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In determining the cause of hydronephrosis, the location of obstruction can be determined with a Whittaker (or pressure perfusion) test, wherein the collecting system of the kidney is accessed percutaneously, and the liquid is introduced at high pressure and constant rate of 10ml/min while measuring the pressure within the renal pelvis.
The renal medulla (Latin: medulla renis 'marrow of the kidney') is the innermost part of the kidney. The renal medulla is split up into a number of sections, known as the renal pyramids. Blood enters into the kidney via the renal artery, which then splits up to form the segmental arteries which then branch to form interlobar arteries.
Before reaching the hilus of the kidney, each artery divides into four or five branches. The anterior branches (the upper, middle, lower and apical segmental arteries) lie between the renal vein and ureter, the vein being in front, the ureter behind. The posterior branches, which are fewer in number and include the posterior segmental artery ...
From anterior to posterior, the renal vein exits, the renal artery enters, and the renal pelvis exits the kidney. On the left hand side the hilum is located at the L1 vertebral level and the right kidney at level L1-2. The lower border of the kidneys is usually alongside L3.
The kidney is well supplied with lymphatic vessels, [114] which remove excess fluid with substances and macromolecules dissolved in it from the interstitium that fills the space between the tubules and blood vessels. [115] [116] The anatomy of the lymphatic system of the kidney is similar between mammals. [117]
The arcuate arteries of the kidney, also known as arciform arteries, [1] are vessels of the renal circulation. They are located at the border of the renal cortex and renal medulla. They are named after the fact that they are shaped in arcs due to the nature of the shape of the renal medulla. Arcuate arteries arise from renal interlobar arteries ...
[citation needed] A large "staghorn" kidney stone may block all or part of the renal pelvis. The size of the renal pelvis plays a major role in the grading of hydronephrosis . Normally, the anteroposterior diameter of the renal pelvis is less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [ 2 ]
The vasa recta of the kidney, (vasa recta renis) are the straight arterioles, and the straight venules of the kidney, – a series of blood vessels in the blood supply of the kidney that enter the medulla as the straight arterioles, and leave the medulla to ascend to the cortex as the straight venules.