Podcast
Questions and Answers
What is the nerve supply of the kidney?
What is the nerve supply of the kidney?
- T10-L1 (correct)
- T5-L3
- C3-C5
- S1-S4
Which renal anomaly involves a non-union of the secretory and collecting parts?
Which renal anomaly involves a non-union of the secretory and collecting parts?
- Renal calculus
- Renal artery variation
- Pyelogram
- Polycystic kidney (correct)
Which structure is used to indicate the position of the kidney from the back?
Which structure is used to indicate the position of the kidney from the back?
- Peritoneal reflection
- Morris parallelogram (correct)
- Falciform ligament
- Ligamentum teres
What is the lymphatic drainage of the kidney?
What is the lymphatic drainage of the kidney?
Which spinal levels contribute to the sympathetic innervation of the kidney?
Which spinal levels contribute to the sympathetic innervation of the kidney?
In a surgical exposure of the kidney, which structure poses a risk when resected?
In a surgical exposure of the kidney, which structure poses a risk when resected?
What is the blood supply to the ureter?
What is the blood supply to the ureter?
Which of the following structures does the ureter NOT pass anteriorly to on the right side?
Which of the following structures does the ureter NOT pass anteriorly to on the right side?
On the left side, which structure does the ureter pass anterior to that is NOT mentioned for the right side?
On the left side, which structure does the ureter pass anterior to that is NOT mentioned for the right side?
Which of the following structures does the ureter NOT pass posterior to on both sides?
Which of the following structures does the ureter NOT pass posterior to on both sides?
In males, which of the following structures does the ductus deferens NOT cross in relation to the ureter?
In males, which of the following structures does the ductus deferens NOT cross in relation to the ureter?
In females, which of the following structures does the ureter NOT have a specific relation to?
In females, which of the following structures does the ureter NOT have a specific relation to?
Which of the following arteries does NOT contribute to the blood supply of the upper part of the ureter?
Which of the following arteries does NOT contribute to the blood supply of the upper part of the ureter?
Which of the following structures does the ureter NOT have a constriction at?
Which of the following structures does the ureter NOT have a constriction at?
In which of the following positions does the ureter NOT lie in relation to the cervix and vagina in females?
In which of the following positions does the ureter NOT lie in relation to the cervix and vagina in females?
Which of the following structures does the ureter NOT pass posterior to on either side?
Which of the following structures does the ureter NOT pass posterior to on either side?
Which of the following arteries contributes to the blood supply of the middle part of the ureter?
Which of the following arteries contributes to the blood supply of the middle part of the ureter?
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Study Notes
Kidney Location and Structure
- Kidneys are located in the posterior abdominal wall, on either side of the vertebral column, behind the peritoneum (retroperitoneal)
- They occupy the epigastric, hypochondriac, lumbar, and umbilical regions
- Right kidney is slightly lower than the left
- Transpyloric plane (L1) passes through the upper part of the hilus of the right kidney and the lower part of the hilus of the left kidney
Kidney Dimension and Parts
- Kidney is about 11 cm long, 6 cm broad, and 3 cm thick
- Weighs about 150 gm in males and 135 gm in females
- Bean-shaped with 2 poles (upper and lower), 2 borders (lateral and medial), and 2 surfaces (anterior and posterior)
Kidney Coverings
- Fibrous capsule: a thin membrane that closely invests the kidney
- Perirenal fat: a layer of adipose tissue outside the fibrous capsule
- Renal fascia: a fibro-areolar sheath surrounding the kidney and perirenal fat
- Pararenal fat: fatty tissue lying outside the renal fascia
Kidney Relations
- Right kidney:
- Anterior relations: right suprarenal gland, liver, second part of duodenum, hepatic flexure of colon, and small intestine
- Posterior relations: diaphragm, psoas major, quadratus lumborum, and subcostal vessels
- Left kidney:
- Anterior relations: left suprarenal gland, spleen, stomach, pancreas, splenic vessels, and jejunum
- Posterior relations: diaphragm, psoas major, quadratus lumborum, and subcostal vessels
Kidney Blood Supply and Lymphatic Drainage
- Arterial supply: renal artery from abdominal aorta at the level of L2
- Venous drainage: renal veins drain into the inferior vena cava
- Lymphatic drainage: drains into the lateral aortic nodes situated at the level of origin of renal arteries
Kidney Nerve Supply and Surface Marking
- Nerve supply: by renal plexus composed of sympathetic and parasympathetic fibers
- Surface marking: to indicate the position of the kidney from the back, the Morris parallellogram is used
Ureter Relations and Blood Supply
- Relations:
- Anterior: renal vessels, second and third part of duodenum, right colic vessels, ileocolic vessels, gonadal vessels, root of mesentery, and terminal part of ileum
- Posterior: psoas major, tips of transverse processes of lumbar vertebrae, genitofemoral nerve, internal iliac artery and vein, lumbosacral trunk, and sacro-iliac joint
- Blood supply: upper part - renal, gonadal, and colic arteries; middle part - aorta, gonadal, and colic arteries
Ureter Constrictions and Clinical Importance
- Normal 3 constrictions: at the pelvi-ureteral junction, at the brim of the lesser pelvis, and at its passage through the bladder wall
- Clinical importance: stone formation, pain in renal colic, and ureteric injury during catheterization
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