Kidney structure and function Flashcards
what makes up the urinary system
kidneys, ureters, urinary bladder, and urethra
3 main functions of urinary system
excretion, elimination and homeostatic regulation
Functions of urinary system- excretion and elimination
excretion- the removal of waste products from body fluids
elimination- the discharge of these waste products in the form of urine
Functions of urinary system- homeostatic regulation
regulating blood volume and BP- through controlling water in blood, regulating plasma concentrations of ions- how much is lost in urine, stabilise blood pH, conserves valuable nutrients
kidney structure- position and weight and length
2 kidneys located posteriorly either side of the vertebral column level with T12-L3, 10cm long, 5.5cms wide and 3cms thick
kidney structure
have a suprarenal gland located at the apex of each kidney, reddish brown colour shaped like a kidney bean, hang suspended by collagen fibres of the renal fascia, working part of kidney is a thick layer of fat, has. strong outer fibrous capsule
cross section of the kidney- renal cortex
outer part of kidney, has a number of projections that extend down between the renal pyramids, contains the glomeruli, where ultrafiltration
cross section of the kidney- renal medulla
inner part of kidney, 6-12 distinct triangular structures= renal pyramids, the tip of renal pyramids projects into the renal sinus at a point called renal papilla, each renal pyramids is operated by the cortical columns of cortex, contains collecting ducts
what is the renal lobe
renal pyramid + renal cortex + adjacent cortical column
why do kidneys need a good blood supply
they need to have a good blood supply as blood is filtered in kidneys
blood flow to kidneys
renal artery- segmental arteries- interloper arteries- acute arteries- cortical radiate arteries- afferent arterioles- glomerulus- efference arteriole- peritubular capillaries- venules- cortical radiate veins- accurate veins- interloper vein- renal vein
the nephron
tubular structures within the cortex of each renal lobe
consist of the renal tubule and a renal corpuscle, where filtration occurs
how many nephrons does each kidney have
1.25 million
what is in the renal corpuscle
contains the glomerular capsule or bowman capsule and the glomerulus, glomerulus is the capillary network- 50 intertwining capillaries
functions of the kidney (A WET BED)
A- acid based balance, W- Water balance/ regulation, E- erythropoiesis (erythropoietin)- making of RBC, T- toxin removal, B- blood pressure regulation- through release hormone renin, E- electrolyte balance, D- vitamin D activation
how does the kidney regulate BP
through release of hormone renin- released due to low sodium levels or blood volume, or high potassium levels
renal disorders
Nephritis, nephrosis, cancer, vascular disorder, congenital disorders, acute renal failure, chronic renal failure
what is nephritis
inflammation of the kidneys, many types- interstitial nephritis, pyelonephritis, glomerulonephrtis
what causes nephritis
interstitial- caused by an allergic reaction to medication or by long term medication use causing reaction after a long period of time, pyelonephritis- caused by infection, glomernephritis- begins of tutor and sever immunity issues
symptoms of nephritis
pelvic/ kidney/ abdominal pain/ burning sensation on urination/ pus or blood in urine/ swelling of hands, feet, and face, vommiting, high BP
diagnosis- nephritis
inflammatory/ infective markers, urine tests (looking for bacteria or presents of RBC/WBC), scans, raised creatinine and blood urea nitrogen or renal biopsy
treatment of nephritis
dependent on type and cause, interstitial (take person of medication/ look for alternative medication), bacterial- specific antibodies, short term diaphysis
nephrosis
non- inflammatory disease of kidneys, chiefly affecting the nephrons, characterised by the leaking of blood protein into the urine oedema, often seen as a degenerative disease, can be primary disorder or secondary to another disorder
symptoms of nephrosis
sever swelling of eyes/ ankles/ feet, foamy urine, weight gain, fatigue, loss of appetite
treatment of nephrosis
medication to reduce BP and cholesterol, to thin blood and suppress immune systems and diuretics
cancer of kidneys (renal cell carcinoma)
often malignant, primarily over 50s, male>females, strong link to smoking, tend to be asymptomatic in early stages
5 year survival rate- 96% if caught early (Stage 1), to 23% if caught late (stage IV)
Vascular disorder
above that expected in normal gaining, thickening and hardening of arterioles- reduced blood flow to the kidney- ischemia, linked to HTN, DM and heart failure
what does long term schema cause
destruction of renal tissue and chronic renal failure
treatments of vascular disorders
hypertensives, diuretics
congenital disorders
adult polycystic kidney, most common genetic disease, presents itself at about 40 years, gradual development of cysts in both kidney, which gradually expand over years,
how is congenital disorders diagnosed and treatment
rapid changes to blood and urine tests
treatment- reverse primary problem, temporary dialysis
chronic renal failure
gradual inevitable destructions of the kidney over a long period of time, has several stages- decreased reserve- renal insmffincey- end stage renal failure
causes of chronic Renal failure
chronic kidney disease, HTN, DM
treatment of chronic renal failure
once advanced, progress of CRF may be stopped due to scar tissue and loss of function causing further degenerative changes
Chronic renal failure- decreased reserve
around 60% of nephrons lost, decreased glomerular filtration rate and creatine levels within normal range, no clinical signs
Chronic renal failure- renal insufficiency
around 75% nephron lost, changes in blood chemistry with increase in waste products in blood, loss of control- large volumes of dilute urine, decreased RBC production and increase in BP
Chronic renal failure- end stage renal failure
more than 90% nephron lost, all body systems affected by the retention of waste products, anuria develops, regular dialysis or transplant is required
Chronic renal failure- implications for physiotherapy
be aware of fistulas- be careful not to damage it, exercise tolerance- any renal disease will lead to a patient being more fatigued, won’t follow the normal recovery to illness of injury, psychosocial implications- difficult to motivate
