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Organization of the kidney
- the kidney, adrenal gland and the perinephric fat are enclosed in the renal fascia
- the renal fascia continues onto the ureter and is called the periureteric fat
- the renal fascia is surrounded by the paranephric fat
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vertebral level of kidneys
- left is T11-L2
- Right is T12-L3
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Renal hilum
entrance to the kidney
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renal sinus
open area in the kidney occupied by the calyx and pelvis
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shape of adrenals
- right is pyramid shaped
- left is crescent
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Renal arteries
- arise between L2/L3
- right renal artery passes posterior to the IVC
- Renal veins lie anterior to the arteries and the left passes in front of the aorta
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Arteries to the ureters from three sources
- renal artery
- testicular or ovarian artery
- abdominal aorta
- Each vein drains to the renal or testicular veins
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Three sources of blood to the adrenal glands
- superior- from the inferior phrenic artery
- middle- abdominal aorta
- inferior- renal arteries
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adrenal venous drainage
- right drains to IVC
- left drains to left renal vein
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lymph from kidney, adrenal, and ureters
- follow veins and drain
- lumbar nodes or iliac nodes
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Nerves of kidneys and ureters
- arise from the renal nerve plexus; consists of sypathetics, para and visceral
- least splancnic abdominal pelvic
- pain fibers from ureters go retrograde to T11-L2, nerves from the superior hypogastrtic, renal, and abdominal aortic plexus supply the ureters. Pain follows sympathetics
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Nerves to adrenal gland
- celiac plexus and abdominopelvic splanchnic nerves
- mylenated pre synaptic sypathetics
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Area of transplanted kidney
- pelvic fossa
- only need short vessels
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can have accessory renal arteries from the embryologic ascent of the kidney
each artery is end organ
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metanephric diverticulum
primordial renal pelvis and ureter
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Horseshoe kidney
lies at the level of L3-L5 because it gets caught on the inferior mesenteric artery
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