So here we can see the kidneys in-section,
where if we return to the previous slide
if we're taking a section through the posterior
abdominal wall approximately where that line is,
then we can look down onto the kidneys
and we can see this is the posterior aspect
here. This is anterior aspect. We have got the liver
and here we have got the anterolateral
abdominal wall. We can
see the kidneys are here
on the left and right in this
paracolic gutter which we can see.
We can see the lumbar vertebral bodies here.
We can see the transverse processes.
We can see each of the kidney is sitting
on this muscle bed. What we can't see
also, is that the kidneys are surrounded by
a substantial amount of fat
which is surrounding the kidneys here. And this
is the paranephric and the perinephric fat
which is positioned around
each of the kidneys.
So each kidney is surrounded by this
perinephric fat like a primitive fence
around. And this is continuous in the
renal sinus which is this space
here. We can see this space is kind of
hollow space within the kidney
and that's the renal sinus. And the fat of
the renal sinus is continuous
with this perinephric fat
that surrounds it.
The renal fascia surrounds the perinephric
fat and we can see we have got
tough kind of membrane around here
which is surrounding the kidney.
And then lateral superficial to renal
fasica, we have paranephric fat.
And this is found superficial to this fascia
and it's positioned more posteriorly.
This capsule helps to support with
it's fat that's surrounding it
support and maintain the
position of kidneys.
So let's have a look at the
kidneys in this view which shows
the various relationships that kidneys have
with the other organs and also their blood supply.
So first of all we are looking at the kidneys,
looking at the anterior surface of the kidney
and we can see we've this convenient key
that we have at the bottom here.
In red, we can see this right kidney.
This is the right side. This is the left side.
The most of this kidney here
is associated with the liver.
And remember the space in between the
liver and the kidney on the right side
is the hepatorenal recess. And that recess
is continuous with the pelvis
via that right paracolic gutter.
We can see at the superomedial aspect of
each of kidneys, we have the suprarenal glands.
So we looked at the suprarenal glands and we looked
at the liver. Here we can see the hepatic flexure
or the right flexure of colon is sitting
against the kidney, we can see it here.
And we can see it has relations with
the jejunum that is sitting
alongside this more inferior
whole of the kidney.
We can see that towards this
hilum, we have the duodenum
sitting against the kidney in
this aspect near the renal hilum.
And then we can see on this side on the
left we have the stomach. We have the
spleen and we have the pancreas and we
have the descending part of the colon.
So these shadings indicate the
relationship that kidney have
sitting on the posterior abdominal wall, the
anterior relations they have with those organs.
And you can see they are coming into contact
with a lot of the organs within the abdomen.
If we look at the blood supply then we
can see this really clearly in this diagram
If we look at the right hand side,
we can see we have got the inferior vena cava
and running down the midline
we have got the abdominal aorta.
We can see those unpaired visceral
branches: ceolic trunk, superior mesenteric artery
and down here the inferior mesenteric
artery. And what's shielding
the renal arteries, are the renal veins.
Here we have got the inferior vena cava
and we can see that the kidney is giving
rise to this left renal vein here
Coming away from the kidney we have got this left renal
vein. Coming from the right kidney we have the right
renal vein and this will then drain towards
the heart in the inferior vena cava.
We can see draining into the left renal vein here we have
got the left gonadal vein, testicular or ovarian
and that's draining into the left renal vein.
These are shielding
the arteries that lie behind them; because
the left renal vein runs
anterior to the aorta, it's
longer and it courses across
Here we can see the aorta,
it's running in front of the left
renal artery which we can see here.
The left renal artery can in-fact
course anterior to it, right of the hilum
of the kidney which we can see here.
So we can see this nice blood supply. And
these blood vessels comes off at around about
L1, L2 regions, where the renal
arteries and the renal veins
pass to and from the kidney. So this is really a nice diagram
showing the blood supply and relations of the kidneys.
Here we can just see the notes that
I have added to go alongside this.
We can see the renal arteries and the
renal veins. We can see this renal artery
as a longer one on the right. That's because
of the position of the aorta relative
to the inferior vena cava and the right
renal artery passes posterior to it.
And then we can see that the
renal veins are draining into the inferior
vena cava and we have a longer left
renal vein as it's passing anterior to the aorta.
So a nice diagram indicating the blood
supply and the relations of the kidneys.