Anatomy and Physiology-KIDNEYS

Anatomy and physiology
Kidney
The Kidneys
The kidneys are the primary functional organ of the renal system. They are essential in
homeostatic functions such as the regulation of electrolytes, maintenance of acid–base
balance, and the regulation of blood pressure (by maintaining salt and water balance).
They serve the body as a natural filter of the blood and remove wastes that are excreted
through the urine.
They are also responsible for the reabsorption of water, glucose, and amino acids, and
will maintain the balance of these molecules in the body. In addition, the kidneys
produce hormones including calcitriol, erythropoietin, and the enzyme renin, which are
involved in renal and hemotological physiological processes.
Anatomical Location
The kidneys are a pair of bean-shaped, brown organs about the size of your fist. They
are covered by the renal capsule, which is a tough capsule of fibrous connective tissue.
Adhering to the surface of each kidney are two layers of fat to help cushion them.
The asymmetry within the abdominal cavity caused by the liver typically results in the
right kidney being slightly lower than the left, and left kidney being located slightly more
medial than the right. The right kidney sits just below the diaphragm and posterior to the
liver, the left below the diaphragm and posterior to the spleen.
Resting on top of each kidney is an adrenal gland (adrenal meaning on top of renal),
which are involved in some renal system processes despite being a primarily endocrine
organ. The upper parts of the kidneys are partially protected by lower ribs, and each
whole kidney and adrenal gland are surrounded by two layers of fat (the perirenal and
pararenal fat) and the renal fascia.
The kidneys are located at the rear wall of the abdominal cavity just above the waistline
and are protected by the ribcage. They are considered retroperitoneal, which means
that they lie behind the peritoneum, the membrane lining of the abdominal cavity.
There are a number of important external structures connecting the kidneys to the rest
of the body. The renal artery branches off from the lower part of the aorta and provides
the blood supply to the kidneys. Renal veins take blood away from the kidneys into the
inferior vena cava. The ureters are structures that come out of the kidneys, bringing
urine downward into the bladder.
Internal Anatomy of the Kidneys
The cortex and medulla make up two of the internal layers of a kidney and are
composed of individual filtering units known as nephrons.
There are three major regions of the kidney:
1. Renal cortex
2. Renal medulla
3. Renal pelvis
The renal cortex is a space between the medulla and the outer capsule. The renal
medulla contains the majority of the length of nephrons, the main functional component
of the kidney that filters fluid from blood. The renal pelvis connects the kidney with the
circulatory and nervous systems from the rest of the body.
Renal Cortex
The kidneys are surrounded by a renal cortex, a layer of tissue that is also covered by
renal fascia (connective tissue) and the renal capsule. The renal cortex is granular
tissue due to the presence of nephrons—the functional unit of the kidney—that are
located deeper within the kidney, within the renal pyramids of the medulla.
The cortex provides a space for arterioles and venules from the renal artery and vein,
as well as the glomerular capillaries, to perfuse the nephrons of the kidney.
Erythropotein, a hormone necessary for the synthesis of new red blood cells, is also
produced in the renal cortex.
Renal Medulla
The medulla is the inner region of the parenchyma of the kidney.

The medulla consists of multiple pyramidal tissue masses, called the renal pyramids,
which are triangle structures that contain a dense network of nephrons.
At one end of each nephron, in the cortex of the kidney, is a cup-shaped structure called
the Bowman’s capsule. It surrounds a tuft of capillaries called the glomerulus that
carries blood from the renal arteries into the nephron, where plasma is filtered through
the capsule.
After entering the capsule, the filtered fluid flows along the proximal convoluted tubule to
the loop of Henle and then to the distal convoluted tubule and the collecting ducts,
which flow into the ureter. Each of the different components of the nephrons are
selectively permeable to different molecules, and enable the complex regulation of
water and ion concentrations in the body.
Renal Pelvis
The renal pelvis contains the hilium. The hilum is the concave part of the bean-shape
where blood vessels and nerves enter and exit the kidney; it is also the point of exit for
the ureters—the urine-bearing tubes that exit the kidney and empty into the urinary
bladder. The renal pelvis connects the kidney to the rest of the body.
Supply of Blood and Nerves to the Kidneys
The renal veins drain the kidney and the renal arteries supply blood to the kidney
Renal Arteries
The renal arteries branch off of the abdominal aorta and supply the kidneys with blood.
The arterial supply of the kidneys is variable from person to person, and there may be
one or more renal arteries supplying each kidney.
Due to the position of the aorta, the inferior vena cava, and the kidneys in the body, the
right renal artery is normally longer than the left renal artery. The renal arteries carry a
large portion of the total blood flow to the kidneys—up to a third of the total cardiac
output can pass through the renal arteries to be filtered by the kidneys.
Renal blood supply starts with the branching of the aorta into the renal arteries (which
are each named based on the region of the kidney they pass through) and ends with the
exiting of the renal veins to join the inferior vena cava. The renal arteries split into
several segmental arteries upon entering the kidneys, which then split into several
arterioles.
These afferent arterioles branch into the glomerular capillaries, which facilitate fluid
transfer to the nephrons inside the Bowman’s capsule, while efferent arterioles take
blood away from the glomerulus, and into the interlobular capillaries, which provide
tissue oxygenation to the parenchyma of the kidney.
Renal Veins
The renal veins are the veins that drain the kidneys and connect them to the inferior
vena cava. The renal vein drains blood from venules that arise from the interlobular
capillaries inside the parenchyma of the kidney.
Renal Plexus
The renal plexus are the source of nervous tissue innervation within the kidney, which
surround and primarily alter the size of the arterioles within the renal cortex. Input from
the sympathetic nervous system triggers vasoconstriction of the arterioles in the kidney,
thereby reducing renal blood flow into the glomerulus.
The kidney also receives input from the parasympathetic nervous system, by way of the
renal branches of the vagus nerve (cranial nerve X), which causes vasodilation and
increased blood flow of the afferent arterioles. Due to this mechanism, sympathetic
nervous stimulation will decrease urine production, while parasympathetic nervous
stimulation will increase urine production.

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Anatomy and physiology

Internal Anatomy of the Kidneys

There are three major regions of the kidney:

The medulla is the inner region of the parenchyma of the kidney.

Supply of Blood and Nerves to the Kidneys

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