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CPR Exam 2 > 2. Renal embryology (Kidney, Bladder, Suprarenal Gland) > Flashcards

2. Renal embryology (Kidney, Bladder, Suprarenal Gland) Flashcards

1
Q

What is the first structure to produce urine in an early fetus?

A

The mesonephros

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2
Q

From where is the collecting duct derived?

A

The collecting duct is derived from the ureteric bud.

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3
Q

Why does a fetus need to have a well-developed suprarenal gland?

A

Because of the requirement of DHEA to continue the pregnancy

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4
Q

What gives rise to the ureteric bud?

A

The caudal end of the mesonephric duct

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5
Q

What gives rise to the trigone?

A

The mesonephric duct growing downwards

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6
Q

What gives rise to the ureter, renal pelvis, and major and minor calyxes?

A

The ureteric bud

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7
Q

When do we see the appearance of the pronephros?

When do we see it degenerate?

A

Early week four

It degenerates by day 24 or 25

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8
Q

When do we expect to see the mesonephros producing urine?

A

From weeks 6 to 10

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9
Q

From where is the nephron derived?

A

The nephron is derived from the metanephrogenic blastema, which forms metanephric tubules, which become the nephron.

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10
Q

What gives rise to Bowman’s capsule?

A

The metanephric blastema

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11
Q

What is the pathway of structures leading to the formation of what will become the adult kidney?

(Hint: 5 structures)

A

Urogenital ridge
Nephrogenic cord
Pronephros
Mesonephros
Metanephros

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12
Q
A
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13
Q

What is derived from the pelvic part of the urogenital sinus?

A

The neck of the bladder, as well as:
in males, the prostatic urethra
in females, the entire urethra

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14
Q

What gives rise to the cortex of the suprarenal glands?

A

Epithelial cells from the intraembryonic coelom

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15
Q

What gives rise to the suprarenal medulla?

A

Neural crest cells

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16
Q

What forms the efferent ductules in men?

A

The mesonephric tubules, which produce some urine in early fetal life

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17
Q

What does the intermediate mesoderm form?

A

kidney and gonads

starts lateral to each somite and forms cylindrical structures

urinary system forms first

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18
Q

First thing to form from the intermediate mesoderm is what?

What does the urogenital ridge form?

A

urogenital ridge which is a longitudinal band of mesoderm on each side of the dorsal aorta

nephrogenic cord which makes the nephric structures:

  • pronephros
  • mesonephros
  • metanephros
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19
Q

What is the order and function of the nephric structures?

A

pronephros (rudimentary)

mesonephros (functions in early fetal life)

metanephros (permanent kidneys)

20
Q

Pronephros appears when?

Pronephros degenerates when?

What does the pronephric duct do?

A

bilaterally early in 4th week in cervical region

by day 24-25

run caudally and open into cloaca and persist after pronephros degrades to be used by mesonephros

21
Q

When does the mesonephros appear?

What are the components of the mesonephros?

A

bilaterally in late 4th week caudal to pronephros

mesonephric ducts and tubules (ducts develop 1st and induce tubules from intermediate mesoderm)

22
Q

The mesonphric tubules form renal corpuscles which have two components:

A
  1. medial end of tubules is cup shaped, glomerular capsule
  2. tubule wraps around glomerulus (knot of capillaries)
23
Q

When are the mesonephric tubules functioning?

A

act as intermittent kidneys from 6-10 weeks, producing small amounts of urine

stop working after ten weeks and will regress in females

form efferent ductules in males

degenerate by 12wks

24
Q

The metanephros arises when?

A

during the 5th week, the ureteric bud is induced by the caudal end of each mesonephric duct

the metanephros consists of the ureteric bud and the blastema

25
Q

What is the ureteric bud?

What is the metanephric blastema?

When do these form a functional and definitive kindey?

A

outgrowth of mesonephric duct

form nephrogenic cord

9-10th week

will have excretory and collecting portions

26
Q

How does the ureteric bud morph into the collecting system?

A

ureteric bud elongates and penetrates the blastema to form the renal pelvis

the stalk of the ureteric bud becomes the ureter

cranial part of the ureteric bud branches into collecting tubules to first make the major calices and then the minor calices

27
Q

What are the five steps of nephron development?

