9 - Renal Anatomy & Histology Flashcards
List the organs of the urinary system
Kidneys
Ureters
Bladder
Urethra
______ filter metabolic waste products and toxins from the bloodstream and convert the filtrate into urine; important role in BP regulation
Kidneys
The ureters, urinary bladder, and urethra make up the ______ ______ because they store and transport the urine out of the body
urinary tract
The retroperitoneal lies at about the _____ - ______ levels
T12
L3
Why are the right kidneys lower than the left?
Liver
The _______ ______ is above the kidney
suprarenal gland
The ______ ______ is the entrance to the renal sinus (area in kidney where BV, renal pelvis, nerves are locate)
Renal hilum
The left hilum is near the _____ _____
transpyloric plane
Transpyloric plane runs through ______ pole of right kidney
superior
The upper pole of the left kidney rises to the level of the ________ _____ , but the right kidney is slightly lower (due to the bulk of the liver on the right).
eleventh rib
The hilum of each kidney is _____ ______ (2 in) from the midline.
5 cm
The lower edge of the costodiaphragmatic recess of the pleura crosses the _______ ______
twelfth rib
_______ ______ is adjacent kidney capsule; extends into renal hilum and pelvis
Perinephric fat
The _____ ______ covers fat
enveloping kidney and suprarenal
gland
renal fascia
Where is paranephric fat in relation to everything else?
external to the renal fascia
What is normal renal mobilitY?
3 cm
The _______ is composed of dense irregular CT on surface with inner layer of myofibroblasts
capsule
The renal cortex is the outer portion of the kidney and contains the ______ ______
renal corpuscles
The _____ _____ is a collection of renal pyramids and columns
renal medulla
Where are the renal pyramids?
In the renal medulla projecting into the calyx
______ ______ is issue lying between pyramids running from cortex to the calyx
renal columns
______ _______ are single pyramids plus surrounding adjacent cortex
renal lobes
The ____ ______ is the collecting funnel for urine
renal pelvis
What are renal calyxes?
Outpocketing of the renal pelvis
The _____ ______ are projections of medullary pyramids’ apices into calyxes
renal papillae
What are the branches of the ureter arteries?
I P RAGS
Iliac Pelvic Renal Abdominal Aorta Gonadal Superior vesicular branches
_______ ______ is the traction of the SMA (superior mesenteric artery) compression of the LRV (left renal vein)
Nutcracker syndrome
What are the sx of Nutcracker syndrome?
- Hematuria, proteinuria, flank pain, nausea vomiting (duodenum traction)
- Uncommon – left sided varicocele
Describe the arterial blood flow from the aorta to the Glomerulus
- aorta
- renal artery
- segmental artery
- interloper artery
- arcuate artery
- cortical radiate artery
- afferent arteriole
8 Glomerulus
Describe the venous flow from the glomerulus to the IVC
- Glomerulus
- Efferent arteriole
- Peritubular capillaries and vasa recta
- cortical radiate vein
- arcuate vein
- interloper vein
- renal vein
- IVC
What is the sympathetic innervation of the renal nerve plexus?
– Lesser splanchnic (T10-11) and
least (T12) splanchnic nerves
synapsing in aorticorenal ganglia
– Lumbar splanchnic nerves (L1-L2)
What is the parasympathetic innervation of the renal nerve plexus?
Parasympathetic innervation
Urine forming and carrying units are made of _____ and _____ and _______ collecting ducts
Nephron
Cortical and medullary collecting ducts
What does the nephron consist of?
Renal corpuscle and renal tubules, juxtamedullary and cortical nephrons
What is involved in the final concentration of urine?
The cortical and medullary collecting ducts?
The _______ has a Tuft of capillaries, Fenestrated Endothelium, and is fed by afferent and drained by efferent arterioles
Glomerulus
What are the peritubular capillaries?
Cortical
Long medullary (vasa recta)
Describe the cortical capillaries
In the cortex
Surround proximal and distal convoluted tubules
Fenestrated Endothelium
The ______ _______ surround the loop of Henle
vasa recta (long medullary)
What kind of endothelium makes up the ascending portion of the vasa recta?
Fenestrated endothelium
What kind of epithelium makes up the descending portion of the vasa recta?
continuous endothelium
Why are some sections of peritubular capillaries Fenestrated Endothelium and others Continuous?
Corresponds with what molecules are being reabsorbed or secreted in that section of the nephron
What kind of endothelium is found in the glomerulus?
fenestrated
The ______ _______ consists of 3 layers; the visceral layer, Glomeruluar space, and the parietal layer
Glomerular capsule (Bowmans)
Which layer of Bowman’s capsule has podocytes?
Visceral
The _____ ______ of Bowmans capsule consists of simple squamous epithelium
Parietal layer
What are the 2 poles of the renal corpuscles?
- vascular pole
2. Urinary pole
In the vascular pole, the vessels are (ENDOTHELIUM/EPITHELIUM) and the urinary pole are (ENDOTHELIUM/EPITHELIUM)
Endothelium
Epithelium
What are the functions of mesangial cells?
Structural support
Phagocytic
Prevents glomerular distention due to the high glomerular BP
secret growth factors in response to injury
Mesangial cells provide structural support for _____ _____ and the _______ of podocytes
glomerular loops
ECM of podocytes
The ______ ______ has open fenestrations, a thick luminal glycocalyx, and have a large number of aquaporin water channels
glomerular endothelium
The ______ _______ ______ acts as a physical and a chemical barrier
Glomerular basement membrane
What is the glomerular basement membrane made of?
