Kidneys, Ureters, and Adrenal Glands
- The renal fascia(the false capsule or Gerota’s fascia) is a discrete fascial
layer that surrounds each kidney. Paranephric fat outside this capsule
and perinephric fat inside this fascial layer support the kidney. - Minor calycesreceive one or two pyramids before fusing into major
calyces. Two to four minor calyces join to form major calycesthat coa-
lesce to form the renal pelvis. - The uretersnarrow at three points—at the renal pelvis, at the pelvic brim,
and at the bladder. Kidney stones may lodge at these locations with pain
referred, respectively, to the subcostal, inguinal, and perineal regions. - Adrenal arteriesarise from the inferior phrenic arteries, the aorta, and
the renal arteries. The right adrenal vein usually drains medially into the
inferior vena cava; the left adrenal vein usually drains inferiorly into the
left renal vein.
56 Anatomy, Histology, and Cell Biology
Diaphragm
Central C3–C5: neck and shoulder Phrenic nerve
Marginal T5–T10: thorax Intercostal nerves
Forgut:
Stomach, gallbladder, T5–T9: lower thorax, Celiac plexus to greater
liver, bile duct, epigastric region splanchnic nerve
superior duodenum
Midgut:
Inferior duodenum, T10–T11: umbilical region Superior mesenteric plexus
jejunum, ileum, to lesser splanchnic nerve
appendix,
ascending colon,
transverse colon
(Kidney, upper T12–L1: lumbar and Aorticorenal plexus to least
ureters, gonads) ipsilateral inguinal splanchnic nerve
regions
Hindgut:
Descending colon, L1–L2: suprapubicand inguinal Aortic plexus to lumbar
sigmoid colon, regions, anterior scrotum splanchnic nerves
mid-ureters or labia, anterior thighPAIN REFERRAL FROM ABDOMINAL VISCERA
Organ Referral Area Pathway