CPR 41+42 Flashcards
what are the 3 constrictions of the ureter?
- ureteropelvic junction
- crossing of the illiac Artery
- ureterovesical junction
water under the bridge; female?
the ureter is under the uterine artery and vein
water under the bridge; male?
The ureter is under the ductus deferens
urinary tract stones?
more common in males
20-60 years of age
Aggregates of calcium, phosphate, oxalate, urate and other soluble salts
Urine becomes saturated and a small change in pH can cause precipitation of these salts
stones may be caused by bacteria
complications:
infection, urinary obstruction, renal failure
pain from kidney stones is referred where and why?
what nerves?
commonly referred to the flanks, inguinal area, upper thigh
sympathetics are supplied from T12-L2
Ilioinguinal N, Iliohypogastric N, subcostal N.
blood and lymph supply of the bladder?
blood: superior and inferior vesicle artery
lymph: external iliac nodes
relationship of bladder in female and male?
female:
bladder then uterus and then rectum (A to P)
male:
anterior to rectum and rectovessicle space
Detrusor muscle of the bladder?
internal urethral sphincter?
sphincter urethrae?
Detrusor: SM of the bladder wall relaxes to allow filling contracts to empty autonomic innervation
internal urethral:
located at the neck of the bladder
continuation of detrusor muscle
autonomic innervation
sphincter urethrae:
located in deep perineal space
skeletal muscle
somatic innervation (pudendal N)
ligamentous support for males and females’, regarding the bladder?
male: puboprostatic
female: pubovesical
innervation of the bladder? sympathetic versus parasympathetic
detrusor:
sym: relaxation
para: contraction (pelvic splanchnics)
internal urethral:
sym: contact
para: relax
external sphincter: Pudendal N (somatic)
sensation of filling/ fullness = visceral afferents
Who is more likely to get a UTI?
females; much shorter urethra
parts of the male urethra?
prostatic: anterior half of the prostate
membranous: located within the deep perineal pouch
penile / spongy: proximal portion and has openings for the bulbourethral glands
two types of catheterization?
urethral and suprapubic
stress incontinence
weakness of the pelvic floor muscles and sphincters, thus urine can leak
Cystocele
prolapse of the bladder into the vaginal canal
common causes: repetitive straining for bowel movements constipation chronic cough (violent) heavy lifting obesity
renal transplant
transplant is placed and attached in the region of the iliac fossa
nutcracker syndrome?
The compression of the left renal vein between
the superior mesenteric artery (SMA) and aorta.
symptoms:
pain (left flank, pelvis)
varicocele
hematuria
histology of the renal cortex?
granular in appearance
contains most components of the nephron
goes between the medullary pyramids as renal columns
histology of the renal medulla?
arranged in pyramids
projects into renal minor calyx
striated appearance
medullary ray?
cortical labyrinth?
renal lobule?
medullary ray: pars recta
within the cortex
contains the straight tubules
cortical Labyrinth: pars convoluta
contains renal corpuscle and convoluted tubules
renal lobule:
medullary ray is in the middle and has the cortical labyrinth on both sides.
blood supply of the kidney?
renal artery segmental A interlobar A Arcuate A Interlobular A afferent arteriole glomerulus efferent arteriole
efferent arteriole of the cortical and Juxtamedullary nephrons
cortical:
efferent arterioles forms peritubular capillary network
Jx:
efferent arterioles become vasa recta
vasa recta:
run parallel to LOH
countercurrent exchange on ions in the medulla
what are the three different nephrons?
differences?
- cortical
short loops of henle - intermediate
mid-cortical - Juxtamedullary
long loops of henle (concentration of urine)
components of the renal corpuscle?
function?
glomerulus: afferent of efferent arterioles are found at the vascular pole
bowman’s capsule: surrounds glomerulus
Mesangium: mesangial cells (intra-glomerular)
parts of the bowman’s capsule?
visceral layer: inner layer
consists of podocytes (modified squamous cells)
invests glomerular capillaries
parietal layer: outer layer
simple squamous
continuous with PCT
urinary space: lies between the two layers
collects ultrafiltrate
characteristics of the endothelium of glomerular capillaries?
numerous fenestrations
no diaphragms
produces NO and PGE
lots of aquaporin-1 receptors
Glomerular basement membrane
fused basal lamina of endothelial cells and podocytes
made up of type 4 collagen and heparan sulphate
Factors that affect filtration?
- charge
negative charged molecules are repelled since BM is negative - size
larger molecules have more difficulty passing - shape
Goodpasture’s syndrome?
IgG against the type 4 collagen of the basement membrane, thus glomerulonephritis
hematuria, proteinuria
two types of mesangial cells?
function?
Lacis cells and extraglomerular mesangial cells
they are within the capsule
function:
phagocytosis of residue along with GBM
secretes ECM
secretion of IL-1, PE2, PDGF (inflammatory)
histology of PCT?
function?
found in the cortex
simple cuboidal epithelium
large cells
brush border
function:
reabsorb glucose and amino acids, and polypeptides
