The document discusses the anatomy and physiology of the kidney and knee joint. It provides details on the structure, blood supply, and relations of the kidney. It describes the kidney as being bean-shaped and protected by ribs. It also discusses the inner structure of the kidney including the cortex, medulla, pyramids and calyces. For the knee joint, it identifies it as the largest synovial joint, containing three joints. It outlines the ligaments and articulating bones of the knee and provides an overview of the muscles of the anterior abdominal wall including the external oblique, internal oblique, transverse abdominis and rectus abdominis muscles.

2. ANATOMY& PHYSIOLOGY
Year : 2017
University Annual Exam
Revision Video Tutorial – Part - 3

3. KIDNEY
• The kidneys are paired retroperitoneal
structures.
• Normally located between the transverse
processes of T12-L3 vertebrae.
• The left kidney typically somewhat more
superior in position than the right.

5. KIDNEY STRUCTURE
• The kidneys are bean-shaped with the convex
side of each organ located laterally and the
concave side medial.
• The indentation on the concave side of the
kidney, known as the renal hilus, it provides a
space for the renal artery, renal vein, and
ureter to enter the kidney.

6. KIDNEY STRUCTURE
• Kidney is protected partially by 11th and 12th pair of
ribs.
• Exteriorly kidney is covered by four coverings.
1. Fibrous Capsule
2. Perirenal Fat
3. Renal Fascia
4. Pararenal Fat

7. KIDNEY COVERINGS
• Fibrous Capsule: It surrounds the kidney and
closely applied to its outer surface.
• Perirenal Fat: It surrounds the fibrous capsule.
• Renal Fascia: It is the condensation of connective
tissue and lies outside the perirenal fat.
• Pararenal Fat: Present in larger quantity and lies
external to renal fascia.

8. KIDNEY INNER STRUCTURE
• Renal parenchyma is the internal structure
of the kidney.
• It is divided into two main areas.
– The outer cortex
– The Inner Medulla

9. KIDNEY INNER STRUCTURE

10. KIDNEY INNER STRUCTURE
• The cortex extends into the medulla, dividing
into triangular shapes. These are called as
renal pyramids.
• The apex of the renal pyramid is “Renal
Papillae”.
• Each renal papillae is associated with a
structure known as “Minor Calyx”.

11. KIDNEY INNER STRUCTURE
• Urine passes through the minor calyces and
enter into the renal pelvis.
• Renal pelvis is the funnel shaped structure.
• From renal pelvis the urine drains into the
ureter, from there it goes to the bladder for
storage.

12. KIDNEY INNER STRUCTURE
• Renal Hilum is the entry and exit site for
structures which enters and exits the
kidney, such as vessels, nerves, lymphatics
and ureters.

13. KIDNEY ANATOMICAL RELATIONS
Right Kidney
Anteriorly
Suprarenal gland
Liver
Duodenum
Right Colic Flexure
Posteriorly
• Diaphragm
• 12th rib
• Psoas Major
• Qudratus Lumborum
• Transverse Abdominis
• Subcostal
iliohypogastric and
ilioinguinal nerves

14. KIDNEY ANATOMICAL RELATIONS
Left Kidney
Anteriorly
Suprarenal gland
Spleen
Stomach
Pancreas
Left colic fissure
Jejunum
Posteriorly
• Diaphragm
• 12th rib
• Psoas Major
• Qudratus Lumborum
• Transverse Abdominis
• Subcostal
iliohypogastric and
ilioinguinal nerves

15. KIDNEY ANATOMICAL RELATIONS
ANTERIOR

16. KIDNEY HEIGHT & WEIGHT
• Each kidney is 11 cm long, 6 cm broad and 3
cm thick, weight 150 g in males and 135 g in
males.

17. KIDNEY BLOOD SUPPLY
• Renal Artery
• Interlobar Arteries
• Arcuate Arteries
• Interlobular Arteries
• Afferent Arterioles
• Glomerular Capillaries
• Renal Vein
• Interlobar Vein
• Arcuate Vein
• Interlobular Vein
• Efferent Arteriole
• Glomerular Capillaries

18. KIDNEY LYMPHATIC DRAINAGE
Lymph from the kidney drains into the lateral
aortic nodes, which are located at the origin of
the renal arteries.

19. KIDNEY INNERVATIONS
Renal nerves arise from the superior mesenteric
ganglion and it enters into the hilum.
Splanchinic Nerves (Parasympathetic) supplies
the renal blood vessels.
Hypogastric Plexus (Sympathetic)

20. KIDNEY APPLIED ANATOMY
Congenital Anomalies such as
Horse Shoe Kidney
Ectopic Kidney
Congenital Polycystic Disease
Renal Calculi and Others.

