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CPR > Renal Anatomy and Histology > Flashcards

Renal Anatomy and Histology Flashcards

1
Q

Ureter relation to testicular/ovarian arteries and common iliac

A

Ureter passes posterior to the testicular/ovarian arteries and anterior to the common iliac at its bifurcation into internal/external

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2
Q

Ureter in relation to uterus

A

Passes underneath the uterus

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3
Q

Right kidney vs left kidney location

A

Both located about T12-L3

Right kidney is lower because liver pushes it down

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4
Q

4 procedures the ureter could possibly be damaged

A

Pelvic dissection
Ligation of uterine vessels
Ligation of gonadal vessels
Dissection of bladder/vagina

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5
Q

Renal nutcracker syndrome

A

Superior mesenteric artery compresses the left renal vein while it passes underneath
Hematuria, proteinuria, nausea/vomiting, left sided varicocele

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6
Q

Blood supply from aorta through kidney and back to inferior vena cava

A

Aorta–>Renal artery–> Segmental artery–> interlobar artery–> arcuate artery–> cortical radiate artery–> afferent arteriole–> glomerulus–> efferent arteriole–> peritubular capillaries and vasa recta–>cortical radiate v–> arcuate v–> interlobar v–> renal v–> IVC

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7
Q

Sympathetic innervation to kidneys

A

Lesser and least splanchnic nerves
-Synapse in aorticorenal ganglia
Lumbar splanchnic nerves as well

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8
Q

Parasympathetic innervation to kidney

A

Vagus nerve

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9
Q

Urine forming and carrying units made of

A

Nephron - consists of renal corpuscle and renal tubules

-Juxtamedullary (in medulla) and cortical (in cortex) nephrons

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10
Q

Glomerulus endothelium

A

Fenestrated

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11
Q

Descending vs ascending vasa recta

A

Ascending is fenestrated

Descending is continuous endothelium

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12
Q

Mesangial cells

A

Structural support for glomerular loops
Phagocytic cells
Prevents glomerular distension due to high glomerular BP
Secrete growth factors and cytokines in response to injury

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13
Q

What indicates a damaged glomerular basement membrane

A

Albuminia- albumin in urine

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14
Q

What are the components of the filtration membrane

A

Glomerular fenestrations
Glomerular basement membrane
Podocyte foot processes

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15
Q

Parietal layer of bowmans is what type of epithelium

A

Simple squamous

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16
Q

Proximal convoluted tubule

A

Only in renal cortex
Most active tubule in resorption and secretion
Simple cuboidal–>simple columnar
Abundant microvilli and mitochondria

17
Q

Loop of henle thin descending segment

A

Simple squamous w/o brush border

Main function is water reabsorption

18
Q

Loop of henle ascending segment

A

Thick:
Simple cuboidal w/numerous microvilli
Impermeable to water
25% sodium reabsorption
Na/K/2Cl (NKCC2) cotransporter establishes the concentration gradient in the interstitium
Increase in K concentration in the cells causes back diffusion of K into the tubular lumen, allowing a lumen-positive electrical potential to drive reabsorption of cations (Mg, Ca) via the paracellular pathway
Thin:
Relatively impermeable to water, other ions/solutes

19
Q

Distal convoluted tubule

A

Only found in renal cortex
Simple cuboidal epi
Angiotensin II influences Na reabsorption
Impermeable to water
10% NaCl reabsorbed
Na/Cl cotransporters transport NaCl out of lumen
Ca reabsorbed by calcium channels regulated by PTH
Tubular fluid is diluted here

20
Q

Macula densa

A

Tight nuclei at distal end of thick ascending loop of henly
Monitors Na levels
Signal release of renin if Na is low

21
Q

Collecting tubules/ducts

A

Final urine osmolarity determined here by water reabsorption
Target of both ADH and aldosterone increasing water reabsorption and Na reabsorption, respectively
Lined with simple cuboidal epithelium, simple columnar at distal end
Several ducts join together to form larger papillary ducts that then drain into renal minor calyx

22
Q

Principal cells

A

Target of aldosterone

23
Q

Intercalated cells

A

Involved in H+ and bicarbonate transfer

24
Q

Cortex contains:

A

Renal corpuscles, convoluted and straight tubules of nephron, portions of collecting ducts

25
Q

Medulla contains

A

Renal columns and pyramids, loops of henle, collecting tubules

26
Q

Transitional epithelium- keeping barrier to urine

A

Contains umbrella cells in superficial layer which have urothelial plaques made up of largely uroplakin proteins
When bladder is distended, these plaques move to surface and form impermeable barrier to the hypertonic urine
When it is empty, these plaques are endocytosed and stored

27
Q

Bladder location

A

Anterior to uterus and rectum, sitting within pelvis

Can expand into abdomen when very full

28
Q

Female urethra length, UTI

A

It is shorter than male, therefore more susceptible to UTI

E. coli usually

29
Q

Male Prostatic vs membranous vs spongy urethra epithelium

A

Prostatic-Transitional
Membranous- pseudostratified/stratified columnar
Spongy urethra- pseudostratified/stratified columnar proximal, stratified squamous distally

30
Q

Female proximal vs intermediate and distal urethra epithelium

A

Proximal- transitional

Intermediat/distal- nonkeratinized stratified squamous

31
Q

Polycystic kidney disease

A

Cysts that form crush tissue and impede drainage
Eventually leads to kidney failure and BP dysregulation
Hypertension, renal hemorrhage, UTI
Dialysis or kidney transplant only options

32
Q

Schistosoma hematobium

A

Parasitic blood flukes
Genitourinary tract disease
Chronic infection can cause fibrosis and calcification of bladder
Risk for bladder cancer

33
Q

Proximal tubule reabsorption

A 
Active reabsorption
85% sodium bicarbonate
65% NaCl
65% K+
100% glucose and amino acids
Passive reabsorption
Water
Carbonic anhydrase highly active here
Na/K ATPase maintains low intracellular Na levels
This is where drugs such as diuretics, NSAIDs, Abx are secreted into the lumen from the blood
34
Q

Collecting tubule reabsorption

A

Epithelial Na channel ENaC
-responsible for 2-5% Na reabsorption which creates electrical gradient that facilitates K+ secretion down the concentration gradient
Most important area of K+ secretion by kidney
This is where diuretic-induced changes in K+ balance occur- more Na delivered to collecting tubule means more K+ secretion
Proton pumps increase urine acidity here *

35
Q

Aldosterone effect on collecting tubule

A

Increases the expression of ENaC and basolateral Na/K ATPase–>increases Na reabsorption and K+ secretion–> water retention and increase in blood volume and BP

36
Q

Where does ADH have its effect

A

On the collecting tubule
Controls permeability of tubule to water by regulating expression of aquaporin-2 channels
Alcohol inhibits ADH release

CPR (24 decks)

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