Kidney, Ureter, Bladder and Urethra
- East Carolina University
- Physician Assistant
- Physician Assistant 1234
- Kidney, Ureter, Bladder and Urethra
Last Modified: 2011-06-30
Directly covers the kidneys and can readily be stripped from the surface of the kidney.
(except in some conditions that cause adhesion due to scarring.
A false capsule
Important in staging renal cell carcinoma
Defines the perirenal space which containes the kidney, adrenal gland, ureter, gonadal artery and vein and perirenal fat
Common method for reducing portal hypertension
Diverts blood from the portal venous system by creating a communication between the hepatic portal vein and the IVC.
Can also connect the splenic vein to the left renal vein after a splenectomy (splenorenal anastomosis)
Any fat located outside the perirenal space
Most abundant posterolaterally
Anterior of kidney faces anterolaterally.
LEFT KIDNEY: Upper pole at T11. Related to ribs 11 and 12
RIGHT KIDNEY: Upper pole at T12. Related to rib 12
Hila of both located 5 cm from the median plane.
Concave medial margin where these structures come out anterior to posterior:
1. renal vein
2. renal artery
3. renal pelvis
Continuous with the Renal sinus
- renal pelvis
- major and minor calyces
- renal blood vessels
Lies just under the renal capsule and also extends between the pyramids as the renal columns of Bertin
5-11 renal pyramids of Malpighi
Tips terminate as 5-11 renal papillae which abut minor calyces.
Papillary dicts of Bellini open onto the surgace of the renal papillae athe the area cribrosa
5-11 cup-shaped structures that abut the renal papillae.
Each may receive 1-3 papillae.
Continuous with the major calyces.
Tapers inferomedially to become continuous with the ureter at the ureteropelvic junction.
Form in calyces and renal pelvis.
Small ones may pass through the ureter into the bladder.
Larger ones may lodge
1) at ureteropelvic junction
2) where ureter crosses the pelvic brim
3)entrance of the ureter into the bladder
Abdominal aorta branches at L1 into the left and right of this.
The longer right renal artery passes posterior to the IVC on the way to the right kidney.
Each gives rise to the inferior suprarenal arteries.
Near the renal hilum, each divides into an ANTERIOR DIVISION AND A POSTERIOR DIVISION.
Branch off anterior division of Renal artery - supply anterior segments of the kidney:
- apical segmental artery
- anterosuperior segmental artery
- anteroinferior segmental artery
- inferior segmental artery
312 N (bottom pic!)
Just continues as the posterior segmental artery from the posterior division of the renal artery which supplies the posterior segment of the kidney!
NOTE: LIGATION OF A SEGMENTAL ARTERY RESULTS IN NECROSIS OF THAT ENTIRE SEGMENT OF KIDNEY!!
Since there is very little collateral circulation between segmental arteries (THEY ARE END ARTERIES/DON'T ANASTOMOSE), this can be created between anterior and posterior segments.
A longitudinal incision thourgh the kidney that produces minimal bleeding
Useful for surgical removal of staghorn calculi.
Form during fetal development and persist into the adult. May arise from the renal artery or the aorta.
Ligation of one of these can result in necrosis of the entire segment of kidney.
Segmental arteries of the kidney branch into 5-11 of these.
These then branch into the arcuate arteries.
Arise from the interlobar arteries.
Travel along the base of the renal pyramids at the corticomedullary junction
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