21. KNEE JOINT
• Knee joint is the largest and most complicated
joint in the body.
• It has 3 joints within a synovial cavity.
Medial Condylar Joint
Later Condylar Joint
Patellofemoral Joint

22. KNEE JOINT
• The fibula is not directly involved in this joint.
• Medial Condylar Joint lies between the medial
condyle of the femur & medial condyle of the
tibia.
• Lateral Condylar Joint lies between the lateral
condyle of the femur & lateral condyle of the
tibia.
• Patellofemoral Joint lies between patella and
patellar surface of the femur.

23. KNEE JOINT
• Knee joint comes under Modified Hinge
Joint variety, because it allows some
rotatory movements besides flexion and
extension.

24. KNEE JOINT LIGAMENTS
• Four main ligaments stabilize this joint.
• Medially – Medial Collateral Ligament
• Laterally – Lateral Collateral Ligament
These two ligaments stabilize the knee joints against
angulation & Translation.
The other two ligaments are the
• Anterior and Posterior Cruciate ligaments.
There main function is to stabilize the joint against
translation forces.

25. KNEE JOINT LIGAMENTS

26. KNEE JOINT ARTICULATION
• Knee joint is articulated
• Above with the round condyles of the femur.
• Below: with the condyles of the tibia and
their cartilaginous menisci.
• In front: between the lower end of the femur
and the patella.

27. KNEE JOINT CAPSULE
• Knee joint capsule is the structure surrounding
the knee, made up of ligaments, bone and fluid
filled cavities.
• It allows the full knee to have flexion, or
bending motion due to the folds within the
capsule.
• The capsule contains synovial fluid. This fluid
circulates around the patella, tibia, and femur.
It helps lubricate and provide nutrients to the
joint.

28. KNEE JOINT BURSAE
• This joint is also surrounded by small sac like
structures, that have an inner lining of synovial
membrane called bursae.
• The function of these is to allow, smooth
movement of various ligaments and tendons.
• There are 13 bursae around knee joint.
– 4 anteriorly
– 4 laterally
– 5 medially

29. KNEE JOINT BURSAE

30. KNEE JOINT BLOOD SUPPLY
• Popliteal artery
• Femoral artery
• Tibial Artery

31. KNEE JOINT NERVE SUPPLY
• Femoral Nerve
• Tibial Nerve
• Common Peroneal Nerve
• Obturator Nerve

32. KNEE JOINT APPLIED
ANATOMY
• Bursitis
• Meniscal tears
• Ligament tears
• Dislocation

33. MUSCLES OF
• The muscles of the anterior abdominal wall
consist of three thin sheets.
• External Oblique
• Internal Oblique
• Transverse Abdominis
These muscles are present from the exterior to
interior.

34. MUSCLES OF ANTERIOR
ABDDOMINAL WALL
• On the other side in anterior midline is a
additional, wide vertical muscle, the rectus
abdominis is present.

35. MUSCLES OF ANTERIOR
ABDDOMINAL WALL

36. EXTERNAL OBLIQUE MUSCLES
• It is one of the largest part of the trunk
area.
• Each side of the body has an external
oblique muscles.
• Origin: Anterior angles of lower eight ribs.
• Insertion: Anterior Iliac Crest and
abdominal aponeurosis to linea alba.

37. INTERNAL OBLIQUE MUSCLES
• It is located beneath the external oblique
muscles.
• Origin: Iliac crest, Inguinal ligament,
Thoracolumbar fascia.
• Insertion: Cartilage of ribs 8 – 12.

38. INTERNAL OBLIQUE MUSCLES

39. TRANSVERSE ABDOMINIS
MUSCLES
• It is also known as Trnsverse Abdominal
Muscle (TVA) and Transversalis Muscle.
• It is the deepest of the abdominal muscle.
• It lies internally to the internal abdominal
muscles.
• It is a thin sheet of muscle fibers, these fibers
runs horizontally and anteriorly.

40. TRANSVERSE ABDOMINIS
MUSCLES

41. TRANSVERSE ABDOMINIS
MUSCLES
• Origin: Costal Margin, Lumbar Fascia,
Anterior two thirds of the iliac crest and lateral
half of the inguinal ligament.
• Insertion: Aponeurosis of posterior and
anterior rectus sheath and conjoint tendon to
pubic crest and

42. RECTUS
ABDOMINIS MUSCLES
• Rectus Abdominis Muscle is also called as
“Abs”.
• These are a pair of long, flat muscles that
extends vertically along the entire length of
the abdomen adjacent to the umbilicus.
• Each muscle consists of a string of four
fleshy muscular bodies connected by narrow
bands of tendon.

43. RECTUS
ABDOMINIS MUSCLES

44. RECTUS
ABDOMINIS MUSCLES
• This lumpy appearance results in the rectus
abdominis muscles being referred to as the
“six-pack.”
• Origin: Pubic crest and the pubic
symphysis.
• Insertion: 5, 6, 7 Intercostal cartilages.
Medial intercostal margin and posterior
aspect of xiphoid.

45. END OF PART – 3
ANATOMY END