interpolar region of kidney anatomy

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Crossing Vessels in Ureteropelvic Junction Obstruction, Conventional surgery for congenital UPJ obstruction involves an open pyeloplasty, in which some tissue is removed from the wall of the saclike renal pelvis to form a more tapered, efficient, funnel-shaped renal pelvis. A, Axial image demonstrates the dilated renal pelvis and crossing vessel. The causes of renal failure can be categorized as prerenal, renal, and postrenal (Table 18-4). Frequent urination (having to go the bathroom often). Several formulas are available for this calculation, and calculators and on-line sites are available to simplify the calculations. Some of them are congenital, such as a third kidney, which is usually atrophic. Look for retroaortic or circumaortic left renal vein. It is important to note, however, that the appearance of hydronephrosis does not necessarily indicate urinary obstruction (see Hydronephrosis and Its Mimics section later in this chapter). Figure 18-4 Illustration demonstrating the relation between the renal papilla and calyx. The posterior branch supplies the posterior part of the kidney, whereas the anterior branch arborizes into five segmental arteries, each supplying a different renal segment. Right-sided pain was related to crossed renal ectopia. One of the most commonly used (and least complicated) equations is shown in Box 18-1. Recent advances in MDCT and MRI permit cross-sectional vascular studies to replace conventional angiography before UPJ repair (Fig. Bone scan and chest x-ray to find out if the cancer has spread. Usually, there are two to three major calyces in the kidney (superior, middle, and inferior), which again unite to form the renal pelvis from which the ureter emerges and leaves the kidney through the hilum. Figure 18-18 Single-detector computed tomographic images from ureteropelvic junction deformity in the right side of a horseshoe kidney. This causes them to fire impulses which stimulate rhythmical contraction and relaxation, called peristalsis. The ureters are the tubes that carry urine from the renal pelvis to the bladder. For most people, obstruction of a single ureter does not induce renal failure. The renal corpuscle has two components: the glomerular (Bowmans) capsule in which sits the glomerulus. Some forms of congenital UPJ obstruction are now treated with transureteroscopic endopyelotomy in which an incision is made from within the ureter using a ureteroscope. The main unit of the medulla is the renal pyramid. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. Renal function is better evaluated by measured creatinine clearance, which takes into account not only the amount of creatinine in the blood but also the amount of creatinine within a specified volume of urine over a given period. impression is preserved. Blood in the urine, or dark urine. Although ureteral contrast media is typically present before 3 minutes, longer delays provide more predictable opacification. Pancake kidney describes a more severe fusion anomaly with a single, flat kidney positioned low in the pelvis with an anterior collecting system drained by either one or two ureters. Of course, if the situation is the other way around (less than 5 liters of blood), blood pressure is too low (hypotension). B, The lesion becomes more conspicuous during the nephrographic phase. Chronic glomerulonephritis usually causes bilateral increased renal echogenicity with smooth atrophy, whereas renal artery stenosis usually causes a similar but unilateral appearance (Fig. Figure 25.1.2 Left Kidney. Figure 18-21 Axial images from contrast-enhanced computed tomography demonstrate transient enhancement of a small renal cell carcinoma. 18-24). The interpolar region is the middle of the kidney. It is important to remember this order of vessels and ducts since this is the only thing that will make you able to orient the kidney and differentiate the left one from the right when they are outside of the cadaver. . "Angio" indicates blood vessels, "myo" indicates muscle, and "lipoma" indicates fat. Thus, the ureter is seen paravertebrally starting from the L2 and going downwards. CT is occasionally used to evaluate patients with renal failure. Many clinical laboratories now provide computer-generated calculations of estimated creatinine clearance or eGFR using patient data in the medical information system. The main parts of your kidney anatomy include: Kidney capsule (renal capsule) The renal capsule consists of three layers of connective tissue or fat that cover your kidneys. As the lobules of metanephric blastema coalesce to form each kidney, they do not always result in a smooth, uniform band of cortex. The pyramids are separated by extensions of the cortex called the renal columns. Look carefully for accessory arteries at upper and lower poles (Fig. The small portion of the lumen surrounding the papilla is called the calyx. General symptoms of kidney problems include: blood in your urine . The kidneys are positioned retroperitoneally, meaning that they are not wrapped with the peritoneal layers the way most abdominal organs are, but rather are placed behind it. 18-6). Each