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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
Q

what are urothelial plaques

what makes the plaques

A

form impermeable barrier on membrane

= made of uroplakin proteins & fusiform vesicles (store plaque when endocytosed)

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26
Q

what happens to the transitional epithelium when the bladder distends/empties

A

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
Q

what are ureters & its fxn

A

fibromuscular tube facilitating kidneys –> bladder

enter bladder obliquely to prevent retrograde flow

= muscularis moves w/ waves of peristalsis, fold form when empty

28
Q

what are the histology layers of the ureter

A
  1. Transitional epithelium
  2. Muscularis - 3 indistinct layers
  3. Advntitia - typical CT
29
Q

where is the urinary bladder and why is it imp

A

anterior to uterus & rectum

sits w/i pelvis but when full expand up into abd

clinical relavence = pregnant women

30
Q

what are detrusor Ms

A

smooth M

muscular sac enclosing bladder

31
Q

what are the components of the urinary bladder

A

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
Q

what does the female urethra do and what are its components

A

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
Q

what are the epithelium changes thru the urethra

A

transitional near bladder

majority of urethra = pseudostratifiec columnar

distal end = stratified squamous epithelium

34
Q

why does the female urethra lead to UTI risk

A

urethra - 3-5 cm

shorter travel distance for bacteria to infect

35
Q

what are the components of the male urethra & what is its fxn

A

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
Q

what causes polycystic kidney disease & what happens

A

auto dom (mutation of PKD1 or PKD2)

cyst form that crush tissue & impede drainage –> eventually leads to kidney failure & BP miss-regulation

37
Q

what are common symptoms of polycystic kidney disease

& how do you treat it

A

HTN, renal hemorrhage, calculi or UTI

treat w/ dialysis & kidney transplant (delay symptoms by changing diet)

38
Q

where is the location of the suprarenal gland in relation to the kidneys

A

superomedial aspect

but not actually attached! -glands work on their own

39
Q

what are the retroperitoneal structures and where are they located

A

superior urinary organs (kidneys, ureter), their vessels and suprarenal glands

located on post abd wall

40
Q

what is perinephric fat

A

adjacent kidney capsule - extend into renal hilum and pelvis

41
Q

what does renal fascia do

A

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
Q

where is the paranephric fat located

A

external to the renal fascia

43
Q

what is the normal renal mobility

A

3 cm

occurs during resp & changing position from supine to erect

44
Q

where are kidneys located

A

retroperitoneally on post abd wall

one on each side of the vertebral column at the level of T12 - L3

45
Q

what is the renal hilum

A

entrance to renal sinus

vessels, Ns, and structures that drain urine from kidney travel along hilum

46
Q

where do the kidneys sit relative to the transpyloric plane

A

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
Q

where is the kidneys’ location on the post aspect

A

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
Q

what is the normal size of a kidney

A

10 cm long

5 cm wide

2 cm think (book says 5.5?)

49
Q

what is the relation of the renal A, V and pelvis at the level of the hilum

A

Renal A ant to renal pelvis

V ant to A

50
Q

what is the renal pelvis

A

funnel shaped expansion of superior end of ureter

51
Q

what do the renal calyxes do

A

minor calyx drain into major calyx which then drains into renal pelvis

renal papillae (apex of pyramids) drain into minor calyx

52
Q

describe the internal structures of the kidney

A

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
Q

what is the fxn of the ureter

A

carry urine from kidney to bladder

54
Q

where are the ureters located

A

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
Q

the ureters demonstate relative constrictions in what 3 planes

A
  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
Q

what are the branches of the ureter

A

renal

gonadal

abd aorta

iliac

sup vesicular

pelvic (rectal, uterine, vaginal, inf vescular)

57
Q

what are segmental As & where do they form

A

end As supplying specific segments of the kidney

form from renal A after it enters the hilum

58
Q

how does blood flow to and from the kidneys

A

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
Q

why is the L renal V susseptible to entrapment

A

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
Q

what are the symptoms of Renal V entrapment syndrome

A

hematuria, proteinuria, flank pain, nausea, vomitting (doudenum traction)

rmr AKA nutcracker syndrome

61
Q

what is the path of renal lymphatic vessels

A

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
Q

what is the renal N plexus supplied by

A

sym: fibers from lesser splanchnic (T10-11) & least splanchnic (T12) –> synapse in aroticorenal ganglia

& lumbar splanchinic Ns (L1-L2)

parasym: vagus N

63
Q

what is the urine forming and carrying unit made of

A

nephron (form urine) = corpuscles and tubules

& cortical/medullary collecting ducts

CPR Exam 2 (20 decks)

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