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Renal I Midterm > Lecture 2: Kidney, Bladder, and Suprarenal Gland Embryo > Flashcards

Lecture 2: Kidney, Bladder, and Suprarenal Gland Embryo Flashcards

1
Q

3 separate kidneys develop, what are they called?

A

1) Pronephros
2) Mesonephros
3) Metanephros

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2
Q

In the Intermediate mesoderm, you have a structure in which the nephron and the duct system will form. What is this structure?

A

Nephrogenic cord

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3
Q

What embryological layer gives rise to the kidneys?

A

Intermediate mesoderm

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4
Q

What is the first kidney formed, when, and where in the body, when does it degenrate; is it functional?

A

Pronephros during the 4th week; forms in the neck/cervical region; degenerates late 4th week; never functional

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5
Q

What structures move down towards the cloaca in week 4?

A

Pronephric ducts

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6
Q

When does the Mesonephros appear and function; for how long is it functional?

A

Appears late in 4th week; serves as interim kidney for 1st trimester (urine production); functional until about 11 weeks.

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7
Q

Where does the Mesonephros form?

A

Thoracic and Lumbar region

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8
Q

What will the mesonephric tubule form?

A

Forms the actual nephronic unit that will concentrate urine.

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9
Q

When and where does the Metanephros form; significance?

A

Forms during 5th week in pelvic region and is the true kidney.

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10
Q

Where does the Metanephric duct come off of and eventually becomes?

A

Sprouts off the mesonephric duct (aka uteric bud) and eventually becomes the ureter

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11
Q

What is the embryological origin of the Glomeruli (capillaries), Bowman’s capsule, and Mesonephric tubules?

A

Glomeruli: Somatic lateral plate mesoderm; lateral segmental arteries

Bowman’s and Mesonephric tubules: Intermediate mesorderm

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12
Q

What induces nephrons to grow?

A

The mesonephric duct induces nephrons in adjacent nephrogenic cord to grow.

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13
Q

What is the major component of amniotic fluid?

A

Fetal urine

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14
Q

What 2 structures does the Metanephros give us and where are the derived from?

A

1) Uteric bud (metanephric duct): outgrowth from mesonephric duct
2) Metanephric blastema: derived from nephrogenic cord

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15
Q

What 5 structures form from the Uteric bud?

A

1) Ureter
2) Pelvis
3) Major calyces
4) Minor calyces
5) Collecting tubules

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16
Q

What 4 structures form from the Metanephric blastema?

A

1) Renal vesicles
2) Bowman’s capsule
3) Proximal and distal convoluted tubules
4) Loop of Henle

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17
Q

Describe the subsequent bifurcations in the development of the collecting system?

A
  • Uteric bud first contacts metanephric blastema and will give rise to renal pelvis
  • Uteric bud bifurcates and branches/come together to form major calyces
  • Branches will branch again and then combine to form the minor calyces
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18
Q

Nephron originates where and is surrounding what?

A

As a vesicle within the blastemic cap surrounding the ampulla of a collecting duct

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19
Q

What happens to the vesicle within the blastemic cap?

A

Elongates into a tube and the glomerulus forms at one end, tubule near the glomerulus will invaginate and form Bowman’s capsule

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20
Q

What occurs at the other end of tubule formed from the blastemic cap?

A

Lengthens and differentiates into the proximal convolute tubule, loop of henle, and the distal convoluted tubule

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21
Q

Explain unilateral renal agenesis; more common in; Dx??

A
  • Missing one kidney, affects males more than females, and typically the left kidney is missing.
  • Asymptomatic
  • Dx using US if you see ONE umbilical artery
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22
Q

Explain bilateral renal agenesis; associated with; Tx?.

A

No kidneys!

  • Associated with oligohydramnios, because fetal urine is not being produced and is the major component of amniotic fluid
  • These infants need dialysis and kidney transplant to survive
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23
Q

Embryologically how do we account for unilateral agenesis?

A

Ureteric bud did not form or it formed and then degenerated. Without ureteric bud we get no ureteric cord or mass.

24
Q

What’s duplex kidney and how does it occur embryologically?

A
  • Having 2 ureters

- Results from abnormal division of ureteric bud

25
Q

Renal agenesis is commonly seen in which patients?

A

20% of Potter sequence patients

26
Q

When do kidneys reach adult position and what occurs to get them there?

A
  • By 9th week
  • Ascent from caudal growth of embryo
  • Rotate 90 degrees during ascent
27
Q

Where do kidneys receive blood supply from during ascent; which arteries?

A

Vessels that are closest to them

  • In pelvis: Common iliac arteries

During ascent: Renal arteries from aorta

28
Q

What structure do the kidneys end their ascent by?

