WBR0412

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Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D. and Alison Leibowitz [1])]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Anatomy
Sub Category SubCategory::Renal
Prompt [[Prompt::A 56-year-old male smoker presents to the surgical ward for a left nephrectomy. The patient had recent complaints of gross hematuria and was then diagnosed with renal clear cell carcinoma. During his surgery, the surgeon notes the anatomy of the renal blood vessels and their neighboring structures. Which of the following statements is most accurate regarding the renal blood vessels and their surrounding structures?]]
Answer A AnswerA::The renal veins lie posterior to the renal arteries
Answer A Explanation [[AnswerAExp::The renal veins lie anterior to the renal arteries.]]
Answer B AnswerB::The right renal vein drains directly into the inferior vena cava, while the left renal vein drains into the inferior mesenteric vein
Answer B Explanation [[AnswerBExp::Both the left and right renal veins drain directly into the inferior vena cava.]]
Answer C AnswerC::The renal arteries lie at the same level of the vertebral body as the inferior mesenteric artery
Answer C Explanation AnswerCExp::The renal arteries lie at a higher level than the inferior mesenteric artery. The renal arteries lie at the level between the L1 and L2 vertebral bodies while the inferior mesenteric artery lies at the level of the L3 vertebral body.
Answer D AnswerD::The right gonadal vein drains into the right renal vein
Answer D Explanation [[AnswerDExp::The left gonadal vein drains into the left renal vein, whereas the right gonadal vein drains directly into the inferior vena cava.]]
Answer E AnswerE::The left renal vein is longer than the right renal vein
Answer E Explanation AnswerEExp::The left renal vein is correctly longer than the right renal vein.
Right Answer RightAnswer::E
Explanation [[Explanation::The left renal vein is usually longer than the right renal vein because the inferior vena cava is located slightly to the right side of the body closer to the right renal vein. This anatomical distinction is especially significant in renal transplantation, where donor kidneys are generally retrieved from the left side due to the surgical advantage provided by the long left renal vein.

Educational Objective: The left renal vein is longer than the right renal vein. This has significant surgical implications in the preferential choice of left kidney donation over the right kidney in renal transplantation.
References: Mir NS, Ul Hassan A, et al. Bilateral duplication of renal vessels: anatomical, medical, and surgical perspective. Int J Health Sci. 2008;2(2):179-185.
First Aid 2014 page 524, 563]]

Approved Approved::Yes
Keyword WBRKeyword::Renal vein, WBRKeyword::Renal transplant, WBRKeyword::Kidney transplant, WBRKeyword::Renal cell carcinoma
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