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Renal > Histology > Flashcards

Histology Flashcards

1
Q

Location of pain fibers of the kidney

A

renal pelvis
calyces
ureter
renal capsule

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2
Q

muscles the kidneys lie over in the abdominal wall

A

quadratus lumborum

psoas muscles

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2
Q

what part of the kidney does not contain afferent pain fibers

A

parenchyma

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2
Q

afferent innervation of the kidney

A

abdominal and thoracic splanchnic nerves

these terminate in the renal capsule, renal pelvis & major & minor calyces

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3
Q

divisions of the renal artery prior to entering the hilum

A

anterior and posterior divisions

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4
Q

Where do the arcuate arteries start?

A

cortico-medullary junction

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5
Q

What serves as the margins of the renal lobules?

A

interlobular arteries

these give off afferent arterioles

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6
Q

What type of gland is the kidney considered to be?

A

compound tubular gland

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7
Q

Contents of the medullary ray

A 
straight tubules (both proximal and distal)
cortical collecting ducts
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8
Q

embryologic origin of the nephron

A

metanephric blastema

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9
Q

What part designates the termination of the nephron?

A

connecting tubule

Note: the collecting ducts are not part of the nephron

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10
Q

embryologic origin of the collecting ducts

A

ureteric bud

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11
Q

do not have a loop of Henle that penetrates the inner medulla or an ascending thin limb of LOH

A

cortical nephrons

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12
Q

What type of epithelium lines Bowman’s capsule?

A

simple squamous epithelium

aka parietal epithelium

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13
Q

What type of endothelium lines the glomerular capillary?

A

fenestrated endothelium

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14
Q

What composes the visceral epithelium of the renal corpuscle?

A

podocytes

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15
Q

cells which play a role in regulating the sieving coefficient (Kf) of the glomerular filter

A

mesangial cells
They alter the caliber of the lumen of the glomerular capillaries and the size of the endothelial fenestrations with their contractile properties

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15
Q

3 Elements of the Glomerular Filtration Barrier

A 
glomerular capillary endothelium
basal lamina (shared by endothelium and epithelium) 
podocytes
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16
Q

mesangial cells are derived from?

A

bone marrow

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17
Q

cells which play a role in regulating the sieving coefficient (Kf) of the glomerular filter

A

mesangial cells

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17
Q

What generates the negative charge of the lamina rara externa?

A

heparan sulfate and other glycosaminoglycans and glycoproteins

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18
Q

What size molecules are restricted from passage through the GB lamina (GBL)?

A

36 Angstroms or 70 kD (70,000 Daltons)

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19
Q

Which layer of the GBM contains Type IV collagen fibers layered to prevent filtration of albumin

A

lamina densa

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20
Q

Which part of the GBM are pedicels of podocytes attached?

A

lamina rara externa

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21
Q

What generates the negative charge of the lamina rara externa?

A

heparan sulfate and other polyanions

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22
Q

What size molecules are restricted from passage through the GBM?

A

36 Angstroms or 70 kD (70,000 Daltons)

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23
Q

What anchors nephrin 2 to the pedicels?

A

CD2-associated proteins & podocin

Podocin is attached by zonula occludin-1, F-actin and CD2-associated protein

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24
Q

Size of albumin

A

66-68 kD
since molecules greater than 70 kD are restricted, the negative charge is important in prevention of albumin from passing into the filtrate

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25
Q

What height does the filtration sit above the glomerular basement lamina?

A

60 nm

It is the final barrier to the glomerular capillary lumen

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26
Q

Surface area of the rectangular filtration pore

A

56 nm2

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27
Q

What anchors nephrin 2 to the pedicels?

A

CD2-associated proteins & podocin

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28
Q

Size of albumin

A

66-68 kD

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29
Q

Which part of the proximal tubule is not in the cortex?

A

S3
It is only as long as the outer stripe of the medulla.
All S3 segments terminate at the junction of the outer and inner stripes.

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30
Q

Area of the rectangular filtration pore

A

56 nm2

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31
Q

Receptors of the proximal tubule membrane for endocytosis of albumin

A

Megalin and Cubulin

these prevent protein from appearing in the urine, since protein is normally filtered daily

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32
Q

Which parts of the proximal tubule are convoluted?

