Renal anatomy and physiology Flashcards
What are the rough dimensions of each kidney?
11cm long, 5cm wide and 3cm thick
The kidneys lie on the anterior surface of which muscle?
psoas major
Which kidney lies 1.5cm superior to the other?
Left
The upper pole of each kidney is roughly associated with which rib?
11th rib
The lower border of both kidneys approximates to which vertebral level?
L3.
Describe the approximate vertebral level of the hila of each individual kidney
Left hilum = L1 vertebral level
Right kidney = L1-2.
Which kidney has the following relations?
Posterior: Quadratus lumborum, diaphragm, psoas major, transversus abdominis
Anterior: Hepatic flexure of colon
Superior: Liver, adrenal gland
Right
Which kidney has the following relations?
Posterior: Quadratus lumborum, diaphragm, psoas major, transversus abdominis
Anterior: Stomach, Pancreatic tail
Superior: Spleen, adrenal gland
Left
With what structures does the right kidney have direct contact without a layer of peritoneum in between?
Right suprarenal gland
Duodenum
Colon
With what structures does the right kidney have contact WITH a layer of peritoneum in between?
Liver
Distal part of small intestine
With what structures does the left kidney have direct contact without a layer of peritoneum in between?
Left suprarenal gland
Pancreas
Colon
With what structures does the left kidney have contact WITH a layer of peritoneum in between?
Stomach
Spleen
Distal part of small intestine
Each kidney and suprarenal gland is enclosed within a common layer of investing fascia, derived from the transversalis fascia. It is divided into anterior and posterior layers.
What is the name given to this fascia?
(Gerotas fascia).
Describe the general structure of the kidney
outer cortex and an inner medulla which usually contains between 6 and 10 pyramidal structures.
The papilla marks the innermost apex of these.
What is found in the renal sinus
- Branches of the renal artery
- Tributaries of the renal vein
- Major and minor calyces’s
- Fat
At the renal hilum which structures lies most anteriorly and which most posteriorly?
The renal vein lies most anteriorly,
then renal artery (it is an end artery)
ureter lies most posterior.
What percentage of resting cardiac output is received by the kidneys
up to 25%
how does the kidney autoregulate its blood flow at a variety of different blood pressures?
myogenic control of arteriolar tone, both sympathetic input and hormonal signals (e.g. renin) are responsible
Does the renal cortex or medulla have more blood flow?
renal cortical blood flow > medullary blood flow
(i.e. tubular cells more prone to ischaemia)
Total volume of plasma per unit time leaving the capillaries and entering the Bowman’s capsule =?
Glomerular filtration rate (GFR)
Volume plasma from which a substance is removed per minute by the kidneys =?
Renal clearance
Properties of substances used to measure GFR
- Inert
- Free filtration from the plasma at the glomerulus (not protein bound)
- Not absorbed or secreted at the tubules
- Plasma concentration constant during urine collection
examples: inulin, creatinine
Main function of tubules
reabsorption and secretion
in which part of the tubule is up to 2/3 of water reabsorbed?
Proximal tubule
the thin ascending limb of the Loop of Henle is impermeable to water. TRUE/FALSE?
TRUE
but highly permeable to sodium and chloride ions
