Kidneys (Daves notes)

Question 1

Describe the location of the kidneys

Answer 1

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

Question 2

Where is the vascular pedicle of the kidney found?

Answer 2

Well back in the paravertebral gutter, with hilum facing forwards and medially

Question 3

What is the renal pelvis?

Answer 3

The funnel shaped commencement of the ureter, normally most posterior ??

Question 4

What is the normal size and weight of a kidney?

Answer 4

12x6x33cm and weighs about 130gm

Question 5

What renal landmark is associated with the transpyloric plane?

Answer 5

The right hilum lies just below and the left just above

Question 6

Describe the renal coatings

Answer 6

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

Question 7

What structure is between the right hilum and the peritoneum?

Answer 7

D2

Question 8

What structure is between the left hilum and the peritoneum?

Answer 8

Tail of pancreas

Question 9

What structure is between the lateral part of the right lower pole and the peritoneum?

Answer 9

The hepatic flexure

Question 10

What structure is between the lateral part of the left lower pole and the peritoneum?

Answer 10

The splenic flexure

Question 11

What structure is between the medial part of the right lower pole and the peritoneum?

Answer 11

This is in contact with peritoneum. The ascending right colic artery also though.

Question 12

What structure is between the medial part of the left lower pole and the peritoneum?

Answer 12

This is in contact with peritoneum but also the upper left colic artery is found here

Question 13

What structure is found between the posterior aspect of the right kidney and the peritoneum?

Answer 13

Diaphragm, quadratus lumborum, laterally transversus abdominus

Question 14

What structure is found between the posterior aspect of the left kidney and the peritoneum?

Answer 14

Diaphragm, quadratus lumborum, laterally transversus abdominus

Question 15

What structure is found between the upper half of the right kidney and the peritoneum?

Answer 15

The peritoneum of the hepatorenal pouch

Question 16

What structure is found between the upper half of the left kidney and the peritoneum?

Answer 16

The peritoneum of the lesser sac (part of the stomach bed)

Question 17

Describe the arterial supply to the kidney

Answer 17

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

Question 18

What are the five arterial supply segments of the kidney?

Answer 18

anterior (apical, upper, middle, lower) and posterior

Question 19

What vascular communication is there between kidney segments?

Answer 19

There is no arterial communication but the veins communicate profusely

Question 20

Describe the locations of the vein, ureter and arteries in the renal hilum reletive to one another

Answer 20

Vein, artery, ureter anterior to posterior

Question 21

Where does renal lymph drain to?

Answer 21

Para-aortic nodes (upper pole may drain to posterior mediastinum)

Question 22

What is the nerve supply of the kidney?

Answer 22

Parasympathetic and sympathetic

Question 23

Describe the course and action of the sympathetic supply of the kidney

Answer 23

T12-L1 to splanchnic nerves then to coeliac nerves, then renal and superior hypogastric plexus. Vasomotor in function.

Question 24

Describe the course and action of the parasympathetic supply of the kidney

Answer 24

??Course. Present with no real function.

Question 25

What is the afferent nerve supply to the kidney?

Answer 25

With sympathetic fibres and probably also with parasympathetic (?nausea)

Question 26

structure

Answer 26

see histology notes

Question 27

Describe the development of the kidney

Answer 27

An indeterminate cell mass ??in the pelvis forms tubules which form the metanephros. A bud forms and ascends, developing into the kidney

Question 28

Describe the development of the renal blood supply

Answer 28

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.