lecture 1 Flashcards
the kidney lie according to the peritoneum
retroperitoneal
Upper pole of the kidney lies opposite
T12
Lower pole of the kidney lies opposite
L3
Hilum of the kidney lies opposite
L1 vertebra or transpyloric plane
The hilum transmits, from the front
backward ————— in addition to ———-
Renal vein, renal artery, ureter
Lymph vessels and
sympathetic fibers
During respiration, both kidneys move ———- in a ———— as much as ———-
downward in a vertical direction as much as 1 in (2.5 cm)
The right kidney is slightly———- than the left, because of ————
lower
the large size of the right
lobe of the liver
The long axis of each kidney is directed
downwards and laterally (the upper poles
are slightly nearer midline than the lower
poles)
Upper pole ————- cm from the MIDLINE
2.5
The hilum ———— cm from the MIDLINE
5
Lower pole ———– cm from the MIDLINE
7.5
The kidney is surrounded by a delicate fibrous capsule called the
renal capsule
renal capsule is surrounded by
Perirenal fat
Renal fascia
Pararenal fat
Pararenal fat forms part of the
retroperitoneal fat
Renal fascia is a —————- it continues with ————
Condensation of Connective tissue
continue laterally with transversalis fascia
Anterior relations of RIGHT kidney
(4 structures)
1- suprarenal gland - upper pole
2- liver - 3/4 surface below suprarenal gland
3- 2nd (descending) part of duodenum - medial border
4- right colic (hepatic) flexure
Anterior relations of LEFT kidney
(6 structures)
1- suprarenal gland - upper pole medially extending on medial border to the hilum
2- spleen - lateral half of the anterior surface
3- pancreas and splenic vessels - central quadrilateral area
4- stomach - triangular region, between suprarenal + splenic + pancreatic areas (1+2+3)
5- left colic flexure and the beginning of the descending colon - Below the pancreatic and splenic areas, a narrow lateral strip
6- jejunum - extensive medial area
Posterior relations of the kidneys
3 MUSCLES : (medial -> lateral)
psoas major
quadratus lumborum
transversus abdominis
3 NERVES : (superior->inferior)
subcostal (T12)
iliohypogastric (L1)
ilioinguinal (L1)
2 LIGAMENTS :
medial + lateral arcuate ligament
- subcostal vessels
- diaphragm
RIBS:
right - 12 rib
left - 11+12 ribs
the cortex looks
pale and granular
The medulla is composed of
12 - 20 conical masses termed the renal pyramids,
the renal papilla projects ——— into the interior of ———-
medially
minor calyx
Renal pyramids are separated by
renal (cortical) column
The region of the cortex between the bases of the pyramids and fibrous capsule are called
the cortical arches or cortical lobules
the renal sinus is ———-
devoid of renal tissue
The renal sinus is occupied by the
renal pelvis (the dilated upper part of ureter)
Renal pelvis is divided into ————–, each of which divides into ———— Each of them receives ————
(With the numbers)
2-3 major calyces
2-3 minor calyces
1-3 renal papillae
the filtration barrier that separates urinary
space and blood in the capillaries
the thick basement membrane btw the podocytes and the endothelial cells
the type of the endothelial cells of glomerular capillaries are
fenestrated capillaries
The glomeruli are composed of arterial capillaries in which hydrostatic pressure about ———- which is (lower/higher) than that found in other capillaries
4.5 mm Hg
higher
Particles greater than ——— in diameter do not readily pass through the basal lamina
10 nm
characteristics of mesangial cells
- contractile
- have receptors for angiotensin 2
- receptors for natriuretic factor produce by cardiac atria cells
what is the effect of angiotensin 2 on glomerular flow
reduce it
what is the effect of natriuretic peptide
vasodilator and relaxes The mesangial cells, probably increasing the blood flow and the effective surface area
available for filtration
Proximal convoluted tubule are lined by
simple cuboidal or low columnar epithelium
each transverse section of a proximal tubule contains
3-5 spherical nuclei only
juxtaglomerular complex or apparatus of the kidney is made of
juxta glomerular cells and macula densa
a sample was taken from a tissue showed, The luminal border of these cells has abundant microvilli, which form a brush border from which type of tubules are they
Proximal convoluted tubule
these tubules are found in the cortex
proximal and distal convoluted tubules
the thin segments of henl’s loop are lined with
simple squamous epithelium whose nuclei bulge into the lumen
collecting tubule originate in
cortical medullary rays
The collecting tubules are lined with
simple cuboidal epithelium
The collecting ducts are lined with
simple columnar epithelium
collecting tubules and ducts are composed of cells that stain
weakly with usual dyes
renal artery lies opposite
L2
renal artery divides into ——— that are positioned ———
5 segmental artery
4 in front and one behind the renal pelvis
renal artery divides into -> ——– -> ———- ->———
(Mention the numbers)
segmental arteries (5) -> lobar arteries one for each renal pyramid -> 2-3 interlobar arteries (run through the renal column btw the renal pyramids)
interlobar artereis give -> ———-
arcuate arteries (btw cortex and medulla) -> interlobular arteries (ascend in the cortex )
A renal lobule is
group of nephrons that open into branches of the same collecting duct
The afferent glomerular arteries arise as branches of the
interlobular arteries
The efferent arterioles divide to form the
peritubular capillaries
supply the tubular portions of the nephron in the renal medulla
Extending from some efferent arterioles are long loop shaped capillaries called vasa recta
Lymphatic Drainage of the kidney
Lateral aortic lymph nodes
Nerve Supply of Kidneys + afferent and the level they enter the spinal cord
through the renal sympathetic plexus -> The lowest splanchnic nerve (preganglionic sympathetic fiber) from T12 -> celiac ganglia ->Postganglionic sympathetic fibers enter the renal plexus
Visceral afferent fibers that travel through
the renal plexus enter the spinal cord in the
T 10 11 and 12 spinal nerves
pain in the kidney is felt in
the flank and the anterior abdominal wall