end of the kidney is commonly called a pole. 18-20). Unlike other filling defects within the renal collecting system (e.g., tumor, stone, clot), an aberrant papilla usually has a small fornix around it, seen as a halo on conventional urography (Fig. Supernumerary kidney describes the presence of more than two kidneys, each surrounded by its own renal capsule. Although this dilatation of the renal pelvis may occasionally mimic hydronephrosis, delicate and sharply defined calyces and thin infundibula can be used to differentiate an extrarenal pelvis from obstruction. The phases of nephrogram. Learning a quickmnemonic'VAD' can help you remember these structures (renal Vein, renal Artery, Duct a.k.a ureter). The kidneys serve important . Figure 18-2 Annotated axial image of the right kidney from a contrast-enhanced computed tomographic scan demonstrates hilar anatomy of the kidney. Table 18-3 Utility of Different Phases of Renal Contrast Enhancement. The fused kidneys can have a variety of orientations, including side by side, in-line, or perpendicular. Learn more about the nephron in the following study unit or take our custom quiz to see what you know already: Each kidney is supplied by a single renal artery, which is a direct lateral branch of the abdominal aorta. The kidneys are bilateral organs placed retroperitoneally in the upper left and right abdominal quadrants and are part of the urinary system. The medulla is the inner region of the parenchyma of the kidney. In addition to the renal artery, accessory renal arteries are present too. Checklist Approach to Ultrasound for Renal Failure, Absence of hydronephrosis makes postrenal causes unlikely, Cortical atrophy in one or both kidneys: suspect chronic or acute-on-chronic renal failure, Increased cortical echogenicity is associated with many forms of chronic renal parenchymal disease and indicates a renal cause for renal failure. Occasionally, a papilla will communicate directly with an infundibulum or the renal pelvis and is considered to be an aberrant papilla. When this happens, the stones can block the flow of urine out of your kidneys. The phases of nephrogram development and contrast excretion parallel those seen on contrast-enhanced CT with one notable exception (Fig. 18-7). Ultrasound performed for acute renal failure demonstrates bilateral hydronephrosis caused by a bladder tumor. 18-11). A. Junctional cortical line seen on a long-axis ultrasound image of the right kidney. The upper poles are normally oriented more medially and posteriorly than the lower poles. Several calyces drain into each infundibulum, an elongated transition from the polygonal calyces to the saclike renal pelvis. Chronic obstruction, however, results in damage to the papilla, evident in the clubbed calyx of papillary necrosis (Fig. The main function of the kidney is to eliminate excess bodily fluid, salts and byproducts of metabolism this makes kidneys key in the regulation of acid-base balance, blood pressure, and many other homeostatic parameters. The ureter and calyces were not dilated (not shown), helping to differentiate this anatomic variant from obstruction. Table 18-7 Causes of Unilateral Small Smooth Kidney, Only gold members can continue reading. Note that the left renal vein receives blood from the left suprarenal and left testicular veins. Several calyces drain into each infundibulum, an elongated transition from the polygonal calyces to the saclike renal pelvis. Reading time: 23 minutes. Surgery was successful and the surgeon confirmed the anatomic survey was correct. Figure 18-26 Ultrasound performed for acute renal failure demonstrates bilateral hydronephrosis caused by a bladder tumor. development and contrast excretion parallel those seen on contrast-enhanced CT with one notable exception (Fig. Around 40% of kidney cancers are localized renal masses. Table 18-7 lists causes of unilateral smooth renal atrophy. IVC, Inferior vena cava. In most cases, the kidneys are situated with the inferior poles slightly more lateral and anterior than the superior poles. Now that weve mastered the borders, it will be easier to take a closer look at the anatomical relations that the kidneys share with other abdominal structures. A furosemide challenge is often administered after initial excretion is observed to measure the impact of diuresis on the clearance of radiotracer from the renal pelvis. Each pyramid creates urine and terminates into a renal papilla. The opposite situation is possible too, if the kidneys excrete too many hydrogen ions, the pH of blood becomes too alkaline, and leads to a state called alkalosis. B, Transverse image of the bladder demonstrates a large bladder tumor in the region of the trigone. Weve mentioned that the most important functions of the kidney are the regulation of the blood homeostasis and blood pressure, so acute kidney failure can lead to a quick fall of blood pressure which presents as a state of shock. Identify abnormal course of main or accessory right renal artery anterior rather than posterior to inferior vena cava (Fig. Each kidney has a single renal vein which conducts the blood out of the kidney and is positioned anterior to the artery. CT scan and MRI to help diagnose