gross Anatomy of kidney, description of external and internal structure of kidney, the relation of right and left kidney. difference between right and left kidney, and some clinical abnormalities relate to kidney,
Urinary system
a) Anatomy and physiology of urinary system
b) Formation of urine
c) Renin Angiotensin system – Juxtaglomerular apparatus - acid base Balance
d) Clearance tests and micturition
anatomy of stomach,functions of stomach, location, shape position and parts of stomach,orifices of stomach, curvature of stomach, relations of stomach, blood supply, innervation, lymphatic drainage, clinical relation , GERD, peptic ulcer,
gross Anatomy of kidney, description of external and internal structure of kidney, the relation of right and left kidney. difference between right and left kidney, and some clinical abnormalities relate to kidney,
Urinary system
a) Anatomy and physiology of urinary system
b) Formation of urine
c) Renin Angiotensin system – Juxtaglomerular apparatus - acid base Balance
d) Clearance tests and micturition
anatomy of stomach,functions of stomach, location, shape position and parts of stomach,orifices of stomach, curvature of stomach, relations of stomach, blood supply, innervation, lymphatic drainage, clinical relation , GERD, peptic ulcer,
Hope this will help you in studying! :) because you used this, you are obliged to do the same, to upload publicly so that others will have an easy way on researching for their school works! keep up the good work studes! Goodluck!
The genitourinary system, or urogenital system, are the organs of the reproductive system and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathways, like the male urethra.
This was done as a Student presentation on the kidney.
Here following topics are covered.
Macroscopic structure of the urinary system
Microscopic anatomy of the urinary system
Functions of the nephron
Renal blood supply
Kidneys and blood pressure regulation
Structure of ureters and urinary bladder to perform its function
Renal failure
these slides are prepared to understand Urinary system IN EASY WAY Important links- NOTES- https://mynursingstudents.blogspot.com/ youtube channel https://www.youtube.com/c/MYSTUDENTSU... CHANEL PLAYLIST- ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list=PL93S13oM2gAPM3VTGVUXIeswKJ3XGaD2p COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPyslPNdIJoVjiXEDTVEDzs CHILD HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gANcslmv0DXg6BWmWN359Gvg FIRST AID- https://www.youtube.com/playlist?list=PL93S13oM2gAMvGqeqH2ZTklzFAZhOrvgP HCM- https://www.youtube.com/playlist?list=PL93S13oM2gAM7mZ1vZhQBHWbdLnLb-cH9 FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPFxu78NDLpGPaxEmK1fTao COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list=PL93S13oM2gAOWo4IwNjLU_LCuhRN0ZLeb ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list=PL93S13oM2gAPkI6LvfS8Zu1nm6mZi9FK6 MSN- https://www.youtube.com/playlist?list=PL93S13oM2gAOdyoHnDLAoR_o8M6ccqYBm HINDI ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAN4L-FJ3s_IEXgZCijGUA1A ENGLISH ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAMYv2a1hFcq4W1nBjTnRkHP facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-S... facebook group NURSING NOTES- https://www.facebook.com/groups/24139... FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsu... Twitter- https://twitter.com/student_system?s=08
#Nephrons, #kidney, #urine, #BORN,#ASSESSMENT, #APPEARENCE,#PULSE,#GRIMACE,#REFLEX,#RESPIRATION,#RESUSCITATION,#NEWBORN,#BABY,#VIRGINIA, #APGAR, #OXYGEN,#CYANOSIS,#OPTICNERVE, #SARACHNA,#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Functions Of Urinary System
Eliminates metabolic waste products from body
Regulates blood volume and hence blood pressure
Electrolytes and metabolites balance
Maintains acid-base balance
3. Organs Of Urinary System
Kidney
Ureter
Urinary bladder
Urethra
4. Kidney
Reddish Brown, Bean Shaped Retroperitoneal Organ
Weight: 150gm
Location: Posterior Abdominal Wall, T12 To L3
Right Kidney Is Slightly Lower Than Left.
