A26 



APPLIED ANATOMY. 



portion of the anterior surface is an area for the spleen and below one for the splenic 

 flexure of the colon and jejunum. 



The hilum is the name given to the notch in the inner edge of the kidney. It 

 contains the pelvis and commencement of the ureter and the renal vessels and nerves. 

 The sinus is the cavity of the kidney. The edges of the pelvis are attached to the 

 borders, or rim, of the hilum. 



Renal Vessels. The renal arteries come off opposite the first lumbar verte- 

 bra. The right one, a little the longer and higher, passes out beneath the vena 

 cava, head of the pancreas, and second portion of the duodenum. The left one 

 passes behind the pancreas. On reaching the kidney they break into three or four 

 (sometimes more) branches. One of these branches usually proceeds down and 

 enters the kidney on the lower posterior side of the pelvis. The other branches 

 enter anteriorly. The renal vein on leaving the kidney is formed by several branches 



Anterior view 



View of inner edge 

 FIG. 434. The right kidney, showing the relations of the pelvis and blood-vessels. 



which pass either in front or posterior to the arterial branches. Greig Smith held 

 ("Abdominal Surgery," vol. ii., p. 799) that the veins were posterior to the 

 arteries. The pelvis is posterior; hence in searching for stone if it is desired to open 

 the pelvis of the kidney it should be incised posteriorly. The usually accepted order 

 is, pelvis posterior, then the arteries, and lastly the veins most anterior (Fig. 434). 

 The blood-vessels of the anterior portion pass out toward the cortex and on passing 

 its middle encroach a little on the posterior side. For this reason incisions through 

 the kidney substance are made on its convex border about i cm. (f in. ) posterior 

 to its middle (Fig. 435). 



Renal Capsules. There are two capsules of the kidney a fibrous one and a 

 fatty one. The fibrous capsule covers the outside of the kidney and is prolonged into 

 the hilum and lines the sinus. It can be stripped from the kidney, but when the 

 organ is diseased it brings small portions of the kidney substance with it. The fatty 

 capsule surrounds the kidney, being more abundant around its edges and not so 



