Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Embryology Kidney > 305 > Flashcards

305 Flashcards

1
Q

What is the first and rudimentary kidney to develop?

A

Pronephroi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the second and briefly functional kidney to develop?

A

Mesonephroi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the third and permanent kidney to develop?

A

Metanephroi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does the pronephroi develop?

A

EARLY 4th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pronepheroi composed of?

A

clusters of cells and tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do the pronepheroi ducts run and open into?

A

Pronepheroi run caudally and open into the cloaca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens to the ducts of the pronepheroi?

A

remain and are utilized by the Mesonephroi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does the Mesoneophroi develop?

A

LATE 4th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the mesonephroi composed of?

A

the glomerulus and tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the purpose of the mesonephroi?

A

to function as the interim kidney for FOUR weeks until the permanent kidney develops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where do the mesonephroi ducts open?

A

into the pronephroi ducts and into the cloaca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does the mesonephroi degenerate?

A

At the end of the first trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens to the tubes of the mesonephroi?

A

become the efferent ducts of the testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the metanephroi?

A

The primitive permanent kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does the metaneprhoi develop and then become functional?

A

Develops in the 5th week; functional in the 9th week to produce urine that contributes to amniotic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the nephron consist of?

A

glomeruli, collecting tubules and loop of Henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

From what end of the metanephric tubule does the glomeruli develop?

A

proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The metanephric diverticulum develops from the metanephric kidney and begins with the development of what?

A

ureteric bud

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The ureteric bud develops into the permanent kidney and differentiates into what structure?

A

ureter and collecting tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What occurs during the 10th - 18th week in the metanephroi?

A

increase in number of glomeruli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When does the metanephric kidney reach full complement?

A

32 week GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How many nephrons does the functional kidney have at term?

A

400k- 2million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The fetal kidney is divided into what?

A

lobes, will disappear in postnatal life as nephrons continue to grow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Initially, where are the kidneys positioned?

A

The kidneys are initially close together and with the growth of the abdomen, are elevated from the pelvis into the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When do the kidneys attain adult positioning?

A

by the 9th week GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How much do the kidneys rotate to achieve correct positioning?

A

90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where are the mature kidneys located in the body?

A

retroperitoneal; outside of the peritoneal cavity on the posterior wall of the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where do the kidneys receive their blood supply when final position is achieved?

A

from the distal end of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In rudimentary stages, where do the kidneys receive their blood supply?

A

from nearby vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where do the renal arteries initially branch off?

A

from the common iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which renal artery is longer and more superior?

A

right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When does glomerular filtration begin?

A

9 week GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Accessory renal arteries occur in what percentage of the population?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How many arteries will a kidney have if they have accessory arteries?

A

2-4; typically will only have 1 per kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

From where do the accessory renal arteries arise?

A

the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where do the accessory renal arteries attach?

A

to the inferior or superior poles of the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If an accessory renal arteries attaches to the right inferior pole it can cross what structures leading to what?

A

the anterior ureter and IVC; hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is hydronephrosis?

A

the distension of the renal pelvis and renal calicies with urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

If the accessory renal arteries are damaged or ligated, what happens to the area of the kidney perfused by these vessels?

A

ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the incidence of unilateral renal agenesis?

A

1:1k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Does unilateral renal agenesis affect more males or females?

A

males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

In unilateral renal agenesis, which kidney is more likely to be affected?

A

the LEFT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

In the presence of a single umbilical artery, what is the likely renal congenital implication?

A

unilateral renal agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When is the diagnosis of unilateral renal agenesis typically made?

A

with the discovery of right renal hypertrophy; typically asymptomatic until that time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the incidence of bilateral renal agenesis?

A

1:3k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the prognosis of an infant with bilateral renal agenesis?

A

incompatiable with life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the cause of bilateral renal agenesis?

A

Failure of ureteric buds to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Bilateral renal agenesis is apart of what congenital syndrome?

A

Potter’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is a malrotated kidney?

A

the kidney fails to rotate therefore remaining in embryonic position; a/w ectopic kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is an ectopic kidney?

A

Failure of one or both kidneys to ascend into the abdomen from the pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is a horseshoe kidney?

A

The poles of the kidney are fused become a U shaped organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the incidence of a horseshoe kidney?

A

0.2% of general population; 7% of Turner’s syndrome patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Why can’t a horseshoe kidney ascend into the abdomen?

A

It is held in place by the inferior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Is a horseshoe kidney symptomatic?

A

No; the ureters, bladder and collecting systems all develop typically

55
Q

What is the inheritance pattern in polycystic kidney disease?

A

autosomal recessive

56
Q

What occurs in neonates with polycystic kidney disease?

A

bilateral accumulation of small cysts that lead to renal insufficiency

57
Q

What is the prognosis of an infant with polycystic kidney disease?

