Project 1

1. The organs I am going to talk about are:

Gross Structure of Carpal Bones:

Blood Supply for carpal bones:

Gross anatomy of Liver

Blood Supply of liver

Kidneys: Located near the base of the rib cage, the kidneys are two fist-sized organs. Each side of the spine has a kidney. A healthy body relies on functioning kidneys. Waste products, excess water, and other contaminants are mostly filtered out of the blood by these organs. The bladder stores these poisons, which are eventually flushed out during urination. The kidneys are also responsible for maintaining the body's pH, salt, and potassium concentrations. Hemoglobin and red blood cell synthesis are regulated by hormones produced by these glands. Even a type of vitamin D that aids the body in absorbing calcium is activated by the kidneys. An estimated 37 million persons in the United States are living with some form of kidney disease. When your kidneys are damaged and unable to operate properly, this condition occurs. Diabetes, high blood pressure, and a host of other long-term (chronic) illnesses can all cause damage. In addition to weak bones, nerve damage, and hunger, kidney failure can cause a wide range of additional health issues. If the condition progresses, your kidneys may fail to function at all in the future. As a result, the kidneys will have to be replaced through the use of dialysis. Dialysis is a medical procedure that uses a machine to filter and purify the blood. It is not a cure for renal illness, but it can help you live longer. The disease I am going to address below is Kidney stone.

Fig. KIdney Stones

Gross Anatomy of kidney

Kidney blood supply

2. The kidneys are fist-sized organs under the rib cage. Each spine has a kidney. A healthy body needs kidneys. They filter blood for waste, excess water, and contaminants. Toxins accumulated in the bladder are eliminated during urine. Kidneys regulate pH, salt, and potassium. Their hormones affect blood pressure and red blood cell formation. The kidneys activate vitamin D to absorb calcium. 37 million Americans have kidney disease. Damaged kidneys can't function. Diabetes, hypertension, and other chronic diseases can cause damage. Kidney illness causes weak bones, neurological degeneration, and starvation. Eventually, the condition may cause renal failure. This requires dialysis to replace the kidneys. Dialysis purifies blood with a machine. It can't cure renal illness but prolongs life.

• Kidney Stone: Stones in the kidney are yet another typical complication of the kidneys. They are the result of minerals and other chemicals in the blood crystallising and producing mass in the kidneys, which leads to kidney stones (stones). Urination is the normal route for the passage of kidney stones out of the body. The passing of kidney stones can be an excruciatingly painful process, but they rarely result in serious complications.
  
• Glomerulonephritis: An inflammation of the glomeruli is referred to as glomerulonephritis. Glomeruli are incredibly minute structures that are located within the kidneys and are responsible for filtering the blood. Infections, medications, or conditions that manifest themselves during or immediately after birth are some of the potential triggers for glomerulonephritis (congenital abnormalities). The majority of the time, it gets better on its own.
  
• Polycystic kidney disease: Polycystic kidney disease is a hereditary condition that leads to the development of a large number of cysts, which are defined as small sacs filled with fluid. These cysts can disrupt the normal function of the kidneys, which can lead to renal failure. It is essential to keep in mind that individual cysts in the kidney are not only reasonably common but also nearly invariably innocuous. Polycystic kidney disease is a different condition that is far more severe.
  
• Urinary Tract Infections: Urinary tract infections, sometimes known as UTIs, can affect any region of the urinary system and are caused by bacterial infections. The majority of urinary tract infections originate in the bladder and the urethra. They are simple to cure, and they almost seldom result in further health complications. In the event that these infections are not treated, however, they may progress to the kidneys and result in renal failure.
  

