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Renal Exam 1 > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

What cells give rise to urogenital system, which creates our kidneys and genitelia,

A

Intermediate mesoderm.

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2
Q

What does the urogenital ridge consist of?

A
  1. Gonadal ridge–> where testes and ovaries form
  2. Nephrogenic cord–> makes nephron and duct collecting system
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3
Q

What does the mesonephric tubule give rise to?

A

Nephron

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4
Q

What are the three different kidneys that are produced during the production of the kidneys?

A

1st : Prenephros (non functional)

2nd: Mesonephros (functional)
3rd: Metanephros (true)

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5
Q

How big are the kidneys in the emrbyo?

A

they run the length of the embryo

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6
Q

1. Pronephros

A. When does it form and generate?

B. Where does it form?

C. What does it form?

A

A. Forms–> 4th week

  • Degenerates –> late 4th week.

B. Forms in cervical region

C. Forms the pronephric duct (which, extends to the cloaca) and the pronephric tubule.

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7
Q

2. Mesonephros

A. When does it form and when is it remodeled?

B. Where does it form?

C. What does it form?

A

A. Forms late 4th week and remains functional until the 11th week. Then, it is remodeled into genetilia for M and degenerates in F.

B. Cervical region

C.

  • Pronephric duct–>mesonephric duct, which extends to the cloacha.
  • Pronephric tubules degenerate and the mesonephric tubules form on the mesonephric duct, filtrating urine into the duct–> cloacha.
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8
Q

3. Metanephros

A. When does it form and degenerate?

B. Where does it form?

C. What does it form?

A

A. Begins to develop in the 5th week and it remains functional forever.

B. Metanephros has 2 components that grow in the pelvis

  • Uteric bud,
  • Metanephrogenic blastema
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9
Q

What are other names for the uteric bud?

A

1. Metanephric duct

2. Metanephric diverticulum

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10
Q

What are other names for the metanephrogenic blastema?

A

1. Metanephrogenic mass

2, Metanephrogenic cap

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11
Q

Nephrons are the functional unit of the kidney that consists of what?

A
  1. Glomerular capillaries, which came from the dorsal arota
  2. BC. which came from intermediate mesoderm
  3. Mesonephric tubules, which came from intermediate mesoderm
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12
Q

The nephron of mesonephros is the functional unit which consists of the glomeruli (from the dorsal aorta), bowmans capsule and mesonephric tubules which are from intermediate mesoderm.

The mesonephric duct does what?

A
  1. Induces nephrons in the adjacent nephrogenic cord.
  2. Mesonephric duct sends signals to the nephrogenic cord to form mesonephric vesicles.

A. Nephrogenic cord then send recipricol feedback to the duct.

–>B. Mesonephric vesicle elongatest to form a mesonephric tubule

–> C. Mesonephric tubule meets with the mesonephric duct

–> D. Mesonephric tubule continues to elongates and will will also surround the glomerulus, eventually forming the glomerular capsule.

—This creates and open system made up of: glomerular capsule + collecting system (mesonephric tubule) + mesonephric duct, allowing us to concentrate urine–> collect–> send to cloacha—-

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13
Q

When the glomerular capsule is forms when…

A

The mesonephric tubule has fully merged with the mesonephric duct,

forming an open-system to concentrate urine, collect and send to cloacha.

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14
Q

As we have said, the

metanephros = [uteric bud (metanephric duct) & metanephric blastema]

What are these two derived from?

A

Uretic bud (metanephric duct) and the metanephric blastema form in the pelvis.

Uteric bud–> grows from the mesonephric duct

Metanephric blastema–> derived from the nephrogenic cord

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15
Q

In the development of the metanephros (true kidney),

how do the ureteric bud and metanephric blastema interact?

A

Uretic bud will grow towards the metanephric blastema, forming the tubules of the kidney.

-formation of the tubules is controlled via recipricol feedback.

