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Renal Anatomy > Kidney > Flashcards

Kidney Flashcards

1
Q

Where is the kidney located?

A

Retroperitoneally in the abdominal cavity against the posterior abdominal wall

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2
Q

Where does the left kidney lie?

A

T12 to L3

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3
Q

Where does the right kidney lie and why?

A

Slightly lower than left kidney due to position of liver

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4
Q

What lies superiorly to the kidneys?

A

Adrenal glands

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5
Q

What are the 4 layers of connective tissue surrounding the kidneys?

A
  1. Renal capsule
  2. Perirenal fat
  3. Renal fascia
  4. Pararenal fat

From deep to superficial

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6
Q

What is the clinical significance of fascial coverings?

A

TNM classification for renal cell carcinoma

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7
Q

What does the parenchyma contain?

A

Cortex -> Renal Column -> Renal pyramid
Medulla -> Renal pyramid -> Base + Renal papilla

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8
Q

What does 1 lobe of kidney contain?

A

1 pyramid and overlying cortex

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9
Q

Name the functional unit

A

Nephron

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10
Q

What are the 2 components of the nephron?

A
  1. Renal corpuscle
  2. Renal tubule
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11
Q

What does the renal corpuscle contain?

A

Glomerulus, glomerular capsule (Bowman’s capsule)

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12
Q

Bowman’s space is continuous with the ____ of renal tubule at the tubular pole

A

Bowman’s space is continuous with the lumen of renal tubule at the tubular pole

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13
Q

What are the layers of the Bowman’s capsule?

A

Parietal and Visceral layer

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14
Q

What does the parietal layer of the Bowman’s capsule contain?

A
  • Basement membrane
  • Squamous epithelium
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15
Q

What does the visceral layer of the Bowman’s capsule contain?

A
  • Podocytes
  • Basement membrane
  • Squamous epithelium
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16
Q

What is the 3-layer filtration membrane of the renal corpuscle?

A
  1. Filtration pores of capillary
  2. Basement membrane
  3. Filtration silt (final barrier to proteins)
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17
Q

Outline the filtration flow chart in the renal corpuscle

A

Plasma > Filtration pores of capillary > Basement membrane > Filtration silt > Capsular space > PCT

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18
Q

What does the renal tubule contain?

A
  • PCT
  • Nephrone loop/Loop of Henle
  • DCT
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19
Q

What are the cells of PCT?

A

Simple cuboidal epithelial cells with brush border

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20
Q

What is the main function of PCT?

A

Reabsorption from renal tubule to peritubular capillaries
- 65% filtered H2O
- Na+, K+, Mg2+, Cl-, PO4 3-
- 100% glucose, amino acids, plasma protein

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21
Q

Function of thin descending limb of Loop of Henle

A

Water reabsorbtion

Has squamous cells

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22
Q

Function of thick descending limb of Loop of Henle

A

Secrete solutes into interstitium via active transport

Has squamous cells

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23
Q

What are the cells of DCT?

A

Cuboidal epithelium, no brush border

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24
Q

What is the main function of DCT?

A

Secretion of substances from peritubular capillaries into renal tubule
- K+, H+, HCO3-
- Toxins (urea, uric acid, drugs)

25
Q

What hormone works at DCT?

A

Aldosterone
- Enhance Na+ reabsorption from DCT
- Promotes H2O retention
- Increase blood volume and pressure

26
Q

What hormone works at the collecting duct?

A

Antidiuretic hormone
- Increase H2O retention by principal cells
- Prevent dehydration

27
Q

What are the 3 functions of the collecting duct?

A
  1. Absorption of H2O and Na+
  2. Regulate acid-base balance
  3. Drain urine from renal papilla into minor calyx
28
Q

What are the 2 types of cuboidal cells in the collecting duct?

