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COT - Exam 2 > 11.1 - Kidney + Urinary System > Flashcards

11.1 - Kidney + Urinary System Flashcards

1
Q

Describe the anatomical composition and location of the kidney

A
  • Consists of several lobe
  • each lobe consists of cortex and medulla
  • surrounding the lobes is CT capsule
  • CT capsule forms an adventitia around the organ
  • Organ is located in CT space retroperitoneally located (behind peritoneal cavity)
  • renal artery, renal vein, ureter enter the kidney at the hilar region (hilum, hills)
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2
Q

What is the hilar region (hilum, hilus) WRT the kidney

A
  • responsible for the largest indentation of the kidney’s shape
  • site where the renal artery, renal vein, and ureter enter the kidney
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3
Q

Renal sinus

A

= CT space between the lobes and continuous with the hilum

  • contains the first branches of the major vessels
  • contains the distal branches of the ureter the major calyces and minor calyces
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4
Q

What are the distal branches of the ureter

A
  • major calyces

- minor calyces

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5
Q

What are the minor calyces

A

= epithelial-lined structure separating the renal sinus from each lobe’s medullary region

  • shape a structure = medullary pyramid
  • lumen of each minor calyx extends into the medullar as a series of small tubes = collecting ducts
  • the openings from the minor calyx to the collecting ducts = Ducts of bellini
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6
Q

What is the medullary pyramid

A

= structure formed from the minor calyces function of separating the renal sinus from each lobe’s medullary region

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7
Q

What are the collecting ducts, what do they branch from, how do they branch, and where do they end?

A
  • a series of small tubes with a lumen continuous (stemming from) the lumen of the minor calyces
  • site of connection with the minor calyces is called the ducts of bellini
  • they branch as they travel radially outwards into the cortex of the kidney
  • end in a short, tangentially arranged collecting tubule
  • collects filtrate from numerous nephrons
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8
Q

What are the ducts of Bellini

A
  • the openings of the collecting ducts tubes into minor calyx
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9
Q

What is the medullary ray

A
  • defines the center of each lobule
  • exists in the cortex
    = a handful of collecting ducts traveling together (radially outward from the minor calyces
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10
Q

What is a Collecting tubule

A

= the terminal end of a collecting duct

- consists of a short, tangentially arranged tubule

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11
Q

What is the mesonephric duct and describe it development

A
  • is the origin fro the entire epithelial-lined lumen from collecting tubule outward toward the ureter
  • is a single paired tubular embryonic epithelium
  • comes from intermediate mesoderm
    During development,
    1) segments of the duct become the pronephros
    2) pronephros degenerates to the mesonephros
    3) mesonephros degenerates except for 2 parts:
    –> A) mesonephric duct - becomes tubes of reproductive system and
    –> B) metanephros - gives rise to ureteric bud (origin of bladder, ureter, adult human kidneys)
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12
Q

Where does the ureteric bud come from and what does it give rise to?

A
  • Is derived from the intermediate mesoderm, which gives rise to the mesonephric duct –> pronephros–>mesonephros–>ureteric bud
  • is the origin of the:
    • bladder
    • ureter
    • adult human kidneys
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13
Q

Describe a kidney’s lobular organization

A
  • within each lobe are several lobules
  • each lobule is organized around a central collecting duct
  • each collecting duct is a tubule that collects filtrate from numerous nephrons
  • each nephron is a single, highly folded, epithelium-lined tubule together with an encapsulated capillary bed at its distal-most end (glomerulus)
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14
Q

What is a nephron

A

= single, highly folded epithelium-lined tubule

- also has an encapsulated capillary bed at its distal most end (glomerulus)

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15
Q

What is a glomerulus

A
  • an encapsulated capillary bed at the distal-most end of a nephron
  • located within the cortex
  • tubular portion of their associated nephron descends to varying depths in the medulla, before turning around passing again in close approximation to the originating glomerulus and finally joining a collecting duct (this close contact is the juxtaglomerular apparatus)
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16
Q

What is the juxtaglomerular apparatus (JGA)

A
  • site where the proximal nephric tubule comes in close contact with its originating glomerulus as the tubule ascends from the medulla towards a collecting duct
  • important for transmitting signals about the efficiency of filtration
  • includes specialization of epithelial cells of the nephric tubule (macula densa), nearby CT (extraglomerular mesangial cells, or lacis cells), and in the specialized smooth muscle lining of the arterioles that enter and leave the glomerulus (juxtaglomerular cells - secrete renin)
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17
Q

Describe the location of the 3 specializations of the epithelial cells associated with the JGA and what those specialization are

A

1) Nephric tubules –> macular dense
2) nearby CT –> extraglomerular mesangial cells = lacis cells
3) Specialized smooth muscle lining of the afferent/efferent arterioles of the glomerulus –> juxtaglomerular cells - secrete renin

