Renal - anatomy

-endothelial cappillaries

-basal lamina of endothelium and podocytes

-slits of podocytes

- in paravertebral gutter.
- level of T12 until L3.
- lie in mass of pararenal fat.

-superior pole
-inferior pole
-medial margin is concave
-lateral margin is convex in shape.
has hilum at the medial margin that is the pathway of which renal blood vessels enter and out of kidney.

-strong fibrous capsule
-can be stripped easily from the kidney surface
-it capsule the kidney passes the lips of hilum
-line the renal sinuses, becomes continuous with the minor calices.
-surrounded by pararenal fat

right kidney:
1. projection of 11th rib
2. area for diaphragm
3. projection of 12th rib
4. aponeurosis of transverse abdominis muscle
5. medial to (4), quadratus lumborum muscle
6. medial to (5) psoas major muscle.

left kidney: same as right without the 11th rib projection.

both has
-subcostal nerves and vessels
-iliohypogastric nerve
-ilioinguinal nerve
cross obliquely thru the posterior border of the post border.

right:
-bare area of the liver
-liver
-colon
-duodenum
-small intestine

left:
-stomach
-spleen
-descending colon
-small intestine

arterial:

renal artery branch into segmental arteries:
-post
-sup
-ant sup
-ant inf
-inf

correspond to the arterial blood supply. goes all to renal vein, enter IVC.

-comes out of the renal pelvis
-retroperitoneal
-descend vertically anterior to psoas major
-as the right ureter descend, it lies closely to IVC, lumbar lymph nodes, and sympa trunk
-cross pelvic brim, just beyond bifurcation of the common iliac artery.

1. after renal pelvis
2. kinked as it crosses the pelvic brim
3. as it about to enter the urinary bladder.

usually from 3 sources, any of:
-renal
-ovarian
-aorta
-common iliac
-internal iliac

testicular or ovarian vein.

sympa:
T10&T11-lesser splanchnic
T12-least splanchnic
L1-to renal artery

para:
vagus to celiac ganglion
sacral plexus (S2,3,4)