Renal Anatomy

Question 1

What surrounds the kidneys immediately?

Answer 1

The kidneys are surrounded by perinephric fat (perirenal fat capsule) that extends into the renal sinuses

Question 2

What surrounds the kidneys, suprarenal glands and the perirenal fat capsule?

Answer 2

These are enclosed (except inferiorly) by membranous renal fascia which continues medially to ensheath the renal vessels.
Inferomedially the renal fascia continues along the ureter as the periureteric fascia.

Question 3

What is external to the renal fascia?

Answer 3

The paranephric fat (pararenal fat body)

Question 4

What structures hold the kidneys in a relatively fixed position?

Answer 4

The collagen bundles sent out from the renal fascia through the paranephric fat, renal fascia, peri and paranephric fat, the renal vessels and ureter all act to anchor the kidneys.

Question 5

When does movement of the kidneys occur?

Answer 5

During respiration and when changing from the supine to erect position. normal movement is around 3cm.

Question 6

What is the basic function of the kidneys?

Answer 6

To remove excess water, salts and wastes of protein metabolism from the blood whilst returning nutrients and chemicals.

Question 7

What is the vertebral level of the kidneys?

Answer 7

T12-L3

Question 8

What are the heights of the kidneys in relation to one another and the transpyloric plane?

Answer 8

The right kidney is 2.5cm lower than the left. This means the transpyloric plane passes through the hilum of the left kidney and the superior pole of the right.

Question 9

What is the usual surgical approach to the kidneys and how can they be located?

Answer 9

Usually through the posterior abdominal wall and the inferior pole of the right kidney is located approximately a fingers breath superior to the iliac crest.

Question 10

what seperates the kidney from the liver?

Answer 10

The hepatorenal recess

Question 11

What are the order of the vessels at the renal hila?

Answer 11

The renal vein is anterior to the renal artery which is anterior to the renal pelvis.

Question 12

What occupies the renal sinus within the kidneys?

Answer 12

The renal pelvis, calices (tributaries of the renal pelvis), vessels, nerves and a variable amount of fat.

Question 13

What tributaries meet the renal pelvis?

Answer 13

The renal pelvis receives two or three major calices each of which divides into two or three minor calices. Each minor calyx is indented by a renal papilla which are the apex of the renal pyramid.

Question 14

What are ureters?

Answer 14

Muscular ducts, around 25-30cm long, that carry urine to the bladder by peristalsis.

Question 15

What is the ureters course from the kidneys to the bladder?

Answer 15

They run inferiorly from the hila of the kidneys passing over the pelvic brim at the bifurcation of the common iliac artery. They then run along the inferior wall of the wall of the pelvis to the bladder.

Question 16

How do you find the course of the ureters?

Answer 16

Link the point 5cm lateral to L1 spinous process to posterior superior iliac spine.

Question 17

What are the three constrictions of the ureters?

Answer 17

Junction of the ureters and renal pelves
where the ureters cross the brim of the pelvic inlet
during passage through the wall of the urinary bladder

Question 18

At what level do the renal arteries arise?

Answer 18

The intevertebral disc between L1 and L2

Question 19

Which renal artery is longer?

Answer 19

The right

Question 20

What are the different renal segments and what are their arterial supplies?

Answer 20

Superior segment is supplied by the superior segmental artery
Anterosuperior segment is supplied by the anterosuperior segmental artery
Antero-inferior segment is supplied by the antero-inferior segmental artery
Inferior segment is supplied by the inferior segmental artery
Posterior segment is supplied by the posterior segmental artery

Question 21

What is the venous drainage of the kidneys?

Answer 21

The kidneys drain via many renal veins into the left and right renal veins. These lie anterior to the left and right renal arterys.

Question 22

What is the arterial supply and venous drainage of the ureters?

Answer 22

The arteries for the abdominal sections of the ureters tend to arise from the renal arteries with less constant branches arising from the testicular and ovarian arteries.
Veins drain into the renal and gondal (testicular or ovarian) veins

Question 23

What is the nervous supply of the kidneys and ureters?

Answer 23

Sympathetic and parasympathetic innervation to the kidneys originate from the renal nerve plexus. This is supplied by the abdominopelvic splanchnic nerves.
The ureters abdominal innervation have visceral afferent fibres that originate from T11-L2. This means uteric pain is usually referred to the lower quadrant of the anterior abdominal wall especially to the groin.