments?
There is no arterial communication but the veins communicate profusely
Describe the locations of the vein, ureter and arteries in the renal hilum reletive to one another
Vein, artery, ureter anterior to posterior
Where does renal lymph drain to?
Para-aortic nodes (upper pole may drain to posterior mediastinum)
What is the nerve supply of the kidney?
Parasympathetic and sympathetic
Describe the course and action of the sympathetic supply of the kidney
T12-L1 to splanchnic nerves then to coeliac nerves, then renal and superior hypogastric plexus. Vasomotor in function.
Describe the course and action of the parasympathetic supply of the kidney
??Course. Present with no real function.
What is the afferent nerve supply to the kidney?
With sympathetic fibres and probably also with parasympathetic (?nausea)
structure
see histology notes
Describe the development of the kidney
An indeterminate cell mass ??in the pelvis forms tubules which form the metanephros. A bud forms and ascends, developing into the kidney
Describe the development of the renal blood supply
The definitive kidney (metanephros) develops in the pelvis and is supplied by the internal iliac artery. It migrates upwards and is sequentially supplied by the common iliac and then the aorta; old blood supplies degenerating as new ones form.
