Includes the anatomical positions, surroundings, morphology, blood supply, drainage and innervation of the kidneys, ureters (abdominal, pelvic and intravesicular portions) and the bladder
Kidneys
- Lies retroperitoneally
○ Outside the peritoneum
§ Layer of membrane
§ Smooth
§ Parietal
§ Visceral
□ Covers surface of the kidney
○ On posterior abdominal wall
○ Lie between the transverse processes of T12 and L3
- Right kidney is about 1cm inferior to left one
○ Downward displacement by bulk of liver
§ Liver is anterior to right kidney
§ Separated by the hepatorenal recess
○ Right kidney is posterior to the ascending colon and the second
part of duodenum medially
- Left kidney
○ Posterior to descending colon
○ Its renal hilum is lateral to the tail of the pancreas
○ Its superomedial aspect is adjacent to the greater curvature of the
stomach
○ Left upper pole adjacent to spleen
§ Attached by splenorenal ligaments
- Measurements
○ 10cm long
○ 5cm wide
○ 2.5cm thick
- Hilum
○ At concave medial margin of each kidney
○ Vertical cleft
○ Holds the following structures
§ Renal vein
□ Drains directly into inferior vena cava
® More anterior than the aorta
® Right renal vein passes anterior to aorta
§ Renal artery
□ Derive from descending aorta directly
□ Posterior to renal vein
, □ Drains directly into inferior vena cava
® More anterior than the aorta
® Right renal vein passes anterior to aorta
§ Renal artery
□ Derive from descending aorta directly
□ Posterior to renal vein
§ Pelvis of the ureter
□ More posterior
§ Nerves and lymphatics
○ The hilum Lies near transpyloric plane
§ Which Located at L1
§ The transpyloric plane goes through lots of structures
§ Midway between suprasternal notch and the pubic
symphysis
- Posteriorly the superior pole of left kidney lies deep in 11th rib
○ Right kidney lies deep to 11th intercostal space
§ T12
- Posterior
○ Diaphragm
§ Posteriorly, it rests on the upper third of each kidney
○ 11th and 12th rib on left side
§ 12th rib on right side
○ Back muscles
§ Kidneys sit over the medial aspect of the psoas major
§ And lateral aspect of quadratus lumborum
○ Anterior rami of lumbar spinal nerves
§ To supply abdominal wall muscles and skin
- Medial
○ The hila of the kidneys
- Superior
○ Suprarenal glands
§ Separated by renal fascia
- Anterior
○ Right side
§ Suprarenal gland
□ Pyramid shape
□ Orientated apically on right kidney
§ Liver
§ 2nd part of duodenum
§ Hepatic flexure of colon
□ Ascending colon becomes transverse colon
□ The turning point
§ Ascending colon
§ Small intestines
○ Left side
§ Suprarenal gland
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