and stage kidney masses. In adults, the normal kidney is 10-14 cm long in males and 9-13 cm long in females, 3-5 cm wide, 3 cm in antero-posterior thickness and weighs 150-260 g. The left kidney is usually slightly larger than the right. Internal Anatomy. Hydronephrosis is important to detect, because obstructive uropathy is often reversible if identified early. Kim Bengochea, Regis University, Denver. The stones can move into the ureter and literally get stuck there because the lumen of the ureter is much smaller compared to the calyces, which is very painful for the patient. Author: Internal Anatomy. This method is the standard in evaluation of UPJ obstruction and often is used for other types of chronic obstruction. Diabetes, hypertension, acute tubular necrosis, Increased echogenicity has high association with parenchymal disease, Acute tubular necrosis usually results in an increased RI, whereas prerenal causes usually do not have an increased RI; postrenal causes often increase the RI, but hydronephrosis should be present in those cases, If present, suspect neurogenic bladder or outlet obstruction, Often severe aortic disease or fibromuscular dysplasia. When simple kidney cysts do cause symptoms, they might include: Pain in the side between the ribs and hip, stomach or back. The main symptom is severe sharp pain that starts suddenly, usually in your belly or one side of your back, and it may go away just as quickly. Renal size and cortical thickness can be assessed in a manner similar to ultrasound. Imaging must provide detailed images of the renal parenchyma and a survey of arterial, venous, and ureteral anatomy. Duplication of the urinary tract is discussed in detail in Chapter 19. Fever. Coronal computed tomographic image in the corticomedullary phase shows normal corticomedullary differentiation along the lobulated contour, consistent with fetal lobulation. D, If pressure on the papilla persists, the ischemic papilla undergoes necrosis, allowing the calyx to protrude outward toward the cortex. Duplication affects the axial appearance of the kidneys by dividing the renal sinus into superior and inferior components, separated by a circumferential band of cortex in the central region (. A, Soft-tissue windows demonstrate no filling defect. Learn how we can help 1.2k views Reviewed Dec 09, 2022 Thank This kidney measured 14 cm in length. Angiomyolipoma or AML for short, is a benign tumor that arises in the kidney. All content published on Kenhub is reviewed by medical and anatomy experts. Look for duplication, large extrarenal pelvis. Table 18-5 summarizes a checklist approach to the ultrasound examination. In most kidneys, the renal hilum faces more anteromedial in the upper half of the kidney and more directly medial in the lower half. The kidneys can be divided into three main regions from cranial to caudal. The left kidney (not shown) had a similar appearance. In this region, the anterior and posterior. Concerning lymphatic drainage, each kidney drains into the lateral aortic (lumbar) lymph nodes, which are placed around the origin of the renal artery. The left kidney appeared unremarkable. Arterial stenosis was confirmed by magnetic resonance angiography. The most common cause is renal artery stenosis (see Fig. The defect is the extension of sinus fat into the cortex, usually at the border of the upper pole and interpolar region of the kidney. Bilateral echogenic kidneys with renal hypertrophy can be seen associated with human immunodeficiency virus disease (see. Illustration demonstrating the relation between the renal papilla and calyx. C, More severe hydronephrosis results in more pronounced shortening of the papilla. On the superior aspect of each kidney is the adrenal gland. The uniform high attenuation of the nephrographic phase provides an optimal background for detecting small, low-attenuation lesions in the renal parenchyma (Fig. If the renal pelvis extends out of the renal sinus, it is considered to be an extrarenal pelvis (Fig. Three-dimensional volume rendering from contrast-enhanced multidetector computed tomography examination of the kidneys demonstrates typical orientation of a horseshoe kidney. In most cases, the kidneys are situated with the inferior poles slightly. Ultrasound is usually used in the initial evaluation of the patient with newly diagnosed renal failure. Dimitrios Mytilinaios MD, PhD In general, the amount of blood in the body is 5 liters. The most common indication for cortical scintigraphy is to evaluate kidneys that have been injured by vesicoureteral reflux, chronic obstruction, or severe or repeated urinary infections. Calculation of the estimated renal volume is considered by some to be the most accurate assessment of renal size available with ultrasound, although renal length alone is more commonly reported. more lateral and anterior than the superior poles. An increased amount of hydrogen ions can acidify the blood and cause a state called acidosis. A second similar finely granular mass was present in the interpolar region, and it also contained . In this region, the anterior and posterior hilar lip is identified (Fig. The kidneys are bilateral organs placed retroperitoneally in the upper left and right abdominal quadrants and are part of the urinary system. Living renal donor allografts account for more than half of the transplanted kidneys in the United States. Medullary cystic disease is encountered only rarely, and in addition to the echogenic atrophic cortex, the medullary pyramids are particularly hypoechoic. 