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CPR Test 2 > 62: Urinary System Development > Flashcards

62: Urinary System Development Flashcards

1
Q

Where does the Urinary System develop from?

A

Intermediate mesoderm & Urogenital sinus

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2
Q

Where is the intermediate mesoderm located?

A

between paraxial and lateral mesoderm; extends along dorsal body wall of the embryo

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3
Q

How does the development of kidneys begin?

A

as a longitudinal elevation of intermediate mesoderm on the

dorsal wall of the embryo

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4
Q

Urogenital ridge

A

Nephrogenic cord: gives rise to urinary components

Gonadal ridge: gives rise to genital system components

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5
Q

What are the 3 systems of the kidney during development?

A

Pronephros: rudimentary sequential systems

Mesonephros: functions very briefly during the early fetal period

Metanephros: forms the permanent kidney

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6
Q

Pronephros

A

Beginning of week 4

7-10 cell groups in the
cervical region

Forms vestigial excretory units = nephrotomes

Regress caudally & disappears by end of week

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7
Q

Mesonephros

A

Beginning of week 5

Excretory tubules appear, lengthen to form an S-shaped loop

Acquires a tuft of blood vessels medially; primitive glomerulus

tubules form the
bowman’s capsule

tubules elongate laterally, join w/ longitudinal collecting duct (mesonephric duct)

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8
Q

Ureteric bud

A

outgrowth of mesonephric duct covered by metenephric blastoma (cap)

forms primitive renal pelvis and splits into caudal and cranial portion (gives rise to major calyces)

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9
Q

Permanent Kidney

A

ureteric bud stalk forms ureter

diverticulum undergoes branching (major & minor calyces, & collecting tubules)

The end collecting
tubule divides and become arched

mesenchymal
cells form small metanephric vesicles which elongate to form S shaped
renal tubules

Capillaries grow into renal tubules, proximal ends invaginated by glomeruli

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10
Q

Lobulated Kidney

A

fetal kidney lobulated

lobulations disappear after birth b/c connective tissue growth, vascularity & increasing size of nephrons

if process fails, results in fetal lobulations after birth

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11
Q

When is nephron formation complete?

A

at birth

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12
Q

How many nephrons are in each kidney?

A

1-2 million in each

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13
Q

Excretory part of nephron

A

Bowman’s capsule, loop of Henle, Distal and Proximal Convoluted tubules

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14
Q

Where does Excretory part of nephron develop from?

A

From mesenchyme of the metanephric blastema

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15
Q

Conducting part of nephron

A

Collecting tubules, minor calyces, major calyces, pelvis

and ureter

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16
Q

Where does Conducting part of nephron develop from?

A

from the ureteric bud

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17
Q

What happens when the kidneys ascent?

A

initially hila face ventrally & get blood from branches of common iliac

embryo grows, kidneys higher in stomach

as kidneys “ascend”
they rotate medially
almost 90 degrees

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18
Q

What happens when the kidneys FURTHER ascent?

A

they are supplied by higher branches of aorta

renal arteries persist

week 9: kidneys reach suprarenal (adrenal) glands and reach final position

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19
Q

Accessory Renal Arteries

A

arise above or below main renal artery

cross over ureter at (lower pole) & can cause obstruction (hydronephrosis)

renal segmental arteries are end arteries

injury or ligation of
accessory artery leads to ischemia of segment supplied

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20
Q

Renal Agenesis

A

Early degeneration or failure of formation of the ureteric bud

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21
Q

Unilateral Renal Agenesis

A

common in boys

Left kidney usually absent

usually asymptomatic if Right kidney normal

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22
Q

Bilateral Renal Agenesis

A

Oligohydramnios (low amniotic fluid)

Pulmonary hypoplasia (underdeveloped lungs)

POTTER sequence (clubbed feet, pulmonary hypoplasia, and cranial anomalies)

Incompatible with post-natal life

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23
Q

Supernumerary Kidney

A

3 kidneys, very rare

two kidneys, two ureters: from 2 separate ureteric buds

two kidneys, one bifid ureter (double kidney): early and complete division of one ureteric bud

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24
Q

Horseshoe Kidney

A

1:500 births (common)

Fusion of lower poles while still in pelvis

Ascent interrupted at the inferior mesenteric artery

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25
Q

Ureters

A

starts at ureteropelvic jxn

travel along posterior abdominal wall

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26
Q

Blood supply of Ureters

A

Renal arteries
Abdominal aorta
Iliac arteries

27
Q

3 Constrictions or Ureters

A

Ureteropelvic
junction (UPJ): At junction of ureters and renal pelvis

At point that ureters cross the brim of pelvic outlet

Ureterovesical junction (UVJ): During passage through wall of the urinary bladder

28
Q

Female Ureter

A

“Water under the bridge”

ureter (water) crosses under uterine artery & vein (bridge)

Clinical significance: ureter can be accidentally clipped or cut during hemispherectomies

29
Q

Male Ureter

A

“Water under the bridge”

ureter (water) crosses under gonadal artery & vein (bridge)

30
Q

Crossed fused ectopia

A

Left kidney fused with right kidney (while in pelvis) then carried along ascent of right kidney

31
Q

Urinary bladder

A

Muscular organ for collection of urine

32
Q

Where is the bladder located?