• Blood Testing: Blood tests could show that your blood has too much calcium or uric acid. The results of your blood test help your doctor check on the health of your kidneys and may lead him or her to look for other health problems.
• Urine Testing: The 24-hour urine test may show that you're getting rid of too many minerals that cause stones or not enough substances that stop stones from forming. For this test, your doctor might ask you to give two urine samples on two different days.
• Imaging: X-rays might be able to show that you have kidney stones in your urinary tract. Computerized tomography (CT) that moves quickly or uses two kinds of energy can show even tiny stones. Simple abdominal X-rays are used less often because small kidney stones can be missed by this type of imaging test.
• Ultrasound: Noninvasive kidney ultrasounds show size, shape, and location. Sonography measures kidney blood flow. High-frequency ultrasound employs a transducer. Ultrasonic waves travel from the skin to organs and structures. Organs echo sound to the transducer. Computers turn reflected waves into images of organs or tissues. Bone conducts sound quicker than air. The transducer converts sound wave speed and volume into tissue types. Ultrasound gel is applied to the transducer and skin to improve sound conduction. Doppler ultrasound displays chest blood flow speed and direction. Unlike ultrasound, Doppler waves are audible. Ultrasound can be used during pregnancy without radiation or contrast dyes. An ultrasound can be used to evaluate the kidneys, ureters, and bladder. Ultrasound detects kidney cysts, tumours, abscesses, blockages, fluid accumulation, and infection. Ultrasound detects kidney and ureter stones. An ultrasound can help put needles needed to biopsy the kidneys, drain a cyst or abscess, or place a drainage tube. This method can also measure renal artery and vein blood flow. Kidney ultrasonography is used to examine a transplanted kidney. Doctors may order a renal ultrasound for different reasons.

• Dietary management: Fluid consumption and dietary adjustments prevent kidney stone recurrence. Increasing urine volume to at least 2 L/day can prevent stone recurrence by 40–50%. Water should dominate fluid consumption. Tea and coffee contain oxalate; milk binds free oxalate. Increasing urine volume reduces citrate. Cucumber, green peppers, beetroot, spinach, soya bean, chocolate, rhubarb, popcorn, and sweet potato are oxalate-rich foods that should be avoided. Calcium restriction increases stone disease risk, hence it's not suggested. Hypocitraturia is present in 16–63% of calcium stone formers. Oral potassium citrate increases urine citrate and reduces stone recurrence. High citrate has been explored as a Kcit alternative. Lemonade treatment increased urinary citrate. Orange juice increased Odvina's urine pH and citrate. Both Kcit and lemonade treatment increased urine citrate, according to Kang et al. Kcit worked better than lemonade. Yilmaz et al. analysed tomato, orange, lemon, and mandarin juice. Fresh tomato juice has high citrate and low oxalate. Calcium oxalate and uric acid stone formers should limit animal protein.

Stone-specific therapies

• Calcium oxalate stones: Thiazide diuretics reduce idiopathic hypercalciuria recurrence rates by 70%. It's the only treatment for urinary calcium. Citrate supplements are helpful. Pyridoxine can help in primary hyperoxaluria, but not idiopathic. Oxalobacter formigenes degrades oxalate in the gut. Increased gut colonisation may reduce oxalate absorption and urine excretion. A prospective, randomised, placebo-controlled, double-blind trial contradicted the benefits of O. formigenes colonisation.
• Uric acid stones: Treatment for uric acid stones is to make uric acid more soluble in urine. Alkali treatment and increasing the amount of urine excreted are two ways to do this. The medication allopurinol is a helpful addition to treatment.
• Struvite stones: Struvite stones occur in alkaline urine from infection with urea-splitting bacteria. Antibiotics are the mainstay of the therapy with occasional use of acetohydroxamic acid.
• Cystine stones: This is an uncommon sort of stone. The goal of treatment is to decrease the free cystine concentration and enhance its solubility in urine. Desirable are a high fluid intake of up to 4-5 L/day OR 4-5 lit and alkalinization of urine with a target urine pH of >7. When the 24-hour urine cystine concentration surpasses 2,000 mol/l, chelating drugs such D-penicillamine or tiopronin are suggested.

