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COT - Exam 2 > 11.2 Lab + Lecture Notes > Flashcards

11.2 Lab + Lecture Notes Flashcards

1
Q

Glomeruli

A

= circular, largely basophilic structures

  • always found within the cortex
  • use them to segment slide into cortex, medulla, sinus regions
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2
Q

what does Unperfused tissue mean

A

= vascular space filled with blood

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3
Q

Transitional epithelium will be seen where in kidney

A
  • major + minor calyces

- ureter = thickest

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4
Q

what are Medullary Rays

A
  • comprised of collecting ducts that travel radially towards the medullary pyramid
  • define center of the cortical lobules
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5
Q

What are ducts of Bellini

A

= largest collecting duct as it exits medullary pyramid

  • recognize it primarily by its location
  • only nephric tubule near there is the thin tubule
  • only capillary near that will be the vasa recta
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6
Q

PTCP

A

= systemic capillary bed supplying the cortex

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7
Q

Vasa Recta

A

= systemic capillary bed supplying the medulla

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8
Q

What are three things in the kidney you can label primarily by location

A
  • thin tubules
  • vasa recta
  • ducts of Bellini
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9
Q

To identify a collecting duct in cortex

A
  • use location + morphology
  • look for medullary rays
  • contains 2 types of cells
    1) principle cells
    2) Intercalated cells (5-10%) - contain higher density of mitochondria than principle cells
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10
Q

Compare the morphology of the PCT to the DT

A
  • highly eosinophilic
  • basal enfoldings
  • cells should be larger (fewer nuclei within a given profile
  • prominent brush border (microvilli) + glycocalyx
  • since it is larger there will be more profiles ~ 7:1 ratio
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11
Q

Compare the morphology of the thick descending tubule to the think ascending tubule

A
  • thick descending (like PCT)
  • thick ascending (like DT)
  • can’t use frequency of occurrence in the medulla though because it is closer to 1:1 ratio
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12
Q

What are the 4 cell types within the renal corpuscle and where will you find each

A

1) Epithelial Cells of parietal layer of bowman’s capsule = simple squamous epithelium (outside of bag)
2) Podocyte = visceral layer of Bowman’s capsule - poke into the urinary space, have relatively condensed nucleus
3) Capillary endothelial cell = squamous cell inside of glomerulus, poke inward towards capillary lumen
4) intraglomerular mesangial cell = round/cuboidal cell, euchromatic nucleus

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13
Q

What elements comprise the juxtaglomerular apparatus

A

1) Macula Densa
2) JG cells
3) Extraglomerular mesangial cells

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14
Q

What is the urinary pole of renal corpuscle

A

= where urinary space drains into a PCT

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15
Q

What are the components of the urinary system

A

1) Kidneys
- produce urine as filtrate of the blood
2) ureters
- tube the connects each kidney to the bladder
3) bladder
- stores urine until voiding
4) uretra
- tube the connects bladder to external environment

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16
Q

Describe the anatomy of the kidney

A
  • each kidney is composed of lobes (with medulla at center surrounded by cortex)
  • renal artery/vein give blood to/from the kidney
  • urine is conveyed from minor calyx –> major calyx –> leaves kidney via ureter
  • medulla = completely surrounded by minor calyx
  • hilar = generic term describing region of indentation in kidney bean space
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17
Q

What is the location of the kidney

A

= retroperitoneal organ

  • have dense CT compartment surrounding whole organ (adipose tissue in this CT)
  • adrenal gland sits above it
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18
Q

Describe the FXN of the kidney

A

= filter blood - steps:

1) everything we could possible want removed is removed
- function of glomerular filtration barrier
- produces ultrafiltrate
2) somethings are selectively reabsorbed into circulation
- function of nephron + collecting ducts
- substance as it is being modified = filtrate
3) urine = end product

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19
Q

Describe the function of a nephron

A 
= take everything out of blood + selectively reabsorb
A) PCT
- takes glucose (+ other lg. molecules) back
- puts it into CT --> then back to blood
B) descending parts
= just water
C) ascending parts
= just salt
D) collecting ducts
= differential water resorption
- hormonally dependent
20
Q

What are the 4 basic morphologies of the kidney based on their function - include the relevant parts of the nephron and any functional ultrastructures that are important

A

1) Active resorption of water salts, especially small molecules
- PCT, PST, Thick descending
- basal striations, microvilli
2) Passive resorption of water
- thin loops
- squamous shaped cells?
3) Active salt transport + control of interstitial osmolarity
- Thick ascending, DST, DCT (DTs)
- basal striations
4) Active modification
- hormonally controlled
- collecting ducts/tubules
- cuboidal cells

