Gross Anatomy Of The Kidney
- Describe the external structure of the kidney, including its location, support structures, and covering
- Identify the major internal divisions and structures of the kidney
- Identify the major blood vessels associated with the kidney and trace the path of blood through the kidney
- Compare and contrast the cortical and juxtamedullary nephrons
- Name structures found in the cortex and medulla
- Describe the physiological characteristics of the cortex and medulla
The kidneys lie on either side of the spine in the retroperitoneal space between the parietal peritoneum and the posterior abdominal wall, well protected by muscle, fat, and ribs. They are roughly the size of your fist, and the male kidney is typically a bit larger than the female kidney. The kidneys are well vascularized, receiving about 25 percent of the cardiac output at rest.
What External Covering Protects The Kidney From Physical Shock
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Brain And Spinal Cord Cancers Facts
Brain and spinal cord cancers can grow in the central nervous system, which is known as a primary cancer. They can also travel from other parts of the body, like the lung or breast, and form deposits in the brain or spinal cord this is called a secondary cancer or brain metastases. Many brain cancers are the result of metastasis of cancer from other places in the body to the brain.
The Seattle Cancer Care Alliance Brain and Spine Metastases Clinic specializes in treating patients whose cancer has metastasized to the brain or spinal cord.
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Blood And Nerve Supply
The spongy bone and medullary cavity receive nourishment from arteries that pass through the compact bone. The arteries enter through the nutrient foramen , small openings in the diaphysis ). The osteocytes in spongy bone are nourished by blood vessels of the periosteum that penetrate spongy bone and blood that circulates in the marrow cavities. As the blood passes through the marrow cavities, it is collected by veins, which then pass out of the bone through the foramina.
In addition to the blood vessels, nerves follow the same paths into the bone where they tend to concentrate in the more metabolically active regions of the bone. The nerves sense pain, and it appears the nerves also play roles in regulating blood supplies and in bone growth, hence their concentrations in metabolically active sites of the bone.
Watch this video to see the microscopic features of a bone.
Primary Cancers From Glial Cells
Astrocytomas start from brain cells called astrocytes . They are the most common type of glioma, slow-growing, and can be anywhere in the brain, but are most often in the cerebrum. If found early, they can often be surgically removed.
There are different grades of astrocytomas:
- Pilocytic astrocytoma grows slowly and usually does not grow into surrounding tissues.
- Low-grade astrocytoma grows faster than pilocytic astrocytomas and spreads into surrounding tissues.
- Anaplastic astrocytoma grows faster than low-grade astrocytoma and often recurs.
- Glioblastoma multiforme is the most common brain cancer. It grows faster than low-grade astrocytomas and mainly occurs in the cerebrum.
- Brain stem gliomas are located where the brain and spinal cord meet.
Ependymomas grow slowly from the lining of the ventricles of the brain and the hollow central canal of the spinal cord. Well-differentiated ependymomas look much like normal cells and grow slowly. Anaplastic ependymomas do not look like normal cells and grow more quickly than well-differentiated ependymal cancers.
Oligodendrogliomas begin in brain cells called oligodendrocytes, which provide support around nerves by building a sheath of myelin to cover the nerve cells and pass along electrical nerve impulses.
Genetic testing is important for these cancers because it helps us predict prognosis and treatment response. There are different grades of oligodendroglial cancers:
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Portals Of Entry/pathways Of Spread
Kidney as a Whole
The urinary system and especially the kidney can be exposed to injurious stimuli and microbes via a number of routes , including the following:
- Hematogenous
See previous section on Tubules.
Lymphoid Nodules.
Although often present as aggregates or less commonly as nodules, lymphoid infiltrates within the interstitium are not normal however, small aggregates or nodules are often incidental findings and of unknown cause. Previous insults typically from infectious etiologies, such as Leptospirosis, or as a result of ascension secondary to long-standing pyelonephritis can result in larger aggregates and nodules.
Vasculature
As in all visceral organs, the sustaining blood supply can provide a portal of hematogenous entry for infectious organisms, which in the case of the kidney principally leads to arterial localization at one of several gradated sites as follows:
When Can The Individual Return To Activity
Depending if the kidney was repaired, excised , or left to conservative treatment, return to play may vary case-by-case, but full recovery may take up to three weeks, providing there are no complications. Athletes are not typically allowed to return to play to contact sports with one organ that is normally paired, however some physicians or circumstances may allow it.
Conservatively managed athletes with renal contusions should be observed until hematuria clears and should be excluded from contact sports for 6 weeks. However, RTP is individualistic and depends on severity/intensity of the injury and the individual athlete. More severe injuries may take 6-8 weeks to heal and return to contact/collision sports can be delayed 6 to 12 months with extensive renal injuries, where as some may not choose to return to his/her respective sport.
