KIDNEY AND CLINICAL ASPECTS

TIWARI ABHISHEK

Roll. No. 37

The kidney are the pair of excretory organs which waited on posterior abdominal Wall one on each side of vertebral column behind the peritoneum.

The main function of the kidney is removing of waste product from our body

• The kidneys are retroperitoneal paired organs
• Each kidney lies lateral to the vertebral column, on the posterior abdominal wall largely under cover of the costal margin
• In the supine position, the kidneys extend from approximately T12 vertebra superiorly to L3 vertebra inferiorly
• The right kidney lies slightly lower than the left kidney because of the large size of the right lobe of the liver.
• With contraction of the diaphragm during respiration, both kidneys move downward in a vertical direction by as much as 1 in. (2.5 cm)

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• The Kidneys are reddish brown bean-shaped organs with the dimensions of 12 x 6 x 3cm
• Although they are similar in size and shape, the left kidney is a longer and more slender organ than the right kidney, and nearer to the midline.
• Each kidneys has:
• Convex upper & lower ends
• A convex lateral border
• A medial border that has a vertical slit called the hilum
• Internally the hilum extends into a large cavity called the renal sinus.

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1. Upper Pole- it is broad and it is close contact with the corresponding suprarenal gland and closer to the median plane.

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2. Lower Pole- it is narrow pole of kidney present at lower side.

2. Posterior surface- it is Flat surface of the kidney.

1. Anterior surface- it is Ir-regular surface of the kidney. Which consist Following Impressions

2. Lateral Border- it is Convex

1.Medial Border- Medial border is a concave its middle part show depression called hilum

Right Kidney��Anteriorly-��Supra renal gland, liver, duodenum(2nd part) Hepatic flexure.��• Posteriorly-��Diaphragm, 12th rib Psoas, Transverse abdominis muscle, Quadratus lumborum muscle, Sub costal, Ilio- inguinal nerve.��Left Kidney��Anteriorly-��Supra renal gland, Spleen, Stomach, Pancreas, left colic flexure.��• Posteriorly-��✓ Diaphragm, 11th rib Psoas, Transverse abdominis muscle, Quadratus lumborum muscle, Sub costal, Ilio- inguinal nerve.

• As the left kidney lies at higher level than the right, it is related to 11^th & 12th ribs and the last intercostal space.The right kidney is related to 12^th rib and the last intercostal space.
• The diaphragm & the costodiaphragmatic recess intervene between the thoracic wall & the kidney
• Psoas, quadratus lumborum, transversus abdominis muscles (from medial to lateral)
• Subcostal (T12), ilio-hypogastric & ilio-inguinal nerves

kidney have following coverings-

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1.Fibrous capsule

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2.Peri renal fat

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3.Renal fascia

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4. Para renal fat

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1. Fibrous capsule- It surounds the kidney and it closely applied to Its outer surface.

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2. Peri renal fat- This covers the fibrous capsule.

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3. Renal facia- this is a condensation of connective tissue that lie outside the perennial hat and enclose the kidney and suprarenal gland.

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4. Para-renal fat - this lies external to the renal fascia it from the part of retroperitoneal fat.

The kidney is divided into two major structures-

1. the outer renal cortex

2. the inner renal medulla.

Grossly, these structures take the shape of eight to 18 cone-shaped renal lobes Each containing renal cortex surrounding a portion of medulla called a renal pyramid

The tip, or papilla, of each pyramid empties urine into a minor calyx, minor calyces empty into major calyces, and major calyces empty into the renal pelvis. This becomes the ureter. At the hilum, the ureter and renal vein exit the kidney and the renal artery enters. Hilar fat and lymphatic tissue with lymph nodes surround these structures.

The renal sinus collectively contains the renal pelvis and calyces and separates these structures from the renal medullary tissue.

Hilar fat and lymphatic tissue with lymph nodes surround these structures. The hilar fat is contiguous with a fat-filled cavity called the renal sinus.

• Each kidney has 5 segmental branches and thus is divided into 5 vascular segments named as:
• Apical
• Caudal
• Anterior Superior
• Anterior Inferior
• Posterior

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Glomerulus

Both renal veins drain to the inferior vena cava. The left renal vein enters the inferior vena cava a little above the right vein.

.The venous drainage of each kidney proceeds through a single vein that drains into the inferior vena cava (IVC) at a right angle. The renal veins are formed near the hilum in front of the renal artery. The right renal vein is shorter (2-4 cm) than the left (6-10 cm).

Lymphatic Drainage

The lymph vessels follow the arteries. Lymph drains to the lateral aortic lymph nodes around the origin of the renal artery.

Nerve Supply

The nerve supply is the renal sympathetic plexus. The afferent fibers that travel through the renal plexus enter the spinal cord in the T10-12 nerves.

1. Polycystic Kidney Disease

Polycystic kidney disease (PKD) is an inherited disorder in which clusters of cysts develop primarily within your kidneys, causing your kidneys to enlarge and lose function over time. Cysts are noncancerous round sacs containing fluid. The cysts vary in size, and they can grow very large. Having many cysts or large cysts can damage your kidneys.

Symptoms

1.High blood pressure

2.Back or side pain

3.Blood in your urine

4.A feeling of fullness in your abdomen

5.Increased size of your abdomen due to enlarged

kidneys

2. Chronic Kidney Disease

Kidney disease means your kidneys aren’t working properly and are beginning to lose their function. Chronic kidney disease (CKD) worsens over time. High blood pressure and diabetes are two common causes of CKD. There’s no cure for CKD, but you can take steps to preserve function for as long as possible. Late-stage kidney disease requires dialysis or a kidney transplant.

Citation:- Rouiller, C. (1969). General anatomy and histology of the kidney. In The kidney (pp. 61-156). Academic Press.

Abstract

This chapter discusses the general anatomy and histology of the kidney. Most of the new discoveries in the domain of renal structure have been obtained through the use of histochemical and cytochemical techniques or with the electron microscope. The chapter provides a description of the kidney as it appears to the naked eye and under the magnifying glass and light microscope after routine staining. The shape of the mammalian kidney has been compared to that of the bean, being more or less elongated, rounded, or irregular according to the particular species in question. The kidney has two types of tubules: those which secrete urine, and those which conduct it to the pelvis. The first is derived from the metanephrogenic blastema, and it constitutes all segments of the nephron. The second type comes from the bud of the Wolffian duct, and it is known as the collecting duct.