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The kidneys

• Retroperitoneal structures on posterior abdominal wall
• Largely covered by costal margins
• Right kidney is slightly lower than left
• Hilum lies on medial border of each kidney
• Hilum transmits
  • Renal vein
  • The ureter
  • Branches of renal artery
• Kidneys are surrounded by fibrous capsule
• Surrounding kidney is perinephric fat and fascia
• Upper end of each ureter expands in to renal pelvis
• Renal pelvis divides into 2 or 3 major calyces
• Each major calyx divides into 2 or 3 minor calyces
• Arterial supply is by the renal artery arising directly from the aorta
• Venous drainage is via the renal vein into the inferior vena cava

Relations of right kidney

• Anterior
  • Suprarenal gland
  • Liver
  • Second part of duodenum
  • Hepatic flexure of colon
• Posterior
  • Diaphragm
  • Costodiaphragmatic recess of pleura
  • Twelfth rib
  • Psoas muscle

Relations of left kidney

• Anterior
  • Suprarenal gland
  • Spleen
  • Stomach
  • Pancreas
  • Splenic flexure of colon
• Posterior
  • Diaphragm
  • Costodiaphragmatic recess of pleura
  • Twelfth rib
  • Psoas muscle

The ureters

• Each ureter is about 25 cm long
• Lined by transitional epithelium
• Retroperitoneal structure
• Runs down over the psoas muscle
• Lies in the line of the tip of the transverse processes of the lumbar vertebrae
• Crosses bifurcation of common iliac artery
• Runs down lateral wall of pelvis to region of ischial spine
• Has three constrictions along its course
  • Where renal pelvis joins ureter
  • Where ureter crosses pelvic brim
  • Where ureter enters the bladder

Relations of right ureter

• Anterior
  • Duodenum
  • Terminal ileum
  • Right colic and ileocolic vessels
  • Right testicular / ovarian vessels
• Posterior
  • Psoas muscle
  • Bifurcation of right common iliac artery

Relations of left ureter

• Anterior
  • Pelvic colon
  • Left colic vessels
  • Left testicular / ovarian vessels
• Posterior
  • Psoas muscle
  • Bifurcation of left common iliac artery

Author:  Dr Shakeeb Khan

Last updated: 21 April 2009

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