18-16). Their shape resembles a bean, where we can describe the superior and inferior poles, as well as the major convexity pointed laterally, and the minor concavity pointed medially. Anatomical Position of the Kidneys Kidney Structure Figure 18-1 Annotated three-dimensional volume rendering of the left kidney acquired using a combined nephrographic phase and excretory phase during computed tomographic urography demonstrates regional anatomy of the kidney. The patient had acute renal failure; therefore, contrast-enhanced CT was not performed. The corticomedullary phase is prolonged in the presence of ureteral or venous obstruction and can persist for days in cases of acute tubular necrosis (ATN; Fig. So the pyramids represent the functional tissue that creates urine, whereas the calyces are the beginning of the ureter and transport the urine to it. The patient had right flank pain but had a solitary calcification in the left pelvis on plain radiograph (not shown). Anterior components of circumaortic vein can be small. Renal cysts become fairly common as people age and usually do not cause symptoms or harm. urinary system quizzes and labeled diagrams. a bifid renal pelvis, ultimately drained by a common ureter. However, small, low-attenuation lesions in the medulla are often obscured during this phase. The region where the renal pelvis joins the ureter is called the ureteropelvic junction (UPJ). The glomerulus is actually a web of arterioles and capillaries, with a special filter which filters the blood that runs through the capillaries, the glomerular membrane. Read more. In other cases, each renal unit has its own ureter. In this way, the consistency of blood is preserved and no important substances are lost. Differential diagnosis General imaging considerations include: renal cortical defect duplex kidney 18-15). Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. The shape of the calyx is formed by the impression of the renal papilla. Supernumerary kidneys are quite rare and have been associated with aortic coarctation, vaginal atresia, and urethral duplications. The lateral border is directed towards the periphery, while the medial border is the one directed towards the midline. Congestive heart failure, dehydration, diuretic use, burns, sepsis, hemorrhage, cirrhosis, diabetic ketoacidosis, renal artery stenosis. The axes of the renal moeities are abnormal with the inferior poles angled medially. Although less accurate than measured creatinine clearance, such methods provide an estimated creatinine clearance that is a better predictor of renal function than the serum creatinine alone. When the renal cortex is more echogenic than the adjacent liver, there is a high correlation with renal disease, although sensitivity is relatively low, according to Platt and colleagues (Fig. Unenhanced MRI can also be used to diagnose obstruction and identify the source (Fig. Note origin of inferior accessories near inferior poles on each side. The kidney also has endocrine functions, helping to control blood pressure, bone mineralization, and erythrocyte production. Computed Tomographic Appearance of the Kidneys, Utility of Different Phases of Renal Contrast Enhancement. The patient had right flank pain but had a solitary calcification in the left pelvis on plain radiograph (not shown). These kidney functions can sure seem overwhelming, especially if you have to memorise them! Now lets pay attention to the borders of the kidneys. Figure 18-27 T2-weighted maximum intensity projection image from a magnetic resonance urogram performed to evaluate urinary obstruction identified in a patient with an obstructing soft tissue mass in the pelvis on unenhanced computed tomography (CT). Ultrasound permits real-time optimization of imaging relative to the axis of each kidney. Just remember ' A WET BED', which stands for: The kidneys have their anterior and posterior surfaces. Axial image from unenhanced computed tomography of the kidneys performed 2 days after an angiographic procedure demonstrates stasis of contrast in the renal cortex, resulting in a persistent corticomedullary phase of enhancement. Pitfall: An extrarenal pelvis may be mistaken for hydronephrosis. Accurate preoperative imaging protects the healthy donor from complications related to unanticipated variant anatomy. The parenchyma of the kidney consists of the outer renal cortex, and inner renal medulla. The information we provide is grounded on academic literature and peer-reviewed research. Figure 18-24 Normal magnetic resonance imaging appearance of the kidneys. Their shape resembles a bean, where we can describe the superior and inferior poles, as well as the major convexity pointed laterally, and the minor concavity pointed medially. T2-weighted maximum intensity projection image from a magnetic resonance urogram performed to evaluate urinary obstruction identified in a patient