1258 



THE UKO-GENITAL SYSTEM. 



If a line is drawn round the body at the level of the lowest part of the thoracic 

 wall, the whole, or almost the whole, of the left kidney will be found to lie above 

 the level of the subcostal plane so determined. It is, therefore, situated in the 

 subcostal zone of the abdominal cavity. The right kidney, however, although it 

 lies for the most part in the subcostal zone, usually projects at its inferior part 

 somewhat below the subcostal plane, and hence lies to some extent in the umbilical 

 zone. It is often stated that the kidneys are placed on a somewhat lower level 

 in the female than in the male subject. 



By far the greater part, usually two-thirds or more, of the kidney lies to 

 the medial side of a line drawn vertically upwards through the middle point of 

 the inguinal ligament. 



The posterior aspect of the kidney is closely applied against the muscles 

 attached to the bodies of the last thoracic and upper three lumbar vertebrae, and is 

 placed in front of the last rib and of the transverse processes of the upper three 



Hepatic artery 



Inferior vena cava 



Pancreas 



Left suprarenal gland 



Splenic artery 



Right suprarenal gland 

 Portal vein 



Spleen 



Bile-duct 



Descending part 

 of duodenum 



Right 

 kidney 



Left flexure 

 of colon 



Right flexure 

 of colon 



Left kidney 



Right ureter Spermatic vein 



Inferior Left ureter 

 mesenteric vein 



FIG. 979. DISSECTION TO SHOW THE RELATIONSHIPS OF THE KIDNEYS. The greater part of the stomach 

 has been removed by an incision made close to the pylorus. The transverse colon has been taken away 

 and the small intestine has been cut across close to the duodeno-jejunal flexure. 



A model prepared by the late Professor Birmingham has been made use of in this drawing. 



lumbar vertebras. In some cases, more frequently on the left side of the body, 

 the eleventh rib also lies behind the upper part of the kidney. The relationship 

 of the kidney to the lower two ribs is, however, very inconstant, owing partly to 

 the great variability in size and inclination of these bones. 



The inferior end of the kidney is usually situated from 1 J to 2 inches above the 

 highest part of the crest of the ilium ; the interval between the kidney and the 

 ilium being usually greater on the left side of the body. 



Sometimes the inferior end of the kidney lies on the same level as, or only a 

 short distance above, the iliac crest ; this condition is sometimes due to the crest 

 rising to a higher level than usual, the kidney occupying its normal position in 

 relation to the vertebral column. It is important to remember that during life 

 the kidney moves upwards and downwards, following the respiratory movements 

 of the part of the diaphragm against which it rests. 



The long axis of each kidney is somewhat oblique, its superior end approaching 

 nearer to the median plane than the inferior. The surface of the kidney which 

 is applied against the muscles forming the posterior wall of the abdomen looks, 



