THE KIDNEYS. 



1259 



as a whole, backwards and medially, and that which projects into the abdominal 

 cavity looks forwards and laterally. Hence it happens that the lateral border lies 

 on a more posterior plane , than the medial border. The kidney is rotated in this 

 manner on its long axis to such a degree that the medial margin and hilum are 

 scarcely visible from behind, and only a limited view of the lateral border can be 

 obtained from the front (Figs. 979 and 980). 



The kidneys are placed behind the peritoneum, and project into the posterior 

 part of the abdominal cavity. Each is surrounded by a considerable amount of loose 

 tissue, often loaded with fat ; the fatty tissue, or capsula adiposa, being present 

 in greater quantity round the margins of the kidney, and only to a less extent in 

 front of and behind the organ. The renal vessels and nerves lie in this fat before 

 they enter the kidney, and the adipose tissue is continued, along with the vessels, 

 through the hilum into the renal sinus, where it fills up all the space unoccupied 

 by the vessels and nerves. 



Embedded in the soft fatty tissue surrounding the kidney is a layer of fibrous 



Duoderio-jejunal flexure 

 Stomach 



Head of Pancreas 

 Liver (left lobe) i. Transverse colon just below right flexure 



Gall-bladder 



Ascending 

 colon just 

 below right 

 flexure 



Liver (right 

 - lobe) 



Descending 

 part of 

 duodenum 



llth 

 " Paranephric fat " 



! : Intervertebral nbro-cartilage 



" Perinephric fat " ' Crus of diaphragm 



Quadratus lumborum 

 Cartilage of 12th rib Body of pancreas 



}. 980. TRANSVERSE SECTION THROUGH THE BODY OF A CHILD. The position and relationships of the 

 kidneys are well seen, and the arrangement of the fascia renalis is indicated. The fascia is coloured green. 



tissue to which the term fascia renalis is applied. This fascia surrounds the 

 kidney and a considerable amount of its fatty capsule in the form of a loose 

 sheath, in which may be distinguished anterior and posterior walls. The sheath 

 is open inferiorly and medially, but closed above and to the lateral side of the 

 kidney by the apposition of its walls. Laterally, the anterior and posterior 

 walls of the sheath come into contact and are connected with the retro-peritoneal 

 ; tissue. Medially they remain distinct, and the anterior wall is continued across 

 , the median plane, in front of the renal vessels and the aorta, to join the correspond- 

 ing layer of the opposite side, while the posterior wall fuses with the fascia 

 i covering the psoas and quadratus lumborum muscles. Inferiorly, below the level 

 of the kidney, the anterior and posterior layers of the renal fascia remain 

 i separate, and can be traced downwards into the iliac fossa. Above the level of 

 i the kidney and the suprarenal gland the layers of the renal fascia unite and 

 join the fascia covering the diaphragm. It has been suggested that the terms 

 '' tunica adiposa" and "perinephric fat" should be restricted to the loose fatty 

 bissue enclosed along with the kidney within the sheath of renal fascia, and that 

 the term " paranephric body," or " fat," should be used to denote the tissue outside the 

 sheath. The fibrous capsule of the kidney is joined to the loose sheath formed by 



