2. KIDNEY: PAIR OF EXCRETORY
ORGAN SITUATED ON THE
POSTERIOR ABDOMINAL WALL,
REMOVE THE WASTE PRODUCTS
OF METABOLISM AND EXCESS
OF WATER AND SALTS FROM
THE BLOOD, AND MAINTAIN
THE PH .
LOCATION: OCCUPY THE
EPIGASTRIC, HYPOCHONDRIAC,
LUMBER AND UMBLICAL
REGION.
3. Structure : Kidney is about:
*11cm long
*6cm broad
*3cm thick
# the weight of the kidney on an
average:
in males-150 g
in females-135 g
#The left kidney is little longer and
narrower than the right kidney
4. Function of kidney:
1. Excretes most of the waste
products of metabolism.
2. Erythropoietin hormone
stimulates bone marrow for
RBCs formation.
3. Converts vitamin D to its active
form.
4. Regulates the blood pressure
by rennin enzyme.
5. Controls water and electrolyte
balance of the body.
6. Maintain acid base balance of
the blood.
5. Relationships to other structure:
on the anterior surface- some structure
separated from the kidney by layer of peritoneum
but some are directly against them.
*Superior pole cover by suprarenal glands
*anterior pole right one cover by liver and left one
is cover by stomach, pancreas and spleen.
*inferior pole cover by small intestine
6.
7. On the posterior surface: right and left kidney related
to same structures.
*Superiorly- it is diaphragm
*Inferiorly-(medial to lateral) muscles are psoas,
quadratus lumborum and transversus abdominis
muscles.
The superior pole of the right kidney is anterior to rib
XII, while the same region of the left kidney is anterior to
ribs XI and Xll
8.
9. Renal facia:
*Outside the renal capsule, there is
accumulation extraperitoneal fat perinephric/
perirenal fat surround the kidney.
*Inside the perinephric fat is a membranous
condensation of extraperitoneal fascia.
# the renal fascia must be incised in any
surgical approach to this organ.
10.
11. Structure of kidney:
*Hilum: medial margin of each kidney,
which is vertical slit through which
renal vessels, lymphatics and nerves
are enter.
*Renal cortex: outer part of kidney
which extends into the medulla
between adjacent pyramids as the
renal column.
*Renal medulla: It is composed of
about 12 renal pyramids.
Outer
cortex
Inner
medull
a
Composed of
renal pyramids
Extended into the medulla
between pyramids as renal
column
Base of each
pyramids directed
toward the cortex
Apex (the rena
papilla)
projecting
medially
12. *extending from the bases of the renal
pyramids into the cortex are striation
known as medullary rays
*the renal sinus within the hilum, contains
the upper expanded end of the ureter, the
renal pelvis.
*renal pelvic divides into two or three
major calyces, which divides into two or
three minor calyces
13.
14. Blood Supply:
*Renal artery single large branch of
the abdominal aorta, supplies each
kidney. Origin of these vessels is
superior mesenteric artery between
vertebrae L1 and L2.
# the left renal artery usually arises a
little higher than the right, and the
right renal artery is longer and passes
posterior to the inferior vena cava.
Renal artery divides into ant. and
15. Renal artery divides into 5
segmental arteries:
* 4 in front and 1behind the renal
pelvis.
16. 1.Lobar artery arises from each segmental
artery, one for each renal pyramid.
2.Each lobar artery gives off 2 or 3
interlobar arteries.
3.interlobar arteries give off the arcuate
arteries at the junction of the cortex and
medulla.
4.the arcuate arteries give off several
interlobular arteries.
5.Interlobular artery gives off afferent
glomerular arterioles.
6.Each nephron is associated with 2
capillary beds : the glomerulus and the
peritubular capillary bed.
17.
18. Nerve of kidneys:
*Renal sympathetic plexus.
*the afferent fibers that travel through the renal plexus
enter the spinal cord in the 10th 11th and 12th thoracic
nerves.
1. The least splanchnic nerve is primarily responsible
for the afferent signaling from the kidney to the brain.
The least splanchnic nerve also carrier visceral efferent
fibers.
2. Sympathetic input to organ is brought visceral
efferent fiber, responsible for stimulating for
stimulating beta-1-adrenergic receptors in the
juxtaglomerular cell of the kidney this leads to
19.
20. Structural and functional unit of kidney:
Nephron (the excretory part)
It is comprises of:
1. Renal corpuscle or Malpighian corpuscle made up
of glomerulus, a tuft of capillaries and bowman’s
capsule.
2. Renal tubule made up of pct, loop of Henle with its
descending and ascending limbs, and the distal
convoluted tubule.
3. Collecting part begins as a junctional tubule from
the distal convoluted tubule. Many tubule unite
together to from the ducts of Bellini which open
into the minor calyces through the renal papillae.
21.
22. Juxtaglomerular apparatus:
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.
Consists of:
1. Macula densa : altered cells of distal convoluted
tubule.
2. Juxtaglomerular cell: epithelioid cells in the media
of the afferent arteriole.
3. Some agranular cell: between macula densa and
the glomerulus proper.
23.
24. Disorders
Common disorders are: Nephritis, Pyelonephritis,
tuberculosis of kidney, renal stone and tumours.
1. Nephritis: condition in which the tissue in the kidney
become inflamed and have problem with filtering waste
from the blood.
2. pyelonephritis: it is a type of uterine tract infection
(UTI) that can spread up to the kidney.
3. tuberculosis of kidney: arise by secondary
hematogenous spread of bacilli to the renal cortex
4.renal stone: hard deposits made of minerals and salts
that form inside the kidneys. This is due to- drink too little
water
obesity
25.
26. 5. Kidney Tumour: these are the growths in kidneys that can
be benign or cancerous. Most of the tumour do not cause
symptoms and are discovered unexpectedly when being
diagnosed and treated for another condition.
this includes: Renal adenoma
Renal oncocytoma
Angiomyolipoma
Fibroma
Lipoma
6. Polycystic kidney: an inherited disorder in which cluster
of cysts develop primarily within your kidneys, causing
kidney to enlarge and lose function over time. These cysts
are noncancerous round sacs containing fluid.
27.
28. Dialysis:
way to remove waste products from your blood when your
kidneys can't adequately do the job any longer.
* This procedure filters the blood in a different way than does
the more common blood-filtering procedure called hemodialysis.
