Kidneys

Question 1

Where are the kidneys located?

Answer 1

Retroperitoneal lying at about T12-L3

Question 2

What is the renal hilum?

Answer 2

Entrance to renal sinus (area in kidney where BV, renal pelvis and nerves are located)

Question 3

Describe the posterior aspect of the kidneys

Answer 3

Superior parts lie deep to 11th and 12th ribs

Right kidney lower than left

Question 4

The left kidney hilum is near what?

Answer 4

Transpyloric plane (~5cm from median plane)

Question 5

The transpyloric plane runs through what?

Answer 5

Superior pole of right kidney (2.5cm lower than left)

Question 6

The inferior pole of the right kidney is slightly superior to what?

Answer 6

Iliac crest

Question 7

Which muscles cover the kidneys posteriorly?

Answer 7

Psoas major, quadratus lumborum (mostly) and transversus abdominus
Quadratus lumborum lies posterior to largest part of the kidney with intervening fat

Question 8

Which nerves are present near the posterior aspect of the kidneys?

Answer 8

Subcostal (protected by the 12th rib), Iliohypogastric (L1) and ilioinguinal (L1)

Question 9

What are the three types of renal fat?

Answer 9

Perinephric fat, paranephric fat and renal fascia

Question 10

What is perinephric fat?

Answer 10

Adjacent to kidney capsule

Extends into renal pelvis

Question 11

What is renal fascia?

Answer 11

Covers fat enveloping kidney and suprarenal gland
Blends and ensheaths renal vessels
Superiorly continuous with inferior diaphragmatic fascia

Question 12

Paranephric fat is located external to what?

Answer 12

Renal fascia

Question 13

Normal renal mobility is what?

Answer 13

~3cm

Question 14

What is the location of the ureter?

Answer 14

Runs inferiorly from renal pelvis passing over the pelvic brim and along the lateral pelvic wall and running posterior to ductus deferens (male) and uterine artery (female)

Question 15

What are the three potential sites of obstruction by kidney stones (constrictions of the ureter)?

Answer 15

Junction of ureter with renal pelvis, crossing pelvic brim and entering bladder wall

Question 16

What is a pyelogram?

Answer 16

X-ray of ureter enhanced with contrast media

Question 17

What are the renal arteries?

Answer 17

Segmental arteries

Question 18

Which arteries supply the ureter?

Answer 18

Renal branches, gonadal branches, abdominal aorta branches, iliac branches, superior vesical branches, pelvic branches (rectal, uterine, vaginal and inferior vesicular)

Question 19

Describe the location of the right suprarenal gland

Answer 19

Lies near the right crus, right kidney and IVC

Question 20

Describe the location of the left suprarenal gland

Answer 20

Lies near left crus, spleen, stomach, pancreas and left renal a

Question 21

What provides blood supply to the suprarenal glands?

Answer 21

Superior, middle and inferior suprarenal A and veins

Question 22

What innervates the suprarenal glands?

Answer 22

Preganglionic sympathetics from T10-L1
Celiac plexus and abdominopelvic splanchnic nerves (thoracic, lumbar, etc splanchnics)
Synapse with chromaffin cells in the adrenal gland (exception to two neuron chain of the ANS)