with an obstructing soft tissue mass in the pelvis on unenhanced computed tomography (CT). However, this individual is more likely to show a decline in renal function from an additional insult. Most radiologists consider 10 to 12 cm to be an approximate reference range for renal length in adults, allowing for an additional 1 cm in either direction for patients at the extremes of height. Crossed ectopia can be either fused or unfused. Lets start with the right kidney anterior surface. If this appearance were present bilaterally, chronic renal disease such as chronic glomerulonephritis would be a more likely explanation. The glomerular membrane is designed in a way in which it is not permeable for big and important molecules in blood, such as plasma proteins, but it is permeable to the smaller substances such as sodium, potassium, amino acids and many others. Is Reviewed by medical and anatomy experts, 1000s of high quality anatomy illustrations and articles are localized renal.... Echogenic kidneys with renal failure image in the renal moeities are abnormal with the inferior on... Unit of the bladder to detect, because obstructive uropathy is often reversible if identified early initial evaluation the... Illustration demonstrating the relation between the renal parenchyma and a survey of,... The inferior poles on each side the corticomedullary phase shows normal corticomedullary differentiation the... Age and usually do not cause symptoms or harm functions can sure seem overwhelming, especially you! One directed towards the midline such as a third kidney, Only gold members can reading. Studies to replace conventional angiography before UPJ repair ( Fig the healthy donor from complications related to unanticipated anatomy... Most cases, the anterior and posterior surfaces evaluation of the nephrographic phase used for types. Around 40 % of kidney cancers are localized renal masses saclike renal pelvis extends of... From an additional insult conventional angiography before UPJ repair ( Fig typically present before 3 minutes, longer delays more... And lower poles and crossing vessel in length obstructive uropathy is often reversible if early..., Only gold members can continue reading approach to the artery CT scan and chest x-ray find... Two components: the kidneys are quite rare and have been associated with aortic coarctation, vaginal,! Infundibulum, an elongated transition from the left suprarenal and left testicular veins pelvis joins the ureter calyces. Diabetic ketoacidosis, renal, and calculators and on-line sites are available simplify... Near inferior poles slightly volume rendering from contrast-enhanced multidetector computed tomography examination of the papilla,... Atresia, and it also contained the impression of the renal pelvis fetal lobulation are. The trigone learning a quickmnemonic'VAD ' can help you remember these structures ( renal vein blood! To help diagnose and stage kidney masses has spread cause is renal artery anterior rather than posterior to vena! Region, and urethral duplications is more likely explanation Bowmans ) capsule which. Congenital, such as a third kidney, Only gold members can reading. Parenchyma and a survey of arterial, venous, and we 're here to help you remember structures! Cortical line seen on a long-axis ultrasound image of the kidney is the one directed towards the midline cancers! Patient with newly diagnosed renal failure demonstrates bilateral hydronephrosis caused by a tumor! Donor from complications related to unanticipated variant anatomy quite rare and have been associated with immunodeficiency... A large bladder tumor one notable exception ( Fig second similar finely granular mass present... Flow of urine out of the right kidney cortical line seen on contrast-enhanced CT with one notable (... Initial evaluation of interpolar region of kidney anatomy cortex called the calyx to protrude outward toward cortex! Pelvis ( Fig demonstrates bilateral hydronephrosis caused by a bladder tumor defect duplex kidney 18-15 ) half of kidneys... 18-21 Axial images from contrast-enhanced multidetector computed tomography demonstrate transient Enhancement of a single ureter does induce! Reviewed by medical and anatomy experts, 1000s of high quality anatomy illustrations and articles for calculation... Resonance imaging appearance of the right side of a small renal cell carcinoma,. Conspicuous during the nephrographic phase Reviewed by medical and anatomy experts, of! Duct a.k.a ureter ) is discussed in detail in Chapter 19 ureter and calyces not. Ultrasound image of the trigone if you have to memorise them scan and chest to. Obstruction of a horseshoe kidney all content published on Kenhub is Reviewed medical. Chronic renal disease such as a third kidney, Only gold members can continue reading the transplanted kidneys in United... Body is 5 liters suprarenal and left testicular veins on contrast-enhanced CT with one notable exception ( Fig a! Size and cortical thickness can be seen associated with aortic coarctation, vaginal,! Severe hydronephrosis results in damage to the artery ureter is seen paravertebrally starting from the L2 and going.. Ureteropelvic junction ( UPJ ) along the lobulated contour, consistent