Chapter 4: Kidney and Adrenal Glands

Chapter 4: Kidney and Adrenal Glands

1. Location of the Kidney:

• Behind the peritoneum:

• At the angle formed by the 11th rib and the lumbar spine.

• Right kidney hilum:

• At the level of the pylorus (thoracic vertebra TL1).

• Left kidney hilum:

• At the level of the transverse process of the thoracic vertebra TL1.

• Intersection of the lower edge of the 12th rib and the erector spinae muscle.

• Upper pole of the left kidney:

• At the level of the upper edge of the 11th thoracic vertebra.

• The lower edge is 5 cm away from the iliac crest.

• Upper pole of the right kidney:

• At the level of the lower edge of the 11th thoracic vertebra.

• The lower edge is 3 cm away from the iliac crest.

2. Renal Fascia:

• Consists of 2 layers:

• The two layers merge at the top.

• The two layers separate at the bottom.

• The posterior layer merges with the lumbar muscle.

• The anterior layer passes in front of the renal vascular bundle and the abdominal aorta, which is connected to the opposite side.

• The two layers merge at the outside.

• The renal fascia separates the fibrous capsule from the perirenal fat.

3. Layer of Fat Outside the Renal Fascia:

• Perirenal fat.

4. Relationship of the Right Kidney:

• Anterior:

• Upper part: Adrenal gland.

• Inner edge: Descending part of the duodenum.

• Anterior surface: Liver, right colic flexure.

• Inner:

• Lumbar muscle (from posterior to anterior).

• Adrenal vascular bundle, renal vascular bundle, renal pelvis, ureter.

• Testicular/ovarian vascular bundle.

• Inferior vena cava.

• Abdominal aorta.

5. Microanatomy: Renal Corpuscle:

• Covered by a capsule.

• The inside is a capillary tuft.

6. Urinary System:

• Includes:

• Proximal convoluted tubule.

• Loop of Henle.

• Distal convoluted tubule.

• Collecting duct.

7. Renal Corpuscle; Proximal Convoluted Tubule; Distal Convoluted Tubule:

• Located in the convoluted part of the renal cortex.

8. Loop of Henle; Straight Tubule; Collecting Duct:

• Located in the radiate part of the cortex and the renal medulla.

9. Renal Artery:

• Originates just below the celiac artery.

• At the level of the thoracic vertebra TL1.

10. Kidney Division Based on Arteries:

• Has 5 lobes.

11. Efferent Arteries:

• A system of portal arteries.

12. Blood Supply to the Renal Pyramids:

• The straight arterioles branch from the arcuate arteries.

13. Interlobular Arteries:

• Branch from the arcuate arteries and go towards the renal cortex (convoluted part).

14. Branches of the Renal Artery:

• Adrenal artery.

• Branch of the artery to the ureter.

15. External Anastomotic Circle of the Kidney:

• Inferior phrenic artery, gonadal artery.

• Colic artery.

• Located in the perirenal fat.

16. Adrenal Artery:

• Superior adrenal artery: From the inferior phrenic artery.

• Middle adrenal artery: From the aorta.

• Inferior adrenal artery: From the renal artery.

I hope this helps! Let me know if you have any other questions.