THE ANATOMY OF THE KINEY

2016
 KIDNEYS
• Reddish brown, lying retroperitoneally on the posterior
abdominal wall
• Lie on either side of vertebral column at the level of
T12 through L3
• Right kidney usually lie slightly inferior to the left
kidney because of large size of right lobe of liver
• Kidneys moves vertically downwards by 3 cm with
contraction of diaphragm in respiration
• Function to excrete most of waste products of
metabolism which leave the kidney as urine
Kidneys
 Kidneys
• Renal hilum is a concave medial margin of the
kidney where the renal artery enters and renal
vein and pelvis leave renal sinus
• Arrangement of at the hilum from
front backwards renal vein, two branches of
structures
renal artery, ureter and third branch of renal
artery (V.A.U.A)
• Lymph vessels and autonomic nerves also pass
through the hilum
Kidneys
 Coverings of the kidneys
• Fibrous capsule – surrounds the kidney
• Perirenal fat – covers fibrous capsule
• Renal fascia
– Condensation of connective tissue that lies outside
the perirenal fat
– Encloses the kidneys and suprarenal glands
• Pararenal fat
– Lies external to renal fascia and often in large
quantity
Kidneys
 Renal structure
• Cortex is an outer dark brown part
• Medulla is light brown inner part
– Composed of about dozen renal pyramids
• Pyramids
– Have a base oriented toward the cortex
– Its apex (renal papilla) projects medially
• Renal column
– Extension of the cortex into the medulla between
adjacent pyramids
Renal structure
 Renal structure
• Medullary rays
– Extensions from the bases of the renal pyramids into
the cortex
• Renal pelvis
– Is the upper expanded end of ureter
– Divides into 2 or 3 major calyces, each of which
divides into 2 or 3 minor calyces
– Each minor calyx is indented by renal papilla
 Blood and nerve supply
• Arterial
– Renal arteries from abdominal aorta at L2
– Each divides into 5 segmental arteries that enter the
hilum of the kidney
• Veins
– Renal veins emerge from hilum and drain into
inferior vena cava
• Nerves
– Sympathetic and parasympathetic nerves
Blood supply
 URETER
• Muscular tubes about 25-30 cm long
• Extends from kidneys to the posterior surface of
the urinary bladder
• Urine is propelled along the ureter by peristaltic
contractions of the muscle coat
• Abdominal part of ureter adheres to parietal
peritoneum hence is retroperitoneal
 URETER
• Ureters usually constricted at 3 places
– At the junction of ureters and renal pelvis
– Where the ureters cross the pelvic brim
– Where it pierces the urinary bladder
• These constrictions are potential sites of
obstruction by renal stones
 Blood supply
• Arterial
– Upper end by renal artery
– Middle part by testicular or ovarian artery
– The pelvic part by superior vesical artery
• Veins
– Correspond to the arteries
SUPRARENAL (ADRENAL) GLANDS

• Two yellowish retroperitoneal organs that lie on

the upper poles of the kidneys
• Surrounded by renal fascia but separated from
the kidneys by perirenal fat
• Each gland has
– a yellow cortex and dark brown medulla
– These parts have different embryological origin and
different functions
Suprarenal (adrenal) glands
 Suprarenal (adrenal) glands
• Suprarenal cortex
– Derived from mesoderm
– Secretes corticosteroids and androgens
• Suprarenal medulla
– Mass of nervous tissue
– Derived from neural crest cells associated with
sympathetic nervous system
– Secretes epinephrine and norepinephrine
 APPLIED ANATOMY
RENAL FAILURE:
• Renal failure is the last (most severe) stage of
chronic kidney disease.
• Diabetes and Hypertension are the most
common causes
• Renal failure can be categorized as:
– Acute renal failure
– Chronic renal failure
 KIDNEY CANCER
 Nephrotic Syndrome
• Nephrotic syndrome is a group of symptoms
that include protein in the urine, low blood
protein levels in the blood, high cholesterol
levels, high triglyceride levels, and swelling
• Nephrotic syndrome has many causes,
including primary kidney diseases such as
minimal-change nephropathy, focal
glomerulosclerosis, and membranous
nephropathy.
 KIDNEY STONES
Kidney stones (renal lithiasis, nephrolithiasis) are small,
hard mineral deposits that form inside your kidneys. The
stones are made of mineral and acid salts.
The End