A
  1. collecting tubules induce metanephrogenic blastema to form metanephric vesicles
  2. Metanephric vesicle will elongate to form metanephric tubules
  3. proxomal end of tubules will form glomerular capsule and is invaded by glomeruli
  4. distal end of tubule will lengthen and differentiate into PCT, DCT, and nephron loop
  5. Each DCT contacts an arched collecting tubule and is now connected!
28
Q

Explain the blood supply to the kidneys

A

Kidneys start in pelvis and move up into abdomen

first branch form from common iliacs (will undergo involution and disappear)

definitive renal arteries are from abdomdinal aorta

29
Q

Unilateral renal agenesis

A

1:1000, males more affected

typically asymptomatic

suspected in infants with 1 umbilical A.

30
Q

bilateral renal agenesis

A

1: 3000

oligohydramnios

non-viable, pulmonary hypoplasia, potter’s sequence

31
Q

Renal Duplications

A

abnormal division of ureteric bud

incomplete: divided/bifed kidney
complete: double kidney and bifid ureter or separate ureters

32
Q

Horseshoe Kidney

A

1:1000

fusion of inferior poles

asymptomatic

ascent prevented by IMA (what is IMA)

33
Q

Accessory Renal Vessels

A

multiple renal arteries (2-4)

25% of adult kidneys affected

2x common as accessory veins

can obstruct ureter and cause hydronephrosis

“end arteries” so if damaged can cause ischemia

34
Q

Polycystic Kidney Disease

A

Autosomal recessive mutation in PKHD1

cysts present in both kidneys

renal insuffiency

25% assx with pulmonary hypoplasia

35
Q

Multicystic dysplastic kidney disease

A

abnormal development of renal system

cysts are probably dilations in loop of henle

one kidney affected 75% of the time

36
Q

How is the urogenital sinus formed (the pee hole)

A

ventral cloaca contains the urogenital sinus and anorectal canal separated by the urorectal septum

  1. vesicle part: forms most of bladder
  2. pelvic part: forms neck of bladder, prostatic urethra (m) and urethra (f)
  3. phallic part: spongy urethra (m), lining of vagina (f)
37
Q

How is the trigone formed?

A

at 4-6 weeks, mesonephric duct is incorporated into posterior wall of bladder

ureteric bud is attached then and will connect openings of ureteric buds into bladder wall

openings of mesonephric duct are carried inferiorly to the pelvic urethra

this forms the trigone

38
Q

What is the trigone?

A

triangular region of the mesonephric and ureteric ducts blending into posterior bladder

39
Q

What develops from the vesicle part of the urogenital sinus?

epithelium comes from

submucosa nad muscularis comes from

tigone comes from

A

bladder!

urogenital sinus

splanchnic mesoderm

intermediate mesoderm

40
Q

the bladder is continuous with what structure?

what forms the median umbilical ligament?

A

Allantois

allantois constricts and forms the urachus

extends from the apex of the bladder to the umbilicus

this forms the median umbilical ligament

41
Q

Exstrophy of the bladder

A

1:10-40,000, typically males

arises during body folding in 4th wk

defective closure of ventral abdominal wall

exposure of musosa of the posterior wall of the bladder

42
Q

Epispadias

A

1:30,000 males

urethral opening is on the dorsum of the genital tubercle rather than on its ventral side

Exostrophy of the bladder with epispadias occurs 1:40,000

43
Q
  • Urachal cysts
  • Urachal sinus
  • Urachal fistula
A
  • remnants of the epithelial lining of the urachus that can become enlarged and infected
  • end of the urachus remains open into bladder or umbilicus
  • entire urachus remains patent and allows urine to escape from umbilical orifice

sx: leaking urine or other discharge, peritonitis, infection

44
Q

remeber the Zones and their hormones of the suprarenal gland?

Medulla:

A

Salt, Sugar, Sex, the deeper you go the sweeter it gets.

ZG: mineralcorticoids

ZF: glucocorticoids

ZR: sex hormones

Medulla: chromaffin cells (Ne/Epi)

45
Q

What are the four steps in the development of the suprarenal glands?

A
  1. 5ht week, coelomic epithelium delaminates and enters mesoderm making fetal cortical cells
  2. Neural Crest Cells migrate into medulla and diff. into chromaffin cells. Contain postganglionic sym. neurons (epi/ne)
  3. Fetal cortex regresses and final cortical cells reorganize into the three zones
  4. fetal cortex secretes DHEA and is converted to estradiol to maintain pregnancy, along with ACTH and glucocorticoids

CPR Exam 2 (33 decks)

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