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18
Q

Describe the nephric tubule regions from distal to proximal

A

1) Proximal convoluted tubule
2) Proximal Straight tubule
3) Thick descending tubule
4) Thin tubule (descending thin tubule + ascending thin tubule)
5) thick ascending tubule
6) Distal tubule ( distal straight tubule + distal convoluted tubule)

—> “proximal” + “distal” - are relative to the glomerulus

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19
Q

What is Bowman’s Capsule

A
  • epithelial lined space of the nephric tubule encapsulating its associated glomerulus
  • consists of an inner epithelium = visceral epithelium of bowman’s capsule (considered part of the glomerulus) - consists of podocytes
  • outer parietal epithelium = simple squamous cells
  • Bowman’s space = space between the two epithelia = also called the urinary space
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20
Q

Describe the visceral epithelium of Bowman’s capsule

A
  • considered part of the glomerulus
  • inner epithelium of bowman’s capsule
  • consists of podocytes
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21
Q

what are Podocytes

A
  • make up the visceral epithelium of Bowman’s capsule
  • contain numerous, interdigitating extensions = pedicels
  • between the pedicles of adjacent podocytes = filtration slit
  • filtration slit spanned by a filtration diaphragm - - - filtration diaphragm - consisting largely of the transmembrane protein nephron
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22
Q

What are pedicels

A
  • interdigitating extensions from podocyte cells comprising the inner epithelium of bowman’s capsules
  • space formed between pedicels of adjacent podocytes = filtration slit
  • transmembrane proteins - nephrin - from each of the adjacent peicels form the filtration diaphragms spanning this slit
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23
Q

What is the filtration slit

A

= space formed between the interdigitating pedicels of adjacent podocytes
- spanned by filtration diaphragms made up of nephrin

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24
Q

What are filtration diaphragms

A

= structures consisting mostly of the transmembrane protein nephrin
- they span across the filtration slit spaces formed from the gaps between interdigitating pedicels of adjacent podocytes

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25
Q

What is the outer Parietal Epithelium

A
  • the outer epithelial cell layer of bowman’s capsule

- consisting of simple squamous cells

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26
Q

What is Bowman’s space and what is another name for it

A
  • space enclosed between the visceral and parietal epithelia of bowman’s capsule
  • also called the urinary space
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27
Q

Describe the highly convoluted capillary system in the glomerulus starting with its location

A
  • is underneath the visceral epithelium and requisite CT space (essentially 2 juxtaposed BMs) basal to both epithelia
  • capillary bed originates in an afferent arteriole + terminates in efferent arteriole –> forms an arterial portal system
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28
Q

What is a intraglomerular mesangial cell

A
  • the major element of the glomerular CT
  • migratory cell type
  • functions as a resident macrophage, smooth muscle, and fibroblast for the glomerulus
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29
Q

What is the renal corpuscle

A

= the glomerulus + the encapsulating nephric tubule (parietal layer of bowman’s capsule)

  • has vascular pole (location of afferent/efferent arterioles)
  • have urinary pole (at original of PCT)
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30
Q

Where are the vascular and urinary poles of the renal corpuscle

A

Vascular pole = at the location of the afferent + efferent arterioles

Urinary Pole = at the origin of the proximal convoluted tubule (PCT)

31
Q

Describe the blood supply of the kidney (from renal artery to renal vein - 13 steps if you could #9 as two separate options A and B)

A

1) Renal Artery
2) Segmental arteries
3) Interlobar arteries
4) Arcuate Arteries (“arch-shaped”)
5) interlobular arteries
6) afferent arterioles of glomerulus
7) glomerular capillary bed
8) efferent arterioles - to 9.A or 9.B
9. A) peritubular capillary plexus
9. B) vasa recta
10) interlobular veins
11) arcuate veins
12) Interlobar veins
13) Renal veins

32
Q

Renal Artery (1)

A

= enters at hilum

- branches within the renal sinus to 5 anatomically distinct segmental arteries

33
Q

Segmental arteries (2)

A
  • come from renal artery

- branch to form numerous interlobar arteries

34
Q

Interlobar arteries (3)

A
  • come from segmental arteries
  • large arteries
  • oriented roughly radially from the hilar region in direction out towards kidney capsule
  • leave the renal sinus + enter lobe –> branch to form the arcuate arteries
35
Q

Arcuate arteries (4)

A
  • come from the interlobar arteries branching at the beginning of a lobe
  • arch-shaped
  • run parallel along the cortico-medullary border
  • branch outward towards capsule as interlobular arteries
36
Q

Interlobular arteries (5)

A
  • come from the arcuate arteries
  • branch perpendicularly from the arcuate arteries
  • run towards the capsule
  • branch to form the afferent arterioles
37
Q

Afferent arterioles (6)

