Renal Anatomy and Histology

Question 1

Kidney location

Answer 1

Retroperitoneal lying about T12-L3

Right kidney sits lower.

Question 2

Left hilum lies:

Answer 2

Near the transpyloric plane (right kidney’s superior lobe is near transpyloric plane).

Question 3

Posteriorly, the superior parts of the kidneys lie deep to:

Answer 3

The 11th and 12th ribs

Question 4

Renal tissue gets its blood supply from:

Answer 4

Segmental arteries

Question 5

Ureter gets its blood supply from:

Answer 5

A variety of sources en route (renal branches, gonadal branches, iliac branches, abdominal aorta branches, etc)

Question 6

Succession of renal blood supply (9)

Answer 6

Aorta
Renal a.
Segmental a.
Interlobar a.
Arcuate a.
Cortical radiate a.
Affarent arteriole
Glomerulus
Efferent arteriole

Question 7

Sympathetic innervation to the kidney

Answer 7

Via lesser splanchnic n. (T10-11) and least splanchnic n. (T12) synapsing at the aorticorenal ganglia.
Lumbar splanchnic ns. also play a role (L1-L2)

Question 8

What exists in the renal interstitium?

Answer 8

Fibroblasts producing EPO depending on O2 levels.

Question 9

Parietal layer and visceral layer of Bowman’s capsule:

Answer 9

P: simple squamous epithelium
V: consists of podocytes

Question 10

Vascular pole contains (2)

Answer 10

Afferent and efferent arterioles

Question 11

Urinary pole contains (1)

Answer 11

Origin of the proximal convoluted tubule

Question 12

Glomerular endothelium (4)

Answer 12

Has fenestrations.
Thick luminal glycocalyx.
Has lots of aquaporins.
Can generate NO and PGE2

Question 13

Function of podocytes

Answer 13

Regulate size, patency, and selectivity of filtration.

Question 14

GBM is composed of (4)

Answer 14

Type IV and XVII collagens, laminin, entactin, proteoglycans.

Question 15

What is albuminia and what does it indicate?

Answer 15

Urine albumin.

Damage to GBM.

Question 16

Roles of mesangial cells

Answer 16

Support podocytes.
Phagocytic - removes debris, aggregates, etc.
Can control glomerular filtraion rate.
Secretes growth factors and cytokines.
Can proliferate in certain diseases.

Question 17

PCT

Answer 17

In renal cortex.
Most active tubule in resorption and secretion.
Simple cuboidal and columnar epithelium.
Abundant mito.

Question 18

Proximal straight tubule

Answer 18

Not as tall as the PCT with worse-developed brush border.

Has SGLT1’s.

Question 19

Loop of Henle

Answer 19

Loops into the medulla and back to the cortex.
Thin end has simple squamous and thick end has simple cuboidal w/ microvilli.
Sets up hyperosmotic gradient.

Question 20

DCT

Answer 20

Confined to cortex.

Lined with simple cuboidal epithelium.

Question 21

Angiotensin II affects which cells?

Answer 21

Influences Na+ resorption in the DCT

Question 22

Collecting ducts

Answer 22

Receive primitive urine from nephrons.
Has both simple cuboidal and simple columnar epithelium.
Functions to resorb water.

Question 23

What is the target of ADH and aldosterone?

Answer 23

Collecting tubules/ducts

Question 24

Light cells (principal cells) of the collecting tubules/duct

Answer 24

Target of aldosterone

Question 25

Dark cells (intercalated cells) of the collecting tubules/duct

Answer 25

Involved in H+ and bicarb transport.

Question 26

Peritubular capillaries

Answer 26

Arise from efferent arterioles and surround convoluted tubules. Lined with fenestrated epithelium.
Can re-uptake H2O and salts.

Question 27

Vasa recta

Answer 27

Run alongside LoH as part of the collecting system.

Have continuous endothelium when descending and fenestrated endothelium when ascending.

Question 28

Juxtaglomerular cells

Answer 28

Mechanosensory cells

Secrete renin if BP is low.

Question 29

Macula densa

Answer 29

Acts as a chemoreceptor by monitoring salts. Can signal the release of renin from JGCs if Na is low.

Question 30

Renin release causes (3)

Answer 30

Increase in Na retention, BV and BP

Question 31

Function of:
Superficial layer
Intermediate layer
Basal layer

Answer 31

Stretch
Slide
Stem cells

Question 32

Fusiform vesicles

Answer 32

Fuse with PM when cell is distended.

Question 33

Urothelial plaques

Answer 33

Form impermeable barrier via uroplakin proteins

Question 34

3 muscular layers of the ureter

Answer 34

Inner longitudinal layer
Outer circular layer
Outer longitudinal layer

Question 35

Composition of epithelium in the urethra (3)

Answer 35

Transitional epithelium at the origin
Psuedostratified columnar for the majority of the urethra
Stratified squamous at the very distal end

Question 36

Polycystic kidney disease

Answer 36

Auto dominant
Cysts form that impede drainage and can lead to kidney failure and poor regulation of BP and infections.
Asymptomatic at first (usually see signs at 30-40)
Dialysis and transplant only main options.