Anatomy of the Kidneys and Adrenal Glands Flashcards
- which kidney is higher up?
- what are they covered by?
- they are located behind the peritoneal cavity, what is this term called?
- left higher
- covered by floating ribs
- retro-peritoneal
adrenal glands cap what border of the kidneys
superior-medial border
how many lobes are in a kidney
the number of meduallary pyramids (8-10)
where does 90% of blood passing through the kidney go
cortex
where are medullary rays in? what do they represent
cortex
represent aggregations of straight and collecting tubules
what is a renal lobule
medullary ray with surrounding cortical material
how many major calices are there
2-3
the collecting ducts perforate the tip of the ______
medullary pyramid
ex. renal papilla
what is the point of convergence of the 2-3 major calices
renal pelvis
_______ nephrons contribute tubules to the loop of henle
juxtamedullary
the kidney receives ____% of cardiac output
___% of flow is through the cortex
20%
90%
blood supply to the medulla is derived from the _________ of ___________
efferent arterioles of juxtamedullary glomeruli
the efferent arterioles juxtamedullary glomeruli give rise to _____ capillaries, and ______
peritubular capillaries (like other glomeruli) vasa recta (straight, long capillaries)
what give rise to vasa recta?
arcuate arteries
efferent arterioles juxtamedullary glomeruli
urea is a breakdown product of ….
protein and ammonia metabolism
creatinine is a breakdown product of…
creatine (importnat part of muscle)
plasma glucose > _____mg% will spill into the urine
> 180mg%
what are the endocrine functions of the kidney
erythropoietin
renin
what is erythropoietin (EPO) produced by
when is it released
peritubular capillary endothelium
-released in response to low blood oxygen (hypoxia or reduced hemotocrit)
when is renin produced?
what system does renin stimulate?
what has the opposite effect as renin?
- produced when bp is low
- stimulates angiotensin system => increases blood pressure
- atrial natiuretic factor has the oppoiste effect
what contains cells of the macula densa?
where does macula densa occur?
what does the macula densa do?
- distal convoluted tubule
- occurs where the distal CT makes contact w/ the JG cells on the arteriole feeding into bowman’s capsule
- monitors composition of fluid in tubular lumen
what do extraglomerular mesangial cells (aka lacis cells) do
transmit information from macula densa to granular cells
what do granular (JG) cells receive
the low sodium signal from cells of the macula densa
what are granular cells
modified smooth muscle cells w/ epithelioid appearance located in afferent arteriole close to glomerulus
-synthesize the proteolytic enzyme renin
the JG cells secrete renin in response to…
- beta-1 adrenergic stimulation
- contract blood vessels/increase BP - reduced renal perfusion presssure
- detected directly by the JG cells - decreased NaCl reabsorption by the macula densa
- due to reduction in glomerular filtration rate
what catalyses conversion of angiotensinogen to angiotensin I
renin
what converts angiotension I to II
ACE
angiotensin converting enzyme
-produced the epithelial cells in lung capillaries
what do ACE inhibitors do
block production of angiotensin II
angiotensin II is a very potent…
vasoconstrictor
normally, _______ splits to form the 2 kidneys, if it doens’t you will end up with a horseshoe kidney
primordial tissue
what does metanephric duct develop to
what does metanephric blastema develop to
what does mesonephric duct develop to
what are all other parts derived from (except methanephric blastema)
most mature kidney tissue
nephrons and part of collecting duct
bladder trigone and the gonads
ureteric bud
polycystic kidney disease
- recessive or dom?
- accounts for ____% of dialysis patients in the US
- unilateral? bilater?
- one of the most common….
- what is the leading cuase of this
- autosomal dominant disease
- 10%
- bilateral, progressive cystic dilation of the renal tubules
- one of the most common inherited disorders
- end stage diabetic nephropathy is the leading cuase
there is an association btwn polycistic kidney disease and…
(similar 7-10th week embryognetic stages)
blepharochalasis
- inflammation of the eyelid => atrophy
- tends to affect upper lid more
- thought to stem from a problem at the same embryological development point as PKD
what are some associated abnormalities btwn kidney and eye problems
severe myopia, cataracts, papilledema, peripheral retinal pigmentation
constrictions prevent backflow of urine from where to wehre
bladder to kidney
where are the 3 locations wehre preventing backflow would be problematic
- where renal pelvis ends and ureter begins
- at point where ureter passes from abdomen to pelvis around sacral prominence
- where ureter obliquely enters bladder
what is the detrusor muscle
the smooth muscle of the bladder
-outer longitudinal layer
what is the detrusor muscle contolled by
- what give feelings of fullness
- what is the lumen lined by
parasmpathetic nervous system
- sensory fibers give ruse to feelings of fullness
- lumen lined by transitional epithelium
what is incontinence
loss of bladder control
more common in women
the first part of the male urethra travels through what
prostate
what is benign prostatic hyperplasia
the constant feelings of needing to urinate
what is reiter’s disease
triad of arthritis, conjunctivits, or anterior uveitis, and urethritis
-autoimmune disease
what bacteria are known to cause Reiter’s disease
shigella slamonella yersinia species campylobacter jejuni chlamydia trachomatis -these bacteria have proteins (antigens) w/ similar molecular structure to those in host => autoimmune reaction
what are intravenous pyelogram used for
what is the most common cuase of blockage
-dye is injected and it filters throgh what before x rays are taken
to detect suspected obstruction to the flow of urine through the collecting system
- most common cuase of blockage is a kidney stone (nephrolith)
- dye is injected, it filters through kidneys and then x-rays are taken
what is the capsule of the adrenal gland bound by
-where are the the adrean glands
renal fascia
-above the superior medial border of the kidneys
in adrenal glands innervation is mostly _____ sympathetics that go to cells of the meulla
preganglionic
what do zona glomerulosa
zona fasciculata
zona reticularis produce?
mineralcorticoids
glucocoritcoids
androgen/estrogen
how do optometrists prescribe glucocorticoid steroids? for what?
- how do these work
- when the pt is taken off steroids what happens
topically or orally to treat inflammatory conditions
- these steroids feed back to adrenals to turn off steroid production
- their adrenals need time to bounce back
- ocular steroids are tapered down slowly in pts that received topical steroids for more than a week
