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Renal Module > Histology of Urinary System- Herron > Flashcards

Histology of Urinary System- Herron Flashcards

1
Q

Urinary system consists of what?

A

paired kidneys and ureters, a bladder, and a urethra

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2
Q

Big picture path of urine?

A

kidney produces urine, goes to ureters, and then to bladder for storage until discharged into urethra

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3
Q

A) Kidney is covered by________?
B) Hilum contains?
C) Parenchyma of kidney is divided into what?

A

A) a connective tissue capsule
B) renal vessels, nerves, and the renal pelvis (leads to ureter)
C) outer cortex and inner medulla

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4
Q

Location of Pyramids?
Apex of a pyramid?
Tissue between adjacent pyramids?

A

The medulla
Renal papilla
The renal column

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5
Q

What is a lobe (8-18 per kidney)?

A

A medullary pyramid and the overlying cortex plus 1/2 of the renal columns on each side of the pyramid.

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6
Q

A) Calyces?

B) Minor vs Major Calyces

A

A) Extensions of the renal pelvis
B) A minor calyx surrounds a renal papilla: A major calyx is a combination of two or more minor calyces
Pyramids–Papilla–Minor–Major–Pelvis–Ureter

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7
Q

Functions of the Kidney (4)?

A

Remove waste from the blood and excrete it as urine; Regulate electrolyte balance (Na, H, K, Ca); Regulate plasma volume and blood pressure; Produce/Activate hormones

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8
Q

Hormones produced by kidney and their functions?

A
  1. EPO (RBC production in BM)
  2. Renin (control of blood pressure and volume)
  3. Activation of inactive form of Vitamin D
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9
Q

Structural/Functional unit of kidney and what is it composed of? How many per normal human kidney?

A

Nephron: consists of a renal corpuscle and its tubule. 800K to 1 Mill per kidney

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10
Q

Renal corpuscle? Tubule?

A

RC is the beginning of the nephron and the site for filtering blood. The tubule originates from the RC and ends at collecting duct (CD is not part of the nephron)

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11
Q

The Renal Artery is one of the_________ arteries in the body, and it circulates about _______% of the cardiac output thru the kidney. So, lots of nephrons are needed to filter that much blood.

A

largest; 25%

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12
Q

Four major segments of each nephron tubule?

A
  1. Proximal Thick segment (PCT and PST)
  2. Thin segment (with descending and ascending limbs)
  3. Distal Thick segment/Thick Asc Limb (Medullary TAL, Cortical TAL with the Macula Densa)
  4. Distal Nephron (DCT and Connecting Segment (CS))
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13
Q

Which segments make up the Loop of Henle?

A

PST, tL, MTAL

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14
Q

Importance of segments of each nephron tubule?

A

They are important bc the exchange of ions in the cortex and medulla. The electrochemical interxns are different in different in different segments of the tubule and are critically important for the isotonic concentration of urine.

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15
Q

What separates the proximal and distal tubules?

A

Macula Densa: PT is proximal to MD and DT is distal to it from MD til ends at CD

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16
Q

Proximal Nephron (proximal to MD from RC to MD) consists of?

A

Prox Thick Segment (PCT, PST)
Thin segment/limb
Thick Asc Limb (MTAL, CTAL, MD)

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17
Q

Distal Nephron (distal to MD) consists of?

A

Distal Convoluted Tubule and Connecting Segment

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18
Q

Collecting Ducts: a) Do what? b) Consist of what?

A

a) CDs conduct urine from nephron tubules to renal papillae; b) they consist of CCD (cortical) and MCD (medullary)
CD’s are NOT part of the nephron

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19
Q

Medulla divisions

A

Inner and outer Medulla; outer medulla consists of an inner and an outer stripe

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20
Q

Ducts of Bellini, where are they and what do they do?

A

These are large orifices thru which urine, that has drained into the CD and then papillae, can drain empty/drain into the minor calyces.

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21
Q

Convoluted parts of nephron tubule are always found where?

A

in the cortex

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22
Q

Distinguishing Proximal Tubules vs Distal Tubules?

A

a) PT has star-shaped lumen and brush border (microvillae), while lumen of DT is more rounded and the luminal surface of cells is sharper.
b) PT has bigger diameter and 2x as long
c) DT have larger number of nuclei and cells around the lumen in cross-section

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23
Q

Distinguishing characteristics of Collecting Ducts?

A
  1. Comparable diameter to PT
  2. Cells forming the wall of CDs are cuboidal and smaller than those of PTs, and they are nicely organized with a larger number of nuclei relative to PT’s.
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24
Q

Thin Limbs/Segments?

A

Have thinner walls than tubules and walls are made of simple squamous (flattened) epithelium (or low cuboidal), and they have a very small lumen

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25
Q

T/F? There are no transitional epithelial cells within the kidney.

A

True

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26
Q

Most of the tubules near the Renal corpuscle are what type?

A

Most are proximal tubules, with occasional DT’s.

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27
Q

What is the beginning of the nephron in which blood is filtered and the ultrafiltrate is produced?

