326 Kidney

Coronal section through right kidney and suprarenal gland

(posterior aspect). The renal pelvis has been opened and the fatty

tissue removed to display the renal vessels.

Right kidney (posterior aspect). Partial coronal section to expose

internal aspect of the kidney.

Cast of renal pelvis and calices.

1–4 = Renal segments on anterior surface.

1 Renal vein

2 Renal artery

3 Renal pelvis

4 Abdominal part of ureter

5 Major renal calyx

6 Cribriform area of renal papilla

7 Cortex of suprarenal gland

8 Medulla of suprarenal gland

9 Cortex of kidney

10 Medulla of kidney

11 Renal papilla

12 Minor renal calyx

13 Renal sinus

14 Renal columns

15 Fibrous capsule of kidney

Each kidney can be divided into five segments

supplied by individual interlobar arteries

known as end arteries. Thus, obstruction leads

to infarcts marking the trace of segment

borders. The anterior kidney surface reveals

four segments; the posterior, only three (Nos.

1, 4, and 5).

327

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Kidney

1 Hepatic vein

2 Anterior and posterior vagal trunk

3 Inferior vena cava

4 Lumbar part of diaphragm

5 Right greater and lesser splanchnic nerves

6 Celiac trunk

7 Celiac ganglion and plexus

8 Superior mesenteric artery

9 Left renal vein

10 Right sympathetic trunk and ganglion

11 Abdominal aorta

12 Left sympathetic trunk

13 Esophagus (cut),

left greater splanchnic nerve

14 Left suprarenal gland

15 Left renal artery

16 Renal pelvis

17 Renal papilla with minor calyx

18 Left testicular vein

19 Ureter

20 Psoas major muscle

21 Quadratus lumborum muscle

22 Lumbar vertebra (L2)

23 Renal calyx

24 Catheter

Left kidney and suprarenal gland in situ. The anterior cortical layer of

the kidney has been removed to display the renal pelvis and papillae.

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Right kidney (ultrasound image; by courtesy of

Prof. Herrlinger, Fürth, Germany).

Renal pelvis with calices and ureter (X-ray, retrograde

injection; by courtesy of Prof. Herrlinger, Fürth, Germany).

328 Kidney: Arteries

1 Celiac trunk

2 Superior mesenteric artery

3 Middle colic artery

4 Abdominal aorta (with catheter)

5 Splenic artery

6 Upper pole of kidney

7 Anterior branch of renal artery

8 Interlobular arteries

9 Left renal artery

10 Lower pole of kidney

11 Body of first lumbar vertebra

12 Posterior branch of renal artery

13 Anterior inferior segmental artery

14 Superior suprarenal artery

15 Upper capsular artery

16 Perforating artery

17 Lower capsular artery

18 Ureter

19 Right inferior phrenic artery

20 Left inferior phrenic artery

21 Middle suprarenal artery

22 Inferior suprarenal artery

23 Renal artery

24 Left testicular (or ovarian) artery

25 Inferior mesenteric artery

Left kidney (arteriography).

The kidneys are perfused by app. 1.500–1.800 l of blood per

day via the renal arteries. Out of more than 1.2 million

renal corpuscles (glomeruli), 1% of this volume (id 150–180 l)

is filtered as a cell free fluid. In the tubular system, 99% of

this fluid, together with useful substances like glucose and

ions, are reabsorbed. Only 1–1.5 l of urine containing waste

material is excreted.

Diseases of the renal vascular system may impair the filtering

process and thereby the composition of the blood.

Abdominal aorta (subtraction angiography).

Arteries of kidney and suprarenal gland (schematic drawing).

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