structure of kidney.pdf

kidney

1. RENAL
SYSTEM

2. Organs of Renal System
▪2Kidneys
▪2Ureters
▪Urinarybladder
▪Urethra

3. KIDNEY

4. LOCATION
▪Thekidneysarelocatedbehindtheperitoneum,
andsoarecalledretroperitonealorgans.
▪Theylieinthebackoftheabdomenbetween
thelevelsoftheT12andL3vertebrae.
▪Therightkidneyisslightlylowerthantheleft
kidneytoaccommodatetheliver.
▪Bothkidneysarebean-shapedandaboutthe
sizeofanadultfist.

6. COLOR & SHAPE
▪Reddish brown in colour and bean shaped
HEIGHT & WEIGHT
▪Eachkidneyis11cm(4-5”)long,6cm(2-3”)
broadand3cm(1”)thick,
▪Weight150gramsinmalesand135ginfemales.

7. Cont..
▪Thekidneyisabean-shapedstructurewith
aconvexandaconcaveborder.Arecessedarea
ontheconcaveborderistherenalhilum,where
therenalarteryentersthekidneyandtherenal
veinandureterleave.
▪Thekidneyissurroundedbytoughfibrous
tissue,therenal(fibrous)capsule,perirenal
fat,renalfascia,andpararenalfat.

8. COVERINGS

9. ORGANS ASSOCIATED WITH THE KIDNEYS
▪Superiorly-AdrenalGlands
▪Anteriorly-rightlobeofliver,duodenum&
hepaticflextureofcolon
▪Posteriorly-musclesofposteriorabdominalwall

16. ▪Thebaseofeachpyramid
facestherenalcortexand
itsapexcalledrenal
papilla.
▪Portionsofrenalcortex
thatextendsbetween
renalpyramidsarecalled
renalcolumns.

17. ▪Eachkidneyhave2-3majorcalyx&8-18
minorcalyx.
▪Urineformedinthekidneypassesthrough
papillaattheapexofthepyramidintominor
calyxthenintomajorcalyxbeforepassing
throughthepelvisintotheureter.
▪Thewallsofthepelviscontainssmooth
muscleandarelinedwithtransitional
epithelium
▪Peristalsisofsmoothmuscleinthewallsof
thecalycespropelsurinethroughthepelvis,
ureterstothebladder.

18. Blood Flow in the Kidneys

20. FUNCTIONS OF KIDNEYS
▪Regulationofbloodioniccomposition:The
kidneyshelpregulatethebloodlevelsofseveral
ions,mostimportantlysodiumions,potassium
ions,calciumions,chlorideionsandphosphate
ions.
▪RegulationofbloodpH:Thekidneysexcretea
variableamountofhydrogenionsintotheurine
andconservebicarbonateions,whicharean
importantbufferofH+intheblood.Bothofthese
activitieshelpregulatebloodpH.

21. Cont..
▪Regulationofbloodvolume:Thekidneysadjust
bloodvolumebyconservingoreliminatingwater
inurine.
▪Regulationofbloodpressure:Thekidneysalso
helpregulatebloodpressurebysecretingenzyme
renin,whichactivatesrenin-angiotensin-
aldosteronepathway.

22. Cont..
▪Maintainanceofbloodosmolarity:By
separatelyregulatinglossofwaterandlossof
solutesintheurine,thekidneysmaintaina
relativelyconstantbloodosmolaritycloseto300
milli-osmolesperliter.
▪Productionofhormones:Thekidneysproduce
twohormones.Calcitriol,theactiveformof
vitaminD,helpsregulatecalciumhomeostasis,
andErythropoietinstimulatestheproductionof
redbloodcells.

23. Cont..
▪Excretionofwasteandforeignsubstances:the
kidneysexcreteanumberofendproductsof
metabolisminurine.Inadditiontothemetabolic
wastes,thekidneysalsoexcreteforeignsubstances
fromthebody,suchasdrugs,pesticides,andother
chemicalsingestedinfood.

25. RAS OR RAAS
▪Itisahormonesystemwhichregulatesblood
pressureandfluidandelectrolytebalance.
▪Whenrenalbloodflowisreduced
juxtaglomerularcellsinkidneysconvertthe
precursorproreninintoreninandsecreteit
directlyintocirculation.
▪Plasmareninthencarriesouttheconversionof
angiotensinogenreleasedbyliverto
angiotensin-I.

26. ▪Angiotensin-Iissubsequentlyconvertedto
angiotensinIIbyangiotensin-converting
enzymefoundonthesurfaceofvascular
endothelialcells.
▪AngiotensinIIisapotentvasoconstrictivepeptide
thatcausesbloodvesselstonarrow,resultingin
increasedbloodpressure.
▪AngiotensinIIalsostimulatesthesecretionofthe
aldosteronefromtheadrenalcortex.
▪Aldosteronecausestherenaltubulestoincrease
thereabsorptionofsodiumandwaterintothe
blood,andcausingtheexcretionofpotassium.

36. Advance Surgical Treatment
1.ESWL(Extra-CorporealShockWave
Lithotripsy)
2.PercutaneousNephrolithotomy(PCNL)
3.RetrogradeIntraRenalSurgery(RIRS)-
Lasertechnique
4.Open/LaparoscopicApproachto
stones