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BPM1 Exam 5 - Cardiovascular, Pulmonary, and Renal 2 > CPR 64-65 - Urinary System 1-2 > Flashcards

CPR 64-65 - Urinary System 1-2 Flashcards

1
Q

List the endocrine functions of the kidney.

A
  1. Hydroxylation of 25-OH VitD3 to hormonally active 1,23-(OH)2 VitD3
  2. Secretion of EPO
  3. Secretion of Renin
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2
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A
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3
Q

List and describe the two distinct regions of the renal cortex.

A
  1. Medullary rays: straight tubules of the nephron and collecting ducts. AKA - pars recta
  2. Cortical labyrinth: convoluted tubules of the nephron. AKA - pars convoluta
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4
Q

Differentiate a renal lobe from a renal lobule.

A

Renal Lobe: medulla and associated cortex

Renal Lobule: medullary rays (pars recta) and adjacent cortical tissue (labyrinth/pars convoluta) bounded by interlobular arteries. Functionally, a lobule consists of a collecting duct and the nephrons it drains.

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5
Q

What is outlined in this image?

A

A renal lobule

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6
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A
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7
Q

What do the pars convulta and pars recta consist of?

A

Pars Convulta - predominantly consists of rounded structures like renal corpuscles, PCTs, DCTs, and peritubular capillaries

Pars Recta (medullary rays) - predominantly consists of straight structures like the loop of Henle and collecting ducts

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8
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9
Q

What is a juxta medullary nephron and how is it different from the other nephrons?

A

A juxta medullary nephron is simply a nephron that is closer to the renal medulla than cortical and intermediate nephrons.

  • Juxta medullary nephrons have their proximal straight tubule, thin loop of henle, and distal straight tubule situated in the medulla while cortical nephrons have these structures located in the cortex.
  • In juxta medullary nephrons the efferent arterioles descend into the medulla and become vasa recta while they become peritubular capillaries in cortical nephrons.
  • The juxtamedullary nephrons also have much longer loops of henle which makes them crucial for concentrating urine
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10
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11
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12
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13
Q

What is the mesangium?

A

A structure associated with the glomerular capillaries. It is outside of the capillary lumen but continuous with the capillary smooth muscle and surrounded by the capillary basement membrane. It is filled with intra-glomerular mesangial cells and the matrix they produce.

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14
Q

What is ultra-filtrate?

A

The fluid that collects in the the urinary space just outside of the glomerulus

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15
Q

What makes up the visceral and parietal layers of Bowman’s Capsule?

A

Visceral Layer - surrounds the glomerular capillaries and is composed of podocytes which are modified squamous cells that invest the glomerular capillaries

Parietal Layer - outer capsular layer of simple squamous epithelium which is continuous with the PCT

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16
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17
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18
Q

How many types of intra-glomerular mesangial cells are there and what are their functions?

A
  1. Secretory Mesangial Cells - secrete mesangium ECM and inflammatory substances, and phgocytose residue along the glomerular basement membrane
  2. Contractile Cells - regulate glomerular distension in high blood pressure in response to antiotensin II and atrial natriuretic factor
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19
Q

Describe the structure and function of the glomerular capillary endothelium.

A

They are fenestrated capillaries without a diaphragm and abundant aquaporin receptors. The cells serve to help filter blood and produce NO and PGE2

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20
Q

Describe the golmerular basement membrane (GBM) structure and composition.

A
  • Thicker than most basement membranes because it is actually two fused together (one from endothelium and the other from podocytes)
  • Consists of three layers:
    • Lamina rara interna - capillary layer
    • Lamina densa - middle layer composed of Type IV collagen (physical barrier)
    • Lamina rar externa - podocyte layer rich in heparan sulphate to repel negatively charged molecules
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21
Q

Describe the structural components of the podocytes that are important for filtration.

A
  • The pedicels are separated by 40nm and this space, referred to as a filtration slit, is covered by a slit diaphragm
  • The slit diaphragm is a zipper like thin sheet with a dense center containing nephrin (transmembrane protein) which is anchored to the actin filaments within the pedicels of the podocytes
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22
Q

List the three most important factors that determines if a substance makes it past the glomerular capillaries into the urinary space.

