Project 1

1. FORMATION OF KIDNEY STONES:

The system involved is "urinary system".

The stones formed are of different size and shape.

The stones formed are in medulla and ureter while leads to blocking of ureter which carry urine to urinary bladder and leads to severe pain.

ANATOMY OF ORGAN INVOLVED IS

The urinary system usually consists of pair of bean shaped kidneys present in lumbar region.

The right is lower level due to presence of liver and left one is at higher level.

The tubules like structure araises from hileum of kidney is called ureter.

This Carries urine to urinary bladder from which it is excreted by urethra.

The outer layer is known as capsule which has adipose tissue,which acts as shock absorbing layer.

The outer part is known as Renal Cortex and inner layer is known as Medulla.

The Cortex has pyramid like structures called Renal pyramids or papillae.

These are the ducts carry urine from calycus of kidney for excretions.

Renal hileum that acts as entry and exit for vessels,nerves ,ureter and lymphatic ducts.

MICROSCOPIC STRUCTURE OF KIDNEY:

The functional and structural unit of kidneys are nephron.

The nephron has two major portions:

a. Renal tubules

b. Renal corpsules.

Two types of nephron present one is cortical nephron and the other is juxtamedullary nephron.

The functions of nephron is remove solid wastes,reabsorption,ultrafiltration,secretion,excretion.

MACROSCOPIC STRUCTURE OF KIDNEYS:

The kidney has outer renal cortex and inner renal medulla.

The cortex is used in filtration of blood where as medulla is used in formation of urine which need to be excreted.

BLOOD SUPPLY TO KIDNEYS:

The blood is supplied to kidney by both renal artery and renal veins.

Oxygenated blood comes to kidney from heart via right and left renal arteries.

Deoxygenated blood leaves kidney by right and left veins runs into inferior venacava,which carries deoxygenated blood from lower parts of body.

NERVE SUPPLY TO KIDNEY:

The nerve supply to the kidney consists of both afferent and efferent nerves.

The efferent nerves is sympathitic where as afferent nerves as parasympathetic in nature.

2.THE COMMON DISORDERS OF URINARY SYSTEM:

Infections,formation of kidney stones,urinary tract obstructions,urination process,kidney failure.

THE DIAGNOSTIC METHODS INVOLVED ARE

Sonogram,x-rays,CT scan,sonography.

COMPUTERUSED TOMOGRAPHY(CT) SCAN:

The imaging tests shows kidney stones in urinary tract .

This helps in reveal even tiny stones.

In general kidney stones are formed when your urine has more crystal forming substances such as calcium,oxalate and uric acid. Urine may lack substances that prevent Crystal's from sticking together creating an ideal environment for kidney stone formation.

The rays used in CT scan are combination of X-rays and computer technology for getting image of urinary system.

CT scan shows the size and shape and location on stones with the urinary system.

3.THE MEDICAL MANAGEMENT AND SURGICAL TREATMENT FOR REMOVAL OF KIDNEY STONES:

Medical management:

The only way to reduce this formation of calculi is drinking water atleast 3 litres in order to avoid surgical processes.

The post operativecare may also results in recurrent stone formation.

The self care is very significant in order to reduce the risks.

Surgical method :

The process used in removal of stones is percutaneous nephrolithotomy.

4.SURGICAL MANAGEMENT OF DISORDER:

Anatomy of surgery :

Usually this surgery has 4 methods involved.

The main method is "shock wave lithotripsy" where high frequency sound waves are used to pinpoint where a kidney stone is.Waves are then sent to stone from machine and breaks into small pieces.

This all done by cut opening on back at the lumbar region and a nephroscope is passed through it and into kidneys.

The region operated here is ureter ,which Carries urine from renal papulae to bladder.

The instrument and equipment used in surgery are an operating table to be mobile and modular with hydraulic system.

Should contain adequate dimensions for lifting lumbar area is important.

The operating table should be radio transparent to allow intra operative fluoroscopic control.

The irrigated fluid should be drained.

The complications involved are sepsis,injury to ureter,urinary tract infection and bleeding during surgery and pain.

The nephroscope introduced was used for viewing pyelocalicual system and nephroscope with optical fibers and rojndnlenses was for long time standard instrument for renal percutaneous surgery.

The post operative care to be taken is rest for 2 to 4 weeks for sure.

No weight lifting it causes pain in the region where the surgery takes place.

The devices used to monitor after the surgery is pulse oximeter which helps in monitoring the oxygen levels.

Overnight monitoring is also another process after surgery.

5.Self study:

The previous surgery is conducted under anesthetics conditions.

As technologies are developing day by day tremendously. Making people aware not to get effected and developing the techniques to treat it.

One of the newer technique is combining 2 ultrasound technologies offer an option to move kidney stones out of ureter with minimal pain.

Part B

Case study -

The bones present in skull are known As flat bones.

The skull is usually made up of 22 bones.

The microscopic anatomy of bone:

The basic microscopic unit of bone is Osteon.

Osteons are cylindrical structures which has lamellar of compact bone tissue that surrounds central canal.

It has bones blood supply. The boundary of osteon is called Cement line.

The osteoblasts are mononucleate cell from which bone developed.

The osteocytes are star shaped bone cell that found in nature bones.

Osteons are arranged into woven and lamellar bone.

Woven Bone: It is characterised by irregular organization of collagen fibres and they are mechanically weak.

Lamellar bone: It make up the compact bone in skeleton,such as long bones in legs and arms.

Lamellar bone is loosely arranged is referred to as trabecular bone,which shows spongy pattern.

After a fracture woven bone forms initially but it is replaced gradually with lamellar bone.

BLOOD SUPPLY :

It actually done by three systems.

. Nutrient artery

. Periosteal vessel and

. Epiphyseal vessels.

Diaphysis and metaphysis are nourished primarily by nutrient artery that passes through cortex to medulla and comes out through haversian canal.

Periosteal vessels supply blood to superficial layers of cortex and connects with nutrient artery.

Epiphysis are supplied by seperate system that consists of ring of arteries.

The blood supply to skill is mainly by external carotid.

It travels up the side of neck with 8 branches. The important one is maxillary artery.

BONE REMODELLING:

It has 4 stages.

Activation, Resorption, reversal formation and quiescence.

Bone remodelling involves the removal of mineralized bone by osteoclasts followed by formation of bone matrix through osteoblasts that subsequently become mineralized.

BONE FORMATION:

Bone ossification is the process of bone formation.

The cartilage cells die out and are replaced by osteoblasts clustered in ossification centers. The bone formation proceeds outward from these centers.

This replacement of cartilage by bone is known as endocondral ossification.

BONE IMPLANT:

It is also known as Bone Grafting.

The surgical procedure that uses transplanted bone to repair and rebuild damaged and diseased bone.

The surgeon might take bone from ribs,hip and leg to perform graft.

Some times metal plates are introduced to reconstruct the damaged bone.

The usual metal used is titanium.

The total process takes 6 months to heal. Proper rest is to be taken after surgery.

Sometimes grafting rejection takes place due to internal factors.