UPSC MainsMEDICAL-SCIENCE-PAPER-I201310 Marks
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Q6.

Describe the morphological features of kidney. Add a note on relations of right kidney.

How to Approach

This question requires a detailed anatomical description of the kidney, covering its external morphology and a specific focus on the relations of the right kidney. The answer should be structured into two main parts: first, a comprehensive description of the kidney's morphological features (shape, size, surfaces, borders, poles, hilum, etc.), and second, a detailed account of the relations of the right kidney – anterior, posterior, superior, inferior, and medial. Diagrams, while not possible in text format, should be mentally visualized while describing the relations. A clear and concise language is crucial for effective communication.

Model Answer

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Introduction

The kidneys are vital organs responsible for maintaining fluid and electrolyte balance, removing metabolic waste products, and regulating blood pressure. Understanding their anatomical features is fundamental to comprehending their physiological functions and clinical significance. The kidney, a bean-shaped organ, exhibits distinct morphological characteristics that facilitate its role in filtration and excretion. This answer will detail these morphological features, followed by a comprehensive note on the relations of the right kidney, providing a complete anatomical overview.

Morphological Features of the Kidney

The kidney is a reddish-brown, bean-shaped organ located retroperitoneally. Its morphology can be described under the following headings:

1. Shape and Size

  • Shape: Roughly bean-shaped, but somewhat asymmetrical.
  • Length: Approximately 10-12 cm in adults.
  • Width: Approximately 5-7 cm.
  • Thickness: Approximately 2.5-3 cm.
  • Weight: Around 120-170 grams in males and 110-140 grams in females.

2. Surfaces

  • Anterior Surface: Convex and relatively smooth.
  • Posterior Surface: Mostly convex, but with a vertical groove called the renal hilum.

3. Borders

  • Lateral Border: Convex.
  • Medial Border: Relatively straight or slightly convex.

4. Poles

  • Superior Pole: Rounded and extends beyond the 12th rib.
  • Inferior Pole: Tapered and lies near the lumbar vertebrae.

5. Hilum

The renal hilum is a vertical fissure on the medial surface. It is the entry and exit point for renal vessels, nerves, and the ureter. Structures passing through the hilum, from anterior to posterior, are:

  • Renal Vein
  • Renal Artery
  • Ureter
  • Nerves (sympathetic and parasympathetic)
  • Lymphatics

6. Internal Structure

Internally, the kidney is divided into:

  • Renal Cortex: The outer layer, containing renal corpuscles and convoluted tubules.
  • Renal Medulla: The inner layer, consisting of renal pyramids and renal columns.
  • Renal Pelvis: A funnel-shaped structure that collects urine from the renal pyramids and directs it into the ureter.

Relations of the Right Kidney

The right kidney is situated at the level of the 12th thoracic and 1st lumbar vertebrae. Its relations are as follows:

1. Anterior Relations

  • Liver: The right lobe of the liver lies anterior and medial to the kidney.
  • Duodenum: The second part of the duodenum lies anterior and inferior to the kidney.
  • Right Adrenal Gland: Superiorly.
  • Ascending Colon & Hepatic Flexure: Inferiorly.

2. Posterior Relations

  • Diaphragm: The right crus of the diaphragm forms the posterior boundary.
  • Psoas Major Muscle: Lies posterior and lateral to the kidney.
  • Quadratus Lumborum Muscle: Lies posterolateral.
  • Subcostal Nerve & Vessels: Run along the posterior surface.

3. Superior Relations

  • Right Adrenal Gland: Directly superior.
  • Inferior Vena Cava: Lies anterior and to the right.
  • Second Part of Duodenum: Superiorly and medially.

4. Inferior Relations

  • Ascending Colon & Hepatic Flexure: Lies inferiorly.
  • Right Ureter: Descends inferiorly.
  • Iliac Vessels: Distally.

5. Medial Relations

  • Renal Fascia: Encloses the kidney and its relations.
  • Aorta: Anterior to the hilum.
  • Inferior Vena Cava: Anterior and to the right of the aorta.
  • Lymph Nodes: Para-aortic and para-caval lymph nodes.

Conclusion

In conclusion, the kidney’s morphological features are intricately linked to its functional role in maintaining homeostasis. A thorough understanding of its external and internal structures, along with its specific relations – particularly those of the right kidney due to its proximity to the liver and duodenum – is crucial for medical professionals. Accurate anatomical knowledge is essential for diagnosis, surgical planning, and interpreting radiological images. Further research continues to refine our understanding of renal anatomy and its clinical implications.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Retroperitoneal
Located behind the peritoneum, the membrane lining the abdominal cavity. Retroperitoneal organs include the kidneys, ureters, adrenal glands, and pancreas.
Renal Fascia
A dense layer of fibrous connective tissue that surrounds the kidney and provides support and protection.

Key Statistics

Chronic Kidney Disease (CKD) affects approximately 14% of the US adult population (based on 2021 data).

Source: National Kidney Foundation

Globally, an estimated 850 million people have chronic kidney disease (CKD) as of 2019.

Source: Global Kidney Health Atlas

Examples

Renal Transplant

Kidney transplantation is a common treatment for end-stage renal disease, requiring precise anatomical knowledge of the renal vessels and ureter for successful surgical outcomes.

Frequently Asked Questions

What is the significance of the renal hilum?

The renal hilum is the point of entry and exit for vital structures – renal artery, renal vein, ureter, nerves, and lymphatics – connecting the kidney to the circulatory and nervous systems.

Topics Covered

AnatomyUrinary SystemKidneyMorphologyRelationsRight Kidney