ANAT Developmental and Congenital Abnormalities of the Renal System - Week 7

Question 1

Which embryonic mesenchyme gives rise to the kidneys & urinary tract?

Answer 1

Intermediate mesoderm.

Question 2

What duct develops abnormally to give rise to Meckel’s diverticulum?

Answer 2

Vitelline duct.

Question 3

What duct degenerates during development to form the mesonephric duct?

Answer 3

Pronephroi duct.

Question 4

Metanephric diverticulum/enteric bud forms of what duct to form what?

Answer 4

Metanephric diverticulum/enteric bud = bud forms off mesonephric duct to form metanephric blastema/mesenchyme -> eventually form the kidney.

Question 5

Developmental precursor of the bladder?

Answer 5

Allantois.

Question 6

Collecting ducts, calyces, pelvis, ureter develop from what structure?

Answer 6

Ureteric bud.

Question 7

Nephron, interstitium develop from what structure?

Answer 7

Metanephric mesenchyme.

Question 8

Describe CAKUT in relation to BMP4 gene.

Answer 8

Genetic basis in terms of heterozygous vs homozygous for BMP4 gene, however, in the heterozygous population there is great variation in kidney function & development, which can only be explained by the influence of environmental factors.

Question 9

Healthy kidney nephron no. range

Answer 9

Healthy kidney can be btw 200,000-2,500,000 nephrons.

Question 10

Relationship btw nephron no. & CKD.

Answer 10

Lower nephron no., associated w higher risk of developing CKD.

Question 11

MCDK Expand. Consequences to function.

Answer 11

Multicystic dysplastic kidney. Kidneys effected will be unable to produce urine. 40% chance that an issue will develop with the contralateral kidney.

Question 12

How does a duplex ureter form? What complications are associated?

Answer 12

Duplex ureter forms when 2 x ureteric buds bud off mesenteric duct. Increases pt risk of kidney stone, blockage, hydronephrosis, cyst formation.

Question 13

Describe kidney migration & rotation during development.

Answer 13

Migrate superiorly & rotate anteriorly.

Question 14

What duct degenerates in the development of the testes, ductus deferens, seminal vesicles?

Answer 14

Paramesonephric duct.

Question 15

What duct degenerates in the development of the ovaries, fallopian tubes, uterus, vagina?

Answer 15

Mesonephric duct.

Question 16

What mesoderm layer gives rise to the gonads, ducts & accessory glands?

Answer 16

Intermediate mesoderm.

Question 17

What is Mullerian duct syndrome?

Answer 17

Leads to persistent structures from mullerian duct – often presents with development of penis, scrotum, undescended testis, underdeveloped uterus, fallopian tubes.

Question 18

What is PUV? What does it lead to? In which pts is it most common?

Answer 18

Posterior Urethral Valve (PUV). Leads to bilateral hydronephrosis. NB: More commonly observed in patients with a penis.

Question 19

Nephrogenesis occurs via interactions btw which 2 x structures?

Answer 19

Uretic bud & metanephric mesenchyme.

Question 20

Perfusion of the kidneys in early development & post normal development.

Answer 20

Kidneys are supplied by the renal arteries - branching off the common iliac arteries initially.
Then supplied, still by the renal arteries - but branching off the aorta, post normal development.