A

incompatible with life unless treated with postnatal dialysis or kidney transplant

58
Q

What is the prognosis of an infant with multicystic dysplastic kidney disease?

A

good outcome expected; typically unilateral

59
Q

What is multicystic dysplastic kidney disease?

A

the formation of cysts (fewer and smaller than PKD) that cause dilation of parts of the nephron- typically the loop of Henle

60
Q

What organs does the urogenital sinus give rise to?

A

bladder, urethra and penis/ clitoris

61
Q

What type of tissue is the bladder derived from?

A

epithelial

62
Q

The prenatal bladder is initially continuous with what embroyologic structure?

A

the allantois

63
Q

As the allantois thickens into a fibrous cord, it becomes what structure?

A

the urachus

64
Q

What contributes to the formation of the trigone and ureters?

A

the mesonephric ducts

65
Q

What is the function of the trigone of the bladder?

A

is is a smooth, triangular region of the bladder that, as it stretches, will signal the brain of the need to void

66
Q

The openings of the mesonephric ducts move close together to enter what structure?

A

the prostatic part of the urethra

67
Q

The mesonephric ducts become what structures in the male and female child?

A

in the male, the ducts will become ejaculatory ducts; in the female, they will degenerate

68
Q

What is the incidence of exstrophy of the bladder?

A

1:10k-1:40k

69
Q

Is exstrophy of the bladder more likely to affect males or females?

A

males

70
Q

Exstrophy of the bladder is likely to occur with what penile anomaly?

A

epispadias

71
Q

What structures are exposed to the environment with exstrophy of the bladder?

A

the trigone and ureteric orficies

72
Q

When does the fetal kidney achieve an adult number of nephrons?

A

34-35 wk GA

73
Q

When does Na and H2O reabsorption begin in the loop of Henle and tubules?

A

12-14 wk GA

74
Q

Amniotic fluid is primarily composed of what >18wk GA?

A

fetal urine

75
Q

How frequently does the fetal bladder fill and empty?

A

Q20-30 min

76
Q

Low renal blood flow and low GFR is related to what in the intrauterine environment?

A

high pulmonary vascular resistance, low systemic vascular resistance

77
Q

Renal blood flow in both term and preterm infants is low in direct correlation to what?

A

high renal vascular resistance (transition is slower in preterm infants)

78
Q

What causes a reduction in renal vascular resistance?

A

an increase in renal blood flow and GFR increase

79
Q

What is the rate of effective renal perfusion in a postnatal infant at 30 week, 3 mo and 1-2 yrs?

A

30 week: 20cc/min
3 mo: 300cc/min
1-2 yr: 650cc/min

80
Q

Increases in renal blood flow are directly related to what factors?

A

the formation of new glomeruli, vascular remodeling, a decrease in renal vascular resistance and the release of vasoactive substances (adenosine, angiotensin II, NO, and the RAAS system)

81
Q

What is the fetal urine concentration abilities of an infant (compared to an adult)?

A

20-30%

82
Q

What are the implication of fetal physiology on urine production?

A

impaired ability to conserve Na (loose a lot of Na) and fetal kidneys are less sensitive to ADH (tendency to diuresis)

83
Q

What organ produces Renin and why?

A

Kidneys; in respones to decreased Na in distal tubules

84
Q

What organ produces Angiotensinogen and why?

A

Liver; renal artery hypotension decreased Na in distal tubules

85
Q

What does Renin convert?

A

Angiotensinogen into Angiotensin I

86
Q

Angiotensin converting enzyme is produced by what organ?

A

Lungs

87
Q

What does ACE convert?

A

Angiotensin I to Angiotensin II

88
Q

Angiotensin II causes what physiological changes?

A

1) constriction of blood vessels (inc BP)
2) Stimulates adrenal cortex to secrete aldosterone
3) Aldosterone acts on kidneys to reabsorb Na Cl (therefore H2O) and excrete K- inc fluid vol/inc BP
4) stimulates posterior pituitary to secrete ADH (acts on distal tubule ducts to NOT reabsorb H2O)
4) inc sympathetic activity

89
Q

What is the net outcome of the RAAS system?

A

cascade of events causing the retention of Na, H2O, inc effective circulating vol and inc perfusion of juxtaglomerular apparatus

90
Q

Angiotensin in fetal life is produced by what?

A

yolk sac

91
Q

When is AT II found in immature renal tubules

A

by 30d GA

92
Q

What is the fetal response to aldosterone?

A

low, therefore infants are not retaining H2O

93
Q

What is RAAS system activity in neonates?

A

higher than adults; gradually decreases over first few months of postnatal life

94
Q

Angiotensinogen and plasma renin activity patterns are parallel, what are they and when do they change?

A

High postnatally for 2-3 weeks, then decrease

95
Q

Low aldosterone production, responsivness and few receptors put the VLBW infant at risk for what?