A

posterior to the pubic symphyses area

33
Q

Empty vs. Full bladder

A

Empty: 4-sided pyramid, resides in true pelvis

Full: ovoid, protrudes into abdominal cavity

34
Q

Where is the apex of bladder attached?

A

to umbilicus by the median umbilical fold

35
Q

What is the blood supply of bladder?

A

superior and inferior

vesicle artery

36
Q

What is the lymphatic drainage of bladder?

A

external iliac nodes

37
Q

Retropubic space

A

extra peritoneal space located between the pubic symphysis and the urinary bladder

38
Q

Urinary bladder ligaments

A

pelvic fascia/loose connective
tissue

Pubovesical ligament (♀)

Puboprostatic ligament (♂)

Hold neck of
bladder in place & help
support/suspend bladder

39
Q

Bladder Trigone

A

smooth area of the bladder in the nondistended state

40
Q

Detrusor muscle

A

smooth muscle of bladder wall

relaxes to allow filling

contracts to empty

autonomic innervation (SNS relaxes, PSNS contracts)

41
Q

Internal Urethral Sphincter

A

located at neck of the bladder

continuation of detrusor (smooth muscle)

autonomic innervation (SNS contracts, PSNS relaxes)

42
Q 
Sphincter Urethrae (external
urethral sphincter)
A

located in deep perineal space

skeletal muscle

somatic innervation (pudendal nerve) - voluntary

43
Q

Sensation of filling/fullness (stretch)

A

Afferents accompanying PSNS (pelvic splanchnics)

44
Q

Infant bladders

A 
no cortical control of the external sphincters or of the
voiding reflex (automatic voiding)
45
Q

Adult bladders

A

cortical control of external sphincters and voiding reflex is learned

46
Q

Innervations of bladder

A

Parasympathetic from S2-4 (Pelvic splanchnic)

Sympathetic T10-12, L1&2 (Hypogastric plexus)

Visceral afferents for pain & distention travel with the parasympathetic nerves

Pudendal (S2- S4) somatic motor to the external urethral sphincter

47
Q

Where area is the pain from the bladder referred to?

A

Perinuem

48
Q

Where are the sympathetic
innervation to the
kidneys, ureters and
bladder are derived from?

A

lesser and least
thoracic and lumbar
splanchnic nerves

49
Q

How do ureters receive their innervation?

A

Segmentally

50
Q

What does the cloaca divide into?

A

urogenital sinus anteriorly and anal canal posteriorly which are divided by urorectal septum

51
Q

Urogenital sinus

A

Upper: largest, forms bladder

Middle: give rise to prostatic and membranous portions of male urethra and entire female urethra

Phallic: differs b/n the sexes, forms most of penile urethra in males

52
Q

How do the ureters enter the bladder during development?

A

caudal portion of mesonephric ducts are absorbed into wall of urinary bladder

53
Q

Male urethra

A

divided into: prostatic, membranous and penile/spongy urethra

54
Q

Female urethra

A

4 cm in length

membranous urethra

55
Q

Ascending UTI

A

more common in women b/c of short urethra, proximity to vagina and anus, and intercourse (honeymoon cystitis)

56
Q

Urethral catheterization

A

Inserting flexible tube through urethra

2 bends in urethra:
1st, spongy urethra (less painful)
2nd, membranous urethra (more painful)

can damage bulb of penis

57
Q

Suprapubic catheterization

A

inserted through skin, 1 inch above pubic symphysis

general or local anesthetic

used for closed drainage

may be left in place for a time

sutured to the abdominal skin

58
Q

Pros of Suprapubic catheterization

A

Lower incidence of urinary tract infection, ease of voiding naturally when catheter clamped, and ease of ambulation

59
Q

Cons of Suprapubic catheterization

A

Initially inserted by physician

insertion site must be cleaned daily using
sterile technique

60
Q

Suprarenal (Adrenal) glands

A

superomedial pole of each kidney surrounded by renal fascia

61
Q

Blood supply of Suprarenal glands

A

superior, middle and inferior supra-renal arteries

Suprarenal vein (left empties into renal vein, right into IVC)

62
Q

Innervation of Suprarenal glands

A

Preganglionic sympathetic innervation to medulla

63
Q

Ureteric Orifices

A

openings of the ureter into the bladder

CPR Test 2 (28 decks)

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