Two Borders: Lateral And Medial
Two Surfaces: Anterior And Posterior
Two Poles: Upper And Lower
Covering: Fibrous Capsule(Renal Capsule)
Blood Supply: Renal Artery & Renal Vein
5. Organs Associated With The Kidneys
As the kidneys lie on either side of the vertebral column, each is
associated with different structures.
Right kidney
Superiorly – the right adrenal gland
Anteriorly – the right lobe of the liver, the duodenum and the
hepatic flexure of the colon
Posteriorly – the diaphragm, and muscles of the posterior
abdominal wall.
Left kidney
Superiorly – the left adrenal gland
Anteriorly – the spleen, stomach, pancreas, jejunum and splenic
flexure of the colon
Posteriorly – the diaphragm and muscles of the posterior
abdominal wall.
7. Kidney: Internal Structure
There are three areas of tissue that can be distinguished when a longitudinal
section of the kidney
outer fibrous capsule, surrounding the kidney
the cortex, a reddish-brown layer of tissue immediately below the capsule and
outside the renal pyramids
the medulla, the innermost layer, consisting of pale conical-shaped striations,
the renal pyramids.
The hilum is the concave medial border of the kidney where the renal blood and
lymph vessels, the ureter and nerves enter.
8. Kidney: Internal Structure
Urine formed within the kidney passes through a renal papilla at the apex of a
pyramid into a minor calyx.
Several minor calyces merge into a major calyx and two or three major calyces
combine forming the renal pelvis, a funnel shaped structure that narrows
when it leaves the kidney as the ureter.
The walls of the calyces and renal pelvis are lined with transitional epithelium
and contain smooth muscle.
Peristalsis, intrinsic contraction of smooth muscle, propels urine through the
calyces, renal pelvis and ureters to the bladder.
9. Nephron
Structural and functional unit of kidney
Two Parts:
Renal Corpuscle-
Bowman’s Capsule
Glomerulus
Renal Tubule-
Proximal Convoluted Tubule(PCT)
Loop Of Henle (LH)
Distal Convoluted Tubule(DCT)
Collecting Duct
10. Structure of Nephron
Each nephron consists of two parts: renal corpuscle for filtration and renal
tubule for selective reabsorption of filtrate until urine is formed.
Renal Corpuscle
Renal corpuscle is also known as malpighian corpuscle. It is spheroid and
slightly flattened structure situated in the cortex of the kidney. The diameter of
the corpuscle is about 200µ. The renal corpuscle is formed by two portions.
Glomerulus
Bowman’s Capsule
11. Glomerulus
The glomerulus consists of many capillaries called glomerular capillaries. These
capillaries connect afferent arteriole with the efferent arteriole. Thus, the
vascular system in the glomerulus is purely arterial.
The capillaries of glomerulus arises from the afferent arteriole. Afferent
arteriole, after entering the glomerulus divides into 4 or 5 large capillaries.
Each large capillaries subdivides into many small capillaries. The small
capillaries are arranged in irregular loops and form anastomosis. All the smaller
capillaries finally reunite to form efferent arteriole.
12. Bowman’s Capsule
Bowman’s capsule encloses the glomerulus and it is formed by two layers,
both layers are composed of flattened epithelial cells.
The diameter is about 200µ. Its cavity has a network of blood capillaries
forming glomerulus.
An afferent arteriole from a branch of renal artery enters into the Bowman’s
capsule and exits as efferent renal arteriole. Afferent arteriole has wider
lumen than efferent arteriole.
13. Renal Tubule
The renal tubule is a duct that leads away from the glomerular capsule and
ends at the tip of a medullary pyramid. It is about 3cm long and divided into
four major regions.
Proximal Convoluted Tubule(PCT)
It is the coiled portion arising from Bowman’s capsule. This occupies the cortex
near glomerulus. The PCT is formed by single layer of cuboidal epithelial cells.
Its length is about 14mm and diameter is 55µ.
14. Loop of Henle
It dips down from cortex to medulla forming descending limb, then it bend
and forms ascending limb which runs from medulla to cortex.
Descending limb: it is the direct continuation of PCT. Its length is 6mm and
diameter 55µ.
Ascending limb: this segment of the loop is continued from descending loop
of Henle. This segment ascends to cortex and forms DCT.