A
  1. Charge - negatively charged molecules are repelled
  2. Mass - upper limit of 70,000 Da
  3. Shape - upper limit of 3.6 nm radius
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23
Q

What are the common substances that the glomerulus allows through?

A

Water, glucose, small amino acids, ions, urea, hormones, vitamins B and C, and ketones

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24
Q

What percentage of ultra-filtrate is reabsorbed by the PCT? What are the primary components it reabsorbs?

A

The PCT reabsorbs 65% of the ultrafiltrate which includes 100% of glucose and 98% of amino acids and polypeptides

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25
Q

List the distinguishing features of the PCT epithelium.

A
  • Simple cuboidal epithelium
  • Larger than usual cells (large spaces between nuclei)
  • Abundant long microvilli brush border on apical surface which has an extensive glycocalyx that stains well with PAS
  • Lateral suface is full of plicae which interdigitate with adjacent cellular processes and are held together by tight junctions and zonula adherens. This makes the cell boundaries invisible in light micrographs
  • Basal interdigitations and striations which are associated with elongated mitochondria
  • More eosinophilic than surrounding structures due to numerous mitochondria
26
Q

Differentiate proximal straight tubule from a PCT histologically.

A
  • Proximal straight tubules are found in the medullary ray or outer medulla while PCTs are in the pars convoluta
  • Proximal straight tubule epithelial cells are shorter, have a less developed brush border, fewer basal/lateral interdigitations, and have fewer/smaller mitochondria than PCT epithelial cells
27
Q

What is outlined in this image?

A

Proximal straight tubules

28
Q

What are the arrows pointing to in this image?

A

Thin segment of loop of henle

29
Q

What type of capillaries are the vasa recta?

A

Fenestrated

30
Q
A
31
Q

List the sections of the loop of henle from proximal to distal, any alternate names each section might have, and the type of epithelium present in each.

A
  1. Thin descending limb - simple squamous
  2. Thin ascending limb - simple squamous
  3. Thick ascending limb (aka - distal straight tubule) - simple cuboidal
32
Q

What are the arrows pointing at in this image?

A

Distal straight tubule or thick ascending limb of loop of henle

33
Q

How can you differentiate the distal straight tubules from the rest of the loop of henle?

A

The distal straight tubule is more pale staining (less eosinophilic) due to its epithelium having fewer mitochondria.

34
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A
35
Q

Describe the route of the distal convoluted tubule and how this affects its occurence in histological slides.

A

The DCT is very short (1/3 length of PCT) beginning at the macula densa and extending to a connecting tubule. Because of this it appears far less frequently in micrographs than PCTs do.

36
Q

Describe the histological appearance of the DCT epithelium.

A
  • Simple cuboidal
  • Smaller cells than PCT, therefore, nuclei are more visible and closer
  • Their microvilli are blunted making the lumen clearer
  • Less eosinophilic appearance than PCT
  • Fewer and shorter microvilli
  • Extensive basal folds
  • Apically placed nucleus
37
Q
A

Macula Densa

38
Q

Histological facts to know about the macula densa.

A
  • They are modified cells of the distal straight tubule
  • Located on the lumenal surface of the distal straight tubule at the vascular pole
  • They are narrower and taller than the other distal straight tubule epithelial cells
39
Q

List the components of the JG apparatus and what each does.

A
  1. Macula densa cells - osmoreceptors that, when low [Na+] is detected, trigger dilation of the renal afferent arteriole and release prostaglandins that trigger JG cells lining the renal afferent arteriole to release renin into the blood stream
  2. Extraglomerular mesangial cells (lacis/polkissen cells) - function not completely known but they do play a role in renal autoregulation of kidney blood flow at the RAA system
  3. Juxtaglomerular cells (JG cells) - modified smooth muscle cells that produce renin
40
Q
A
41
Q

Identify the components of the JG apparatus

A
42
Q

Histological facts to know about connecting tubules.

A
  • They connect the DCT to a cortical collecting duct
  • Very short in cortical nephrons and longer/arched in mid cortical and JM nephrons
  • Epithelium gradually transitions from DCT (simple cuboidal) to collecting duct (simple cuboidal with prominent cell boundaries)
  • Also contains principal cells
43
Q

What is the arrow pointing to?