Whether moving to a non-contact sport or cleared by a physician for contact, an Athletic Trainer or sports medicine professional should coach the athlete back through gradual return to play and monitor for red flags or return of signs or symptoms.
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Disorders Of Domestic Animals
Nonrenal Lesions of Uremia
Nonrenal lesions of uremia identified clinically or at autopsy are useful indicators of renal failure . The severity of nonrenal lesions of uremia depends on the length of time that the animal has survived in the uremic state. Therefore, in acute renal failure, nonrenal lesions are few, whereas many lesions can be present in chronic renal failure. During renal failure, numerous so-called uremic toxins accumulate in the blood. These toxins fall into three classes: small water-soluble compounds including urea, phosphate, creatinine, and guanidines medium-sized molecules including fibroblast growth factor-23, 2-microglobulin, parathyroid hormone, and leptin and protein-bound compounds including a variety of phenols and indoles. Typically, nonrenal lesions can be attributed to either one of the following mechanisms:
- Endothelial degeneration and necrosis, resulting in vasculitis with secondary thrombosis and infarction in a variety of tissues .
- Caustic injury to epithelium of the oral cavity and stomach, which results in ulcer formation, is secondary to the production of large concentrations of ammonia after splitting of salivary or gastric urea by bacteria.
- Increased erythrocyte fragility and lack of erythropoietin production.
- Altered calcium/phosphorus metabolism .
Bone Cells And Tissue
Bone contains a relatively small number of cells entrenched in a matrix of collagen fibers that provide a surface for inorganic salt crystals to adhere. These salt crystals form when calcium phosphate and calcium carbonate combine to create hydroxyapatite, which incorporates other inorganic salts like magnesium hydroxide, fluoride, and sulfate as it crystallizes, or calcifies, on the collagen fibers. The hydroxyapatite crystals give bones their hardness and strength, while the collagen fibers give them flexibility so that they are not brittle.
Although bone cells compose a small amount of the bone volume, they are crucial to the function of bones. Four types of cells are found within bone tissue: osteoblasts, osteocytes, osteogenic cells, and osteoclasts ).
If osteoblasts and osteocytes are incapable of mitosis, then how are they replenished when old ones die? The answer lies in the properties of a third category of bone cellsthe osteogenic cell. These osteogenic cells are undifferentiated with high mitotic activity and they are the only bone cells that divide. Immature osteogenic cells are found in the deep layers of the periosteum and the marrow. They differentiate and develop into osteoblasts.
| Bone Cells |
|---|
| Bone surfaces and at sites of old, injured, or unneeded bone |
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Anatomy Of The Brain And Spinal Cord
The brain is a remarkable three-pound organ housed in, and protected by, the skull. Not only does it control all five senses , it is responsible for your emotions, thoughts and movement. The right side of the brain controls the left side of your body, and the left side of the brain controls the right side of your body.
Your brain has three main parts: the cerebrum, cerebellum and brain stem.
The cerebrum controls higher brain functions. It has four lobes, each with different tasks:
- Frontal lobe: executive function , decision-making, personality, language, planning and movement
- Parietal lobe: intelligence, reasoning, sensation and reading
- Occipital lobe: vision
- Temporal lobe: language, behavior, hearing, vision, emotions and memory
The cerebellum controls balance, coordination and fine muscle control.
The brain stem controls things we do without thinking, like our heartbeat, breathing and swallowing.
The spinal cord starts at the brain stem and goes to the tailbone. It is about as wide as your little finger and extends the length of your back. Messages are carried from the spinal cord to and from the brain and the rest of the body.
Nerves extend from the spinal cord on each side and go to other parts of the body.
The brain and spinal cord are protected by bony structures the skull and spinal column.
Meninges are membranes that cover and protect the brain and spinal cord. There are three layers of meninges:
Functions Of Connective Tissues
Connective tissues perform many functions in the body, but most importantly, they support and connect other tissues from the connective tissue sheath that surrounds muscle cells, to the tendons that attach muscles to bones, and to the skeleton that supports the positions of the body. Protection is another major function of connective tissue, in the form of fibrous capsules and bones that protect delicate organs and, of course, the skeletal system. Specialized cells in connective tissue defend the body from microorganisms that enter the body. Transport of fluid, nutrients, waste, and chemical messengers is ensured by specialized fluid connective tissues, such as blood and lymph. Adipose cells store surplus energy in the form of fat and contribute to the thermal insulation of the body.
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Compact And Spongy Bone
The differences between compact and spongy bone are best explored via their histology. Most bones contain compact and spongy osseous tissue, but their distribution and concentration vary based on the bones overall function. Compact bone is dense so that it can withstand compressive forces, while spongy bone has open spaces and supports shifts in weight distribution.
Compact Bone
Compact bone is the denser, stronger of the two types of bone tissue ). It can be found under the periosteum and in the diaphyses of long bones, where it provides support and protection.
