ANATOMY: kidney & urinary tract Flashcards
1
Q
How do the kindness lie in the body?
A
Asymmetrically
The left= slight higher than right due to liver
2
Q
Functions of kidney
A
Excretory - remove waste via urine
Regulatory - osmoregulation
Endocrine
3
Q
Outer Layers of kidney
A
- though renal capsule- (innermost)
- adipose
- Renal fascia
4
Q
Where is the adrenal gland?
A
On top of kidney
5
Q
Medulla is subdivided into regions called?
A
Pyramids
These end in a tip called renal papilla
6
Q
Structures of kidney
A
Outer cortex
Inner medulla
7
Q
Papilla emoji ties urine into a fumes called?
A
Minor calyx → major calyces → renal pelvis → ureter → bladder
8
Q
Structure or Renal medulla
A
10-18 renal pyramids
Renal papilla (nipples)
9
Q
Structures of Renal cortex
A
Outer cortical zone
Inner juxtamedullary zone
10
Q
What are the ureters?
A
Hollow muscular tube - 29-30 cm in length & 3 mm diameter
Smooth muscle with peristaltic waves to move urine
Contain valves to prevent back flow
11
Q
As the ureters travel downward towards the bladder they counter 3 main areas of CONSTRICTION?
A
1- Uroteropelvic junction
2- ureter crosses over external iliac a. And v. At pelvic brim
3- ureter traverses the bladder
12
Q
Structures of ureter?
A
Circular smooth muscle
Longitudinal smooth muscle
Transitional epithelium - lumen
13
Q
Layers of bladder
A
- Transitional epithelium - stretchy
Allows for distension while maintaining barrier - Detrusor muscle
Helps with contraction - Fibrous adventitious
( not layer)
Rugae- contract when empty + expand when full
14
Q
What are the three opening of the bladder?
A
2 ureteri orifices
Internal urethral orifice
15
Q
What is the Trigone of the bladder?
A
The three openings: two ureteric orifices, and the internal urethral orifice mark the triangular area called the
trigone of the bladder
16
Q
What is the Internal urethral sphincter?
A
Smooth muscle relaxes reflexively when bladder is full
17
Q
What is the External urethral sphincter?
A
Skeletal muscle- voluntary control of micturition
18
Q
The regions where blood vessels and the ureters renter the kidney is called?
A
HILIUM
19
Q
Arterial suoooy is directly from?
A
Abdominal aorta via renal arteries
20
Q
Explain blood supply of the kidney
A
- Each renal artery divides into many
SEGMENTAL ARTERIE - Which then divide into INTERLOBAR ARTERIES between
medullary pyramids - They then run over the base of the renal pyramids where they’re called ARCUATE ARTERIES
- Finally INTERBOLAR (CORTICAL RADIATE ARTERIES) come off the arcuate arteries which I’m turn give rise to the AFFERENT ARTERIOLES heading for the glomerulus
21
Q
Explain blood supply 2 and drainage of kidney
A
- So the afferent arterioles divide into a capillary network within the glomerulus
- These capillaries do not join arterial and venous systems together
→ instead, they converge to form an
EFFERENT ARTERIOLE - This follows the pathway of the renal tubules of the nephron → PERITUBULAR CAPILLARY → VASA RECTA
- These join an INTERBOLAR ( CORTICAL RADIATE) VEIN→ drains into ARCUATE VEIN → into INTERBOLAR VEIN then finally → RENAK VEIN → IVC.
22
Q
Explain blood drainage 2
A
- RENAL VEINS then leave the hilum of the kidney coursing towards the IVC
- The left renal vein also drains the left gonadal vein and the left suprarenal vein
- The right gonadal vein and right suprarenal vein just drain straight into the IVC
23
Q
Arterial Blood supply of the bladder
A
- Males: Sup & inf vesical arteries from internal iliac artery
- Females: Sup & inf vesical arteries and vaginal artery from internal iliac artery
24
Q
Venous drainage of bladder
A
Achieved by vesical venous plexus, which empties into internal iliac vein → common iliac vein → IVC
25
Lyn oath is of the kidney
- The right kidney is nearer the IVC the lymphatic drainage follows the nodes of the IVC
- Similarly, the left kidney lymphatic drainage follows the nodes of the aorta
26
Lymphatic of left kidney
* Left lumbar
* Lateral aortic
* Preaortic
* Retroaortic
27
Lymphatic of right kidney
* Right lumbar
* Lateral caval • Precaval
* Retrocaval
28
Lymphatic pathway of kidneys
The left & right lumbar trunks → cisterna chyli → thoracic duct → left subclavian vein
29
The kidneys have sympathetic and parasympathetic innervation via
Renal plexus
30
Sympathetic innervation comes from the
Splanchnic nerves - T10- L1
31
Parasympathetic innervation is from
The vagus nerve
32
What do nerve fibres do at kidney - innervation process
These nerve fibres enter the kidney at hilum with the branches of the renal artery etc and regulate the vascular tone (constriction and relaxation of blood vessels).
33
Sympathetic innervation of bladder
Sympathetic (holds on to urine) relaxes detrusor muscle to allow expansion of bladder and constricts internal urethral sphincter (keeping urine in!)
