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Renal 1 > Renal Anatomy & Histology > Flashcards

Renal Anatomy & Histology Flashcards

1
Q

Organs of the urinary system and function

A

kidneys, ureters, urinary bladder, and
urethra

Kidneys filter metabolic waste products and toxins from the bloodstream and convert the filtrate into urine; important
role in BP regulation

The ureters, urinary bladder, and
urethra make up the urinary tract
because they store and transport the urine out of the body

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2
Q

Characteristics of Anterior Aspect (location, size, what does it contain)

A

Retroperitoneal lying about T12-L3 levels

Lower on right

Suprarenal gland above

Size—10 cm long, 5 cm wide, & 2 cm thick

Renal hilum—entrance to renal sinus (area in kidney where BV, renal pelvis, nerves are locate)

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3
Q

Characteristics of Posterior Aspects (plane , what does it contain)

A

Left hilum near transpyloric plane (—5 cm from median plane)

Transpyloric plane runs through superior pole of right kidney (—2.5 cm lower than left)

Posteriorly, superior parts lie deep to 11th and 12th ribs

Inferior pole of right kidney is approximately index fingers breath superior to iliac crest

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4
Q

Renal Fat (3)

A

1) Perinephric fat-adjacent kidney
- extends into renal hilum and pelvis

2) Renal fascia— covers fat enveloping kidney and suprarenal gland
- blends and sheaths renal vessels
- superiorly continuous with inferior diaphragmatic fascia
3) Paranephric fat—external to renal fascia

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5
Q

internal anatomy of kidney (9)

A

1) Capsule—dense irregular CT on surface with inner layer of myofibroblasts
2) Renal cortex—outer portion containing renal corpuscles
3) Renal medulla—collection of renal pyramids and columns
4) Renal pyramids—cone-shaped masses in the medulla projecting into calyx
5) Renal columns—tissue lying between pyramids running from cortex to the calyx
6) Renal lobes—single pyramids plus surrounding adjacent cortex
7) Renal pelvis—collecting funnel for urine
8) Renal calyxes—out-pocketings of the renal pelvis
9) Renal papillae- projections of medullary pyramids apices into calyxes

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6
Q

Renal artery (1) and Ureter branches (6)

A

Renal arteries
• Segmental arteries

Ureter

1) Renal branches
2) Gonadal branches
3) abdominal aorta branches
4) Iliac branches
5) Superior vesicular branches
6) Pelvic branches- rectal, uterine, vaginal, inferior vesicular

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7
Q

Path of renal blood supply

A

aorta-> renal artery-> segmental artery-> interlobar artery -> arcuate artery-> cortical radiate artery-> afferent arteriole-> glomerulus (capillaries)-> efferent arteriole-> peritubular capillaries and vasa recta-> cortical radiate vein-> arcuate vein-> interlobar vein-> renal vein-> inferior vena cava

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8
Q

Renal nerve plexus (innervation)

A

Sympathetic: aorticorenal ganglia

  • Lesser Splanchnic (T10-T11)
  • Least Splanchnic ( T12)
  • Lumbar splanchnic ( L1-L2)

Parasympathetic
- vagus n

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9
Q

What is Urine Carrying Unit made up of? (2)

A

1) Nephron (urine forming unit)- renal corpuscle and renal tubule
2) cortical and medullar collecting ducts- final concentration of urine

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10
Q

Renal Tubular Structures (12)

A 
Bowman's capsule
Proximal convoluted tubule
Proximal straight tubule
Thin loop of Henle (x2)
Thick ascending loop of Henle
Macula densa location 
Distal Convoluted Tubule
Collecting Tubule
Collecting Duct- Cortical
Collecting duct- Medullary 
Papillary Duct
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11
Q

What does the cortex contain?

A

renal corpuscles
convoluted tubules
Straight tubules
portions of collecting ducts

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12
Q

What does medulla contain?

A

renal pyramids ( cone-shaped masses)

Renal columns

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13
Q

What are cortical (medullary) rays? and what do they contain?

A

aggregation of collecting ducts and straight tubules

runs between renal corpuscle and convoluted tubules within cortex

axis of renal lobule

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14
Q

What is renal interstitium?

