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CPR Exam 2 > 8. Renal Anatomy & Histology > Flashcards

8. Renal Anatomy & Histology Flashcards

1
Q

what is the glomerulus

A

tuft of capillaries fed by afferent arterioles and drained by efferent arterioles

fenestrated epithelium

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2
Q

what is the cortical part of the peritubular capillaries

A

located in the cortex

surrounds PCT and DCT

=fenestrated endothelium

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3
Q

what is the long medullary part of the peritubular capillaries

A

(aka vasa recta)

in the medulla

surround loop of henle

ascending = fenestrated endothelium & descending = continuous

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4
Q

what are the parts of the renal corpuscle

A

glomerulus

glomerular (bowman’s) capsule

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5
Q

what are the components of the glomerular capsule

A

visceral layer - podocytes

glomerular space - contain primary filtrate (primary urine)

parietal layer = simple squamous EPIthelium

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6
Q

what is the difference btn vascular pole and tubular pole of the renal corpuscles

A

vascular = ENDOthelium (afferent/efferent arterioles)

tubular (aka urinary pole) = EPIthelium - origin of PCT

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7
Q

what are mesangial cells & what are their fxns

A

structural support for glomerular loops & ECM of podocytes

= phagocytic cells

prevent glomerular distention

secrete growth factors and cytokines

*proliferate in certain kidney diseases*

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8
Q

what are components of glomerular endothelium

A

open fenestrations

thick luminal glycocalyx

w/ large # of aquaporin h2o channels

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9
Q
A

glomerular basement mem

contain type IV & XVIII collagens, laminin, entactin and proteoglycans

=physical barrier -restrict particles >70kD

=chemical barrier -strong anti-anionic (repel neg (aka proteins))

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10
Q

what is an indication of damage glomerular basement mem

A

albuminia - albumin in urine

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11
Q

what is the fxn of podocytes

A

form parts of filtration barrier

make filtration-like slits

slits have intervening ultrathin diaphragm made of several extracel protein critical in regulating size, patency and selectivity of filtration

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12
Q

what are the components of filtration membrane & what is the purpose of filtration membrane

A
  1. fenestrated endothelium
  2. basement mem
  3. podocytes

restricts passage of blood cells, immunoglobins & large proteins into urine

allow passage of water, ions, glucose, AA and urea into urine

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13
Q

what is the purpose of PCT

A

most active tubule in resorption and secretion (simple cuboidal to columnar epithelium)

abundant microvilli & mitochondria

contain Na/K ATPase pumps, aquaporins, glucose & AA transporters

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14
Q

what is at the end of the PCT

A

proximal straight tubule

less developed brush border

quipped with high affinity Na-glu co-transporters (sGLT1)

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15
Q

what are the parts of the loop of henle

A

loops down into medulla & back to cortex –> ends in vascular pole

thin limb - simple squamous epithelial wall w/o brush border

thick ascending segment - simple cuboidal epithelium w/ many microvili but no visible brush border

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16
Q

what is the DCT

A

lined with simple cuboidal epitheloum w/ sparse microvilli

begins from macula densa of thick ascending loop of henle

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17
Q
A
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18
Q

what are juxtaglomerular cells

A

mechanosensory cells in afferent arterioles

secrete renin in response to low BP

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19
Q

what is the macula densa

A

tight nuclei at distal end of thick ascending LoH

monitors Na+ levels & signals renin release if Na is low

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20
Q

what is this, what is its fxn and components

A

collecting tubules/ducts

lined by simple cuboidal epithelium w/ ends being simple columnar

water reabsorption

drain into renal minor calyx

two type of cells: Principal cells (light) & intercalated cells (dark)

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21
Q

what is the purpose of principal & intercalated cells

A

principal - target for aldosterone

intercalated = involved in H+ & HCO3- transport

both help determine [urine]

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22
Q

what do ADH and aldosterone target

A

collecting duct

to increase Na reabs & h2o retention

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23
Q

what type of epithelium lines the urinary tract & where

A

transitional epithelium (urothelium)

calyces, ureter, bladder and part of urethra

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24
Q

what makes up the transitional epithelium

A

deepest = single layer of basal cells

intermediate region = sliding layer - cuboidal/columnar cells (several layers)

superficial= binucleated umbrella cells (where stretch/relax) - contain urothelial plaques

