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Pelvis and Abdomen A&P > Kidney > Flashcards

Kidney Flashcards

1
Q

who has a longer urethra

A

males

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2
Q

role of the urethra

A

females: urination
males: reproduction and urination

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3
Q

location

A

either side of the VC, on the post abdominal wall
behind the peritoneum, below the diaphragm
T12 and L3
lies obliquely upper pole 2.5cm closest to the spine and lower poles 7.5cm away from the kidney
right kidney lies slightly lover due to the liver

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4
Q

left kidney relations

A

sup: left adrenal gland
ant: spleen, stomach, pancreas and jejunum, splenic flexure of colon
post: diaphragm, post abdominal wall

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5
Q

right kidney relations

A

sup: right adrenal gland
ant: right liver lobe, duodenum, hepatic flexure of colon
post: diaphragm, post abdominal wall

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6
Q

renal capsule

A

inner most layer
made of collagen fibres, maintains shape and aids protection

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7
Q

adipose capsule

A

surrounds the kidney
fat people have a thicker layer
helps attach the kidney posteriorly to the abdominal wall, protecting the kidney

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8
Q

renal fascia

A

composed of dense connective tissue, final attachment of the kidney to the abdominal wall
encloses the kidney and the renal fat

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9
Q

renal cortex

A

lies next to the capsule
reddish in colour, granular appearance

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10
Q

renal medulla

A

inner most layer found deep in the cortex, consists of 6-18 renal pyramids due to the CD in the nephron

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11
Q

renal cortex + medulla =

A

renal parenchyma
(functional part)

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12
Q

how many nephrons inside the kidney

A

1-2 million

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13
Q

where does CD transport urine

A

from the pyramids to the calyces

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14
Q

what are the CD supported by

A

connective tissue containing blood vessels, nerves and lymph vessels = diffusion of nutrients and waste

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15
Q

what does the nephron consist of

A

PCT, LoH, CD, DCT and glomerulus

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16
Q

what is the nephron

A

a tubule which is closed at one end that joins a CD at the other end
the closed end is indented to form a glomerular capsule, which almost encloses a network of capillaries
the CD unites forming larger ducts which empty into minor calyces

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17
Q

where does the renal artery enter

A

hilum

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18
Q

what happens to the renal artery

A

it divides into smaller arteries and arterioles, the afferent arteriole enters the casks and subdivides into smaller artery capillaries forming the glomerulus

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19
Q

what are the capillary loops

A

made up of connective tissue, phagocytic mesogial cells which are part of the monocyte macrophage system

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20
Q

describe the difference in arteriole in the glomerulus

A

the afferent is larger in diameter increasing the hydrostatic pressure, this then drives the filtration across the capillary walls
maintaining oxygen and nutrient and removes waste

efferent arteriole subdivides into the peritubular network allowing for the exchange of fluid and blood

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21
Q

what happens to the venous drainage at the glomerulus

A

leaves the kidney at the renal vein into the IVC

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22
Q

glomerulus and GC composed of

A

composed of single layer of flattened epithelium

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23
Q

what are renal blood vessels supplied by

A

sympathetic and parasympathetic
controls diameter and blood flow independent of auto-regulation

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24
Q

what is the hilum

A

entry and exit point for blood and lymph vessels, and ureters

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25
Q

what are the calyx walls and pelvis wall composed of

A

transitional epithelium with smooth muscle
peristalsis forces prune through the calyces renal pelvis and ureters into the bladder

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26
Q

where is urine stored

A

renal pelvis

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27
Q

describe the renal pyramids and calyces

A

minor calyx sits below the pyramid which collects urine from the CD
several minor mere into a major
with 2 or 3 major forming a renal pelvis, which narrow in shape as it leaves as the ureter
renal columns separate the pyramids
renal papillae is the pointed part of the pyramid as the nephron empties urine it goes into these structures