1. Shock Wave Lithotripsy: Patients most commonly use Shock Wave Lithotripsy for kidney stones. Small to medium-sized stones work best. Noninvasive surgery uses high-energy shock waves to break kidney stones without cutting the skin. In this surgery, external shock waves are used to fragment kidney stones. Stones shatter. Large portions can be treated again. Smaller-than-2-cm stones are suitable for SWL. Larger stones may not be treatable.
2. Ureteroscopy: The doctor uses a narrow, flexible scope to locate and remove stones from the kidneys and ureters during this surgery. In this surgical treatment, there are no wounds made in your skin. In order to remove the stone from the ureter and bladder, a scope called a ureteroscope must be sent through these two passages. At this moment, the procedure will be performed. One to three hours are typical for a ureterscopy surgery under general anaesthesia. Small stones can be easily removed from the ureter if necessary. For large stones or ureters with narrower diameters, the stone would have to be shattered by laser, which is typically done. These bits are removed after the stone has been split into small pieces by the impact. Using a ureteroscope to remove large stones is impractical and impossible for individuals who have already had their urinary tracts reconstructed, which prevents a ureteroscope from passing through in the first place.
3. Percutaneous Nephrolithotomy or Percutaneous Nephrolithotripsy: This method treats patients with large or irregular kidney stones, infections, or stones not broken up enough by SWL or who have not been treated by the above two modalities. This technique is for persons with larger than 2 cm (marble-sized) stones. Both procedures include back incisions to access the kidney. Once the surgeon reaches the kidney, a nephroscope and other devices are threaded in. If the stone is removed through the tube, it's called nephrolithotomy; otherwise, it's nephrolithotripsy. High-frequency sound waves break up stone, and a suction mechanism collects the dust.
4. Open Surgery: Open kidney stone surgery is unusual. This approach is for huge stones or stones that can't be removed or crushed. Surgery helps when:

• Ureter stones.
• One hurts badly
• Stone blocks urine flow
• Bleeding or infection

1. Skull belongs to the flat bone category of the bones. It is the job of the flat bones to guard the internal organs of the body, such as the brain, the heart, and the organs in the pelvis. Flat bones are relatively flattened and can give protection, similar to that of a shield. Flat bones can also provide huge regions for muscles to attach themselves to.

2. They have the impression of being flat, which is suggested by the name. These bones are distinguished by the fact that they are composed of bone plates that have been extended, as well as by the fact that they are elongated bones that have been produced to outline the cavity of the body. Each bone is made up of three layers of tissue: two plates of solid bone, one layer of spongy bone, and one layer of marrow. The diploi are known as the intervening spongy tissue that may be found in the vault of the skull.

3. In some cases, such as with the nasal conchae, which are covered by a mucous membrane, these may consist of nothing more than a very thin lamella of hard tissue. Perfusion with India ink demonstrates that the bony plates in these situations receive their blood supply from the periosteal arteries that are located above them. Rarely do solitary perforating capillaries connect the two periosteal vascular plexuses that are located on either side of a bony conchallamina. These plexuses are sandwiching the conchallamina. In most cases, flat bony laminae, regardless of how thin they are, are composed of two bony plates with an intervening medullary layer. For instance, the perpendicular plate of the ethmoid and the vomer in the nasal septum are both examples of this type of structure. Their vasculature is comparable to that of the far more substantial flat bones that make up the cranial vault.

