Kidney_Nursing.pptx

he kidneys are a vital organ critical to the human body. From filtering waste from blood to produce red blood cells, it serves a crucial role. With cells and tissue that work together in synchronized form for common function

1. KIDNEY

2. Introduction The closely packed structure and numerous functions of the kidney illustrate the beautiful workmanship of our creator. It not only applies to the kidney but to each and every part of our body The kidneys are also called rene’s from which we have the derivative renal; and nephron from which we have the terms nephron, nephritis, etc

3. Definition Kidneys are a pair of excretory organs situated on the posterior abdominal wall, one on each side of the vertebral column, behind the peritoneum. They remove waste products of metabolism and excess of water and salts from the blood, and maintain its pH

4. Location The kidneys occupy the epigastric , hypochondriac, lumbar and umbilical regions . Vertically, they extend from the upper border of twelfth thoracic vertebra to the centre of the body of third lumbar vertebra.

5. The right kidney is slightly lower than the left , and the left kidney is a little nearer to the median plane than the right. The transpyloric plane passes through the upper part of the hilus of the right kidney, and through the lower part of the hilus of the left kidney.

6. Shape, Size, Weight and Orientation Each kidney is about 11 cm long, 6 cm broad, and 3 cm thick. The left kidney is a little longer and narrower than the right kidney . On an average, the kidney weighs 150 g in males and 135 g in females . The kidneys are reddish brown in colour

7. EXTERNAL FEATURES OF KIDNEY Each kidney is bean-shaped . It has Upper and lower poles, Medial and lateral borders, and Anterior and posterior surfaces.

8. Pole The upper pole is broad and is in close contact with the corresponding suprarenal gland. The lower pole is pointed

9. Surfaces The anterior surface is said to be irregular and the posterior surface flat, but it is often difficult to recognize the anterior and posterior aspects of the kidney by looking at the surfaces.

10. Borders The lateral border is convex. The medial border is concave. Its middle part shows a depression, the hilus or hilum

11. Hilum The following structures are seen in the hilum from anterior side to posterior side. The renal vein The renal artery The renal pelvis, which is the expanded upper end of the ureter

12. RELATIONS OF THE KIDNEYS The kidneys are retroperitoneal organs and are only partly covered by peritoneum anteriorly.

13. Relations Common to the Two Kidneys The upper pole of each kidney is related to the corresponding suprarenal gland. The lower poles lie about 2.5 cm above the iliac crests. The medial border of each kidney is related to: The suprarenal gland, above the hilus , and b . To the ureter below the hilus .

14. 3. Posterior relations : The posterior surfaces of both kidneys are related to the following. Diaphragm Medial and lateral arcuate ligaments Psoas major Quadratus lumborum Transversus abdominis Subcostal vessels Subcostal, iliohypogastric and ilioinguinal nerves.

15. In addition, the right kidney is related to twelfth rib, and the left kidney to eleventh and twelfth ribs. 4. Hilum

16. Other Relations of the Right Kidney Anterior Relations Right suprarenal gland Liver Second part of duodenum Hepatic flexure of colon Small intestine Out of these, the hepatic and intestinal surfaces are covered by peritoneum. The lateral border of the right kidney is related to the right lobe of the liver and to the hepatic flexure of the colon.

17. Other Relations of the Left Kidney Anterior Relations Left suprarenal gland Spleen Stomach Pancreas Splenic vessels Splenic flexure and descending colon Jejunum Out of these, the gastric, splenic and jejunal surfaces are covered by peritoneum. The lateral border of the left kidney is related to the spleen and to the descending colon.

18. CAPSULES OR COVERINGS OF KIDNEY This is a thin membrane which closely invests the kidney and lines the renal sinus. Normally , it can be easily stripped off from the kidney, but in certain diseases, it becomes adherent and cannot be stripped The Fibrous Capsule

19. Perirenal or Perinephric Fat This is a layer of adipose tissue lying outside the fibrous capsule. It is thickest at the borders of the kidney and fills up the extra space in the renal sinus.

20. Renal Fascia The perirenal fascia was originally described as being made up of two separate layers Posterior layer was called fascia of Zuckerkandal and anterior layer as fascia of Gerota .

21. Pararenal or Paranephric Body (Fat) It consists of a variable amount of fat lying outside the renal fascia. It is more abundant posteriorly and towards the lower pole of the kidney. It fills up the paravertebral gutter and forms a cushion for the kidney

22. STRUCTURE Naked eye examination of a coronal section of the kidney shows:

23. The renal cortex is divisible into two parts. Cortical arches or cortical lobules, which form caps over the bases of the pyramids. Renal columns, which dip in between the pyramids Each pyramid along with the overlying cortical arch forms a lobe of the kidney.

24. The renal sinus is a space that extends into the kidney from the hilus . It contains: Branches of the renal artery. Tributaries of the renal vein The renal pelvis. The pelvis divides into 2 to 3 major calyces, and these in their turn divide into 7 to 13 minor calyces. Each minor calyx ( kalyx = cup of a flower) ends in an expansion which is indented by one to three renal papillae

25. Structure of Uriniferous Tubule Each kidney is composed of one to three million uriniferous tubules. Each tubule consists of two parts which are embryologically distinct from each other . These are as follows. The excretory part, called the nephron, which elaborates urine

26. Nephron is the functional unit of the kidn ey, and comprises: Renal corpuscle or malpighian corpuscle (for filtration of substances from the plasma) made up of glomerulus (Latin ball), a tuft of capillaries and Bowman’s capsule . Renal tubule (for selective resorption of substances from the glomerular filtrate) made up of the proximal convoluted tubule, loop of Henle with its descending and ascending limbs, and the distal convoluted tubule

27. The collecting part begins as a junctional tubule from the distal convoluted tubule. Many tubules unite together to form the ducts of Bellini which open into the minor calyces through the renal papillae

28. Juxtaglomerular apparatus is formed at the vascular pole of glomerulus which is intimately related to its own ascending limb of the Henle’s loop near the distal convoluted tubule. The apparatus consists of: Macula densa , formed by altered cells of the distal convoluted tubule . Juxtaglomerular cells, formed by the epithelioid cells in the media of the afferent arteriole. Some agranular cells between macula densa and the glomerulus proper.

29. Blood Supply of Kidney

30. Venous supply of kidney

31. Nerve supply

32. Applied anatomy Polycystic kidney The common diseases of kidney are nephritis, pyelonephritis, tuberculosis of kidney, renal stones and tumours

33. FUNCTIONS OF KIDNEY Remove waste products from the body. Remove drugs from the body. Balance the body's fluids. Release hormones that regulate blood pressure. Produce an active form of vitamin D that promotes strong, healthy bones. Control the production of red blood cells.

34. Question ask Structure of kidney Relations of kidney Function of kidney

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