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  1. Anatomy
    1. The Kidneys are paired, reddish brown, solid organ, measuring 10-12 cm. in vertical dimension, 5-7 cm. in transverse width and approximately 3 cm. in AP thickness.
    2. In males the normal kidney weighs approx. 150 gm. While in females it is 135 gm.
    3. The kidneys receive about 20% of total cardiac output. Q
    4. At birth Kidneys are irregular in contour with multiple “fetal lobations”, which disappear in first year of life. Some times a focal bulge persists in the mid-lateral contour of the kidney on either side referred to as “DROMEDARY HUMP”.  
    5. This occurs much more frequently on the left side.
    6. The renal parenchyma is divided into Cortex & medulla. The medulla is not contiguous but consists of multiple conical segments,
    7. The RENAL PYRAMIDS, which points centrally into the renal sinus, where it is cupped by an individual minor calyx, thus the number of pyramids corresponds with the number of minor calyx.
    8. The renal cortex covers the pyramids not only peripherally but also extends between the pyramids to renal sinus forming “renal columns of Bertin”. Through these columns renal vessel enter and leave the kidney. 
  2. Renal Vesculature
    1. Each kidney is supplied by an artery (a branch of aorta) and drains into a renal vein (to IVC). The renal vein lies most anterior and pelvis is most posterior, renal artery lies in between (VAP). The right renal artery passes behind the IVC, while the left renal vein is anterior to the aorta.
    2. Some times renal vein divides and sends one limb anterior and one limb posterior to the aorta forming “renal collar”. Q
    3. The main renal artery divides into four or more segmental arteries. The first and most consistent division is posterior branch.
    4. The remaining anterior division branches into apical, upper, middle and lower anterior segmental arteries. Each segmental artery is end artery. Venous drairage overlapping with each signed (Lumbar Lymph node). 
    5. Renal lymphatic: There are often 2 or more lymph nodes at the renal hilum, (first site of metastatis) Q. From the left kidney lymphatic trunk then drain into Para-aortic nodes. From the right kidney, lymphatics drain into inter-aortocaval and para-caval nodes.
    6. Some lymphatics may cross over from right to left and drain primarily into Para-aortic nodes.  
    7. Left renal pedicle longer than right pedicle S-shape.        
  1. In the adult length of Ureter is generally 24 to 30 cm. It is lined by Transitional epithelium. Beneath the epithelium is a layer of connecting tissue, the lamina propria. In a collapsed state ureteral mucosa lies in longitudinal folds. Mucosa is covered by inner longitudinal muscle and outer circular and oblique muscles. Q The adventitial layer contains extensive plexus of ureteral blood vessels and lymphatics.
  2. The Ureter receives its blood supply by multiple feeding branches along its course. In the abdomen feeding vessels comes from, renal artery, gonadal artery, aorta and common iliac artery. In the pelvic cavity additional branches come from internal iliac artery or its branches, mainly the vesical and uterine and also from middle rectal and vaginal Blood supply
  3. The right Ureter is related to the terminal ileum, cecum, appendix, and ascending colon with their mesentery. The left Ureter is related to the descending colon and sigmoid colon along with their mesentery.
  4. Within the female pelvis, Ureters are closely related to the uterine cervix and are crossed anteriorly by the uterine arteries.
  5. Capacity of renal pelvis is 7ml and it is funnel shaped

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