21
Q

Describe how 3 separate embryonic tissues contribute to the functional units of the adult kidney

A

1) mesonephros
- collecting tubule, collecting duct, calycies, ureter
- development of the collecting duct = the first tubular structure derived from CT
2) Metanephros
- loop of Henle & nephron (from metanephric tissue cap
- 2nd tubular epithelial structure being derived from CT
3) Endothelium
- glomerulus (descending artery)
- lined by visceral epithelium
- parietal layer of renal corpuscle (bowman’s capsule) –> between 2 epithelia = double thick BM = site of blood filtration

22
Q

When does the induction of the nephron occur

A

= at week 23

  • presence of nephric tubule (collecting tubule)
  • -> induces formation of nephron out of mesenchymal tissue
23
Q

Describe the kidney lobule organizational development

A

= overal = metanephric derived-tissue –> is centered around mesonephric derived tissue
1) In cortex
A) mesonephric derived center = collecting ducts (in medullary rays - cortical structure containing colelcting ducts that organize the cortex into lobules)
B) Metanephric derived exterior = renal corpuscles, PCTs, DTs

2) In medulla
A) mesonephric derived center = descending collecting ducts
B) metanephric derived exterior = thick descending limb; thin limb; thick ascending limb

24
Q

Describe the kidney’s blood supply

A
  • segmental artery = useful for surgeons because allow controlled blood supply to 1+ desired lobes of kidney only
  • kidney weighs 5% of body weight –> but receives 25% of cardiac output
  • kidney receives 1L/min of blood
  • only produces 1 ml/min of urine
25
Q

Describe the kidney’s innervation + lymphatic drainage

A
  • lymphatic drainage is primarily through hills (arcuate lymphatics < interlobular lymphatics< hilar lymphatics)
  • also is minor capsulary lymphatic drainage (sub capsular + capsular lymphatics)
  • the vascular elements are heavily innervated with sympa fibers
  • nephrons are lightly innervated
  • -> nerves follow the vessels
26
Q

What is a glomerular capillary tuft

A
  • exists on anastomosing capillary pathway (amount of glomerular capillaries the get blood vs. use anastomosing path is controlled by cells/hormones
  • if GFR is low = blood will move from A–>E quickly (use anastomose)
  • if GFR is high = blood will go through all capillaries
27
Q

what is the function of Mesangial Cells

A
  • can change perfusion through glomerular capillary tuft
  • 2 types of extra/intra - glomerular mesangial cells
  • modulate glomerular filtration by contraction
  • generate + respond to vasoconstrictors/dilators
28
Q

Describe the juxtaglomerular apparatus / vascular pole

A
  • 3 specializations
    1) Macular dense
    2) JG cells
    3) Mesangial cells
  • glomerulus = filtration portion of the JGA
29
Q

Describe the macula densa

A

= localized near afferent arteriole
- monitors [NaCl] in DCT + regulates renin secretion = specilization of DCT
= cells in DCT that are closest to glomeruli - have larger nuclei + are tightly packed = specialized sensory cells
- FXN = communicate info to rest of JGA about filtrate –> influence renin secretion

30
Q

Describe the JG cells

A

= specialization of smooth muscle cells of arteriole wall proximal to JGA

  • specialized to produce/secrete renin
  • contain renin granules
  • form the “tunica media” of arterioles
31
Q

Describe the mesangial cells

A
  • function = phagocytose debris + provide structural support to BM + secrete molecules in response to glomerular injury
    = modified smooth muscle cells
  • primarily located in CT compartment of JGA
  • 2 types
    1) extraglomerular mesangial cells
    2) intraglomerular mesangial cells
32
Q

Describe the secretion of renin

A
  • controlled by 3 things
    1) fluid in distal tubule (sensed by macula densa)
    2) pressure in arterioles
    3) sympathetic never fibers near JG cells
33
Q

Describe the cortical glomerulus

A
  • (75%) of glomeruli
  • contacts “cortical nephron” - reaches only outer medulla
  • contributes blood to PTCP
  • PTCP = peritubular capillary plexus = capillary bed in cortex - drains either to interlobular veins or 1st to stellate veins then interlobular veins
34
Q

Describe the juxtamedullary glomerulus

A
  • (25%) fo glomeruli
  • contacts the “juxtamedullary nephron” - travels to inner medulla
  • contributes blood to vasa recta
  • vasa recta = capillary bed in medulla - returns to juxtamedullar region to drain to interlobular veins or arcutate veins
35
Q