4. After birth, bones continue to grow and change until they are fully grown. Bone remodelling is the process of replacing old bone tissue with new bone tissue. It includes the processes of bone formation or deposition, which are done by osteoblasts, and bone resorption, which is done by osteoclasts, which are cells that break down older bone. Minerals like calcium, phosphorus, and magnesium, as well as the vitamins D, C, and A, are important for building strong bones. Hormones like parathyroid hormone, growth hormone, and calcitonin are also important for building and keeping healthy bones. Bone turnover rates, or the rate at which old bone is replaced by new bone, are pretty high, with 5–7% of bone mass being recycled every week. The rate at which old bone is replaced by new bone determines these rates. Different parts of the skeleton and different parts of a single bone have very different rates of bone turnover. For example, the bone in the head of the femur may be completely replaced every six months, while the bone in the shaft of the femur changes much more slowly. When bones are stressed, they go through a process called remodelling, which makes them thicker and stronger so they can handle the stress. When a cast keeps a limb from moving, for example, the bone density goes down because the limb can't go through the normal stresses of daily life. When a bone is broken or cracked, it goes through the following four steps to get better:
How a hematoma forms: How a Hematoma Forms When a bone breaks, blood vessels inside the bone break and bleed. This causes a hematoma, which is a collection of blood that has coagulated at the site of the break. The process of clotting makes sure that the blood vessels at the broken ends of the bone won't leak any more blood. When bone cells don't get enough food, cell death starts to happen.
Bone formation: After a break, capillaries start to grow into the hematoma and phagocytic cells start to eat the dead cells. This is where the process of making new bone starts. Even if there are still pieces of the blood clot left behind, fibroblasts and osteoblasts will move into the area and start to rebuild the bone. Fibroblasts are in charge of making collagen fibres, which are then used to connect the broken ends of a bone. Osteoblasts are in charge of starting the process of making spongy bone. A type of healing tissue called fibrocartilaginous callus grows between the two broken ends of the bone. It is made up of both hyaline and fibrocartilage. At this stage, bone spicules may also start to show up.
Formation of a bony callus: During this process, the fibrocartilaginous callus changes into a bony callus made of spongy bone. After a bone has been broken, it takes about two months for the two pieces to heal together and be strong again. During this process, osteoblasts, osteoclasts, and bone matrix are all present. This is similar to how bone is made when cartilage ossifies, which is called endochondral production of bone.
Bone remodelling: Osteoclasts and osteoblasts then rebuild the bone callus, getting rid of any extra material on the outside of the bone and in the medullary cavity. This process is called "remodelling the bones." First, compact bone must be added to make bone tissue that is the same as the original bone before it was broken. This may take a few months, and the bone may still be uneven for a few years after it is done.

5. In brain surgery, the doctor cuts the skull to reach the brain. First, cranioplasty repairs the skull. Infection and dehiscence complicate reconstruction (parting of the sutured lips of a wound). Cranioplasty corrects head shape. Professor Mommaerts has designed a custom CeTi cranial implant for trauma and reconstruction. Brain tumours, infections, strokes, and head injuries can induce brain swelling. The strong skull protects the brain, but swelling might squeeze it. Without relief, the brain could be permanently damaged. When a patient's brain swells, a surgeon may drill a burr hole to drain blood or do a partial craniectomy to create place. A few weeks later, cranioplasty fixes the damage from the partial craniectomy. This procedure protects the brain's fragile tissue and restores the skull's contour. In recent years, CAD/CAM techniques have grown popular for inlay and onlay cranioplasty (augmentation of cranial bone). After a partial craniectomy, an inlay cranioplasty protects the brain, whereas an onlay treatment fixes abnormalities with the skull's outer shape, including a birth abnormality. Professor Maurice Mommaerts at the Universitair Ziekenhuis in Brussels and his colleagues at the Elisabeth Tweesteden Ziekenhuis in Tilburg, the Netherlands, have tested a new form of implant (CeTi). It was created for infections after first repair (six patients) and psychosocially distressing contour anomalies (two patients). All implants were effective after 18 to 24 months. Eight persons with CeTi implants had no infections, wound dehiscence, or cold sensitivity.

6. You'll wake up in recovery, and after about an hour, you'll be moved to the neurosurgical floor or the NCCU (neurosurgical intensive care unit). Your nurses will keep an eye on you and measure your pulse, blood pressure, limb strength, and level of alertness to see if there are any signs of a problem. You will be woken up during your first night in the hospital for these checks. Most head surgeries don't hurt too much, but you might get a headache. You'll be given painkillers and injections to make sure you're comfortable. After the surgery, you may still have a urinary catheter in place. In about a day, your nurse will take out the IV drip in your arm and tell you to try walking. You will be able to move around normally again in time. On the second day after surgery, the bandage on your head will be taken off. Most people who have a cranioplasty stay in the hospital for two to three days. When your care team decides that you can move around on your own, take a shower, and get dressed, you will get another CT scan of your head. If the area where the surgery was done looks fine, you will be sent home.