Kidneys – Clinical Anatomy (renal anatomy)



hello in this video we're gonna talk about the kidneys this is a clinical anatomy video so let's begin by drawing out the kidneys here here I'm drawing the inferior vena cava and here you have your right kidney and your left kidney if we're look looking at this front on in the very front here you have the renal veins draining into the inferior vena cava the right and left renal veins drains into the inferior vena cava behind the inferior vena cava you have the descending aorta the descending aorta has the branches called the renal arteries here is the left renal artery the renal arteries sit behind the renal veins and then behind the renal artery you have the ureter the superior mesenteric artery branches at around the same level as the renal arteries at l1 to l2 vertebral level and the superior mesenteric artery goes actually over the left renal vein above the superior mesenteric artery you have the celiac trunk which branches at about the t12 vertebral level branches above the celiac trunk are the super renal arteries here is your left super renal artery and your right super renal artery and they supply your adrenal glands which are the glands that sit above your kidneys there's also the infra renal artery which actually is a branch of the renal arteries and these guys also supply the adrenal glands very important to know that their lymph nodes that essentially are surrounding the aorta the descending aorta called the para a or tak lymph nodes the lymph drainage from the kidneys go here it's important to remember that the left go needle vein drains into the left renal vein whereas the right go needle vein drains into the inferior vena cava and this has some clinical relevance as well especially in renal cancer as renal cancer can present with left-sided varicocele obviously your kidneys and all these structures I drew sit behind your abdominal cavity they actually sit in the retroperitoneal cavity which means they sit behind the peritoneum Here I am drawing the peritoneum which is a membrane which surrounds your abdominal cavity the liver sits in the right upper quadrant of your abdominal cavity and is one of the possible reasons why your right kidney sits actually lower than your left kidney the kidneys themselves are surrounded by fat let's take a closer look at the right kidney and see the structures that surround the kidney the kidney has three important lay as you can say which collectively make up what's called the ring the renal capsule or the kidney capsule the inner layer is the true renal capsule which can normally be peeled off the kidney itself or when the renal capsule is inflamed it actually can scar and stick on the kidney the next layer is a perinephric fat which is basically just fat surrounding the kidney after this is the renal fashio which is also known as Kuroda's fashion this fashion is important because it extends medially and surrounds the large vessels the inferior vena cava and the descending aorta but also the renal fascia extends down and wraps around the ureter and goes down towards the pelvis this has some clinical relevance so let's look at the clinical anatomy of the renal fascia blood for example that ruptures from the kidney or pus from the perinephric abscess for example can go down the renal fascial compartment into the pelvis the midline attachment of the renal fascia to the large vessels prevents the movement of these collections medially and so rather than moving medially or sideways the collection will go down towards the pelvis and so can cause pain in the pelvic region for example the relationship of the right kidney to other organs here is where the duodenum sits the right : the hepatic flexure sits here and all this is really where the liver is let's take a look at the relationship of the left kidney with the other organs which is a bit more complicated and congested the colons splenic flexure sits here the spleen is slightly above the left kidney the tale of the pancreas tickles the spleen the jejunum lays here and the stomach covers the top part of the left kidney while on this diagram it's good to know that the splenic vein drains also the pancreas here and will then join with the inferior mesenteric vein and then the superior mesenteric vein before forming the portal vein the embryology of the kidneys now the kidneys actually develop in the pelvis and then they migrate up during embryological development developmental abnormalities can occur during this whole process so for example there is a thing called pelvic kidneys and it is where one of the kidneys can stay in can stay in the pelvis and actually fail to migrate up another is aberrant renal artery's which is where a kidney has more than one renal artery and is a very important consideration especially during surgery as these arteries can get in the way another important congenital anomaly is the horseshoe kidney which is where during development the kidney as they migrate up from the pelvis they accidentally fuse and essentially stick together and so they resemble a horse shoe here's an example of a horseshoe kidney this is a CT scan showing the left and right kidney fusing over the great vessels now I think it's important to talk about the peritoneum and the retroperitoneum and understand the concept because I remembered it was pretty hard to understand it when I first started so try to remember this picture of the peritoneum in from an anterior view and the kidneys here remember the peritoneum is the membrane which lines the abdominal cavity so imagine cutting a whole section in the abdomen around the l2 level here is the anterior part here is the right kidney and left kidney so the peritoneum is one continuous sheet and it can be divided into two parts the sheet which attaches to the abdominal wall and the sheet which lines the visceral organs the sheet which attaches to the abdominal wall is called the parietal peritoneum and the continuation of this sheet the sheet which attaches to the organs is the visceral peritoneum and thus the space it creates is the peritoneal cavity or the abdominal cavity any organ or structure sitting behind the peritoneum is therefore retroperitoneal retroperitoneal organs include the kidneys the pancreas except for the tail of the pancreas the spleen and the stomach just to orientate what we learned about the kidneys remember that inferior vena cava and the renal veins sits in front of the descending aorta and the renal arteries you the true renal capsule surrounds the kidneys the perinephric fat surrounds the renal capsule and the kidney and then you have the renal fashio which surrounds everything those are the important layers that surround the kidneys now surrounding the renal fascia also known as gross fashion is another fat layer called the para nephron fat so the kidneys are pretty securely positioned not only by the ribs but also by fat important muscles at the back here that attach to the fatigue the vertebrae are the psoas major and the quadratus lumborum now let's take a look from a posterior view of the body of the of the abdomen and trunk looking at the vertebral bones here the sacrum and then you have the pelvis to orientate yourself the left kidney is here and sits slightly higher than the right kidney the kidneys are protected partially by the ribs the eleventh and twelfth rib is at the level of the left kidney and the 12th rib surrounds part of the right kidney the muscles we spoke about earlier the psoas major and the quadratus lumborum are situated here the psoas major is probably not well represented here but it actually originates at the vertebral t12 body and extends anteriorly and joins with the iliacus muscle forming the iliopsoas the quadratus lumborum has fibers from ribs number 12 and the transverse process of the fatigue of the vertebra during nephrectomy there are nerves which need to be kept in mind which passes around these muscles and also which are close relationship to the kidneys there are three nerves the subcostal nerve the iliohypogastric nerve and the ileal inguinal nerve some clinical anatomy the kidney extends from t12 to l3 the level the kidney hilum is about l2 or l1 this is all so well where the renal artery is situated ribs 11 and 12 envelopes the left kidney and ribs 12 envelopes the right kidney let's now talk about some of the inner structures of the kidneys and also where urine is formed in how it drains so let's work backwards so urine goes down the ureter from the kidneys into the urinary bladder before the ureter you have the renal pelvis and then you have the major calluses and then the minor calyce's the renal pyramids are here where we can find actually the functional units of the kidneys called the nephrons and this is where essentially Uranus really formed the nephrons itself can be divided into different sections the head of the nephron is the Bowman's capsule blood vessels travel to the head of the nephron forming the glomerulus blood gets filtered into the nephron trivial this filtrate travels through the different parts of the nephron the proximal convoluted tubules the loop of Henle the distal correlate tubules and then the collecting duct all the collecting ducts from the thousands of nephrons will converge essentially and drain into the minor calyce's the major Calla sees the renal pelvis the ureter and then goes down to the bladder where urine is eventually stored and that concludes the video on clinical anatomy of the kidneys I hope that was helpful thank you for more anatomy videos simply click the link for more

33 comments

  1. Great video as usual, excellent art work, just one small piece of constructive criticism, the Stomach and Spleen are not retro-peritoneal organs. Thank you for everything you do and God bless .

  2. You are amazing!!! I love how you break it down for your audience so simply to understand. Keep doing what you do!

  3. This video is very helpful!
    But stomach & spleen are not retroperitoneal organs.
    I always remember a mnemonic SAD PUCKER

    S: suprarenal (adrenal) gland
    A: aorta/IVC
    D: duodenum (second and third part)
    P: pancreas (except tail)
    U: ureters
    C: colon (ascending and descending)
    K: kidneys
    E: (o)esophagus
    R: rectum
    (source: https://radiopaedia.org/articles/retroperitoneal-organs-mnemonic)

  4. the pelvic looks just like a dragon xD, anyway, always love your video, best explanation ever, its just like you really understand and not just reading a script

  5. Sir I feel very lucky to watching ur vedios with in depth knowledge..sir u are real harrison… I find real doctor cm teacher in you sir thanku

  6. this was just pefect. I appreciate the details and the different pov, and the related organs. very sufficient. thank you very much !!

  7. Lovely video ๐Ÿ‘๐Ÿ‘Œ,hey! Can you please tell me how do you make these diagrams, are they hand made and simultaneously recorded or it is some kind of software? Your response will be much appreciated.

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