The Kidneys 241 



left organ has the corresponding capsule and the spleen 

 above it and reaches a little above the level of the eleventh 

 spine. The upper limit of each kidney is situated about 

 two inches from the median line. Inasmuch as the direc- 

 tion of each organ is from above downwards and out- 

 wards, the lower end of each kidney will be at a greater 

 distance (generally about half an inch) from the middle 

 line than the upper end. This lower limit of the right 

 kidney extends to a point a little below the level of the 

 second lumbar spine, or, to a point, about one inch above 

 the crest of the ilium, while that of the left kidney reaches 

 the level of the second lumbar spine, i.e., about one and a 

 half to two inches from the iliac crest. The outer border 

 is convex and is distant about three inches from the spi- 

 nous processes. This border has, on the right side, the 

 liver in contact with its upper two-thirds and the ascend- 

 ing colon with the remainder, while, on the left side, the 

 spleen is in relation to the upper half of this border, and 

 the descending colon to the lower half. The inner border 

 is concave, and, on the right side, lies close to the vena 

 cava, whereas, the inner border of the left kidney is about 

 one inch from the aorta. This inner border presents, about 

 its middle third, a vertical fissure, the hilum with an an- 

 terior and a posterior lip, and, since the kidney is directed 

 obliquely, not only from above downwards, but also from, 

 before backwards and outwards, it follows that the pos- 

 terior lip points forwards rather than inwards. The hilum 

 gives passage to the structures entering and leaving the 

 kidney, and these structures are : The renal vessels ; the 

 renal plexus of nerves; the ureter; the lymphatics and 

 connective tissue, the latter continuous with the capsule. 

 The bloodvessels of the kidney are the renal artery 

 and the renal vein, the latter on the right side being very 

 short on account of the proximity of the kidney on that 