A

Renal Corpuscle

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28
Q

The 2 poles of the RC?

A
  1. Vascular pole: where blood enters and leaves the RC via the afferent and efferent arterioles respectively. 2. The Urinary pole: where the PCT leaves the RC.
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29
Q

How can you distinguish between the afferent and efferent arterioles? Why?

A

Afferent and Efferent are distinguished by size. The afferent arteriole is ALWAYS larger. It has more muscular cells and is involved in the regulation of BP entering the capillary loops (glomeruli).

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30
Q

Blood enters the RC via_________ and exits via _________?

A

afferent; efferent

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31
Q

Renal Corpuscle consists of what?

A
  1. Glomerulus: tuft of capillary loops

2. Bowman’s Capsule: surrounds glomerulus

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32
Q

Components of BC and their functions?

A

BC has two layers, a visceral layer with podocytes that adheres tightly to the capillary tufts and a parietal layer that forms the outer wall.

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33
Q

What is between the visceral and parietal layers of BC?

A

the Urinary Space, where the ultrafiltrate is first drained to.

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34
Q

Cell type of parietal layer of BC?

A

squamous epithelium

35
Q

What gives rise to the visceral epithelial layer of BC?

A

Podocytes– surround the capillaries of the glomeruli; they look like big nuclei on the endothelial cells of the capillaries

36
Q

Connections/Continuations of Parietal layer?

A

connects with visceral layer as the VL leaves the capillary loops, and it continuous with lining of PCT.

37
Q

What type of cells are distributed among the capillaries of glomerulus? Their function?

A

Mesangial cells; They phagocytose debris trapped in the filtration apparatus, provide structural support, and secrete substances (IL-1 PDGF) for repair of the glomerulus.

38
Q

a) The three types of nephrons and b) how are they categorized?

A

b) They are categorized based on the locations of their RC’s in the cortex and the length of their Loops of Henle
a) Cortical nephrons (upper or middle cortex, have short L of H, usually doesnt extend into inner medulla); Juxtamedullary (close to the medullary boundary, long L of H that extends way down into inner medulla); Intermediate (intermediate L of H)

39
Q

Characteristic Features of cortical-medullary boundary? (2)

A

Where the RC’s end is the end of the cortex. Also the presence of arcuate arteries (in medulla?)

40
Q

Name the two subdivisions of the cortex and their components?

A
  1. Cortical Labyrinths: consist of RCs, PCTs, and DCTs

2. Medullary Rays: consist of aggregations of striaght tubules and CDs; lie between cortical labyrinth

41
Q

Cortical labyrinths and medullary rays are organized into what?

A

Lobules

42
Q

A single Lobule consists of what ?

A

A medullary ray and adjacent one-half labyrinths. A medullary ray sits in the center of each lobule.

43
Q

What marks the boundaries of a lobule?

A

Interlobular vessels

44
Q

T/F: the medulla has labyrinths or medullary rays.

A

False: the medulla has no labyrinths or medullary rays, only tubules and collecting ducts.

45
Q

What tubule segments can be found in the medulla?

A

The tubule segments that make up the Loop of Henle: proximal straight, thin limb, distal straight (PST and DST cannot be distinguished in the medulla)

46
Q

Percentage of Cardiac output received by kidneys? Specifically by the cortex?

A

25%; over 90% of that is to the cortex

47
Q

Describe the blood flow pattern in the kidney:

A

Renal Artery (carries blood to kidney)->Lobar Arteries-> Interlobar arteries-> Arcuate arteries (which arc around the borders of the papillae)-> Interlobular arteries-> Afferent arteriole -> glomeruli capillaries -> Efferent Arteriole-> Peritubular Capillaries-> venules and veins

48
Q

a) What carries blood to the kidney?

b) Arcuate arteries arc around the boundaries of what?

A

a) Renal Artery

b) Papillae

49
Q

What are boundary lines of lobules located midway between medullary rays?

A

Interlobular arteries

50
Q

Efferent arterioles give rise to?

A

2nd capillary bed–> the peritubular capillaries that surround tubules

51
Q

What gives rise to arteriole rectae of the medullary plexus (vasa recta)?

A

Efferent arterioles of Juxtamedullary glomeruli descend into the medulla to form these more elongated vessels around the medullary tubules.

52
Q

Which type of artery is located at the cortex-medullary border (just on the medulla side)?

A

Arcuate Artery

53
Q

What are the 3 principal activities of nephrons in producing urine?

A
  1. Filtration 2. Reabsorption 3. Secretion
54
Q

Where does filtration occur?

A

at the filtratio apparatus contained in the glomerulus of the renal corpuscle

55
Q

What does filtration create and where does it go next?

A

The filtered product is the ultrafiltrate (provisional urine) consisting of most everything from the blood except large proteins (albumin) and blood cells; It first enters the Urinary Space and then the PCT at the urinary pole

56
Q

the 2 kidneys filter how much blood each day?