A

dehydration and hyponatremia

96
Q

What is vasopressin and where is it made/stored?

A

the precursor to ADH; made in hypothalamus and stored in posterior pituitary gland

97
Q

What is the response to inc ADH production at birth?

A

distal and collecting tubules have decreased response to circulating ADH levels

98
Q

The postnatal decreased response to aldosterone puts the infant at risk for what?

A

hypovolemia, dehydration

99
Q

What are the contributing factors for increased secretion of ADH?

A

perinatal asphyxia, IVH, RDS, MAS and pneumothorax

100
Q

What are the effects of SIADH?

A

dilutional hyponatremia, inc excretion of Na, decreased UOP, increased urine osmolality

101
Q

How do you treat SIADH?

A

fluid restric (40-60cc/kg/d), monitor serum Na and replete if necessary, monitor UOP and lasix

102
Q

How is SIADH diagnosed?

A

evaluation of serum and electrolyte levels and serum and urine osmolality

103
Q

What changes to kidney function occur with birth?

A

RAAS activity increases, BP inc, RVR dec, inc renal perfusion, dec Na re absorption and inc GFR

104
Q

What is the typical UOP rate for a term infant?

A

15-60cc/kg/d

105
Q

What is the typical UOP rate for a preterm infant?

A

24-48cc/kg/d (1-3cc/kg/h)

106
Q

What is considered oliguria?

A

UOP < 0.5cc/kg/h AFTER 48 hours

107
Q

What is the expected UOP after 2 days?

A

void 1 or more times with each feed

108
Q

What is the bladder capacity of an infant at 32 weeks GA?

A

13cc

109
Q

What is the bladder capacity of an infant at 36 weeks GA?

A

20cc

110
Q

What is the affect of MgSO4 exposure to an infant’s voiding pattern?

A

may delay voiding r/t decreased GFR and urine retention

111
Q

95% of infants will void within how long?

A

24 hours postnatal life

112
Q

What is the GFR in a 28wk and 35wk GA neonate?

A

28 wk: 2cc/min
>35wk: 10-13cc/min (after full complement)
After this, GFR and renal perfusion increase 5 fold

113
Q

What contributing factors cause GFR to inc in direct correlation to inc GA?

A

inc renal perfusion, dec RVR and inc systemis BP

114
Q

What contributing factors cause the kidneys to be unable to handle large amounts of solutes?

A

dec renal perfusion and GFR, smaller tubular reabsorption surface area, fewer solute transporters, dec control of H ions, dec Na/K atpase pump activity

115
Q

What is the Na requirement of an infant?

A

1-3MEq/kg/d

116
Q

What is the Na balance of a term infant?

A

positive

117
Q

What is the Na balance of a preterm infant?

A

negative

118
Q

What are the effects of an immature Na/Katpase pump?

A

high extracellular volume, tubule insensitivity to aldosterone and inc fractional excretion of Na

119
Q

Why are preterm infants at increased risk for Na retention?

A

preemies cannot readily excrete a high Na load. When fluid intake is inadequate, they are at risk for Na retention and hypernatremia (especially in the first week of postnatal life)

120
Q

What does the FENa measure?

A

it is an indicator of tubular function

121
Q

What is the FENa calculation?

A

FENa= (urine Na/serum Na) x (serum creatinine/ urine creatinine) x 100

122
Q

FENa is inversely proportional to what?

A

gestational age

123
Q

The higher a FENa value indicates what?

A

more Na lost in urine

124
Q

Glucose reabsorption is related to what other electrolyte?

A

Na

125
Q

Infants have a glucose fractional excretion rate that is…

A

high

126
Q

VLBW infants should be monitored very closely for

A

hyperglycemia, glycosuria as well as fluid and electrolyte imbalances

127
Q

Attempts to excrete a high glucose load in an neonate can lead to what?

A

hyponatremia and dehydration

128
Q

What is the normal GIR in infants?

A

4-6mg/kg/min

129
Q

What is the GIR calculation

A

GIR mg/kg/min= (%glucose x IV rate)/ (6 x wt in kg)

130
Q

How are glomeruli formed?

A

they are produced on branches of arteries rising from the dorsal aorta

131
Q

Blood from glomerular capillaries is filtered by what?

A

Bowman’s capsule and glomerulus

132
Q

What affect does increasing GA have on body composition?

A

initially total body water and ECF are higher than ICF; with inc GA, balance shifts

133
Q

At 16wk, 32 wk and term, what percentage of the fetus is composed of water?

A

16 wk: 94%
32 wk: 80%
term: 78%

134
Q

What causes total body weight loss following birth?

A

the shift of fluid from extracellular to intracellular compartments (ECF vol peaks at dol 3 followed by diuresis)

Embryology Kidney (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions