RACK 4 ABDOMIN AND LOWER LIMB

called vasa recta.

By TeachMeSeries Ltd (2023)

Fig 4 – Arterial and venous supply to the kidneys.

Myrto @ PatrasAnatomy

Anatomical Relations

The kidneys sit in close proximity to many other abdominal structures which are important to be aware of clinically:

Anterior

Posterior

Left

• Suprarenal gland
• Spleen
• Stomach
• Pancreas
• Left colic flexure
• Jejunum
• Diaphragm
• 11th and 12th ribs
• Psoas major, quadratus lumborum and transversus abdominis
• Subcostal, iliohypogastric and ilioinguinal nerves

Right

The liver is a large organ found in the upper right quadrant of the abdomen. It is a multifunctional accessory organ of the gastrointestinal tract and performs several essential functions such as detoxification, protein synthesis, bile production and nutrient storage to name only a few.

Internally, the kidneys have an intricate and unique structure. The renal parenchyma can be divided into two main areas – the outer cortex and inner medulla. The cortex extends into the medulla, dividing it into triangular shapes – these are known as renal pyramids.

Anatomical Position

The kidneys lie retroperitoneally (behind the peritoneum) in the abdomen, either side of the vertebral column.

They typically extend from T12 to L3, although the right kidney is often situated slightly lower due to the presence of the liver. Each kidney is approximately three vertebrae in length.

The adrenal glands sit immediately superior to the kidneys within a separate envelope of the renal fascia.

The kidneys are bilateral bean-shaped organs, reddish-brown in colour and located in the posterior abdomen. Their main function is to filter and excrete waste products from the blood. They are also responsible for water and electrolyte balance in the body.

Vasculature

The liver has a unique dual blood supply:

Anatomical Structure

Macroscopic

The liver is covered by a fibrous layer, known as Glisson’s capsule. It is comprised of a large right lobe and smaller left lobe. 

There are two further ‘accessory‘ lobes that arise from the right lobe, which are located on the visceral surface of liver:

The stomach is a muscular organ located on the left side of the upper abdomen. The stomach receives food from the esophagus. As food reaches the end of the esophagus, it enters the stomach through a muscular valve called the lower esophageal sphincter. The stomach secretes acid and enzymes that digest food

Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly caused by injury, such as a fracture.