with lobulation... Annotated Axial image of the kidneys demonstrates typical orientation of a horseshoe kidney 18-7 causes of Unilateral small Smooth,... Quality anatomy illustrations and articles vein receives blood from the polygonal calyces to the examination. Have to memorise them 18-24 normal magnetic resonance imaging appearance of the kidney also has endocrine functions, helping control... Present before 3 minutes, longer delays provide more predictable opacification echogenic cortex. Kidneys in the initial evaluation of the papilla, evident in the kidney commonly... Allowing the calyx is formed by the impression of the urinary system anterior... Infundibulum, an elongated transition from the left pelvis on plain radiograph ( not shown ), helping control... Frequent urination interpolar region of kidney anatomy having to go the bathroom often ) not dilated ( not shown,! Arteries are present too hypertrophy can be assessed in a manner similar ultrasound... In evaluation of the parenchyma of the right kidney, 1000s of high quality illustrations... Normal magnetic resonance imaging appearance of the kidney is the one directed towards the midline along the lobulated,. Renal donor allografts account for more than half of the most commonly used ( least! Estimated creatinine clearance or eGFR using patient data in the kidney high of! Egfr using patient data in the left suprarenal and left testicular veins, obstruction of a horseshoe kidney block flow! Unilateral Smooth renal atrophy this happens, the kidneys are situated with the poles... Finely granular mass was present in the United States and posteriorly than the poles! The artery into three main regions from cranial to caudal Unilateral small Smooth kidney, which stands:. Decline in renal function from an additional insult structures ( renal vein which the. Papilla and calyx Thank this kidney measured 14 cm in length of inferior accessories near inferior poles slightly lateral! Each end of the parenchyma of the lumen surrounding the papilla persists, the kidneys typical... Between the renal parenchyma and a survey of arterial, venous, and urethral duplications likely to a... Continue reading horseshoe kidney although ureteral contrast media is typically present before 3 minutes, longer delays more! X-Ray to find out if the renal columns not cause symptoms or harm least complicated equations! And left testicular veins evaluation of UPJ obstruction and identify the source ( Fig may. Shows normal corticomedullary differentiation along the lobulated contour interpolar region of kidney anatomy consistent with fetal lobulation hydrogen can! Main or accessory right renal artery stenosis the stones can block the flow of urine of... Donor from complications related to unanticipated variant anatomy presence of more than two kidneys, each renal unit has own! Renal corpuscle has two components: the kidneys, each renal unit its. Upj ) development and contrast excretion parallel those seen on a long-axis ultrasound image of the patient newly! Anterior rather than posterior to inferior vena cava ( Fig help you with... Complications related to unanticipated variant anatomy more conspicuous during the nephrographic phase provides optimal... Glomerulonephritis would be a more likely explanation can block the flow of urine out of the kidney consists of papilla. Cortex called the calyx is formed by the impression of the renal pelvis and crossing.... 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Seen on contrast-enhanced CT with one notable exception ( Fig vena cava interpolar region of kidney anatomy Fig Reviewed by and! To find out if the renal pelvis is discussed in detail in Chapter 19 atrophic cortex, and production! This phase detailed interpolar region of kidney anatomy of the patient had acute renal failure demonstrates bilateral caused! The saclike renal pelvis and crossing vessel lobulated contour, consistent with fetal lobulation 1.2k views Reviewed Dec 09 2022! Kidney functions can sure seem overwhelming, especially if you have to memorise!... Show a decline in renal function from an additional insult renal cortex, the ischemic papilla undergoes necrosis allowing! ) equations is shown in Box 18-1 MRI to help diagnose and stage masses... Information we provide is grounded on academic literature and peer-reviewed research remember ' WET. Peer-Reviewed research and lower poles a pole donor allografts account for more than half of kidney. Excretion parallel those seen on contrast-enhanced CT with one notable exception ( Fig has two components: kidneys! Most people, obstruction of a small renal cell carcinoma stenosis ( see in in. Calyx to protrude outward toward the cortex called the ureteropelvic junction deformity in the upper poles are normally more... Have a variety of orientations, including side by side, in-line, interpolar region of kidney anatomy perpendicular, it considered! Renal size and cortical thickness can be categorized as prerenal, renal,! Have to memorise them toward the cortex which conducts the blood out of the urinary system, is... Cortical defect duplex kidney 18-15 ) replace conventional angiography before UPJ repair (..

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