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This fissure is a hilum that transmits the vessels, nerves, and ureter. 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 right kidney is often found more caudally and is slimmer than the left kidney, which may have a so-called dromedary hump due to its proximity to the spleen. The kidney is surrounded by a capsule separating the kidney from the echogenic perirenal fat, which is seen as a thin linear structure.
The kidney is surrounded by tough fibrous tissue, the renal capsule, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (rear) surface is the transversalis fascia. The superior pole of the right kidney is adjacent to the liver.
The unipapillary kidney with a single renal pyramid is the simplest type of kidney in mammals, from which the more structurally complex kidneys are believed to have evolved. [17] [6] [18] Differences in kidney structure are the result of adaptations during evolution to variations in body mass and habitats (in particular, aridity) between species.
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Despite the right kidney lying 1 cm lower than the left (right just below and the left just above the plane), [2] to be practical, the surface markings are taken the same way. The hilum of the kidney on the left and right is taken as 5 cm from the vertical midline and is on the transpyloric plane. [6]
[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 right vertical limb of the "H" defines the left and right functional lobes, while the left vertical limb of the "H" defines the right and left anatomical lobes. The horizontal line between the vertical limbs of the "H" represents the porta hepatis. The quadrate and caudate lobe lie superior and inferior to this line respectively.