A

Cortical collecting duct

44
Q

Histological facts to know about cortical collecting ducts

A
  • Found in the medullary ray (pars recta)
  • Lined by simple cuboidal epithelium with prominent cell boundaries
  • Diameter of duct increases as it enters medulla
45
Q

Histological facts to know about medullary collecting ducts

A
  • Simple cuboidal epithelium transitions to simple columnar epithelium
  • The lumen widens from cortex to papila
  • Several merge to form papillary ducts (ducts of Billini)
46
Q

What are the two specialized medullary collecting duct cell types? What are their general function, location, and histological appearance?

A

Light or Principal Cells - these cells are scattered throughout the collecting duct epithelium in the outer medulla and steadily increase in number until they’re the only collecting duct cell type in the inner medulla. The steadily increase in height, are pale staining, possess true basal infolding, have a single primary cilium, and have adundant ADH regulated aquaporins to allow for water reabsorption.

Dark or Intercalated Cells - found only in the collecting duct epithelium in the outer medulla. They have microvilli and secrete H+ and bicab

47
Q

Into what structure do the medullary collecting ducts empty?

A

The area cribrosa on the apex of a renal papilla

48
Q

What are the arrows pointing at in this slide and from what region of the kidney was this slide taken? How do you know?

A

The arrows are pointing to collecting ducts. This slide is taken from the outer medulla. We know that because of the amount of space between the collecting ducts. In the inner medulla, the collecting ducts are much closer together.

49
Q

What are the arrows pointing to in this image and what region of the kidney was this slide taken from? How do you know?

A

Those are collecting ducts and this slide was taken from the inner medulla. We know that because of how close together the collecting ducts are.

50
Q

Label the boxes, circles, and arrows.

A
51
Q

What are the main cell types found in the renal cortical and medullary interstitiums?

A

The cortical interstitium has two main cell types: fibroblasts and mononuclear cells

The medullary interstitial cells resemble myofibroblasts and their present along the descending vasa recta

52
Q

What are the arrows pointing to?

A

Papillary ducts

53
Q

What structures make up the urinary excretory passages?

A

Minor calyx, major calyx, renal pelvis, ureter, urinary bladder, and urethra

54
Q

What does the term “urothelium” refer to?

A

The transitional epithelium present in the excretory passages of the urinary system (minor calices to urethra).

55
Q

Describe the layers of transitional epithelium.

A

Superficial - single layer of dome shaped (umbrella) cells that can stretch out flat with distension. They have abundant tight junctions making this layer impermeable to salts and water. The umbrella cell apical surface is also covered in urothelial plaques that contain crystalline uroplakin. This contributes to the permeability barrier. There are also flattened elliptical vesicles found within these cells called fusiform vesicles

Intermediate - pear shaped cells with abundant desmosomes

Basal - stem cells

56
Q

What is this?

A

Transitional epithelium

57
Q
A

UP - urothelial plaque

FV - fusiform vesicle

HR - hinge region

58
Q

Discuss the layers of the ureter

A

Mucosa - epithelium and lamina propria

Muscularis - upper two-thirds has longitudinal layer surrounded by circular layer of smooth muscle. Lower one-third has an additional longitudinal smooth muscle layer towards the outside. Contraction of these muscle layers produces peristaltic waves

Adventitia

59
Q

Discuss the layers of the urinary bladder.

A

Mucosa - epithelium and fibroelastic connective tissue

Muscularis - very thick; consists of smooth muscle arranged in inner longitudinal, middle circular, and outer longitudinal layers

Adventitia/Serosa

60
Q

Discuss the segments of the male urethra and the epithelium found in each segment.

A

Prostatic Urethra - transitional epithelium

Membraouns Urethra - pseudostratified columnar epithelium

Spongy Urethra - pseudostratified columnar until the fossa navicularis (region just before the external urethral orfice) which is lined by stratified squamous non-keratinized epithelium.

Mucus secreting glands of Littre are located in the subepithelial connective tissue of the entire urethra

61
Q

Discuss the segments of the female urethra and the epithelium found in each segment.

A

The female urethra is short and not separated into segments. Proximally, it is lined by transitional epithelium. The very terminal part is lined by stratified squamous non-keratinized epithelium.

Muscularis is composed of an inner longitudinal and an outer circular layer of smooth muscle.

BPM1 Exam 5 - Cardiovascular, Pulmonary, and Renal 2 (16 decks)

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