ACKNOWLEDGEMEN

I would like to express my sincere appreciate on a gratitude to my tutor for her guidance and encouragement throughout my third semester.

I am graceful to the local preceptors Sister HTAA and all the staffs in the unit for their cooperation, support, sharing of knowledge and patients during

my attachment to their units.

I am also not forgetting all the specialists for their professional teaching.

SECTION 1: ANATOMY & PHYSIOLOGY OF KIDNEY

Structure

• Paired

• Retroperitoneal

• Partially protected by the 11th and 12th ribs

• Right slightly lower due to liver

• Surrounded by renal capsule

• Adipose capsule

Renal fascia

Anatomy

• Hilum (hilus)

• Renal artery and vein

• Cortex

• Medulla

• Renal pyramids and renal papillae

• Major and minor calyces

• Renal Pelvis

Ureters

Function

Kidneys make up 1 % of body mass, but receive about 25% of cardiac output. Kidney has two major functions:

1. Filtration of blood2. Removes metabolic wastes from the body, esp. those containing nitrogen

• Filtering Wastes From Blood Plasma

• The kidneys filter blood plasma out of the bloodstream and remove its undesirable substances to produce urine.

• The kidneys filter about 180 quarts of blood plasma out of the bloodstream each day.

• About 99% of this blood plasma (minus most of the wastes) is reabsorbed by the kidneys to reduce urine production to about 1 to 2 quarts each day.

• Without functioning kidneys, wastes accumulate in the blood causing a serious condition called "uremic poisoning" or "uremia."

• Kidneys are also responsible for regulating the acidity of the blood by excreting alkaline salts when necessary.

2.Regulation:

• Blood volume and composition

• Electrolytes

• Blood pH-

• Blood pressure

• Play a major role in maintaining homeostasis

• Maintain water balance

• Regulate the quantity and concentration of ECF ions

• Regulate the plasma volume

• Regulate pH by controlling elimination of acid and base in urine

• Maintain osmolarity

• Regulate the concentration of plasma constituents (e.g. electrolytes and water)