The renal tract
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
Structure of kidney
- The substance, or parenchyma, of the kidney is divided into two
major structures
- Superficial is the renal cortex and deep is the renal medulla
- These structures take the shape of about 15 cone-shaped renal lobes
- Each containing renal cortex surrounding a portion of medulla called
a renal pyramid
- Between the renal pyramids are projections of cortex called renal
columns
- Nephrons, the urine-producing functional structures of the kidney,
span the cortex and medulla
- The initial filtering portion of a nephron is the renal corpuscle,
located in the cortex
- This is followed by a renal tubule that passes from the cortex deep
into the medullary pyramids
- Part of the renal cortex, a medullary ray is a collection of renal
tubules that drain into a single collecting duct.
Structure of nephron
- The components of the renal tubule are:
- Proximal tubule
- Loop of Henle
- Descending limb of loop of Henle
- Ascending limb of loop of Henle
- Distal convoluted tubule
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
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