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28
Q

where does urine go

A

through the renal papilla at the pyramid apex into a minor calyx

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29
Q

how much cardiac output does a kidney recieve

A

1/4 or 20%

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30
Q

what renal artery is shorter

A

left
the aorta lies left of the midline

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31
Q

what renal vein is shorter

A

right
IVC sits on the RHS

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32
Q

what does the aorta give rise to

A

right and left renal arteries
renal veins merge into the hilum

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33
Q

what is nephritis

A

inflamed kidney

34
Q

what is the flow in lymphatics

A

follow the route of the renal vessels
renal hilar nodes -> para aortic nodes

35
Q

blood supply

A

AA -> L& R renal arteries -> afferent arteriole -> glomerulus -> efferent arteriole -> L&R renal veins -> IVC

36
Q

what do the ureters do

A

carry urine from the kidney to the urinary bladder
continuous with the renal pelvis, passes downed through the abdominal cavity behind the peritoneum and infront of the PSOAS muscle into the pelvic cavity
passes obliquely through the posterior wall of the bladder

37
Q

what happens as urine builds up

A

pressure increases, compressing the ureters and openings into the bladder are occluded, prevents back flow

38
Q

structure of the ureters

A

outer layer = fibrous tissue, continuous with the fibrous covering
middle muscle layer = smooth muscle fibres interlaced, additional longitudinal layer in the lower third
inner mucosa = transitional epithelium

39
Q

function of the ureters

A

smooth muscle creates peristalsis which propels urine along
these increase in frequency with the amount of urine produced

40
Q

what does low GFR impact

A

amount of water reabsorbed, accumulating waste

41
Q

chronic kidney failure

A

gradual loss of kidney function/ nephron activity
loss of nephrons = low GFR
causing high levels of blood, urea and nitrogen
causes: diabetes mellitus, glomerular nephritis and hypertension

42
Q

what is stage 1 of CKF

A

nephron loss is compensated for by the present nephrons, which become enlarged
75% can be compensated for
impact is only visible at stage 2

43
Q

stage 2 of CKF

A

renal insufficiency, no longer able to adore to keep BUN levels stable

44
Q

what is BUN

A

blood, urea, nitrogen

45
Q

stage 3 of CKF

A

uraemia (high urea) sharp increase causes death
CANT BE REVERSED ONLY MANAGED

46
Q

why does end renal failure occur

A

ph imbalance
function is lost
endocrine function is disrupted

47
Q

final stages cause

A

itching, vomiting, muscle twitching, seizures, drowsiness, coma

48
Q

kidney functions

A

urine formation
electrolyte balance
production and secretion of erythropoietin
water regulation
ph balance
maintenance of blood pressure

49
Q

juxtaglomerular apparatus

A

exocrine structure which produces renin, erthropeotin, regulating BP, Hb and volume
assists in the regulation of GFR
close to the afferent arteriole

50
Q

urine is composed of

A

water
ammonia, Na, K, Cl, phosphates, sulphates, oxalates
urea
uric acid

51
Q

what gives urine its colour

A

urobilin

52
Q

what reflects urines composition

A

exchange of substances, between the nephron and the blood in the renal capillaries
waste products of protein metabolism are excreted
water and electrolytes are reabsorbed through the excretion of H +

53
Q

what are the three processes within urine formation

A

filtration
selective reabsorption
tubular secretion

54
Q

glomerular filtration

A

occurs in the renal corpuscle (glomerulus and the BC)
the walls are porus which allows small molecules to pass through whilst plasma proteins remain in the capillaries. filtrate is high in solutes
filtrate has a similar composition to plasma apart fromthe plasma proteins and blood cells
filtration occurs due to the hydrostatic pressure difference, as the efferent is narrower it builds up the hydrostatic pressure

55
Q

structure of the capsule

A

blind ended podocytes hug the capsule, with the gaps allowing the filtrate through
single layer of flattened epithelium

56
Q

is filtration passive or active

A

passive process, which follows a negative pressure difference gradient

57
Q

GFR

A

volume of filtrate formed/ min
tells us how quickly the kidneys can process chemo
can be calculated by injecting a RS monitoring at regular intervals

