424 CLINICAL APPLIED ANATOMY. 



pressure from below. The bed on which the kidney lies is an 

 inclined plane which, in the erect position, slopes downwards and 

 forwards towards the iliac crest. The bed is narrower and less 

 vertical in women. The kidney normally slides a short distance 

 down the inclined plane of its bed in inspiration. 



Absorption of the retroperitoneal fat, yielding of the muscles 

 of the abdominal wall or pelvic floor, and disarrangement of the 

 planes in which pressure is exerted in consequence of tight 

 lacing, all conduce to the occurrence of movable kidney. The 

 greater frequency with which the right kidney is involved is no 

 doubt due to the superincumbent mass of the liver. The frequent 

 occurrence of movable kidney in the female sex is accounted for 

 by the shallow and more vertical kidney bed, coupled with the 

 influence of tight lacing and pregnancy. 



The excursion of which a movable kidney is capable is 

 limited by the length of its vascular pedicle. When displaced 

 from its proper position, the corresponding loin may feel less 

 full and less resistant. 



The symptoms which may accompany nephroptosis are deter- 

 mined by the relations and connexions of the kidneys. The 

 displaced organ may exercise either pressure or traction on 

 neighbouring parts of the intestinal tract. The descending 

 portion of the duodenum may become sharply bent by the 

 agency of peritoneal bands which pass from the anterior surface 

 of the kidney to the duodenum opposite the point of entrance of 

 the bile duct. The duodenum may be carried downwards with 

 the kidney, and become kinked by the traction exerted on it by 

 the hepato-duodenal ligament. The kidney may assume such a 

 position as to exercise direct pressure on the duodenum or 

 pylorus. By any of these agencies dilatation of the stomach may 

 be produced. Transitory jaundice may be induced by traction 

 on the bile duct or by pressure. The ureter may become 

 twisted, flexed, or otherwise obstructed, and the renal veins may 

 suffer in the same way. Thus hydronephrosis, renal congestion, 

 renal atrophy, and even renal thrombosis, may arise. 



Pain may occur in various forms. In some instances it 