15. Distal Convoluted Tubule(DCT)
It is the continuation of ascending loop of Henle and occupies the cortex of
kidney. It opens into collecting duct. The DCT is composed of cuboidal
epithelial cell with length about 14.5-15 mm and diameter 22-55µ.
Collecting Duct
It is composed of cuboidal or columnar epithelial cells. The length is about
20-22mm and diameter varies between 40-200µ. The DCT opens into
collecting duct.
16. Functions Of Different Parts Of Nephron
Renal Corpuscle: Generates Glomerular Filtrate Composed Of Water, Ions And Small Molecule
Bowman’s Capsule: Filtration Of Blood Forming First Step Of Urine Formation
Renal Tubule
PCT: About 70% Of Glomerular Filtrate Is Reabsorbed In PCT
ReabsorbsSodium,Chloride,Potassium,Water,Glucose,AminoAcids,Bicarbonate,CalciumAndPhosphate
Secretes Ammonium And Creatinine
LH: Descending Limb - Passive Transport Of Water
Ascending Limb - Reabsorbs Sodium And Chloride
Secretes Urea
DCT: Reabsorbs Sodium And Chloride
Collecting Duct: Reabsorbs Sodium, Chloride And Water
Secrets Ammonium, Hydrogen Ions And Potassium
18. Components Of Juxtaglomerular Apparatus
Juxtaglomerular Cells
It is specialized smooth muscle cells situated in the wall of afferent arteriole
just before it enters the Bowman’s capsule.
It is also known as granular cell because the presence of secretary granule in
their cytoplasm.
Juxtaglomerular cells form a thick cuff known as polar cushion or polkissen
around the afferent arteriole before it enters the Bowman’s capsule.
19. Components Of Juxtaglomerular Apparatus
Extraglomerular Mesangial Cells
It is situated in the triangular region bound by afferent arteriole, efferent
arteriole and macula densa. These cells are known as agranular cells or lacis
cells.
Macula Densa
It is situated between afferent arteriole and efferent arteriole and opens
into DCT. It is formed by tightly packed cuboidal epithelial cells.
Juxtaglomerular apparatus secretes two hormones: renin and
prostaglandins.
21. Functions Of Kidney
Regulation of blood volume
Production of blood- by secreting erythropoietin
Blood pressure regulation
Blood pH regulation
Regulation of osmotic pressure of blood
Regulation of Ion composition of blood
Vitamin D synthesis
Excretion of unnecessary substances
22. Ureter
Muscular tube from kidney to urinary bladder
25cm long
Three constriction:
at pelviureteric junction
at pelvic brim
where it enters urinary bladder
23. Structure Of Ureter
The walls of the ureters consist of three layers of tissue :
an outer covering of fibrous tissue, continuous with the fibrous capsule of
the kidney
a middle muscular layer consisting of interlacing smooth muscle fibres that
form a functional unit round the ureter and an additional outer
longitudinal layer in the lower third
an inner layer, the mucosa, composed of transitional epithelium
24. Functions Of Ureter
Propel urine from kidney to the urinary bladder by peristaltic
contraction
Ureter is a Common site of renal colic
25. Kidneys are abdominal organ lying
I. On the posterior abdominal wall
II. On each side of vertebral column
III. Behind the peritoneum
IV. All of the above
All are major functions of kidney except
I. Regulation of water content of body
II. Elimination of waste products from the body
III. Destruction of toxic substance in the body
IV. Regulation of body acidity alkalinity
The function of kidney are
I. WBCs production
II. Water and electrolyte balance
III. Metabolism of protein
IV. All of the above
26. Urinary Bladder
Pear shaped hollow muscular organ
Location: pelvic cavity
Capacity: 500-600ml
Interior of urinary bladder is folded into rugae when empty.
It has 3 orifices.
Trigone of bladder:
The base of the bladder contains three openings that form a triangular area
called the trigone. Two of the openings connect the bladder to the ureters,
while the third connects the bladder to the urethra
27. Gross Structure Of Urinary Bladder
Apex
Neck
3 surfaces:
2 inferolateral surfaces(right & left)
superior surface
Base or Fundus
31. Capacity Of Urinary Bladder
Sense of filling: begins at 100-150 ml
first desire of micturition: 150-250 ml
Physiological capacity: 250-450 ml; in new born: 20-50 ml
Painful sensation: above 450 ml
beyond voluntary control: about 800ml
Anatomical capacity: about 1000ml
32. Functions Of Urinary Bladder:
Collects and temporarily stores the urine
Helps in expulsion of urine by contraction of detrusor muscle.