58
Q

what is filtration controlled by

A
  1. renal auto regulation
    maintain GFR at a constant pressure
    operates independently to the NS, stimulated by pressure changes or fluctuating levels of metabolites
    diameter alters itself at the afferent (decrease blood flow = small diameter). If BP is too low auto regulation will stop
  2. neural regulation - stimulation of fibres causes vasoconstriction, reducing flow, less blood will decrease urine formation
    blood is directed to other regions of the body
59
Q

where does selective reabsorption occur

A

PCT

60
Q

describe the structure of the PCT and LoH

A

PCT = cuboidal cells and microvilli
LoH = after the descending limb it becomes squamous epithelium

61
Q

what are reabsorbed at the LoH

A

sodium so the filtrate at the CD is dilute
Na and Cl can be transported actively and passively

62
Q

where does most water reabsorption occur

A

CD

63
Q

what’s the transport maximum

A

maximum capacity for reabsorption of a substance
it takes into account the number of pumps

64
Q

hormones which influence SR

A

parathyroid
aldosterone
ADH
ANP

65
Q

parathyroid

A

secreted by the parathyroid gland
calcitonin regulates reabsorption of calcium and phosphate from the distal CD
parathyroid increases Ca
calcitonin decreases calcium levels

66
Q

ADH

A

secreted by the posterior pituitary gland, which increases permeability in the DCT and CD

67
Q

aldosterone

A

secreted by the adrenal cortex, which increases the reabsorption of Na and water, and excretion of K

68
Q

ANP

A

atrial natriuretic petide
secreted by the atria in response to stretching of the atrium, when the volume increase, reabsorption decrease of Na and water from the PCT and CD

69
Q

tubular secretion

A

mainly in the DCT
actively removes substances
cuboidal epithelium, lack of microvilli
secretion of H+ ions maintains normal blood pH

70
Q

water balance

A

osmoreceptors in the hypothalamus detect changes in the OP in blood, which causes the release of ADH
when OP is high, ADH increases reabsorption in the CD and DCT increases, OP decreases
when BV increases, ANP is released which lowers reabsorption of sodium and water in the CD and PT so more is excreted, low blood volume and reduced atrial stretching
high levels of ANP inhibits aldosterone and ADH

71
Q

what is electrolyte conc dependent on

A

water levels and electrolyte levels

72
Q

what is the most common extracellular cation

A

sodium

73
Q

what is the most common intracellular cation

A

potassium

74
Q

what does the renin-aldosterone system do for sodium and potassium

A

maintains the levels

75
Q

what juice is high is sodium

A

gastric

76
Q

what juice is high in potassium

A

pancreatic and intestinal

77
Q

renin-angiotensin-aldostrone system

A

aldosterone regulates sodium excretion, secrete by the adrenal cortex
cells in the afferent arteriole secrete renin in response to sympathetic stimulation, low BP or low BV
renin converts angiotensinogen to angiotensin 1
angiotensin converting enzymes converts angiotensin 1 to angiotensin 2 which is a vasoconstrictor increasing BP
renin and high potassium stimulates the adrenal gland to secrete aldosterone
reabsoprtion of water and sodium increases BV which reduces renin secretion
sodium reabsorption is high, potassium excretion is high reducing intracellular potassium

78
Q

pH balance

A

PCT secrete H+ into the filtrate, combines with buffers

H+ + HCO3 = H2CO3 (carbonic acid)
H+ + NH3 = NH4+
H+ + HPO3 + H2PO3

carbonic acid dissociates into carbon dioxide and water
carbon dioxide is reabsorbed maintaining the buffering system

79
Q

acute renal failure

A

sudden loss in function especially GF
can’t remove waste, can’t produce urine
obstruction
reduced renal flow (pre renal)
renal: damage to kidney
post renal: obstruction to outflow of urine
reduction in GFR and kidney function
oliguria and anuria accompanied by acidosis due to H+ retention, electrolyte balance and accumulation of nitrogenous waste

80
Q

signs and symptoms

A

dysuria - oliguria (reduced urine), anuria (no urine)
polyuria - large volumes of dilute urine
anaemia - reduced RBC shortness in breath, fatigue, dyspnoea, cardiac failure
high in creatinine
over hydration: water retention, decrease in appetite, confusion
acidosis: high urea therefore high potassium, pH and H+

Pelvis and Abdomen A&P (12 decks)

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