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GU BLOCK > ANATOMY: kidney & urinary tract > Flashcards

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

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2
Q

Functions of kidney

A

Excretory - remove waste via urine

Regulatory - osmoregulation

Endocrine

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3
Q

Outer Layers of kidney

A
  • though renal capsule- (innermost)
  • adipose
  • Renal fascia
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4
Q

Where is the adrenal gland?

A

On top of kidney

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5
Q

Medulla is subdivided into regions called?

A

Pyramids

These end in a tip called renal papilla

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6
Q

Structures of kidney

A

Outer cortex

Inner medulla

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7
Q

Papilla emoji ties urine into a fumes called?

A

Minor calyx → major calyces → renal pelvis → ureter → bladder

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8
Q

Structure or Renal medulla

A

10-18 renal pyramids

Renal papilla (nipples)

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9
Q

Structures of Renal cortex

A

Outer cortical zone

Inner juxtamedullary zone

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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

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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

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12
Q

Structures of ureter?

A

Circular smooth muscle

Longitudinal smooth muscle

Transitional epithelium - lumen

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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

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14
Q

What are the three opening of the bladder?

A

2 ureteri orifices

Internal urethral orifice

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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

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16
Q

What is the Internal urethral sphincter?

A

Smooth muscle relaxes reflexively when bladder is full

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17
Q

What is the External urethral sphincter?

A

Skeletal muscle- voluntary control of micturition

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18
Q

The regions where blood vessels and the ureters renter the kidney is called?

A

HILIUM

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19
Q

Arterial suoooy is directly from?

A

Abdominal aorta via renal arteries

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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
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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.
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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
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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
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24
Q

Venous drainage of bladder

A

Achieved by vesical venous plexus, which empties into internal iliac vein → common iliac vein → IVC

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25
Q

Lyn oath is of the kidney

A
  • 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
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26
Q

Lymphatic of left kidney

A
  • Left lumbar
  • Lateral aortic
  • Preaortic
  • Retroaortic
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27
Q

Lymphatic of right kidney

A
  • Right lumbar
  • Lateral caval • Precaval
  • Retrocaval
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28
Q

Lymphatic pathway of kidneys

A

The left & right lumbar trunks → cisterna chyli → thoracic duct → left subclavian vein

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29
Q

The kidneys have sympathetic and parasympathetic innervation via

A

Renal plexus

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30
Q

Sympathetic innervation comes from the

A

Splanchnic nerves - T10- L1

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31
Q

Parasympathetic innervation is from

A

The vagus nerve

32
Q

What do nerve fibres do at kidney - innervation process

A

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
Q

Sympathetic innervation of bladder

A

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
Q

Parasympathetic innervation of bladder

A 
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
Q

Somatic innervation of bladder

A

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
Q

There are two different types of nephron within the kidney:

A

Cortical nephrons - 80-85 %

Juxtamedullary nephrons - 15-20%

37
Q

Describe Cortical nephrons

A
  • Nephron mainly lies in the cortex of the kidney

- Loop of Henle only ‘ dips’knto medullary pyramid

38
Q

Describe Juxtamedullary nephrons

A
  • Nephron spans cortex & medullary pyramid

- Loop of Henle descend towards renal papilla

39
Q

Each nephron is made up of?

A

Renal corpuscle

Renal tubule

40
Q

Renal corpuscle structure and function

A

→ Bowman’s capsule
→ Glomerulus

Filtration of plasma

41
Q

Renal tubule structure and function

A

→ Proximal convoluted tubule
→ Loop of Henle
→ Distal convoluted tubule
Selective reabsorption and secretion

42
Q

Structure and function of Glomerulus

A
  • 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
Q

Unlike most capillary beds, the glomerular capillaries exit into ?

A

Efferent arterioles rather than venues

44
Q

Glomerulus + Bowman’s capsule =?

A

Renal corpuscle - basic filtration unit of the kidney

45
Q

What is the Glomerular filtration rate (GFR)

A

Rate at which blood is filtered through all of the glomeruli, and thus the measure of the overall renal function

46
Q

The capillary endothelium is fenestrated allows ?

A

Water and soluble substance to pass from capillaries into Bowman’s space

47
Q

Main dogma of filtration

A

Need to control what is Kers and what is lost

Don’t want to be losing RBS and proteins

48
Q

How is glomerulal filtration processed?

A
  • 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
Q

How many nephrons per kidney ?

A

1 million

50
Q

Structure and function of Renal corpuscle in Kidney

A

Made of

  • glomerulus
  • Bowman’s capsule

Function- share filtration begins

51
Q

Layers of glomerulus

A

Epithelium
Basement membrane
Endothelium

+ Filtration slits

52
Q

Function of filtration slits in glomerulus

A

Allow passage of

  • water
  • glucose
  • ionic salts

BUT NOT OF

  • large proteins
  • RBC
53
Q

Cell of glomerulus

A

Podocyte

54
Q

Efferent arteriole

A

Exist glomerulus

55
Q

Afferent arteriole

A

Approaches glomerulus

56
Q

Structure of endothelium of capillary

A
  • fenestrations

- luminal surface negatively charged due to a glycoproteins layer

57
Q

Structure of Glomerulus Basement membrane

A
  • 3 layers: lamina rara interna, lamina densa & lamina rara externa
  • Laminae rarae layers are negatively charged (repel – charged things)
58
Q

Podocytes make?

A

Filtration slits

59
Q

What makes the Juxtaglomerukar apparatuses?

A

Macula densa + juxtaglomerular cells + supporting cells

60
Q

Function of Macula densa cells?

A

Sense changes in solute concentration in the distal convoluted tube - vasoconstrict / dilate afferent arteriole

61
Q

Function of Juxtaglomerular cells

A

Secrete renin which acts to increase Na ions reabsorption= High BP

62
Q

Structure of Proximal convoluted tube

A
  • Restricted to renal cortex
  • Longest section of renal tubule
  • Simple cuboidal epithelium with microvilli (brush border)
63
Q

Structure of Loop of Henle

A

• 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
Q

Where is the macula densa region?

A

Section where LOH meets DCT comes into contact with the afferent arteriole

LOH=Loop of Henle
DCT= Distal convoluted tubule

65
Q

Structure of convoluted tubule

A
  • Simple cuboidal epithelium
  • Different from the PCT (proximal convoluted tubule) due to absence of ‘brush border’ - very few
    microvilli which are irregularly placed
66
Q

Structure of Collecting duct

A
  • Simple cuboidal epithelium

- Intercalated & principal cells

67
Q

What are Principal cells ?

A

Main Na ions reabsorbing cells and site of action of aldosterone

68
Q

What are Intarcalated cells?

A

Maintain acid base balance

69
Q

What is the Urinary transitional epithelium

A

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
Q

Adrenal glands are also called?

A

Suprarenal glands

71
Q

Layers and structure of Adrenal cortex

A

Zona glomerulosa

Zona fasciculata

Zona reticularis

Medulla

72
Q

Sona Glomerulosa secretes?

A

Mineralocorticoids

73
Q

Zona Fasciculata secretes?

A

Glucocorticoids

74
Q

Zona Reticularis secretes ?

A

Androgens

75
Q

Medulla releases ?

A

Catecholamines

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