L1 Anatomy of Kidney PDF

# Renal Module ## Course Information - **Course code:** IMP/07/20318 - **Phase:** I - **Year:** Second year - **Semester**: 3 - **Course duration:** 5 weeks ## Instructor - **Prof. Dr. Olfat Anwar Abd El Aty** - **Professor of Anatomy and Embryology** - **Email**: [email protected]...

# Renal Module ## Course Information - **Course code:** IMP/07/20318 - **Phase:** I - **Year:** Second year - **Semester**: 3 - **Course duration:** 5 weeks ## Instructor - **Prof. Dr. Olfat Anwar Abd El Aty** - **Professor of Anatomy and Embryology** - **Email**: [email protected] ## Anatomy of the Kidney - **Shape:** Bean-shaped - **Renal Angle:** - An area located on either side of the human back between the lateral borders of the erector spinae muscles and inferior borders of the 12th rib - The kidney can be felt at this location. - **Differentiating the Right and Left Kidneys:** - **Medial Border:** Concave and contains the hilum (Right kidney) - **Lateral Border:** Convex (Right kidney) - **Hilum:** (Right kidney) The renal vein is most anterior, the renal pelvis is posterior, and the renal artery is in between. - **Ureter:** Passes downward along the lower part of the medial border. - **Surfaces:** | Surface | Right Kidney | Left Kidney | | --------------------- | ---------------- | ------------------------------ | | Hepatic | - | | | Duodenal | - | | | Right Colic Flexure | - | | | Splenic | | - | | Gastric | | - | | Pancreatic | | - | | Descending Colic | | - | | Small Intestine | - | - | - **Location:** Retroperitoneal, in the upper part of the posterior abdominal region on both sides of the vertebral column. - **Extend:** The kidneys extent from T12 superiorly to L3 inferiorly. - **Position (difference between Rt & Lf kidneys):** The Right kidney lies about 1/2 an inch lower than the left because of its relationship with the liver. ## Anterior Relations of the Kidney | Area | Related Structure | | ---------- | --------------------------------------- | | Suprarenal | Rt. suprarenal gland | | Hepatic | Right lobe of the liver | | Duodenal | Retroperitoneal descending (2nd) part of the duodenum | | Colic | Right colic flexure | | Jejunal | Part of the jejunum | ## Posterior Relations of the Kidneys - **Similar Relations:** - **Superiorly:** The diaphragm, costodiaphragmatic recess of the pleura, the 12th rib in the Rt kidney, and 11th, 12th ribs in the Lt kidney. - **Inferiorly:** Three muscles from medial to lateral: psoas major, quadratus lumborum, and transversus abdominis - **Different by Level of Ribs:** - **Left Kidney:** - 11th rib - 12th rib - **Right Kidney:** - 12th rib ## Covering of the Kidney - **1. Fibrous Capsule:** Innermost covering, surrounds the kidney and continues to the renal sinus. - **2. Perirenal Fat:** It covers the fibrous capsule, acting as a cushion and helping to hold the kidney in a relatively fixed position. Rapid loss of fat can result in renal ptosis. - **3. Renal Fascia (Zukercandle Fascia):** Lies outside the perirenal fat and encloses the kidneys and suprarenal glands. Continuous laterally with the fascia transversalis. - **4. Paranephric Fat:** Lies external to the renal fascia, contains a large quantity of fat, and forms part of the retroperitoneal fat. ## Blood Supply - **Renal Artery:** Arises from the abdominal aorta at the level of the L2. Each renal artery usually divides into 5 segmental arteries. - **Renal Vein:** Emerges from the hilum in front of the renal artery and drains into the inferior vena cava. - **Left Renal Vein:** - **Left Adrenal Vein:** - **Branch of the Inferior Phrenic Vein:** - **Left Gonadal Vein:** - **Lymph Drainage:** Pass to the paraaortic lymph nodes. ## Clinical Notes on Blood Supply - **Renal Cell Carcinoma:** Tumors can early destroy the renal vein. If the tumor is in the left side, early invasion of the left renal vein may result in a defect in the venous drainage of the left gonadal veins, resulting in dilatation of the veins surrounding the left testes and varicose of the left testis. ## Factors Which Stabilize the Kidneys - **1. Intra-abdominal Pressure and Arrangement of Adjacent Organs:** - **2. Extensions of the Covering Fascia and Fat:** - **3. Renal Vessels Connecting the Kidneys to the Abdominal Aorta and Inferior Vena Cava:** ## Clinical Notes on Kidney Stabilization - **Pre-renal Fat Loss:** Rapid loss of pre-renal fat tissue may result in a drop of the kidney in the pelvis, a condition known as ptosis of the kidney. This condition can result in kinking of the ureters, causing severe pain. ## Nerve Supply - **Renal Sympathetic Plexus:** - **Afferent Fibers:** Travel through the renal plexus and enter the spinal cord in the **10th, 11th, and 12th thoracic nerves.** - **Parasympathetic Fibers:** From the vagus nerve which reach the kidney through the renal plexus. ## Surface Anatomy - **Hilum:** Lies on the transpyloric plane, 5 cm from the middle line. - **Upper Pole:** Lies 2.5 cm away from middle line and 5 cm above the hilum. - **Lower Pole:** Lies 5 cm below the hilum and 7.5 cm from the middle line. ## Transpyloric Plane - **Also Known As:** Addison's plane. - **Definition:** An imaginary horizontal plane located halfway between the suprasternal notch of the manubrium and the upper border of the symphysis pubis at the level of the first lumbar vertebrae (L1) ## Parallelogram of Morris - **Definition:** Used on the posterior of the back. - **Formed By:** 4 lines: 2 are horizontal and 2 are vertical. - **Upper Horizontal Line:** Extends from the levels of the tip of the spinous process of the T11. - **Lower Horizontal Line:** Extends from the levels of the tip of the spinous process of the L3. - **Medial Vertical Line:** 2.5 cm from the mid line. - **Lateral Vertical Line:** 9 cm from the mid line.