KUB & Adrenal Gland MCQs

Each kidney is embedded in two layers of fat, with a membrane (the renal fascia), in between the layers. Inside the renal fascia, and directly atop the kidney, is the perirenal fat. Outside the renal fascia, you will find the pararenal fat, which is an elaboration of extraperitoneal connective tissue. Although the kidney is not peritonealized, the peritoneum from the posterior body wall lies over the anterior surface of the pararenal fat. The kidney is not a secondarily retroperitoneal organ it began development in the retroperitoneum. So, it does not have a fusion fascia. Reference : Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186

The kidney is surrounded by a perirenal fatty capsule, the renal (Gerota's) fascia and pararenal fat. The fat offers no resistance to hemorrhage, but blood is contained in the renal fascia. This means that blood would not flow toward the body wall, other kidney, or toward the diaphragm. However, a kidney injury might involve part of the urinary collecting system, and blood from such damage would travel into the ureters and bladder. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186

Preganglionic fibers from the greater thoracic splanchnic nerve directly innervate the suprarenal medulla, causing a systemic sympathetic response. Postganglionic sympathetic axons from the celiac plexus distribute along branches of the celiac trunk to supply the vascular smooth muscle of those arteries. Preganglionic fibers from the lesser thoracic splanchnic nerve travel to the aorticorenal ganglia; postganglionic fibers from the aorticorenal ganglia supply the vascular smooth muscle of the branches of the renal arteries. The postgangionic fibers from the renal plexus provide sympathetic innervation to smooth muscle to the blood vessels supplying the kidney, renal pelvis and upper ureter. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186

The suprarenal medulla is directly innervated by preganglionic sympathetic fibers from the greater thoracic nerve. These fibers synapse on the cells in the adrenal medulla, causing a systemic sympathetic response. Other preganglionic fibers from the greater thoracic nerve synapse in the celiac ganglion; the postganglionic fibers from this ganglion distribute along branches of the celiac trunk. The preganglionic fibers from the lesser thoracic splanchnic nerve synapse in the aorticorenal ganglion--postganglionic processes from this ganglion supply vascular smooth muscle of branches of the renal artery and suprarenal arteries. The preganglionic fibers of the least thoracic splanchnic nerve synapse in the renal plexus. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186

There are five arterial segments in the kidney: Apical Superior Middle Inferior Posterior Blood supply of the kidney: The renal artery is a direct lateral branch of the abdominal aorta. Near the hilum of the kidney, the renal artery is divided into anterior and posterior divisions. These divisions are further divided into five segmental arteries (four anterior and one posterior). The segmental arteries further branch out in a hierarchy to form different arteries. Finally, the renal vein is formed, which joins the inferior vena cava. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186

Ans. is 'b' i.e., 4th part of the duodenum The posterior surface of both kidneys is related to the diaphragm, medial and lateral arcuate ligament, psoas major, quadratus lumborum, transversus abdominis, subcostal vessels, subcostal nerve, iliohypogastric nerve, and ilioinguinal nerve. In addition, the right kidney is related to the 12th rib and the left kidney is related to 11th and 12th ribs. The medial border of each kidney is related to the suprarenal gland above the hilus and ureter below the hilus. The lateral border of the right kidney is related to the right lobe of the liver and hepatic flexure of the colon. On the left side, it is related to spleen and descending colon.

Answer-. is 'C' i.e., The angle between the 12th rib and the erector spinae The angle between the lower border of the 12th rib and the outer border of the erector spinae is known as the renal angle. Overlies the lower part of the kidney. Tenderness in the kidney is elicited by applying pressure over this area.

The renal papillae open into the minor calyces. The papilla is the conical apex of a renal pyramid, where the urine from the collecting ducts enters into the minor calyces. The minor calyces unite to form the major calyces, which further unite to form the renal pelvis. The kidney is divided into an outer cortex and an inner medulla. The renal medulla contains many striated and conical pyramids. The base of the pyramid is peripherally located, whereas the apex is directed towards the renal sinus (hilum). The renal cortex is subcapsular and arches over the bases of the pyramids. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 186