1. Renal Anatomy and Histology

Question 1

Organs of urinary system

Answer 1

Kidneys, ureters, bladder, urethra

Question 2

Kidney location

Answer 2

Retroperitoneal between T12-L3 (right side is lower due to liver)

Question 3

Perinephric fat

Answer 3

Adjacent kidney capsule that supports and protects the kidney.. it extends into the renal hilum and pelvis

Question 4

Renal fascia

Answer 4

covers the fat and suprarenal gland. sheaths renal vessels and will continue superiorly w the diaphragmatic fascia

Question 5

Paranephric fat

Answer 5

external to the renal fascia - pararenal fat body

Question 6

Kidney Capsule

Answer 6

Dense irregular CT on the surface of the kidney w/ an inner layer of myofibroblasts

Question 7

Renal pelvis

Answer 7

collect funnel for urine

Question 8

Renal calyxes

Answer 8

Portions of the renal pelvis that will meet with renal papilla of the pyramid to gather filtrates

Question 9

What various branches will supply the kidney?

Answer 9

Renal branches, abdominal branches, iliac branches, gonadal branches, superior vesciular, and pelvic branches

Question 10

succession of renal arteries through kidney

Answer 10

Renal artery –> segmental –> interlobar–>arcuate

–>cortical radiate

Question 11

Renal innervation

Answer 11

Sympathetic: lesser splanchnic (T10-11) and least splanchnic n (T12). lumbar splanchnic nerve (L1-L2)

Para innervation: vagus n

Question 12

What is found in the cortex?

Answer 12

Renal corpuscles, convoluted and straight tubules, and portions of collecting ducts

Question 13

Cortical (medullary) rays

Answer 13

an aggregation of collecting ducts and straight tubules running between corpuscles and convoluted tubules

Question 14

Renal interstitium

Answer 14

fibroblasts will produce erythropoietin depending on O2 levels

Question 15

Glomerulus

Answer 15

tuft of capillaries - fenestrated w/ open pores and have afferent and efferent arterioles

Question 16

Glomerular capsule

Answer 16

also known as bowman’s capsule.

Pareital layer –> simple squamous epithelium
Visceral layer –> consists of podocytes
Glomerular space –> contains primary filtrate

Question 17

Glomerular endothelium

Answer 17

Open fenestrations w. a few having pores w. diaphragms
Can generate NO and PGE2 (Angiotensin II promotes)
Have large # of aquaporin water channels

Question 18

Filtration membrane

Answer 18

Between blood and capsular space - has fenestrated capillary endothelium

Has filtration slits between foot processes of podocytes w/ slit diaphragm

Basement membrane - fused basement membarnes of the endothelium and podocytes

Question 19

What does the filtration membrane allow passage of?

Answer 19

Water, ions, glucose, AA, and urea

Question 20

What makes up the glomerular basement membrane?

Answer 20

Type IV and XVIII collagen, laminin, entactin, and proteoglycans

Creates a chemical barrier w/ strong anti-anionic characteristics

Question 21

What does it mean if albuminia is present in urine?

Answer 21

It will not typically be able to pass through the glomerular basement membrane (GBM) so this means there is damage to the membrane

Question 22

Mesangial cells

Answer 22

Support cells - remove cell debris and protein aggregates

help control filtration rate

Prevents distension due to high glomerular BP

Secretes growth factors and cytokines in response to injury

Can proliferate in some kidney diseases

Question 23

Proximal convoluted tubule

Answer 23

most active in resorption and secretion

Made of simple cuboidal –> columnar epithelium w/ abundant microvilli and mitochondria

Question 24

What transporters are found in the PCT?

Answer 24

Na/K+ ATPase, aquaporins, glucose transporters, amino acid transporters

Question 25

Proximal straight tubule

Answer 25

Not as tall as PCT, less developed brush border, has high affinity sodium-glucose co-transporters (dGLT1)

Question 26

Loop of henle

Answer 26

Sets up the hyperosomotic gradient to draw water into cells adjacent to the capillaries.

Question 27

Distal convoluted tubule

Answer 27

Where angiotensin II will influce Na+ absorption

Question 28

Collecting ducts

Answer 28

Remove primitive urine from nephrons Active in water reabsorption Join to make papillary duct and drain into renal minor calyx

Question 29

Collecting ducts/tubules

Answer 29

Target of ADH and aldosterone to increase NA+ reabsorption and water retention Determine urine osmolarity by reabsorbing water

Question 30

Principal cells

Answer 30

Light cells | Target of aldosterone

Question 31

Intercalated cells

Answer 31

Dark cells | involved in H+ and bicarbonate transport

Question 32

Glomerulus capillary beds

Answer 32

Feed by afferent, drained by efferent

Question 33

Peritubular capillaries

Answer 33

surround convuluted tubules. arise from efferent arterioles and are lined w/ fenestrated endothelium helps w/ reuptake of h2o and salt

Question 34

Vasa recta

Answer 34

Run w/ loop of henle. arise from efferent arterioles of juxtamedullary glomeruli. Descending: continuous Ascending: fenestrated

Question 35

Juxtaglomerular cells

Answer 35

Mechanosensory that will secrete renin if BP is low

Question 36

Macular densa

Answer 36

On juxtaglomerular apparatus found on distal end of thick ascending LoH and will monitor salt levels and will signal release of renin if sodium is low

Question 37

Fusiform vesicles

Answer 37

fuse w/ plasma membrane when the cell is distended and endocytosed when non-distended part of transitional epithelium

Question 38

Urothelial plaques

Answer 38

Part of transitional epithelium | forms an impermeable barrier w/ uroplakin proteins

Question 39

Trigone

Answer 39

Inferior/posterior wall of bladder where ureters and urethra open

Question 40

Detrusor muscle

Answer 40

found in bladder, 3 layers of thick smooth muscle

Question 41

Describe the epithelium changes found in the urethra

Answer 41

Transitional epithelium -- origin Pseudostratified columnar -- majority of urethra Stratified squamous epithelium - at very distal end

Question 42

Which was is each sphincter a part of?

Answer 42

Internal sphincter --> bladder wall | External sphincter --> pelvic floor

Question 43

Three regions of male urethra

Answer 43

Prostatic urthera: first. passes through prostate Membraneous urethra: goes through urogenital diaphragm (what entire female urethra is) Spongy urethra: passes through length of penis

Question 44

Polycystic kidney disease

Answer 44

cysts form that crush tissue and impede drainage. leads to kidney failure and BP misregulation