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25
what are urothelial plaques what makes the plaques
form impermeable barrier on membrane = made of uroplakin proteins & fusiform vesicles (store plaque when endocytosed)
26
what happens to the transitional epithelium when the bladder distends/empties
bladder distend --\> urothelial plaques (superficial layer) move to surface of plasma mem --\> form impermeable barrier to hypertonic urine when bladder empties - urothelial plaques endocytosed into fusiform vesicles and stored in umbrella cells
27
what are ureters & its fxn
fibromuscular tube facilitating kidneys --\> bladder enter bladder obliquely to prevent retrograde flow = muscularis moves w/ waves of peristalsis, fold form when empty
28
what are the histology layers of the ureter
1. Transitional epithelium 2. Muscularis - 3 indistinct layers 3. Advntitia - typical CT
29
where is the urinary bladder and why is it imp
anterior to uterus & rectum sits w/i pelvis but when full expand up into abd clinical relavence = pregnant women
30
what are detrusor Ms
smooth M muscular sac enclosing bladder
31
what are the components of the urinary bladder
trigone - where ureters and urethra open (inf/post wall of bladder) bladder wall - urothelium, 3 layers of Sm M tissue (detrusor M), fibrous adventitia
32
what does the female urethra do and what are its components
connects bladder to external urethral orifice membranous urethra - thru the urogenital diaphragm internal urethral sphincter - involuntary Sm M external urethral sphincter - Sk. M, voluntary
33
what are the epithelium changes thru the urethra
transitional near bladder majority of urethra = pseudostratifiec columnar distal end = stratified squamous epithelium
34
why does the female urethra lead to UTI risk
urethra - 3-5 cm shorter travel distance for bacteria to infect
35
what are the components of the male urethra & what is its fxn
facilitate urine & semen **prostatic urethra** (transitional epithelium), **membranous urethra** (psuedostratfied columnar & stratified squamous) , **spongy urethra** (stratified squamous and psuedostratfied columnar & distal is all stratified squamous) internal sphincter - involuntary Sm M external sphincter - Sk M, voluntary
36
what causes polycystic kidney disease & what happens
auto dom (mutation of PKD1 or PKD2) cyst form that crush tissue & impede drainage --\> eventually leads to kidney failure & BP miss-regulation
37
what are common symptoms of polycystic kidney disease & how do you treat it
HTN, renal hemorrhage, calculi or UTI treat w/ dialysis & kidney transplant (delay symptoms by changing diet)
38
where is the location of the suprarenal gland in relation to the kidneys
superomedial aspect but not actually attached! -glands work on their own
39
what are the retroperitoneal structures and where are they located
superior urinary organs (kidneys, ureter), their vessels and suprarenal glands located on post abd wall
40
what is perinephric fat
adjacent kidney capsule - extend into renal hilum and pelvis
41
what does renal fascia do
enclose kidneys, suprarenal glands and perinephric fat & send collagen bundles thru paranephric fat -blends with vascular sheaths of renal vessels & superiorly continous w/ inf diaphragmatic fascia
42
where is the paranephric fat located
external to the renal fascia
43
what is the normal renal mobility
3 cm occurs during resp & changing position from supine to erect
44
where are kidneys located
retroperitoneally on post abd wall one on each side of the vertebral column at the level of T12 - L3
45
what is the renal hilum
entrance to renal sinus vessels, Ns, and structures that drain urine from kidney travel along hilum
46
where do the kidneys sit relative to the transpyloric plane
left kidney: near plane (about 5 cm from median plane) right kidney: superior pole of kidney is where the transpyloric plane runs \*R kidney lower than left - likely bc liver\*
47
where is the kidneys' location on the post aspect
superior kidney deep to the 11-12th rib (associated with diaphragm- seperate kidney from ribs & pleural cavities) inferior pole of R kidney = finger's breadth superior to iliac crest
48
what is the normal size of a kidney
10 cm long 5 cm wide 2 cm think (book says 5.5?)
49
what is the relation of the renal A, V and pelvis at the level of the hilum
Renal A ant to renal pelvis V ant to A
50
what is the renal pelvis
funnel shaped expansion of superior end of ureter
51
what do the renal calyxes do
minor calyx drain into major calyx which then drains into renal pelvis renal papillae (apex of pyramids) drain into minor calyx
52
describe the internal structures of the kidney
**capsule** = dense irregular CT on surface w/ inner layer of myofibroblasts **cortex-** outer portion that contains _renal corpuscles_ **medulla** - collection of _pyramids and columns_ **pyramids =** cone shaped masses in medulla where urine is made and collected at its apex (_papillae_) and then projected to _calyx_ **columns-** tissue lying btn pyramids; runs from cortex to calyx **lobe =** single pyramid + surrounding cortex
53
what is the fxn of the ureter
carry urine from kidney to bladder
54
where are the ureters located
run inf from renal pelvis at the hilum - pass over bifurcation of common iliac As then run along lateral wall of pelvis and enter the bladder
55
the ureters demonstate relative constrictions in what 3 planes
1. jxn of ureter and renal pelvis 2. where ureter crosses the brim of the pelvic inlet 3. passing thru the wall of the bladder = potential spots for obstruction by ureteric stones
56
what are the branches of the ureter
renal gonadal abd aorta iliac sup vesicular pelvic (rectal, uterine, vaginal, inf vescular)
57
what are segmental As & where do they form
end As supplying specific segments of the kidney form from renal A after it enters the hilum
58
how does blood flow to and from the kidneys
aorta --\> renal A --\> segmental As --\> interlobar As --\> arcuate As --\> cortical radiate A --\> afferent arteriole --\> glomerulus capillaries --\> efferent arterioles --\> peritubular capillaries and vasa recta --\> cortical radiate V (or straight to arcuate V)--\> arcuate V --\> interlobar V --\> Renal V --\> IVC
59
why is the L renal V susseptible to entrapment
cossing the midline to reach IVC - it runs btn SMA and abd aorta downward traction on SMA --\> compress renal V = renal V entrapment syndrome (nutcracker syndrome)
60
what are the symptoms of Renal V entrapment syndrome
hematuria, proteinuria, flank pain, nausea, vomitting (doudenum traction) rmr AKA nutcracker syndrome
61
what is the path of renal lymphatic vessels
follow renal Vs and drain into R & L lumbar LN lymphatics from middle part of kidney may drain into common iliac LN & inf part into common, external and internal iliac LN
62
what is the renal N plexus supplied by
**sym:** fibers from **lesser splanchnic (T10-11) & least splanchnic (T12**) --\> synapse in aroticorenal ganglia & **lumbar splanchinic Ns (L1-L2)** _parasym:_ _vagus N_
63
what is the urine forming and carrying unit made of
nephron (form urine) = corpuscles and tubules & cortical/medullary collecting ducts

CPR Exam 2 (20 decks)

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