33. Urethra
Canal extending from neck of bladder to exterior
Length differs in male and female
Male: 18-20 cm
Female: 4cm
34. Parts Of Male Urethra:
I. Penile urethra: about 15-16 cm long and passes though the penis to
external urethral orifice.
II. Membranous urethra: short (1-2cm) thin walled portion where urethra
passes through the muscular floor of pelvic cavity.
III. Prostatic urethra: begins at the urinary bladder and passes about 3-4 cm
through the prostate gland.
35. Female Urethra
The external urethral orifice is embedded in the anterior vaginal wall
inferior to the clitoris, superior to the vaginal opening (introitus), and
medial to the labia minora.
Its short length, about 4 cm, is less of a barrier to fecal bacteria than the
longer male urethra and the best explanation for the greater incidence of
UTI in women.
36. Sphincter Of Urethra
Internal urethral sphincter
This sphincter is situated between neck of bladder and upper end of urethra.
It is made up of smooth muscle fibres and formed by thickening of detrusor
muscle. It is innervated by nerve fibres. This sphincter closes the urethra
when bladder is emptied.
External urethral sphincter
External sphincter is located in the urogenital diaphragm. The sphincter is
made up of circular skeletal muscle fibres, which are innervated by somatic
nerves.
38. Urine Formation
Process of blood cleansing
Urine is formed by filtering the blood at renal corpuscle and
reabsorption of necessary substances in renal tubule.
Mechanism Of Urine Formation
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion
39. Glomerular Filtration
Takes place through semi permeable membrane of glomerulus
and glomerular capsule.
Water and large number of small molecules pass through
Blood cells, plasma protein and other large molecules are
unable to filter so remain in the capillaries.
Filtration is assisted by the
differences between blood
pressure in glomerulus and
pressure of filtrate in glomerular
capsule.
40. Because the efferent arteriole is narrower than the afferent arteriole, a
capillary hydrostatic pressure of about (55 mmHg) builds up in the
glomerulus. This pressure is opposed by the osmotic pressure of the blood,
provided mainly by plasma proteins, about (30 mmHg), and by filtrate
hydrostatic pressure of about (15 mmHg) in the glomerular capsule.
The net filtration pressure is, therefore:
Glomerular filtration pressure
= capillary hydrostatic pressure – (osmotic
pressure of blood + filtrate hydrostatic pressure)
GFP= 55 – (30+15) = 10mmHg
41. Glomerular Filtration Rate (GFR)
Volume of filtrate formed by both kidney in one minute is GFR.
GFR=125ml/min. i.e. 180 litres
Most of the filtrate is reabsorbed.
Less than 1% i.e. 1-1.5 litres is excreted as urine.
42. Tubular Reabsorption/Selective Reabsorption
Process by which composition and volume of glomerular filtrate is altered during
passage through renal tubule.
Reabsorb into blood those filtrate constituents needed by the body to maintain
fluid and electrolyte balance and pH balance.
Reabsorption is achieved by active transport, passive transport, osmosis and
diffusion.
Some constituents of glomerular filtrate do not appear normally in urine because
they are completely reabsorbed unless they are present in blood in excessive
quantities.
PCT: glucose, amino acid, vitamin, hormone, calcium, and some urea
PCT, LH and DCT: 99% water, Na+, Cl- ions
43. Renal Threshold/ Transport Maximum
Kidneys maximum capacity for reabsorption of a substance.
If the level rises above the transport maximum, the substance will appear in
urine.
Hormones Regulating Reabsorption:
Parathyroid hormone and calcitonin regulates reabsorption of calcium and
phosphate.
Antidiuretic hormone(ADH) increases permeability of DCT and collecting
tubule, increasing water reabsorption.
Aldosterone increases reabsorption of sodium and excretion of potassium.
