GROSS FEATURES OF KIDNEY

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1 GROSS FEATURES OF KIDNEY LEARNING OBJECTIVES At the end of the lecture the student should be able to Know the details of kidney Differentiate the anterior and posterior surfaces and relations of kidney Identify the internal structure of kidney URINARY SYSTEM Urinary organs comprise Kidneys Which secrete the urine Ureters Which convey urine to the urinary bladder Urinary bladder Where it is for a time retained Urethra Through which it is discharged from the body.

2 KIDNEYS Two reddish brown organs Bean shaped Situated retroperitoneally on each side of the vertebral column in the posterior part of abdomen. Upper ends lie at superior border of T12 Vertebra Inferiorly at L3 Vertebra. (10-12 lobules) KIDNEY Each kidney is 11cm in length 6cm in breadth 3cm in anterioposterior diameter Male 150gm Female 135gm. In thin person it may be palpable The right kidey is usually inferior because of liver. The hilus of left kidney is just above the transpyloric plane and that of right kidney is just below that (hilus is at level of 1 st LV).

3 It has 2 surfaces 2 borders Superior pole Inferior pole KIDNEY ANTERIOR RELATIONS OF RIGHT KIDNEY It is convex. Superior pole small area is in contact with right supra renal gland A large area below this( ¾ of anterior surface) is immediately related to the renal impression on the (R) lobe of liver. Medial border A narrow area is in contact with the descending part of duodenum Inferiorly It is in contact laterally with right colic flexure and medially with part of small intestine

4 ANTERIOR RELATIONS OF KIDNEY ANTERIOR RELATIONS OF RIGHT KIDNEY The areas related to small intestine and in contact with liver are covered with peritoneum which overlies the renal fascia Where as colic,supra renal and duodenal areas are devoid of peritoneum.

5 ANTERIOR RELATIONS OF LEFT KIDNEY Superior pole small area is related to the Left supra renal gland. Upper 2/3 rd of lateral half related to spleen (Splenic area) A central quadrilateral area lies in contact with Pancreas and Splenic vessels. Above pancreatic area there is a variable triangular region i.e Gastric area. Below the gastric area there is Jejunal area and Left colic flexure.

6 ANTERIOR RELATIONS OF LEFT KIDNEY Stomach, jejunum, and splenic areas covered with peritoneum. Supra renal pancreatic and colic areas are devoid of peritoneum POSTERIOR RELATIONS OF KIDNEY Devoid of peritonum Embedded in fat. Posterior surface of kidney lies on Diaphragm Medial and lateral arcuate ligaments Psoas major Quadratus lumboram Transversus abdominus Aponeurotic tendon Subcostal vessels Ilioinguinal and iliohypogastric nerves.. As right kidney is down therefore it lies at the level of 12 th rib and left on 11 th and 12 th rib. Diaphragm separates the kidney from pleura.

7 POSTERIOR RELATIONS OF KIDNEY As right kidney is down therefore it lies at the level of 12 th rib and left on 11 th and 12 th rib. Diaphragm separates the kidney from pleura. Superior pole is related to suprarenal gland. Inferior pole related with iliac crest. Lateral border is covered superiorly with greater sac of peritoneum

8 HILUM OF THE KIDNEY In the centre of medial border there is deep vertical fissure which is known as Hilum Contains renal vessels renal nerve renal pelvis which is continuation of upper end of ureter In hilum the structures are renal vein is in front, the renal artery is in middle and the pelvis is behind. Hilum leads to renal sinus. HILAR FAT The renal fascia separates the kidney from supra renal glands. At the hilum of kidney the fascia is firmly attached to the renal vessels and ureter for stabilizing of kidney and discouraging the spread of pus across the midline section.

9 MINOR AND MAJOR CALYCES The pelvis outside the hilum continues down as ureter. With in the sinus it divides into 2 to 3 large branches named as MAJOR CALYCES and each of which divide into MINOR CALYCES In all there are 7-13 of these minor calices. Each expands as it approaches to the wall of sinus.. PERI-RENAL FAT The kidney and its vessels are embedded in a mass of adipose connective tissue i.e. perirenal fat or perinepheric fat which is thickest at the border of kidney and is prolonged through the hilus into the renal sinus (for retention of kidney in position). Where as renal fascia (perinephric fascia) is the fibroareolar tissue surrounding the kidney and perirenal fat.

10 INTERNAL STRUCTURE OF KIDNEY Renal cortex immediately below the fibrous capsule made of cortical columns that extend down the pyramids. Contains Renal corpuscles Renal tubules except loop of henle Blood vessels Cortical collecting ducts Function ultrafiltration INTERNAL STRUCTURE OF KIDNEY Renal medulla split up into paired conical masses i.e. renal pyramids, it further divides into renal papillae. Consists of vasa rectae (both spuria and vera) venulae rectae medullary capillary plexus loop of Henle collecting tubule Function Reabsorption of water. Nephron is functional unit of kidney.

11 FUNCTIONS OF KIDNEY The kidneys excrete the end products of metabolic activities of body and excess of water, maintains the concentration of body fluids(in the foetus the kidney is lobulated

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