A

S1 and part of S2

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33
Q

Transporters of the proximal tubule that remove anion molecules from the blood to the lumen

A

on the basolateral side: OAT1 and OAT3 and NaC3 (dicarboxylate transporter)
on the luminal side: MRP2 and MRP4
greatest number of these transporters is in S2 and S3

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34
Q

Describe the differences in the S3 segment of the proximal tubule

A

mitochondria are smaller and ovoid (rather than long in S1-S2)
much less complex

35
Q

Enzyme of the proximal tubule that converts Vit D to the active form (1,25-dihydroxycholecalciferol)

A

1alpha-hydroxylase

36
Q

Which segment of the proximal tubule has the greatest number of secondary lysosomes?

A

S2

37
Q

Transporters of the proximal tubule that remove anion molecules from the blood to the lumen

A

on the basolateral side: OAT1 and OAT3 and NaC3

on the luminal side: MRP2 and MRP4

38
Q

Activity of these 2 enzymes is the highest in the proximal tubule brush border, higher than anywhere else in the body

A

gamma-glutamyltransferase

dihydropeptidase

39
Q

Enzyme of the proximal tubule that converts Vit D to the active form

A

1alpha-hydroxylase

40
Q

Which segment of the proximal tubule has the greatest number of lysosomes?

A

S2

41
Q

Where do all thin descending limbs of the LOH begin?

A

at the junction of the inner medullary and outer medullary stripes

42
Q

Where are ascending thin limbs found?

A

intermediate and juxtamedullary nephrons

43
Q

Where does urea enter the medullary interstitium?

A

at the bend of the thin ascending limb in the papillary region

44
Q

Where do all ascending thick limbs of the LOH begin?

A

at the junction of the inner stripe of the outer medulla with the inner medulla

45
Q

Another name for the straight segment of the distal tubule

A

pars recta

may mean straight segment, in general

46
Q

Features of the epithelium of the thick ascending limb

A

cuboidal
no brush border
Thick basolateral membrane
numerous long mitochondria perpendicular to the basal lamina (almost span the thickness)
central nucleus
Called the “diluting segment” -> where furosemide inhibits the Na/K/2Cl transporter

47
Q

Why is the basolateral membrane of the thick ascending limb thicker?

A

to accommodate the numerous Na-K ATPases required to provide the sodium gradient

48
Q

What features of the thick ascending limb of the LOH are absent from the macula densa cells?

A

extensive basolateral invaginations & long mitochondria

49
Q

Where are renin granules located?

A

in the modified smooth muscle cells of the afferent arteriole

51
Q

What is the primary effect of PTH on the DCT?

A

promote calcium reabsorption by the Na/Ca exchanger

52
Q

Features of the epithelial cells of the DCT

A

basolateral infoldings and greater-sized mitochondria push the nucleus toward the apical membrane

53
Q

Where is the Na-Cl cotransporter exclusively located?

A

distal convoluted tubule

54
Q

What is the primary effect of PTH on the DCT?

A

promote calcium reabsorption by the Na/Ca exchanger (NCXT)

The receptors for PTH are on the basolateral membrane

55
Q

Where are calbindin-D28K and calcium channel TRPV5 expressed?

A

connecting tubule and second half of DCT

56
Q

Which 2 distal segments reach the subcapsular space?

A

DCT and CCT (cortical or initial collecting tubules)
Look for the capsule to help identify the segment as DCT rather than medullary thick ascending limb (the cells look the same in DCT and TAL)

57
Q

Where is the activity of the Na-K-ATPase the greatest?

A

Distal convoluted tubule

This is from the ppt and not logical at all

58
Q

What 2 types of epithelial cells are located in the connecting tubule?

A

connecting tubule cells & intercalated cells (alpha type predominates)
The connecting tubule is the first distal segment of the nephron with 2 morphologically distinct epithelial cells

59
Q

What are the effects of aldosterone on the connecting tubule (the first segment to respond)?

A

increased transcription of amiloride-sensitive ENaCs and the Na-K-ATPase

60
Q

Transporters of the alpha-intercalated cells in the cortical collecting tubule and cortical collecting duct

A

apical (luminal) H+-ATPase for H+ excretion
basolateral Cl-/HCO3- exchanger AE1

Note: beta-intercalated cells have the Cl-/HCO3- exchanger on the apical membrane for bicarb secretion

61
Q

Features of the intercalated cell

A

Darker staining
larger
small microvilli (microplicae) on the luminal membrane
smaller ovoid nuclei
thinner basolateral membrane, relative to the connecting tubule cell

62
Q

Features of the cortical collecting duct

A

7-8 cortical collecting tubules merge to form 1 cortical collecting duct
principal cells that respond to aldosterone (increased transcription of amiloride-sensitive ENaC & Na-K-ATPase)
alpha and beta intercalated cells in similar numbers

63
Q

Contribute to chronic metabolic acidosis in hyperglycemia

A

H+-ATPases in the cortical collecting tubule and duct are nonenzymatically glycosylated, making them nonfunctional

64
Q

Factors determining K+ secretion by the cortical collecting duct and tubule

A

plasma levels of K+
aldosterone
ANG II

65
Q

Features of the principal cells

A 
Light staining "light cell"
low cuboidal
few sub-nuclear basolateral infoldings
ovoid nucleus
highly responsive to aldosterone
66
Q

Where are the cilium that serve as mechanosensors located?