A

Suprarenal gland (aka adrenal glands)

29
Q

Why does a pelvic kidney (eptopic) not ascend?

A

Lattice network of blood vessels can trap the kidney and stop it from ascending. Kidney will still be functional.

30
Q

What’s a horseshoe kidney; can’t ascend why; stops at what level?

A
  • The inferior poles of each kidney are fused together

- Runs into Inferior Messenteric a. during ascent and stops around L3

31
Q

7% of individuals with Turner syndrome also have?

A

Horseshoe kidney

32
Q

What 2 problems can occur from accessory renal vessels (“end” arteries)?

A

1) Can cross/compress the ureter

2) Are “end” arteries so they are the only blood supply to a tissue. If they are obstructed or ligated you get necrosis.

33
Q

Discuss Autosomal Recessive Polycystic Kidney Disease.

Cause (genetically), what’s affected, associated with?

A
  • Mutation of PKHD1 gene
  • Both kidneys full of cysts
  • Renal insufficiency
  • 25% associated with pulmonary hypoplasia
34
Q

Discuss Multicystic dysplastic kidney disease

Cause, what’s affected

A
  • Usually only affects 75% of ONE kidney
  • Fewer cysts
  • Though that cysts are wide dilations of the Loop of Henle
35
Q

From where is the Ureter derived from?

A

Mesonephric and Metanephric ducts

36
Q

The bladder is derived from which ‘derm?

A

Hindgut endoderm (epithelial layer)

37
Q

Trigone is derived from which ‘derm?

A

Intermediate mesoderm

38
Q

The mesonephric duct gets incorporated where and becomes the?

A

Posterior bladder wall and forms the Trigone

39
Q

The cloacal membrane gets contributions from which ‘derm layers?

A

Ectoderm and Endoderm

40
Q

What derm layer is the Allantois from and what does it become?

A
  • Hindgut endoerm

- Allantois –> Urachus –> Median Umbilical L.

41
Q

The Urogenital Sinus is composed of what 3 regions?

A

1) Vesicle part: bladder
2) Pelvis Part
3) Phallic

42
Q

What does the Pelvis part of urogenital sinus become in females vs. males?

A

Females: Urethra

Males: Prostatic and Mebranous urethra

43
Q

What does the Phallic part of urogenital sinus become in females vs. males?

A

Females: Lining of the vestibule

Males: Spongy Urethra

44
Q

The Urorectal septum separates what into what?

A

Separates cloacal membrane into:

  • Urogenital membrane
  • Anal membrane
45
Q

What is a urachal fistula, symptoms?

A
  • Bladder is connected to the belly button (aka umbilicus)

- Sx: Urine leaking out of belly button

46
Q

What is a Urachal cyst?

A
  • A cysts of the median umbilical lig., usually patients won’t know they have
47
Q

What’s a Urachal sinus, what problems may arise?

A
  • Not quite a fistula, but is a really deep opening (deep belly button)
  • Men with prostate problems can sometimes have urinary retention which forces this open causing a urachal fistula
48
Q

What is Exstrophy of the bladder (aka extopic vesicase)?

Arises when, caused by, what’s exposed?

A
  • Arises during body folding (week 4)
  • Defective closure of ventral abdominal wall
  • Mucosa of posterior wall of bladder exposed
49
Q

What is Exstrophy of the bladder highly associated with?

A

Episadias - opening on dorsal surface of penis

50
Q

When Episadias occurs in isolation is a result of?

A

Improper location of genital tubercles caudal to cloacal membrane

51
Q

What is a patent urachus, cause?

A
  • Open channel between the bladder and the umbilicus (urachal fistula).
  • Failure of the allantois to produce median umbilical ligament
52
Q

What cells give rise to the medulla: chromaffin system?

A

Neural Crest Cells

53
Q

What derm layers gives rise to the capsule?

A

Mesoneprhic mesoderm (intermediate mesoderm)

54
Q

The cortex is comprised of what kind of epithelium from which derm layer?

A

Coelomic epithelium (somatic lateral plate mesoderm)

55
Q

What causes the first and second cellular waves and what is created

A

Coelomic epithelium (somatic lateral plate mesoderm) creates:

First wave: Fetal cortex

Second wave: Adult cortex

56
Q

Fetal cortex is important for producing?

A
  • Pituitary ACTH
  • Glucocorticoids
  • Dihydroepiandrosterone (estrogen precursor)
57
Q

What structure does the mesonephric duct form in adult?

A

Vas deferens - part of male genitalia

Renal I Midterm (8 decks)

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