A
  1. Principal cells
  2. Intercalated cells
29
Q

Collecting ducts from multiple nephrones converge to form ____ ducts and then the renal ____

A

Collecting ducts from multiple nephrones converge to form papillary ducts and then the renal papilla

30
Q

Structures of hilum from anterior to posterior

A
  • Renal Vein
  • Renal Artery (first and second branches)
  • Ureter
  • Renal Artery (third branch)
31
Q

What are the other structures that passes through the hilum?

A
  • Lymphatic vessels
  • Sympathetic nerves
32
Q

Renal Pyramids

Renal ____ extends into renal ____ , dividing it into triangular-shaped renal pyramids

A

Renal cortex extends into renal medulla, dividing it into triangular-shaped renal pyramids

33
Q

What is the apex of the renal pyramid called?

A

Renal papilla

34
Q

Describe the flow of urine

A

Renal pyramids -> Renal papilla -> Minor Calyx -> Major Calyx -> Renal pelvis -> Ureter

35
Q

Function of minor calyx

A

Collects urine from renal pyramids

36
Q

What does the renal arteries arise from?

A

Directly from abdominal aorta (L2), immediately distal to origin of superior mesenteric artery (L1)

37
Q

Right or left renal artery longer?

38
Q

Where does the right renal artery cross?

A

Posterior to inferior vena cava

39
Q

Where does the renal vein leave?

A

Leaves the renal hilum anterior to renal arteries, just below origin of superior mesenteric artery (L1)

40
Q

Where does renal vein drain into?

A

Directly into inferior vena cava

41
Q

Right or left renal vein longer?

42
Q

Where does left renal vein cross?

A

Anterior to abdominal aorta

43
Q

Left ____ vein and left ____ vein drains to left renal vein -> IVC

A

Left suprarenal vein and left gonadal vein drains to left renal vein -> IVC

44
Q

Right ____ vein and right ____ vein drains directly into ____

A

Right suprarenal vein and right gonadal vein drains directly into IVC

45
Q

What happens in varicocele?

A

Veins of the pampiniform plexus are elongated and dilated

46
Q

Which side does varicocele occur most commonly at?

A

Left side as left testicular vein joins left renal vein which has higher venous pressure

47
Q

What are the 2 divisions that the renal artery divides into at the renal hilum?

A
  1. Anterior - 75% of blood supply
  2. Posterior - 25% of blood supply
48
Q

What are the 5 segmental branches of the renal artery?

A
  1. Apical
  2. Anterior superior
  3. Anterior inferior (middle)
  4. Inferior
  5. Posterior segmental
49
Q

Are renal artery branches anatomical end arteries?

50
Q

Outline the renal portal system

A

Afferent arteriole > Glomerulus > Efferent Arteriole > Peritubular capillaries > Venule

51
Q

What is the triangle zone of JGA formed by?

A

DCT, afferent and efferent arteriole

52
Q

What are the 3 types of cells in JGA?

A
  1. Macula densa
  2. Juxtaglomerular cells
  3. Mesangial cells
53
Q

Where is the Macula Densa cells located?

A

Initial portion of DCT in between afferent and efferent arterioles

54
Q

Function of macula densa cells

A

Na+ sensor and induces JG cells to produce renin

55
Q

Function of juxtaglomerular cells

A

Dilate or constrict arterioles

56
Q

Function of mesangial cells

A

Regulate blood flow through glomerulus

57
Q

What does renal pain presents as?

A

Flank pain that radiates to the lower abdomen

58
Q

What does renal pain result from?

A
  • Stretching of kidney capsule
  • Spasm of smooth muscle in the renal pelvis
59
Q

How does the renal pain come about? (Spinal cord)

A

Afferent nerve fibers pass through renal plexus around renal artery and ascend to spinal cord through least splanchnic nerve in thorax (T12) and sympathetic trunk > Enter spinal cord at T12

Pain is referred along distribution of subcostal nerve (T12) to the flank and anterior abdominal wall

Renal Anatomy (3 decks)

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