A
  • come from the interlobular arteries

- go into the glomerular capillary bed

38
Q

Glomerular Capillary bed (7)

A
  • come from the afferent arterioles

- exit via the efferent arterioles

39
Q

Efferent Arterioles (8)

A
  • come from the glomerular capillary bed
  • carry blood to the second capillary bed of the portal system- 1 of 2 options
    1) peritubular capillary plexus (in the cortex if originating from a cortical nephron)
    2) vasa recta (in medulla if originating from a juxtamedullary nephron)
40
Q

Peritubular Capillary plexus (9.A)

A
  • Come from an efferent arteriole that originated from an cortical nephron
  • exists in the cortex
  • feeds to an interlobular vein
41
Q

Vasa Recta (9.B)

A
  • come from an efferent arteriole that originated from a juxtamedullar nephron
  • exists in the medulla
  • feeds to an interlobular vein
42
Q

Interlobular vein (10)

A
  • receives blood from either a peritubular capillary plexus in the cortex or a vasa recta in the medulla
  • feeds to a arcuate vein
43
Q

Arcuate Vein (11)

A
  • comes from an interlobular vein
  • arch-shaped
  • runs parallel to corticomedullary border
  • feeds to interlobar vein
44
Q

Interlobar Vein (12)

A
  • Comes from an arcuate vein
  • passes through renal sinus
  • feeds to renal vein
45
Q

Renal Vein (13)

A
  • comes from the interlobar vein

- exits at the hilum

46
Q

What part of the trilaminar disc develops into the urogenital system and describe the formation of the ureteric bud.

A

= intermediate mesoderm forms tubular structures developing de novo from mesenchymal tissue - forming the mesonephric duct

  • the mesonephric duct develops into 3 regions
  • 1st the pronephros develops and then degenerates
  • 2nd the mesonephros develops which will degenerate except for the mesonephric duct which will go on to form the reproductive systems
  • 3rd the more caudal region- metanephros region, gives rise to the ureteric bud (which will extend into the metanephros region and develops the kidneys)
47
Q

List the branching of the mesonephric duct from the ureteric bud to the collecting ducts

A
  • bladder
  • ureter
  • major calyx (several minor calyces come together)
  • minor calyx (each one drains 1 lobe of kidney)
  • collecting ducts
48
Q

Describe the metanephros development

A
  • it is mesenchymal tissue (metanephric tissue) that is induced to form a tubular epithelium in response to invading ureteric bud (collecting tubules)
  • forms into an S-shape tube - w/ 1 end connects to end of collecting tubule and other end will envelope capillaries and form the renal corpuscle
49
Q

What is a nephron

A

= functional unit of the kidney (glomerulus + its functional tubule)

  • develops out of metanephric derived tubule
  • consists of glomerulus (surrounds capillary bed) + joins with collecting tubule (mesonephric derived)
50
Q

Renal Corpuscle consists of

A
  • Glomerulus

- Bowman’s capsule - visceral layer + parietal layer

51
Q

Describe the general characteristics of the adult kidney

A
  • 10-15 lobes
  • each lobe has cortex + medulla
  • collecting ducts divide lobes into lobules
  • collecting ducts are centers of each lobule
52
Q

What are the two types of glomeruli/nephrons? Describe their locations and associated vasculature that it feeds into

A

1) Cortical glomeruli (nephron) - sits high in cortex - is associated with peritubular capillary plexus (PTCP)
2) Juxtamedullary glomeruli (nephron) - sits next to medulla –> feeds into the vasa recta

53
Q

What is the CT region outside of each lobe

A

Renal Sinus

54
Q

List the progression of renal vasculature from Renal Artery to Renal Vein (13) steps

A

1) Renal Artery
2) Segmental Artery - supplies defined region of kidney
3) Interlobar Arteries (rises to level of cortical column- where adjacent lobes meet)
4) Arcuate Arteries - arch along cortico-medullary border w/n lobe
5) Interlobular arteries - travel radially toward capsule
6) Afferent Arterioles
7) Glomerular Capillaries
8) Efferent Arterioles
9) PTCP or Vasa Recta (will return to corticomedulary border before leaving kidney)
10) Interlobular Veins (capillary beds as well as stellate veins near the top of the cortex drain into them)
11) Arcuate Veins
12) Interlobar Veins - in the renal sinus region
13) Renal Veins
(** no “intra”s in the kidney**)

55
Q

What does the ultrafiltrate contain?

