Gross Anatomy of Kidney

Lanka Ranaweera Dept. of Anatomy

Objectives

State the position of the kidney Describe the macroscopic structure of the kidney Describe the anatomical relationships of the kidneys State the arterial supply, venous drainage, lymphatic drainage & nerve supply of the kidney

Introduction - Urinary System

Right kidney Right ureter Urethra

Left kidney Left ureter Urinary bladder

The Kidney
Shape : bean

Colour : reddish brown

Location : retroperitoneally post. abdominal wall paravertebral gutters

Approximate dimensions- kidney

Upper pole
Average weight O - 135 g

Hilum

O - 150 g

AP diameter = 3 cm

Lower pole

Abdominal Regions
2.5 cm

R. lateral plane
RH

EG

Median plane
LH

7.5 cm

Transpyloric plane (L1)

RL UR

8 th rib
10 th rib
LL LI

Transtubercular plane (L5)

RI

HG

Surface Projection Of The Kidney

2.5 cm

medial boundary lateral boundary

L1

Back of the body

upper pole
renal vein renal artery hilum medial border lower pole ureter
IVC

lateral border renal artery

Anterior view of kidney

Posterior view of kidney

Hilum structures

renal artery

renal vein ureter

Coverings of the Kidney

Renal capsule Perirenal fat

Renal fascia

Renal artery Renal vein ureter

Pararenal fat

Coronal section through kidney

Gross internal structure

renal cortex major calices pelvis pyramid (medulla) papilla minor calices

ureter

renal column Coronal section through kidney

Anterior relations of the kidneys

duodenal area hepatic area
IVC

suprarenal area

gastric area splenic area

aorta

colic area pancreatic area

colic area

jejunal area

medial lumbocostal arch diaphragm lateral lumbocostal arch

Posterior Relations of the kidney

subcostal nerve & vessels

12th rib

transversus abdominis quadratus lumborum

iliohypogastric nerve

psoas major

ilioinguinal nerve

Right Kidney - From Behind

12 th rib Costodiaphragmatic recess- pleura

Subcostal vessels

Subcostal nerve
Iliohypogastric nerve Ilioinguinal nerve

Psoas major

Blood Supply Kidney

IVC

aorta
kidney
RA

RA

RV

RV

ureter Gonadal vein

Vascular Segments of Kidney

Renal artery

anterior primary posterior branches

segmental arteries

specific region of renal tissue 5 segments of kidney

Renal Segments
apical
upper anterior middle anterior

posterior

posterior

Anterior aspect

Medial aspect

lower

Posterior aspect

Lymphatic Drainage Kidney

Lateral aortic lymph nodes
Lumbar lymph trunks Cisterna chyli

Thoracic duct
Venous circulation in the thorax

Nerve Supply Kidney

Renal Plexus coeliac

plexus

sympathetic fibers (T12-L1)

few afferent fibers cholinergic innervation via vagus nerve

Summary

Urinary system : 2 kidneys, 2 ureters, bladder

& urethra Kidney - excretory organs Location - paravertebral gutters : T11- L3 retroperitoneum 2 poles, 2 surfaces & 2 borders medial border hilum structures

Renal coverings :

fibrous capsule, perirenal fat, renal fascia, pararenal fat

Gross internal structure :

cortex, medulla, pyramid, papilla, minor calyx, major calyx, pelvis, ureter

Relations of the kidneys :

anterior posterior

Arterial supply

: renal artery aorta

Venous drainage : renal vein IVC

Nerve supply

: renal plexus

References

Ellis, H. (1997). Clinical anatomy: A revision & applied anatomy for clinical students. 9 th ed., London: blackwell science Romanes, G.J. (2000). Cunninghamss manual of practical anatomy. 15 h ed., Oxford: Oxford university press Ganong, W.F. (1993). Review of medical physiology. 17 th ed., London: prentice Hall International limited

Snell, R.S.(1986). Clinical anatomy for medical students. 4 th ed., London: little, brown and company Chaurasia, B.D. (1995). Human anatomy: Regional & applied. 3 rd ed., New Delhi: CBS publishers & distributors Agur, A.M.R. (1991). Grants atlas of Anatomy . 9 th ed., maryland: Williams & Wilkins