Renal Flashcards
What three muscles are posterior to the kidneys?
Psoas major
Quadratus lumborum
Transversus abdominis
What three layers surround the kidney? (deep to superficial)
Renal capsule
Adipose capsule
Renal fascia
Where do the renal arteries arise?
From abdominal aorta, just inferior to the SMA
Between L1 and L2
What three arteries supply the adrenal glands?
Superior suprarenal artery
Middle suprarenal artery
Inferior suprarenal artery
Where do the superior suprarenal arteries branch from?
Inferior phrenic arteries
Where do the middle suprarenal arteries arise from?
Directly from abdominal aorta
Where do the inferior suprarenal arteries branch from?
Branches off renal arteries which pass upward to the adrenal glands
What hormones does the adrenal medulla release?
Adrenaline
Noradrenaline
What are the three zones of the adrenal cortex?
Zona glomerulosa
Zona fasciculata
Zona reticularis
Which zone secretes aldosterone?
Zona glomerulosa
What type of hormones, and name them, does the zone fasciculata secrete?
Glucocorticoids:
Cortisol
Corticosterone
What does the zone reticularis produce?
Testosterone
What haematopoietic growth factor do the kidneys produce?
Erythropoietin
Where is the juxtaglomerular apparatus?
Juxtaposition of distal convoluted tubule, squeezed between afferent and efferent arterioles
What do macula densa do?
Sense sodium concentration and tubular fluid flow in the tubular filtrate and feed back to the juxtaglomerular cells accordingly
What is the definition of haematuria?
Excretion of 3 or more RBCs per high powered field in freshly voided urine
What are the two types of haematuria?
Macroscopic (frank)
Microscopic
Name medical renal causes of haematuria.
Glomerulonephritis Autoimmune/vasculitis (SLE, Wegners) Genetic (sickle cell, polycystic kidneys) Infections (TB) Diabetes Amyloidosis
Name surgical renal and lower urinary tract causes of haematuria.
Tumours Calculi Trauma Benign prostatic hyperplasia Urethral stricture
What are the main risk factors associated with development of renal cell carcinomas?
Smoking Obesity Asbestos Unopposed oestrogen Chronic renal failure Some heavy metals
Name the main signs and symptoms of renal cell carcinoma.
Haematuria Costovertebral pain Palpable mass Weight loss Weakness Malaise
Where do transitional cell carcinomas arise from?
Anywhere between the renal pelvis and urethra, including ureter and bladder
What is the most common site of a TCC?
Bladder
In which group of people do TCCs usually arise?
Over 50s who smoke
What are the signs and symptoms of transitional cell carcinoma?
Painless haematuria
Irritating bladder symptoms, including frequency, urgency and dysuria
What is urolithiasis?
A calculi (kidney stone)
What is the first and second most common type of calculus?
Calcium oxalate and phosphate
Struvite
What is the most common infection that causes haematuria?
E. coli
What other infections can cause haematuria?
Enterococcus faecalis
Pseudomonas
Klebsiella species
What happens to water if you add an isotonic solution into the body?
Water remains in the extracellular spaces
Give an example of an isotonic solution.
Saline solution
What happens to water if you add a hypotonic solution to the body?
Water will move into the intracellular spaces
What happens to water if you add a hypertonic solution to the body?
Water will be drawn out of the intracellular spaces into the extracellular spaces
What is the difference in concentration of potassium ions between the intracellular and extracellular spaces?
Higher in intracellular spaces
Intracellular levels: 140mOsm
Extracellular levels: 4mOsm
What is the difference in concentration of sodium ions between the intracellular and extracellular spaces?
Relatively low concentration intracellularly
Intracellular levels: 10mOsm
Extracellular levels: 145mOsm
What controls renin secretion?
Intrarenal baroreceptors
Sympathetic input
Macula densa feedback
What does aldosterone do in the kidneys?
Promotes Na+ reabsorption and K+ excretion in the proximal tubule
What types of cells line the proximal convoluted tubule?
Simple cuboidal epithelial cells with prominent brush borders or microvilli
What type of cells line the descending limb and the thin ascending limb of the Loop of Henle?
Simple squamous epithelial cells
What type of cells line the thick ascending limb of the Loop of Henle?
Simple cuboidal to low columnar epithelial cells
What type of cells line the distal convoluted tubule?
Simple cuboidal epithelial cells
What type of cells line the last part of the distal convoluted tubule and the collecting duct?
Simple cuboidal epithelium consisting of principal cells and intercalated cells
What hormone determines the expression of sodium channels on the surface of principal cells in the collection duct?
Aldosterone
What hormone determines the expression of aquaporins on the surface of principal cells in the collecting duct?
Vasopressin (ADH)
What does parathyroid hormone stimulate in the early distal convoluted tubule?
Reabsorption of calcium ions
