Renal Anatomy and Histology - Brauer Flashcards
Transpyloric Plane
L1 or spinous process of T12
superior to left hilum
through right kidney superior pole
inferior pole of the right kidney
one index finger width from the superior iliac crest
ureter travels how
out from hilum
over the common iliac, beginning of external iliac
into bladder
common constriction points on the ureter
where stones can form more
1. uretopelvic junction (just leaving hilum)
2 over the common/ beginning of external iliac
3. uretovesical junction (entrance to bladder)
Renal Blood supply in order to Glomerular capillaries
- Aorta
- Renal A
- Segmental A
- Interlobar A (between pyramids in cortex)
- Arcuate A
- Interlobular A (ascending to branch)
- AFFERENT ARTERIOLE
- Glomerular capillaries
Renal Blood supply in order from Glomerular capillaries
- Glomerular Capillaries
- EFFERNT ARTERIOLE
- PERITUBULAR CAPILLARIES
- VASA RECTA
- interlobular veins
- arcuate veins
- interlobar vein
- Renal vein
- IVC
Kindney nerve supply
PARA and SYMPA
SYMPA: AORTICORENAL GANLION * (T10- T12), lesser and least splanchnic nerves
PARA: CN10
Cortex has what structures
- Renal Corpuscles (glomerulus)
- Convoluted tubule
- Straight tubule
- CD
Medulla has what structures
- renal columns and pyramids
Cortical (Medullary) rays
CDs and straight tubules running in the cortex
Renal intertitium
fibroblasts making erythropoietin (based on O2 levels)
uriniferous tubule
carries urine
NEPHRON + CD in the medullary ray
nephron consists of
renal corpuscle (glomerulus) renal tubules
cortical and medullary CDs are what
final urine collectors
Glomerular capillary is like what
- fenestrated and truly open pores (no diaphragm covering it)
- AQP-1 aquaporins
- secrete NO and PGE
- Glycocaylx
Bowman’ scapsule layers
- Parietal simple squamous
- visceral layer (podocytes) on top of the capillaries
- glomerular space = ultrafiltrate
glomerular filtration 3 layers
- Glomerular capillary endothelium
- 3 layes of BM
- Podocytes
Podocytes are like what
filtration slits that are sensitive to charge and size (40mn)
has NEPHRIN* (charge selection)
Glomerular BM has what important things
selective for charge and size (70mn) also
heparin sulfate
X ALBUMIN or CELLS
between the parietal layer and the visceral later of the renal corpuscle is what
the glomerular space = urine collects
Mesangial cells location
renal corpuscle
near vascular stalk
(also some in the JG apparatus)
Mesangial cells in certain kidney diseases
proliferate into a bulge (can happen in uncontrolled diabetes)
mesagium
mesangial cells and ECM
Meangial cells function
- phagocytosis
- support
- secrete IL1, PGE, PDGF
- CONTRACTILE based on BP (regulate glomerular distention
how much is reabsorbed in proximal convoluted tubule
65% (120L/day)
proximal convoluted tubule histology
simple cuboidal —-> simple columnar
BRUSH BOARDER
proximal convoluted tubule function
- Na/K/ATPase
reabsorb Na+, Cl-, H2O - AQP-1 : also H2O
- sGLT2 : reabsorb sugars, aa, that could have passed, high capacity, low affinity
Proximal Straight Tubule
function
THICK decsending limb of loop of henle
Shorter
has sGLT1 : low capacity, high affinity for Na+
= NA reabsorption
descending thin loop of henle
HIGH H2O REABSORPTION
X Na and urea permeability
= concentrates urine
ascending thin loop of henle
NA and CL REABSORPTION (out from urine
X H2O permeability
thin LOH histology
simple squamous with NO BRUSH BOARDER or microvilli,
nuclei bulge into lumen
Distal Straight Tubule
Histology
THICK part of ascending LOH
simple cuboidal with some microvilli NOT visible
Distal Straight Tubule
function
NA+, Cl, K+ REABSORPTION (out from urine)
X H2O permeability
nucleus bulges into lumen
Distal Convoluted Tubule
Histology
simple cuboidal with NO cilia
NA + , HCO-3 REABORPTION
K, NH+4 SECRETION (into urine)
Distal Convoluted Tubule
function
Aldosterone : changes reabsorption amount of NA and H2O
Collecting Duct
histology
CORTICAL : simple squamous –> simple cuboidal
MEDUALLRY : simple cuboidal –> simple columnar
* you can see cell boundaries on histology slides*
Collecting Duct
2 cell types
- Light cells (PRINCIPAL) : single cilium, ADH target–> AQP2
- Dark cells (intercalated) : a-intercalated = secrete H+
B-intercalated = secrete HCO-3 (into urine)
Collecting Duct major function
reabsorb H2) with aldosterone and ADH regulation
Peritubular capillaries
around convoluted tubules
REASBSORB H2O and NA
has fenestrations
Vasa Recta capillaries
around LOH
descending one = continuous
ascending one = fenestrated
Histology of bladder and proximal urethra
Transitional epithelium
= umbrella an dome shaped : empty
= flat to accomodate distention : full
transitional epithelium has 3 layers
what are they and function
- Superficial : stretching
- Intermediate : sliding
- Basal : stem cells
what prevents urine to get into the cells in the bladder
the plasma membrane has plaques = UROPLAKIN proteins that they secrete to prevent the diffusion
(in fusiform vesicles)
gives rigid and thicker surface
ureter is what type of hitology
lumin = transitional epithelium
SM (3 layers)
outer = adipose
3 layers of SM of ureter
- inner long
- middle circ
- outer long
urine reflux is prevented by what
- Bladder distetion = compresses ureter opening
- SM contraction of bladder wall = compresses ureter opening
- Ureter enters bladder obliquely: compress ureter opening
urinary bladder has 2 types of SM what are they and function
- DETRUSOR muscle = contraction of bladder to squeeze out urine
- Internal urethral sphincter : around internal urethra orifice (INVOLUNTARY control)
what is the voluntary control to let pee out
external urethral sphincter
striated muscle
urethral histology
- Transitional : proximal
- Psudostratified columnar : majority and middle
- stratified squamous : distal end
female urethra
shorter
posterior to clitoris
male urethra 3 parts and type of histology
- prostatic : transitional (where ejaculatory and prostatic duct enter)
- Membranous : psudostratified columnar (1cm long + has external sphincter**)
- Penile spongy : psudostratified columnar—-> strat squamous (15cm, through the penis, urethral glands, erectile tissue)
Polycystic Kidney Disease
autosomal dominant (ADPKD) intrarenal cysts over time develop = damage and crush normal renal tissue = Kidney failure, HTN or hypotension (BP problems), increased UTI asymptomatic until average of 30 -40 years