Atrial natriuretic peptide(ANP) inhibits NaCl reabsorption.
44. Tubular Secretion
Substances not required and foreign materials eg. Drugs
including penicillin and aspirin may not be cleared from the
blood by filtration because of short time it remains in the
glomerulus.
Such substances are cleared by secretion into the convoluted
tubules and excreted from the body in urine.
Tubular secretion of hydrogen ion (H+) is important in
maintaining homeostasis of blood pH.
45.
46.
47. The normal GFR is
i. 50 ml per min.
ii. 125 ml per min.
iii. 250 ml per min.
iv. 500ml per min.
Normal daily urine output of an adult is
i. 500ml
ii. 1000ml
iii. 1500ml
iv. 2500ml
In kidney glucose is mainly absorbed by
i. PCT
ii. Loop of Henle
iii. DCT
iv. Collecting tubule
Volume of urine is primarily controlled by
i. ADH or Vasopressin
ii. Oxytocin
iii. ACTH
iv. Growth Hormone
48. Formation Of Uric Acid
In the liver, purines are metabolized to uric acid.
The last step in purine metabolism involves an
enzyme called xanthine oxidase.
50. Urine
Clear amber colored fluid of slight acidic reaction excreted by
kidney.
pH: around 6 (normal range: 4.5-8)
Color: light yellow
Volume excreted: 1-1.5 liters per day
The volume depends on:
i. Amount of water intake
ii. Environmental temperature
iii. Diet
iv. Mental state
Odour: faintly aromatic
56. Micturition
Process of emptying of bladder
Also called voiding
Structures Involved In Micturition:
1. Urinary bladder (detrusor muscle)
2. Urethra (sphincter muscle)
3. Parasympathetic nerves supplying urinary bladder and urethra
57. Mechanism Of Micturition
In infants, accumulation of urine in the bladder activates stretch receptors
in the bladder wall generating sensory (afferent) impulses that are
transmitted to the spinal cord, where a spinal reflex is initiated. This
stimulates involuntary contraction of the detrusor muscle and relaxation of
the internal urethral sphincter, and expels urine from the bladder – this is
micturition or voiding of urine.
In adult, micturition occurs when detrusor muscle contracts, and there is
reflex relaxation of internal sphincter and voluntary relaxation of external
sphincter.
58. Micturition Reflex
Filling of urinary bladder
Stimulation of stretch receptors
Afferent impulse passes via pelvic nerve
Sacral segments of spinal cord
Efferent impulse via pelvic nerve
Contraction of detrusor muscle and relaxation of internal sphincter
Flow of urine into urethra and stimulation of stretch receptors
Afferent impulses via pelvic nerve
Inhibition of pudendal nerve
Relaxation of external sphincter
Voiding of urine
60. Stimulation of parasympathetic nervous system
i. Retains urine in bladder
ii. Helps voiding of urine
iii. Neither
iv. Both
Normal specific gravity of urine is
i. 0.980
ii. 1.000
iii. 1.010
iv. 1.020
61. Urinary Changes With Aging
As a person ages, changes in the kidneys and bladder can affect urinary
system function.
Kidneys
After age 40, kidney function may diminish; if the person lives to age 90, it
may decrease by as much as 50%. Age-related changes in kidney vasculature
that disturb glomerular hemodynamics result in a decline in glomerular
filtration rate. Reduced cardiac output and age related atherosclerotic
changes cause kidney blood flow to decrease by 53%. In addition, tubular
reabsorption and renal concentrating ability decline because the size and
number of functioning nephrons decrease. Also, as blood levels of
aldosterone and renin fall, the kidneys are less responsive to antidiuretic
hormone
62. Urinary Changes With Aging
Bladder
As a person ages, bladder muscles weaken. This may lead to incomplete
bladder emptying and chronic urine retention—predisposing the bladder to
infection.
And the rest Other age-related changes that affect renal function include
diminished kidney size, impaired renal clearance of drugs, reduced bladder
size and capacity, and decreased renal ability to respond to variations in
sodium intake. By age 70, blood urea nitrogen levels rise by 21%. Residual
urine, frequency of urination, and nocturia also increase with age