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Review Question - QID 100957

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QID 100957 (Type "100957" in App Search)
A 22-year-old Caucasian male is stabbed in his left flank, injuring his left kidney. As the surgeon undertakes operative repair, she reviews relevant renal anatomy. All of the following are correct regarding the left kidney EXCEPT?

The left kidney has a longer renal vein than the right kidney

13%

63/491

The left kidney has a longer renal artery than the right kidney

36%

175/491

The left kidney lies between T12 and L3

11%

55/491

The left kidney underlies the left 12th rib

15%

76/491

The left kidney moves vertically during deep breathing

23%

114/491

Select Answer to see Preferred Response

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The right kidney, not the left, has a longer renal artery.

The left renal vein is longer than right renal vein (left kidney is therefore preferred during living donor transplantation). Both kidneys move vertically 2-3 cm as the diaphragm moves during deep breathing. The kidneys lie immediately deep to the tips of the 12th ribs (recall that ribs 11 and 12 are floating ribs). A fracture of the 12th rib can injure the kidney.

Moore et al. provide an overview of further clinical consequences of renal anatomy. The longer left renal vein crosses the midline between the SMA (which lies anterior to the left renal vein) and the abdominal aorta (which lies posterior to the left renal vein) to reach the IVC. This makes the left renal vein vulnerable to renal entrapment syndrome when compressed, with symptoms including left testicular pain, hematuria, and/or abdominal pain.

Verma et al. explain that the renal blood supply may be incredibly varied. They describe a case report of three left renal arteries with divergent origins and recommend that for renal surgical cases CT, angiography, and arteriography be done prior to surgery to provide the necessary anatomical information to determine the approach.

Illustration A shows the vascular supply to right and left kidneys.

Incorrect Answers:
Answers 1, 3-5 are all true of the left kidney.


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