Atlas of Human Anatomy in Cross Section: Appendix: Topography of the Thorax and Abdomen

Kidneys

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Right, Superior Extremity

According to Eycleshymer and Schoemaker, the superior extremity of the right kidney varies in position from the middle of the tenth thoracic vertebra to the middle of the first lumbar vertebra. The average position is at the level of the upper third of the twelfth thoracic vertebra. Merkel, Corning, and Morris place the highest point of the right kidney at the level of the twelfth thoracic vertebra. Joessel found it at the level of the lower border of the twelfth; Piersol, at the upper border of the twelfth; and Cunningham, at the level of the twelfth thoracic spine. The present study places it at the level of the lower third of the eleventh thoracic vertebra.

Right, Inferior Extremity

The position of the inferior extremity of the right kidney ranges from the second lumbar disk to the upper third of the fourth lumbar vertebra. The average position is at the level of the lower third of the third lumbar vertebra. Merkel, Corning, Piersol, and Joessel place the inferior extremity of the right kidney at the level of the third lumbar vertebra, and Cunningham places it at the third lumbar spine.

Left, Superior Extremity

The superior extremity of the left kidney was found by Eycleshymer and Schoemaker to range in position from the ninth thoracic disk to a level between the lower third of the twelfth thoracic vertebra and the twelfth thoracic disk. The average position is at the level of the eleventh thoracic disk. Merkel, Spalteholtz, Corning, and Piersol found the highest point of the left kidney at the level of the eleventh thoracic vertebra. Joessel places it at the upper border of the twelfth thoracic vertebra, and Cunningham places it at the level of the tenth thoracic spine.

Left, Inferior Extremity

Eycleshymer and Schoemaker reported that the inferior extremity of the left kidney varied in position from the second lumbar disk to the third lumbar disk with the average position being at the level of the middle of the third lumbar vertebra. Corning found the inferior extremity at the level of the second lumbar disk; Morris, at the middle of the second lumbar; Piersol, at the lower border of the second lumbar; Merkel, at the upper border of the third lumbar; Joessel, at the middle of the third lumbar; Spalteholtz, at the third lumbar; and Cunningham, at the level of the third lumbar spine. Recamier, Glateney, and Gosset (cited but not referenced in Eycleshymer and Schoemaker) reported that most kidneys lie opposite the twelfth thoracic and the first and second lumbar vertebrae. The normal variations, according to these same authors, range from the upper margin of the eleventh thoracic vertebra to the lower margin of the third lumbar vertebra. Birmingham and Thompson (cited but not referenced in Eycleshymer and Schoemaker) reported the average distances of the kidneys from the iliac crests as follows. Right kidney in females, average distance, 2.7 cm; in males, 3.2 cm. Highest in females, 7.5 cm; in males, 6.6 cm. Lowest in females, below the iliac crest; in males, even with the iliac crest. Left kidney in females, average distance, 3 cm; in males, 4 cm. Highest in females, 7.5 cm; in males, 8.5 cm. Lowest in both females and males, similar to that given for the right kidney.

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