Sympathetic innervation comes from the inferior hypogastric plexus (T12-L2)
34
Parasympathetic innervation of bladder
```
Parasympathetic (P makes you Pee) contracts detrusor muscle, relaxes internal
urethral sphincter (only thing holding urine in now is external sphincter)
```
Parasympathetic innervation comes from pelvic splanchnic nerves (S2–S4)
35
Somatic innervation of bladder
Somatic (gives us voluntary control of micturition)
Somatic control of external urethral sphincter via the pudendal nerve (S2-S4)
- Eventually pressure in the bladder would overcome our voluntary control (cannot hold urine forever) NB pudendal nerve damage in childbirth!
36
There are two different types of nephron within the kidney:
Cortical nephrons - 80-85 %
Juxtamedullary nephrons - 15-20%
37
Describe Cortical nephrons
- Nephron mainly lies in the cortex of the kidney
| - Loop of Henle only ‘ dips’knto medullary pyramid
38
Describe Juxtamedullary nephrons
- Nephron spans cortex & medullary pyramid
| - Loop of Henle descend towards renal papilla
39
Each nephron is made up of?
Renal corpuscle
Renal tubule
40
Renal corpuscle structure and function
→ Bowman’s capsule
→ Glomerulus
Filtration of plasma
41
Renal tubule structure and function
→ Proximal convoluted tubule
→ Loop of Henle
→ Distal convoluted tubule
Selective reabsorption and secretion
42
Structure and function of Glomerulus
* Cluster of anastomosing capillaries between the afferent and efferent arterioles
* Unlike most capillary beds, the glomerular capillaries exit into efferent arterioles rather than venules
* The cluster invaginates the Bowman’s capsule. The Glomerulus + Bowman's capsule= a renal corpuscle, the basic filtration unit of the kidney.
* Rate at which blood is filtered through all of the glomeruli, and thus the measure of the overall renal function, is the glomerular filtration rate (GFR).
* The capillary endothelium is fenestrated allows water and soluble substances to pass from capillaries into Bowman’s space.
43
Unlike most capillary beds, the glomerular capillaries exit into ?
Efferent arterioles rather than venues
44
Glomerulus + Bowman’s capsule =?
Renal corpuscle - basic filtration unit of the kidney
45
What is the Glomerular filtration rate (GFR)
Rate at which blood is filtered through all of the glomeruli, and thus the measure of the overall renal function
46
The capillary endothelium is fenestrated allows ?
Water and soluble substance to pass from capillaries into Bowman’s space
47
Main dogma of filtration
Need to control what is Kers and what is lost
Don’t want to be losing RBS and proteins
48
How is glomerulal filtration processed?
* Free passage of: neutral substances of 4nm-e g water
* Extending selective passage of: Substances up to 8nm
* Does not allow –vely charged ions through or those >8nm
49
How many nephrons per kidney ?
1 million
50
Structure and function of Renal corpuscle in Kidney
Made of
- glomerulus
- Bowman’s capsule
Function- share filtration begins
51
Layers of glomerulus
Epithelium
Basement membrane
Endothelium
+ Filtration slits
52
Function of filtration slits in glomerulus
Allow passage of
- water
- glucose
- ionic salts
BUT NOT OF
- large proteins
- RBC
53
Cell of glomerulus
Podocyte
54
Efferent arteriole
Exist glomerulus
55
Afferent arteriole
Approaches glomerulus
56
Structure of endothelium of capillary
- fenestrations
| - luminal surface negatively charged due to a glycoproteins layer
57
Structure of Glomerulus Basement membrane
- 3 layers: lamina rara interna, lamina densa & lamina rara externa
- Laminae rarae layers are negatively charged (repel – charged things)
58
Podocytes make?
Filtration slits
59
What makes the Juxtaglomerukar apparatuses?
Macula densa + juxtaglomerular cells + supporting cells
60
Function of Macula densa cells?
Sense changes in solute concentration in the distal convoluted tube - vasoconstrict / dilate afferent arteriole
61
Function of Juxtaglomerular cells
Secrete renin which acts to increase Na ions reabsorption= High BP
62
Structure of Proximal convoluted tube
* Restricted to renal cortex
* Longest section of renal tubule
* Simple cuboidal epithelium with microvilli (brush border)
63
Structure of Loop of Henle
• Thin descending limb
- simple squamous epithelium
• Thin ascending limb
- simple squamous epithelium
• Thick ascending limb
- simple cuboidal/ low columnar epithelium - no brush border & not permeable to H20
64
Where is the macula densa region?
Section where LOH meets DCT comes into contact with the afferent arteriole
LOH=Loop of Henle
DCT= Distal convoluted tubule
65
Structure of convoluted tubule
- Simple cuboidal epithelium
- Different from the PCT (proximal convoluted tubule) due to absence of ‘brush border’ - very few
microvilli which are irregularly placed
66
Structure of Collecting duct
- Simple cuboidal epithelium
| - Intercalated & principal cells
67
What are Principal cells ?
Main Na ions reabsorbing cells and site of action of aldosterone
68
What are Intarcalated cells?
Maintain acid base balance
69
What is the Urinary transitional epithelium
Lines the :
- minor calyces
- major calyces
- renal pelvis
- ureters
- bladder
→ It consists of multiple layers of epithelial cells
→ It is capable of accommodating expansion & contraction
70
Adrenal glands are also called?
Suprarenal glands
71
Layers and structure of Adrenal cortex
Zona glomerulosa
Zona fasciculata
Zona reticularis
Medulla
72
Sona Glomerulosa secretes?
Mineralocorticoids
73
Zona Fasciculata secretes?
Glucocorticoids
74
Zona Reticularis secretes ?
Androgens
75
Medulla releases ?
Catecholamines