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16
Q

The ureteric bud gives rise to what from intermediate mesoderm? (5)

A
  1. ureter
  2. pelvis
  3. major calyces
  4. minor calyces
  5. collecting tubules
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17
Q

The metanephric blastema which is from the nephrogenic cord (intermediate mesoderm) forms what structures? (5)

A
  1. Renal vesicles
  2. bowman’s capsules
  3. proximal/distal convoluted tubules
  4. loop of henle
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18
Q

How do we develop the collecting system of the kidney?

A
  1. Uteric bud contacts metanephric blastema, creating the renal pelvis.
  2. Uteric bifurcates and the branches coalesce to form major calyces.
  3. 2nd generation of branching and coalesce occur again to form minor calyces.
  4. Branching and coalescing continue, to make the collecting ducts.
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19
Q

Now that the collecting ducts of the metanephros are made,

we need to make the nephrons. What do they originate as?

A

Nephrons orginate as a nephric vesicle, located wiithin the blastemic cap that surrounds the ampulla of the collecting duct.

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20
Q

How are the nephrons of the metanephros made?

A
  1. Collecting ducts will send signals to the metnephrogenic blastema to induce the formation of the nephric vesicle.
  2. NV elongates and then surrounds around the glomerulus, forming the bowmans capsule.
  3. Proximal end connect to the collecting duct forms the
  • Proximal convulted tubule
  • LoH
  • Distal convoluted tubule
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21
Q

Unilateral renal agenesis

  • Males more affected, and many times more the
  • Left kidney gone.
  • Other kidney hypertrophies and takes on the role for both. Thus, no sx.
  • What is looked for during an ultrasound at week 20?
A

when there is only one umbilical artery

22
Q

Bilateral renal agenesis

No kidney structures.

This could be mainly due to?

A

Oligohydramnios- lesser amnoitic fluid, causes lung hypoplasia.

20% of these cases are related to the Potter sequence (many other problems)

23
Q

What is the embryological mechanism is associated with bilateral renal agenesis?

A

The metanephros —

Ureteric bud didnt develop or it didnt get recipricol signal from blastema and then regressed

24
Q

What a duplex kidney and what is the embryological mechanism?

A

Duplex kidney is a double kidney with 2 ureters,

resulting from the abnormal division of the ureteric bud.

25
Q

While the metanephros is forming, the mesonephros is still there.

During the 9th week of fertilization what occurs?

A
  1. The metanephros accend into the adult position due to caudal growth of the embryo.
  2. As they are ascending, they rotate 90 degrees; causing the hilum to move from anterior–> towards aorta.
26
Q

What is the blood supply to the metanephros kidneys?

A

They get BS from whatever vessel is closest to them as they are ascending. Thus, the BV will continue to remodel until we form the renal vessels.

EX: pelvic area: common iliac aorta, once ascended

27
Q

Pelvic kidneys are ectopic kidney (not located in the right spot).

Why do pelvic kidneys occur? (one kidney is ascended correctly and the other is not)

A

the kidney does not ascend due to the cardinal vessels preventing it from ascending

28
Q

A horseshoe kidney is when the inferior poles of the kidneys fuse together, and when they try to ascend, they do not. Why holds the kidneys from acending?

A

The inferior mesenteric artery (IMA) off of the aorta to L3, which stops the kidney from migrating to L2

29
Q

Accesory renal vesels are vesels that come from aorta to the kidney (end arteries are the only vessel suppplying that certain tissue).

What is common problem associated with accessory renal vessels?

A

They commonly cross over the ureters to connect to the aorta which can compress the ureters causing an obstruction

30
Q

Cystic kidney disease and an AR disease where there are multiple small cysts in both kidneys due to a mutation in PKHD1.

What does this lead to?

A

renal insufficiency and 25% cases have lung hypoplasia which are both due to oligohydramnios

31
Q

Multicystic dysplastic kidney disease is due to cysts caused by dilations of the loop of henle, usually only affecting one kidney.

What occurs?

A

So people are asymptomatic, there are fewer cyst present compared to the other cystic disease.