Describe the renal cortical interstitium

A
  • interstitial tissue = 10% of cortex - has lower salt content (300mOsm) - collagen type I and III fibers + fibronectin
  • cortical interstitial cells
    A) fibroblast-like cells –> secrete EPO
    B) lymphocyte-like cells –> prob APCs
36
Q

Describe the renal medullary interstitium

A
  • interstitial tissue = 40% (much more than in cortex) of the tissue in medulla - has high osmolatiry (blood in the vasa recta can be up to 1500mOsm) - the thick ascending gets this up
  • medullary interstitial cells
    A) fibroblast-like cells
  • prominent lipid droplets
  • synthesize prostaglandins
  • change appearance with diuretic state
    B) lymphocyte-like cells
    C) pericytes
37
Q

Describe the hormonal influence/production in the kidneys

A

A) water influences
- secretes ADH
B) salt influence
- Aldosterone (from adrenal cortex) - removes Na & add K to lumen
- ANP (myocytes in hear) - add Na to urine
- PTH - promotes PO4 excretion + Ca absorption
–>produces vitamin D (increases Ca + PO4 absorption from gut)
C) blood pressure influence
- produces EPO (interstitial cells in cortex + medulla) - controls RBC hematopoeisis
- JG cells - release renin (response to perfusion pressure or sympa stim) increases BP
- Medullary interstitial cells - produces prostaglandins (vasodepressor)

38
Q

Describe kidney and blood filtration

A
  • all you need is fenestrated capillary, permeable epithelium, lumen with osmotic gradient
  • 2 types of renal dialysis
    1) Hemodialysis
  • blood passes along filtration membrane which draws out waste via an osmotic gradient
    2) peritoneal dialysis
  • fluid is added to peritoneal space via catheter
  • drained after few hrs.
  • uses peritoneal wall as natural semi-permiable membrane
39
Q

Describe diabetes mellitus in relation to the PCT

A
  • diabetes mellitus = leading cause of kidney disease - increase glucose overworks PCT –> can clog BM (mesangial cells cannot keep up with clearance)
  • in adequate insulin production by pancreas (type I) -
  • or inadequate response of insulin receptors (type II) –> increases blood glucose
  • all glucose is put into filtrate (as usual) but not all can be reabsorbed by PCT
  • glucose lost in urine with water in efferent to balance glucose overload = why get thirst symptom
40
Q

Describe diabetes mellitus WRT glomerular BM

A
  • chronic high glucose in ultrafiltrate - damages the BM (album + other proteins can escape and get into filtrate and eventually lost in urine)
  • albumin level in blood decreases (normally maintains blood osmolarity because does not pass the filtration barrier) - here you get fluid retention by body tissues (edema)
41
Q

diabetes insipidus

A
  • net result = decreased ADH signaling + increased H2O loss in the urine –> see hyper glycemia
  • classic thirst symptom of diabetes with no glucose metabolism problems
42
Q

Ureter

A

= stellate lumen

  • transitional epithelium
  • loose lamina propria/submucosa
  • 3 poorly defined layers in muscularis
  • is small
43
Q

urinary bladder

A
  • mucoase is in many fold (if bladder empty/relaxed)
  • transitional epitehlium
  • thick wall of interlacing bundles of smooth muscle fibers
  • bladder is big - compared to other organs it might be confused with
44
Q

Orafice of ureter

A
  • ureter crosses wall at oblique angle

- FXN: so the full bladder/pressure doesn’t back up to kidney and no back flow when contraction muscle for excretion

45
Q

Urothelium (transitional epithelium)

A

= all of epithelium up until distal urethra that is in contact with fully modified urine

  • urothelial cells have sensory function (mechansensation, chemosensation, can trigger activity in subjacent nerves by releasing NO + ATP)
  • 3 layers of epithelium
    1) umbrella cell layer - tight junctions between cells “plaques” forming asymmetrical unit membrane on out surface (uroplakin protein)
  • common site for UTIs (1st line of defense against them
  • has modified cell membrane with uroplakin protein
  • intracellular vesiclase fuse with surface membrane to expand apical surface of cell
    2) Intermediate layer
    3) basal layer
  • attached to BM
  • stem cells
46
Q

Urethra

A
  • 20 cmin males (4cm prostatic, 1cm membranous, 15cm - penile) - shares function with reproductive system
  • 3-5cm in females
  • transitional epithelium thins to a Stratified or pseudostratified epithelium –> terminating distilling in SSNK –> SSK epithelium

COT - Exam 2 (28 decks)

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