Type IV and XVIII collagens, laminin, entactin, and proteoglycans
_______ is the presence of albumin in the urine and is indicative of damage to the glomerular basement membrane
albuminia
________ is a single layer of cells with foot like processes that interdigitate to make filtration like slits
podocytes
The _____ ______ lies between the blood and the capsular space
filtration membrane
What are the components of the filtration membrane?
fenestrated endothelium, basement membrane, podocytes
What is the function of the filtration membrane?
Restricts: passage of blood cells, immunoglobulins & large proteins
Allows: passage of water, ions, glucose, amino acids and urea
The _____ ______ _____ is the most active in reabsorption and secretion
proximal convoluted tubule
What cell types are found in the proximal convoluted tubule?
simple cuboidal to columnar epithelium
In the proximal convoluted tubule, the _____ and _____ cell membranes are highly folded to increase surface area
basal and lateral
What are the transporters that are involved in the proximal convoluted tubule
Na+,K+-ATPase pumps and aquaporins
Numerous types of glucose transporters (e.g., sGLT2) and amino acid transportersq
The ______ _______ ______ is not as tall as PCT with less well- developed brush border; equipped with high affinity sodium- glucose co-transporters (sGLT1)
proximal straight tubule
the loop of Henle Loops down into the _____ and then back up into the _______; terminates near the ______ _____
medulla
cortex
vascular pole
The _____ ______ _____ of the loop of henle is a thin permeable simple squamous epithelial wall lacking a brush border; some nuclei bulge into the lumen
thin limb segment
Describe the thick ascending segment of the loop of henle
simple cuboidal epithelium with numerous microvilli but no visible brush border
The DCT is only found in the _____
cortex
Describe the epithelium of the distal convoluted tubule
Lined with simple cuboidal epithelium with sparse microvilli;
True/false luminal surface is not smoother than the PCT
no the luminal surface IS smoother than the PCT
______influences Na+ resorption in the DCT
Angiotensin II
The ______ ______ are Mechanosensory cells in afferent (sometimes efferent) arterioles Secrete Renin if low BP
juxtaglomerular cells
The ______ ______ are Tight nuclei at distal end of thick ascending LoH
Monitors Na+ levels
Signals release of Renin (from Juxtaglomerular cells) if low Na+
macula densa
What does renin increase?
Sodium retention
blood volume
blood pressure
The final urine osmolarity is determined by ______ _______
reabsorbing water
The collecting tubules are a target of both _____ and ______ thereby increasing Na+ reabsorption and water retention
ADH
aldosterone
What are the two basic mechanosensory cell types?
– Principal Cells (aka light cells)- target of aldosterone
– Intercalated Cells (aka dark cells)—involved in H+ and bicarbonate transport (those with *** in lower figure)
The ______ ______ receive primitive urine from several nephrons, Lined with simple cuboidal epithelium but are simple columnar at their ends
Primary function is water reabsorption
Collecting duct
What is the pathway of the collecting duct?
Straight through the cortex into the deep medulla
What is the primary epithelium that is found in the urinary system
Transitional epithelium
What is the deepest component of the transitional epithelium?
single layer of basal cells on basement membrane
The intermediate layer of the transitional epithelium is a region of _____/______ cells in several layers
cuboidal/columnar
The superficial layer of the transitional epithelium is made up of ______ _______ ______
binucleate umbrella cells
______ _______ form impermeable barrier on membrane
– Made with Uroplakin proteins
– Fusiform Vesicles–store plaques when endocytosed
urothelial plaques
What is the function of the ureters?
Fibromuscular tube that facilitates the kidney to the bladder
The histology of the ureter is broken up into 3 parts, the ______ ______, ______, and ________
transitional epithelium, muscular, and adventitia
_______ moves with waves of peristalsis, folds form when empty
Muscularis
Describe the location of the bladder
- Anterior to uterus and rectum
- Sits within the pelvis, but when really full can expand up into the abdomen
- Clinical: Pregnant women, etc.
What are the components of the bladder?
Trigone
Bladder wall
The ______ is the location where ureters and urethra open and is the interior and posterior wall of the bladder
Trigone
Why is the female urethra more prone to UTIs?
Because they are small and there is a shorter length for the bacteria to travel
Describe the epithelia changes that occur int eh urethra
- Transitional near the bladder (bladder is transitional)
- Majority of urethra: pseudostratified columnar
- Distal end: stratified squamous epithelium
Describe the differences between the internal urethral sphincter and the external urethral sphincter
internal is involuntary smooth muscle
external urethral sphincter is skeletal muscle and you can control it
What are the three regions of the male urethra?
Prostatic urethra
membranous urethra
spongy urethra
______ ______ _______ is due to a PKD1 or PKD2 mutations
that cause Cysts form that crush tissue and impede drainage.
Eventually leads to kidney failure and blood pressure miss-regulation.
Most common symptoms are hypertension, renal hemorrhage, calculi, or UTI
Polycystic kidney disease
Nearly ___ of women 65+ experience urinary incontinence
50%
____ of men 65+ experience urinary incontinence
21%
What are causes of urinary incontinence in females?
Age, obesity, parity, how they delivered previous children, etc.
What are causes of urinary incontinence in males?
Benign prostate hypertrophy, neuro conditions, certain medications
________ _________ is due to parasitic blood flukes, GU tract disease, chronic infection can cause fibrosis
Schistosoma hematobium