The microscopic structural unit of compact bone is called an osteon, or Haversian system. Each osteon is composed of concentric rings of calcified matrix called lamellae . Running down the center of each osteon is the central canal, or Haversian canal, which contains blood vessels, nerves, and lymphatic vessels. These vessels and nerves branch off at right angles through a perforating canal, also known as Volkmanns canals, to extend to the periosteum and endosteum.
The osteocytes are located inside spaces called lacunae , found at the borders of adjacent lamellae. As described earlier, canaliculi connect with the canaliculi of other lacunae and eventually with the central canal. This system allows nutrients to be transported to the osteocytes and wastes to be removed from them.
Spongy Bone
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Brain And Spinal Cord Metastases
Treatments for cancers have advanced over the last several years, leading to patients surviving and living longer with cancer. As a result of more effective cancer treatments, the disease has more time to spread to the brain and spinal cord.
Some of the most common primary cancers that spread to the brain are lung, breast, skin, colon, gastrointestinal, kidney and gynecologic cancers, but almost all cancers can spread to the brain.
Cancer that has spread to the brain and spinal cord can be found in the brain, the cerebrospinal fluid or the lining of the brain and spinal cord, which is called the leptomeninges.
Metastatic brain and spinal cord diseases include:
- Leptomeningeal disease, or metastatic cancer that is in the cerebral spinal fluid surrounding the brain and spinal cord
- Brain metastases
Chapter : The Tissue Level Of Organization
- Identify and distinguish between the types of connective tissue: loose, dense, cartilage, bone, and blood
- Explain the functions of connective tissues
As may be obvious from its name, one of the major functions of connective tissue is to connect tissues and organs. Unlike epithelial tissue, which is composed of cells closely packed with little or no extracellular space in between, connective tissue cells are dispersed in a matrix. The matrix usually includes a large amount of extracellular material produced by the connective tissue cells that are embedded within it. The matrix plays a major role in the functioning of this tissue. Two major components of the matrix are ground substance and protein fibers. This ground substance is usually a fluid , but it can also be mineralized and solid, as in bones. Connective tissues come in a vast variety of forms, yet they typically have in common three characteristic components: cells, large amounts of ground substance, and protein fibers. The amount and structure of each component correlates with the function of the tissue, from the rigid ground substance in bones supporting the body to the inclusion of specialized cells for example, a phagocytic cell that engulfs pathogens and also rids tissue of cellular debris.
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Structures That Protect The Eye
The bony structures of the orbit protrude beyond the surface of the eye. They protect the eye while allowing it to move freely in a wide arc.
The eyelashes are short, tough hairs that grow from the edge of the eyelid. The upper lashes are longer than the lower lashes and turn upward. The lower lashes turn downward. Eyelashes keep insects and foreign particles away from the eye by acting as a physical barrier and by causing the person to blink reflexively at the slightest sensation or provocation.
The upper and lower eyelids are thin flaps of skin and muscle that can cover the eye. They reflexively close quickly to form a mechanical barrier that protects the eye from foreign objects, wind, dust, insects, and very bright light. This reflex is triggered by the sight of an approaching object, the touch of an object on the surface of the eye, or the eyelashes being exposed to wind or small particles such as dust or insects.
On the moist back surface of the eyelid, the conjunctiva loops around to cover the front surface of the eyeball, right up to the edge of the cornea. The conjunctiva protects the sensitive tissues underneath it.
Tears drain from each eye into the nose through one of the two nasolacrimal ducts. Each of these ducts has openings at the edge of the upper and lower eyelids near the nose, called the punctum.
Primary Cancers From Non
Meningiomas grow from the meninges, which are coverings for the brain and spinal cord. They are usually slow-growing and can be one of three grades. Surgery is often used as a treatment, but radiation therapy may also be used.
Pineal tumors occur near the pineal gland, which is located deep inside the brain and produces melatonin. There are several types of pineal tumors some are cancerous. Some pineal tumors are fast-growing. Surgery may be recommended for these tumors.
Pituitary tumors affect the pituitary gland, which is located at the base of the brain and is responsible for hormones, growth and metabolism. Surgery and radiotherapy are often used for these tumors.
Schwannomas are tumors from schwannoma cells, which form the myelin sheath that covers and protects the nerves. They are usually benign . There are several types, including the acoustic schwannoma, which is a benign tumor of the nerve that is responsible for hearing. Surgery is the primary treatment, but if a patient has more than one schwannoma, a doctor may recommend surgery followed by radiation therapy.
Primary central nervous system lymphoma is a cancer that develops out of lymphocytes, which are a type of white blood cell. Lymphomas of the brain are a form of non-Hodgkin lymphoma, a cancer that is often associated with the lymph nodes. These cancers are usually near the ventricles of the brain, and there may be multiple tumors. It is quite common for this type of cancer to spread.
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