Other kidney picks up the slack

32
Q

Where are the following derived from:

  1. Ureter
  2. Bladder
  3. Trigone
A
  1. Ureter- mesonephric and metanephric ducts
  2. Bladder- hindgut endoderm
  3. Trigone- mesoderm
33
Q

In the adult, where does the ureter come from?

A

ONLY THE METANEPHRIC DUCT (UTERIC BUD)

34
Q

How do we form the ureter and bladder?

A
  1. Ureteric bud grows out of the mesonephric duct
  2. Mesonephric duct is then incorporated into the posterior bladder wall.
  3. Ureteric bud becomes the adult ureter and inserts to the top of the posterior bladder wall.
  4. Rest of the bladder is made from hindgut endoderm, except the trigone.
35
Q

All of the bladder is made up of hindgut endoderm except for which region?

A

Trigone (incorportation of mesonephric duct into the bladder wall) is made up of mesoderm

36
Q

The bladder is from hindgut endoderm. The cloacal membrane is made of endo/ectoderm and will rupture. The cloacal membrane needs to be separated into? (2)

A

the urogential membrane and anal membrane via the urorectal septum

37
Q

The urorectal septum (MESODERM) does what when it migrates?

A

it separates the [urogenital system (above urorectal septum]) from the rectum (below),

forming the urogential membrane and anal membrane- both are endo/ectoderm

38
Q

The allantois is an extension of hindgut endoderm from the bladder

–> goes into umbilical cord–> becomes urachus which in the adult does?

A

it flattens out –> becomes the medial umbilical ligament (abdomen stuff)

**clinical problems**

39
Q

The urogenital sinus (bladder= hindgut endoderm) consists of 3 different regions, including?

A
  1. vesicle part
  2. pelvis part
  3. phallic part
40
Q

Vesicle part–> bladder

Pelvis part–> urethra in females and prosatic and membrabous urethra in M

Phallic part–> ?

A

lining of the vaginal vestibule in females

spongy urethra in males

41
Q

When the allantois does not flatten out to form the median umbilical ligament, a urachal fistula can form. What happens?

A

abnormal connection to the belly button, allowing urine to leak out of the belly button during urination

42
Q

A urachal cyst is when a portion of urachus is maintained and forms a cyst… how is it found?

A

usually causes no problems, found during autopsy

43
Q

A urachal sinus is when there is a deep belly button, with some pathology in men can cause?

A

pressure in bladder which can open it up and create a urachal fistula

44
Q

Exstrophy of the bladder (ectopic vesicae) is when the bladder is on the outside of the anterior abdominal wall. What would cause this to occur?

A

during week 4, bc mesoderm did not insert between endo and ectoderm, causding the anterior abdominal wallto not close

For bladder to close, we need a signal from that the abdominal wall did not close.

so bladder is open as well

45
Q

Epispadias is improper location of genital tubercles caudal to cloacal membrane.

Where would this opening be?

A

opening is on the dorsal side of the penis (remember erect penis is antatomical view) so top of penis when flaccid is gone **commonly seen with ectopic vesicae

46
Q

Suprarenal glands have three different parts including the medulla, capsule and cortex. The cortex is derived from?

A

coelomic epithelium (somatic mesoderm layer of lateral plate)

47
Q

How is the cortex formed?

A

CELLULAR WAVE: coelomic epithelium forms a fetal cortex during week 6

48
Q

The medulla is formed from nueral crest cells which migrate to?

A

the fetal cortex chromaffin system/cells which give rise to medulla

49
Q

There is then a second wave of ceolomic epithelium in the cortex which forms the ?

A

adult/definitive cortex

50
Q

The capsule surrounding the kidneyy comes from?

A

mesonephric mesoderm (intermediate mesoderm)

51
Q

The fetal cortex is a source of a variety of hormones including _____ (2) and dihydroepiandrosterone (estrogen precursor) which is needed for placental development and pregnancy

A

pituitary ACTH and glucocorticoids

Renal Exam 1 (10 decks)

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