A
  • water
  • glucose
  • ions,
  • AAs
  • small molecules (<60kDa)
  • urea
  • DOESNT contain cells, lg. molecules, albumin
56
Q

Renal corpuscle

A
  • contain glomerulus (capillary bed) surrounded by visceral bowman’s capsule + parietal bowman’s capsule
  • contains filtration farrier (ultrafiltrate produced) + 3 distinct cell types in separate compartments
  • develops from the tube of metanephric tissue - forms unique epithelium + capillary bed that inserts into the epithelium –> results in epithelium in inner surface (towards capillary - visceral layer) + epithelium on outer surface (parietal layer)
57
Q

What is a podocyte

A
  • complex epithelial cell covering convoluted capillaries of bowman’s capsule
  • makes up the filtration barrier through which ultrafiltrate flows
    = epithelial cell of visceral bowman’s capsule
  • have interdigitating foot processes that interact over glomerulus basement membrane = pedicels (honey-comb of cell processes)
58
Q

Describe the structure of glomerulus

A
  • endothelial cells = fenestrated capillary
  • glomerulus = surrounded by podocytes (visceral layer of bowman’s capsule) + contains intraglomerular mesangial cells (motile cells that function to clean BM)
  • thick basal lamina creates 2 compartments
    1) inner = continuous (@ vascular pole) with cortical stroma
    2) outer one = urinary space = bag of bowman’s capsule
59
Q

What are mesangial cells

A
  • meso = middle, angio = vessel
  • maintain the BM including phagocytosis (act as resident macrophage) + production of collagen
  • regulate cell proliferation, immune RXN (including response to injury)
60
Q

Describe the filtration barrier

A
  • discrimination is based on charge (cationic proteins pass) + size (small proteins pass)
  • capillary endothelium is fenestrated
  • BM is shared by endothelium + podocytes
  • mesangial cells phagocytose debris from BM
  • adjacent pedicels are separated by filtration slit
61
Q

What is the filtration slit

A
  • separation between pedicels of adjacent podocytes
  • spanned by a diaphragm
  • diaphragm consists of a transmembrane protein = Nephrin from each podocyte
62
Q

What is the ultrafiltrate and where is it found

A
  • filtered substance before modification
  • substances that pass through filtration barrier
  • found in urinary space (Bowman’s Capsule)
63
Q

What is the filtrate and where is it found

A
  • filtered substance during modification
  • ultrafiltrate is modified by tubules + collecting ducts
  • found in renal tubules + collecting ducts
64
Q

What is the urine and where is it found

A
  • filtered substance after modification is completed
  • substance that enters the minor calyx and is excreted
  • found in calicoes, ureter, bladder
65
Q

Describe the morphology of the cells that modify the filtrate

A
  • ultrafiltrate leaves the urinary space and is modified sequentially by renal tubule epithelia including Henle’s loop (metanephric tissue) + collecting duct (mesonephric tissue)
  • 4 basic tubular morphologies are encountered along the way
66
Q

List the different tubular morphologies from PCT to the collecting duct and group them into their 4 morphological groups

A

1a) Proximal Convoluted tubule - majority of cortex tubular structures (w/ basal striations, microvilli =brush border, strong glycocalyx)
1b) Proximal Straight tubule - goes to start of medulla
1c) Thick Descending tubule (into medulla)
2d +e) thin descending loop + thin ascending loop =” thin loop” in LM
3f) Thick ascending loop - in medulla (basal striations, less apical specialization-might be domed)
3g +h) distal straight tubule + distal convoluted tubule = distal tubule (DT)
4i) collecting tubule = short section
4j) Collecting duct - long section - several of them travel together in medullary ray (only in cortex) - has two types of cells Principle + intercalated

67
Q

Describe how morphology predicts function in reference to the 4 renal tubule morphologies

A

1) PCT - large molecular resorption + active resorption due to microvilli, strong glycocalyx + basal striations
2) Thin loop - passive water reabsorption - due to small thin tubes (reminiscent of capillaries)
3) Thick ascending loop + DT - active salt transport across the basal surface - just basal striations here for ion channels
4) Collecting tubule/duct - water reabsorption mediated by hormonal control (hormone receptors)

68
Q

What are principle cells

A

= majority of cells in collecting duct

  • responsive to ADH (activates aquaporin transporters)
  • ion exchange
  • basal infoldings
  • clear cytoplasm
69
Q

What are intercalated cells

A

= minority of cells of collecting ducts

  • have higher mitochondria content –> more eosinophilic cytoplasm (dark cytoplasm)
  • responsible for acid/base balance
  • have bicarbonate transporters
  • ultrastructure: mito, golgi, polyribosomes, H+ transporters
70
Q

What are the Papillary ducts and what is another name for them

A

= Ducts of Bellini
- collecting ducts opening into minor calyx by passing through the area
= exists of the collecting ducts into minor calyces

71
Q

What renal tubule morphologies will be the only ones found in the cortex

A
  • PCT
  • DT
  • Medullary rays (collecting ducts)
72
Q

What renal tubule morphologies will be the only ones found in the Inner medulla

A
  • collecting ducts

- thin tubules

73
Q

What renal tubule morphologies will be the only ones found in the Outer medulla

A
  • will see all morphologies

COT - Exam 2 (28 decks)

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