Figure 11

A, The major renal circulation. The renal artery divides into the interlobar arteries (usually 4 or 5 divisions) that then branch into arcuate arteries encompassing the corticomedullary junction of each renal pyramid. The interlobular arteries (multiple) originate from the arcuate arteries. B, The renal microcirculation. The afferent arterioles branch from the interlobular arteries and form the glomerular capillaries (hemi-arterioles). Efferent arteri-oles then reform and collect to form the post-glomerular circulation (peritubular capillaries, venules and renal veins [not shown]). The efferent arterioles at the corticomedullary junction dip deep into the medulla to form the vasa recta, which embrace the collecting tubules and form hairpin loops. (Courtesy of Arthur Cohen, MD.)

FIGURE 1-2 (see Color Plate)

Microscopic view of the normal vascular and glomerular anatomy. The largest intrarenal arteries (interlobar) enter the kidneys between adjacent lobes and extend toward the cortex on the side of a pyramid. These arteries branch dichotomously at the corti-comedullary junction, forming arcuate arteries that course between the cortex and medulla. The arcuate arteries branch into a series of interlobular arteries that course at roughly right angles through the cortex toward the capsule. Blood reaches glomeruli through afferent arterioles, most of which are branches of interlobular arteries, although some arise from arcuate arteries. ILA—interlobular artery; aa—afferent arteriole.

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