File:Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women (1922) (14579502647).jpg

Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
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Publisher: New York, London : D. Appleton and company

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nch (Fig. 201). (3) In cases of posterior pelvis the anterior arteries preponderate andthe line of arterial division is posterior to the lateral convex border. The lowerpole is always supplied by branches of the anterior system (Figures 198, 199and 200). The overwhelming majority of kidneys are of the third type, already de-scribed at length. There are, of course, many individual variations within thistype, and so we find extreme cases where the posterior artery is very insignifi- 426 THE SURGICAL ANATOMY OF THF KIDNEY. cant, and again others where it is nearly as large as the anterior. The bestguide in the determination of the extent of the territory of the posterior arteryis the posterior contour of the hiluni. If the hilnm forms a deej) transversenotch (Fig. 198), the posterior artery is small and terminates early; if theposterior notch of the hilum is shallow, the artery is larger; and, if its curve isthe same as that of the anterior notch, the two arterial systems are about equal
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Posterior Lateral Fig. 203.—Three Views of Corrosion Preparation of Kidney with Double Pelvis.This represents, Hke the preceding figures, a type form. Note how complex the arterialcirculation has become. There are now two posterior arteries, each skirting the renalpelvis as in a normal case. The lower posterior artery runs obliquely backward betweenthe two renal pelves. The shaded areas represent the territory of the posterior vascular-ization. (Fig. 201), and so forth. Rotation or torsion of the lower half frequentlyproduces an oblique line of arterial division and an overlapping of the posteriorsystem in its lower portion. From a surgical standpoint the most unfavorable arrangement of the ves-sels is found in some kidneys with divided pelvis, in which a large arterialbranch may curve from the anterior system between the two pelves over to the THE ARTERIES. 427 posterior system. There are two oblique planes of arterial division in suchkidneys, coinciding with the oblique axes of th

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