A

125 mL/min aka 180L/day (40 gallons/day)

57
Q

The filtration apparatus consists of what three components?

A
  1. Fenestrated endothelium of the glomerular capillaries (more and larger pores than other capillaries in the body)
  2. Basement membrane of the capillaries
  3. Basment membrane of podocytes (visceral epithelial cells)
    Components 2 and 3 make up the GBM
58
Q

Glomerular endothelium contains what type of channels that allow fast movement of water thru the endothelium?

A

Aquaporin-1 water channels

59
Q

Which two components of the filtration apparatus make up the Glomerular basement membrane?

A

The thick GBM is a joint product of the endotheliem BM (basal lamina) and the Podocyte (visceral epithelium) BM (basal lamina)

60
Q

Podocyte processes form numerous secondary processes called __________ around __________?

A

pedicels (foot processes); the glomerulus (all the capillaries in the capillary loops)

61
Q

Describe the pedicels configuration/mechanism?

A

Pedicels from different podocytes interdigitate around the glomerulus.

62
Q

What are filtration slits?

A

the elongated spaces between interdigitated pedicels

63
Q

What is a filtration slit membrane/diaphragm?

A

a thin membrane that spans the filtration slits

64
Q

Glomerular endothelium vs endothelium of other capillaries in the bodies?

A

Glomerular endothelium has more numerous and larger fenestrations and prevents only large proteins and blood cells and other formed elements of the blood from being filtered

65
Q

Three layers of the GBM/GBL?

A
  1. Lamina Rara Externa- adjacent to pedicels, prevent movement of negative stuff
  2. Lamina Rara Interna– adjacent to capillary endothelium
  3. Lamina Densa–the overlapping portion of the two basal laminas
66
Q

FIltration barrier properties of GBM?

A

Selective based on charge and size (repels negative charge)
Neutral molecules less than 70K Da will pass.
Albumin excluded unless there is damage.

67
Q

What causes the GBM to repel negatively charge compounds?

A

Heparan sulfate and Sialic Acid

68
Q

Describe the GBL abnormality in Diabetes Mellitus:

A

BL is thicker than normal but leaky–> proteinuria and therefore, possible hypoalbuminemia–> low plasma oncotic pressure–>Edema

69
Q

Proteinuria, Hypoalbuminemia, and Edema together are called what?

A

Nephrotic Syndrome

70
Q

Reabsorption occurs where? Example substances? Where do they move?

A

Predominantly in the PCT and to a lesser extent in other tubules; most H2O and elctrolytes and all glucose are reabsorbed; move from tubule to interstitium and into peritubular capillaries

71
Q

Secretion occurs where? What’s secreted?Where do they move?

A

Secretion of most products (H, K, NH3, certain drugs) occurs in the distal part of the nephron (thin limb and distal tubules) and the CDs; they move from peritubular capillaries to interstium and then into provisional urine in the tubules and CD’s.

72
Q

As the ultrafiltrate journeys thru the nephrons and CD’s, reabs and secr are largely managed by what?

A

electrochemical gradients/reactions

73
Q

Components and Function of the Juxtaglomerular Apparatus?

A

consists of macula densa, JGM cells (on mostly afferent arterioles) and extraglomerular mesangial cells; regulates BP and Blood Volume

74
Q

What are the JGM cells?

A

specialized smooth muscle cells on afferent arterioles (and a few on eff arterioles)

75
Q

Describe Macula Densa?

A

distal tubule cells that contact aff arteriole (JGM cells) and are narrower, taller and much more crowded than adjacent (cuboidal) tubule cells

76
Q

Describe the interplay and function of MD cells and JGM cells:

A

MD cells monitor blood volume/delivery and Na+ concentration in the tubule. JGM cells contain granules of stored renin. When Na level or blood volume is low, MD cells sends a paracrine signal JGM cells to release renin which activates RAAS which restores/regulates Na and Bl Vol/hemodynamic homeostasis.

77
Q

Path of urine release from kidneys:

A

Minor to Major Calyces to Renal Pelvis to Ureters to Bladder (storage) and then urethra

78
Q

All excretory passage lumens except __________ are lined on the inner surface by _____________ epithelium.

A

lower part of urethra (stratified or pseudostratified columnar); transitional epithelium (can become thinner during distension)

79
Q

Ureter, bladder, and urethra all have a ________ covered on the outer surface by a __________.

A

mucosa (inner layer surrounding lumen); serosa

80
Q

Bladder: lumen lined with ________. Wall is smooth muscle arranged in _________.
Adventitia except __________.

A

transitional epithelium; an inner longitudinal layer, middle circle, and outer longitudinal layer; where superior surface has serosa

81
Q

Muscularis is thicker in _______ than _______.

A

Muscularis is thicker in bladder than ureter

82
Q

Ureter muscularis arrangement:

A

inner longitudinal layer, a middle circular layer, and only at the lower end of the ureter there is an outer longitudinal layer

83
Q

Regular __________ of the muscularis contribute to the flow of urine.

A

Peristaltic contractions

Renal Module (13 decks)

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