A

principal cells of the cortical collecting duct

67
Q

ECM protein of the cilium mechanosensor of principal cells

A

polycystin-1

gene mutation implicated in ADPKD

68
Q

calcium permeable channel of the cilium mechanosensor of principal cells

A

polycystin-2

gene mutation implicated in ADPKD

69
Q

2 transporters expressed by medullary collecting duct intercalated cells

A

electrogenic H+-ATPase
electroneutral H+-K+-ATPase
both are located on the luminal membrane and are regulated by K+ homeostasis, having important effects on acid-base homeostasis

70
Q

Describe the inner medullary collecting duct

A

3 segments: IMCD1, IMCD2, IMCD3
IMCD1 is similar to the outer medullary collecting duct
IMCD2 and IMCD3 has 1 cell type: columnar & devoid of organelles
AQP2 (apical) APQ3 & APQ4 (basolateral) expression increased for water transport in response to ADH (AVP)
Urea is transported in IMCD2 & IMCD3

71
Q

AQP2 expression in cortical collecting tubule principal cells and connecting tubule cells

A

increased expression on basolateral membrane (with AQP3 & AQP4) for water reabsorption in response to aldosterone
note read slide. This info is very confusing and picky

72
Q

Which urea transporters are expressed exclusively in IMCD cells?

A

UT-A1 (apical)

UT-A3 (intracellular & basolateral)

73
Q

Where is UT-A1 expressed?

A

IMCD3

74
Q

Where is UT-A2 expressed?

A

descending thin limb of LOH

75
Q

Another name for IMCD3

A

papillary collecting duct

76
Q

What type of cell is involved in EPO synthesis?

A

type 1 cortical interstitial cells

77
Q

Types of cortical interstitial cells

A

2 types:
type 1 -> resembles fibroblast & synthesizes & secretes EPO
type 2 -> lymphocyte like

78
Q

What is the function of type 1 medullary interstitial cells?

A 
synthesize prostaglandins (PGE2)in response to ANG (receptors for ANG are present in the medullary interstitial cells)
*these do NOT synthesize EPO
79
Q

Function of medullary type 2 interstitial cell

A

phagocytosis

80
Q

pericyte found between two leaflets of the basement membrane of the vasa recta (in outer medulla & outer-inner medulla)

A

type 3 interstitial cell

81
Q

absent from type 1 medullary interstitial cells

A

EPO mRNA

ecto-5’-nucleotidase

82
Q

What mediates prostaglandin synthesis by medullary interstitial cells?

A

COX-2

this increases during water deprivation and hypertonicity

83
Q

What is in the lipid droplets of the medullary type 1 interstitial cells?

A

triglycerides rich in arachidonic acid and cholesterol esters

84
Q

How many minor calices are present in a multilobar kidney?

A

7-12
3-4 minor calyces merge to form a major calyx
3-5 major calyces merge to form the renal pelvis

85
Q

Parasympathetic innervation of the renal pelvis and ureters

A

S2-S4 via the inferior and superior hypogastric plexuses

86
Q

Muscle layers of the ureter

A

Upper 2/3 has 2 outer layers of smooth muscle, the innermost layer being longitudinally oriented
Lower 1/3 has a 3rd layer of outer smooth muscle oriented longitudinally.

87
Q

arterial blood supply to the bladder

A

internal iliacs

88
Q

Segments of epithelium of the urethra in males

A

transitional epithelium -> prostatic urethra
pseudostratified columnar or stratified columnar -> membranous urethra
pseudostratified columnar epithelium -> penile urethra
Note: urethral opening: nonkeratinized stratified squamous

89
Q

Segments of epithelium in female urethra

A

initial segment is transitional epithelium
near the urethral orifice: nonkeratinized stratified squamous epithelium
female urethra has paraurethral glands that secrete an alkaline substance

90
Q

What type of gland is the prostate?

A

compound tubulo-alveolar gland

91
Q

Key identifying feature of the prostate

A

concretions in the lumen and some glandular regions

Other features:
capsule on posterior and lateral surfaces
anterior portion has no glandular epithelium and is covered in stroma

Renal (8 decks)

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