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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eposit following the ureter (seeFig. 40 A). The capsula adiposa or perirenal fat is enveloped by the fascia renalis,a rather delicate membrane, consisting of two leaves, a prerenal and a retro-renal layer, the latter of which is sometimes called iliac fascia. Both layersunite above, below and laterally to the kidney, but not medianward, wherethe posterior leaf is attached behind the large abdominal vessels to the vertebras,while the anterior leaf passes over to the other side in order to continue asprerenal fascia of the other kidney. Above, the two leaves of renal fascia TOPOGRAPHY OF THE KIDNEYS FROM WITHIN. 57 unite near the tendinous portion of the diaphragm with which they fuse; below,they unite anywhere between the region of the iliac crest and the femoralrinff. according to the amount of fat present. Thev remain, however, some-what apart where the ureter passes between them. Lateral to the kidneys thetwo leaves unite at a varying distance, the length of which again depends upon
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Fig, 39.—Longitudinal Section of the Body Through the Right Mammary Line,Showing the Relations of the Perirenal Fat and the Renal Fascia. the amount of fat present. Approximately, this union takes place just behindthe colon ascendens on the right and the colon descendens on the left. Whenunited the two leaves pass forward directly under the peritoneum between itand the layer of retroperitoneal fat aboA^e described. There is an extensive fibrous framework passing through the perirenal fatbetween the leaves of the fascia and the fibrous capsule of the kidney, andalso around the sides and poles of the kidneys from the anterior leaf over tothe posterior. The fat fills the spaces between these fibrous bands and it de-pends upon the amount whether the bands are long or short. The more fatthere is, the more rigid is the framework enveloping the kidney. If the fatdisappears or decreases in thickness in so short a space of time that the fibrous 58 THE RELATION OF THE KIDNEYS TO THE NEIGHBORI

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