endo 2 W9

Question 1

how does the anatomical position of the kidneys vary from left to right?

Answer 1

right is lower than left (liver)
left posteriorly protected by ribs 11 & 12, right only has relationship with rib 12
left is taller and narrower than right

Question 2

what vessel does the right renal artery pass behind?

Answer 2

IVC

Question 3

what vessel does the left renal vein pass in front of?

Answer 3

aorta

Question 4

what vessel does the left renal vein pass under?
could there be a clinical implication of this?

Answer 4

superior mesenteric artery

nutcracker syndrome - compression of left renal vein between SMA and aorta. presents as haematuria due to renal venous hypertension resulting in rupture of veins in collecting duct.

Question 5

histology - what are the different characteristics of the proximal and distal tubules?

Answer 5

distal tubules are lighter staining as they contain fewer vesicles and mitochondria than proximal tubules
lumen appears larger due to presence of fewer microvilli

Question 6

what are three cell types that have an endocrine function in the kidneys and what is that function?

Answer 6

juxtaglomerular cells - produce renin
macula densa - sensitive to sodium in the filtrate
extraglomerular mesangial (Lacis) cells - contain renin

Question 7

what hormone is produced at the juxtaglomerular apparatus?

Answer 7

renin

Question 8

what is renins function?

Answer 8

control BP by activating RAAS, leading to increase in BP. (cleaving angiotensinogen to angiotensin 1)

Question 9

what is renin specifically produced in response to?

Answer 9

low sodium chloride concentration

Question 10

what are the adrenal arteries and where do they branch from

Answer 10

superior adrenal (from inferior phrenic)
middle adrenal (from abdominal aorta)
inferior adrenal (from renal)

Question 11

what is the difference in venous drainage between the left and right adrenal glands

Answer 11

right - one single adrenal vein drains into the IVC
left - a collection of adrenal veins drain into the inferior phrenic and renal veins

Question 12

layers of the adrenal gland?

Answer 12

capsule
cortex
->zona glomerulosa
->zona fasciculata
->zona reticularis
medulla

Question 13

hormones secreted in different areas of the adrenal glands? function?

Answer 13

mineralocorticoids (water/electrolyte balance)
glucocorticoids (metabolism)
gonadocorticoids (growth, dev of repro organs)
adrenaline and noradrenaline (fight/flight)

Question 14

what ligaments are involved in suspension of the ovary?

Answer 14

proper ovarian ligament (ov -> uterus-ish)
suspensory ligament of ovary
mesovarium

Question 15

blood supply and drainage to the ovaries?

Answer 15

ovarian artery passes through suspensory ligament
surrounded by veins - pampiniform plexus

Question 16

which tissues in the ovary have an endocrinological function and which hormone do they produce?

Answer 16

mature follicle - oestrogen
corpus luteum - progesterone

Question 17

structures in/around the testes?

Answer 17

epididymis (outside scrotum)
seminiferous tubules (in testes)
spermatic cord, containing:
-vas deferens
-pampiniform plexus
-testicular artery

Question 18

structures in testes - histology?

Answer 18

tunica albuginea
connective tissue septa
Leydig cells
blood vessels

Question 19

what cells in the testes produce hormones? which hormones?

Answer 19

Leydig cells - Testosterone, Aldosterone, DHEA

Question 20

what ligament covers the uterus and its surrounding structures?

Answer 20

the broad ligament

Question 21

peritoneal pouches around the uterus?

Answer 21

rectouterine pouch (pouch of Douglas)
vesicouterine pouch

Question 22

blood supply to the uterus?

Answer 22

uterine artery (branch of internal iliac artery)

Question 23

what is an anastomosis?

Answer 23

connection between two usually tubular structures. A circulatory anastomosis usually results in two vessels supplying a shared volume of tissue.

Question 24

venous drainage of the uterus?

Answer 24

uterine vein (drains into internal iliac vein)

Question 25

what histological features of the endometrium indicate that the menstrual cycle is in the proliferative phase?

Answer 25

restricted blood vessels
thin endometrial wall
flat luminal surface

Question 26

what histological features of the endometrium indicate that the menstrual cycle is in the secretory phase?

Answer 26

thickening of functional layer
coiling of glands
some saw-toothed glands

Question 27

what hormones are released during the proliferative phase of the menstrual cycle?

Answer 27

FSH (anterior pituitary)
oestrogen (mature follicles)

Question 28

what hormones are released during the secretory phase of the menstrual cycle?

Answer 28

oestrogen (mature follicles)
progesterone

Question 29

what are the unique features of the maternal and foetal surfaces? (placenta)

Answer 29

foetal surface smooth, covered by chorion
maternal surface rough, containing thin layer of decidua of maternal origin and derived from the endometrium

Question 30

what are the main functions of the placenta?

Answer 30

placental transfer (passes nutrients and O2 to foetus, removes waste products to mother)
protection from maternal immune system (inhibits NK cells, secretes immunosuppressors)
endocrine organ (produces human chorionic gonadotrophin (hCG) and progesterone)

Question 31

what is the outermost later of foetal cells that completely surrounds the foetus and all foetally derived tissues, and lies adjacent to the maternal tissue?

Answer 31

the chorion - outer layer formed by trophoblasts and an inner layer formed by somatic mesoderm

Question 32

which hormone do trophoblast cells secrete in the first few weeks of pregnancy? what does it do?

Answer 32

human chorionic gonadotrophin (hCG)

analogue of LH, maintains function of corpus luteum during first few weeks of pregnancy

Question 33

when does the placenta take over the production of progesterone?

Answer 33

approx. 8 weeks
(luteal-placental shift)

Question 34

why is progesterone important?

Answer 34

after ovulation, converts endometrium to secretory phase, preparing the uterus for implantation. if fertilisation and implantation do take place, it maintains the secretory phase and promotes blood vessel and tissue development - this is important to sustain the embryo.
progesterone also acts on the myometrium to inhibit uterine contractions which might otherwise expel the embryo.