A

Fibroblasts that produce erythropoietin depending on O2 levels

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15
Q

Renal Corpuscle components ( 2 , layers)

A

1) Glomerulus
- capillaries (tuft)
- fenestrated with truly open pores
- afferent and efferent arterioles

2) Glomerular capsule (Bowmans)
- parietal layer- simple squamous
- visceral layer- podocytes
- glomerular space- primary filtrate

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16
Q

Poles of renal corpuscle (2)

A

Vascular pole

  • afferent arteriole
  • efferent arteriole

Urinary pole
- origin of proximal convoluted tubule

17
Q

Glomerular Endothelium characteristics (4)

A
  • truly open fenestrations
  • thick luminal glycocalyx
  • lots of aquaporin water channels
  • can generate Nitric oxide and PGE2 ( via angiotensin II)
18
Q

podocytes characteristics (4)

A

visceral layer of Bowman’s

  • forms part of filtration barrier
  • single layer of cells having foot-like process (pedicels) that interdigitate to make filtration-like slits

-slits important for regulating size, patency, and selectivity of filtration

19
Q

Filtration Membrane ( location, functions, layers (4))

A
  • lies between blood and capsular space

FXN:

  • restricts passage of blood cells, immunoglobulins and large proteins
  • allows passage of water, ions, glucose, amino acids, urea
  • one quart passes through per 8 mins ( ~45 gallons per day) but 1 gallon excreted per day

plasma

1) capillary endothelium
2) basement membrane
3) foot processes of glomerular capsule
4) slit diaphragm

20
Q

Glomerular Basement (content, barriers)

A
  • Type IV and XVIII collagen, laminin, entactin, proteoglycans
  • physical barrier- <70kd passes through
  • chemical barrier - strong anti-anionic characteristics
  • albuminia: urine albumin will show damaged GBM
21
Q

Mesangial cells function (5)

A

FXN:

1) support glomerular loops and ECM of podocytes
2) control glomerular filtration rate
3) prevent glomerular distension ( contractile) due to high glomerular BO
4) secrete growth factors and cytokines in response to injury
5) phagocytic- removing cellular debris and protein aggregates

22
Q

Proximal Convoluted Tubule

location, tissue, content

A
  • in renal cortex
  • most abundant and active tubule in resorption and secretion
  • simple cuboidal/columnar
  • lots of microvilli and mitochondria
  • basal and lateral cell membranes
  • increase SA
  • Na/K Atpase pumps and aquaporins
  • Glucose transporters (sGLT2) and amino acid transporters
23
Q

Proximal Straight Tubule

A
  • less well-developed brush border

- high affinity sodium-glucose cotransporter (sGLT1)

24
Q

Loop of Henle (path, tissue, function) for thin and thick

A

Path- down into medulla, up into cortex, terminates near vascular pole

Thin

  • simple squamous
  • no brush border
  • some nuclei bulge into lumen

Thick

  • simple cuboidal
  • microvilli
  • no brush border

FXN:
- set up hyper osmotic gradient to draw water back into tubule

25
Q

distal convoluted tubule (location, tissue, hormone)

A
  • cortex
  • from macula densa of thick ascending Loop of Henle portion
  • simple cuboidal epithelium
  • little microvilli
  • smooth luminal surface
  • cells taller than Thick ascending LOH
  • Angiotensin II influences Na+ resorption
26
Q

Collecting duct ( tissue, location, function (2), cell types (2), hormone)

A
  • simple cuboidal (some simple columnar)
  • through cortex into deep medulla
  • form larger papillary ducts that then drain into renal minor calyx

FXN:

1) water reabsorption
2) receive primitive urine from several nephron

  • final urine osmolality determined by resorbing H2O
  • individual cells of duct epithelium can be detected

Cell Types

1) Light/Principal cells- target for aldosterone
2) Dark/Intercalated cells- involved H+ and bicarbonate transport

Hormones

  • target of both ADH and aldosterone
  • increasing Na+ reabsorption and water retention
27
Q

Types of Capillary Beds (3)

A

1) Glomerulus- high to low pressure gradient ( afferent arterioles drained by efferent arterioles)

2) Peritubular capillaries
- from efferent arterioles
- surround convoluted tubules
- lined with fenestrated endothelium
- reuptake of H2O and salts

3) Vasa Recta
- thin-walled vessels
- arise from efferent arterioles of juxtamedullary glomeruli
- fenestrated in ASCENDING only
- run alongside loop of Henle
- part of urine concentrating system

28
Q

Juxtaglomerular Apparatus (components (2))

A

1) Juxtaglomerular cells - mechanosensory
- secrete renin if BP is low

2) Macula Densa
- distal end of thick ascending LOH
- acts as chemoreceptor (monitor salt levels)
- signal release of renin from juxtaglomerular cells if sodium is low

29
Q

Function of Renin

A

Increase sodium retention, blood volume, and blood pressure

30
Q

Transitional Epithelium (location, layers, content)

A
  • lines urinary tract

Layers

1) superficial- stretched and relaxed
2) intermediate- sliding layer
3) basal- stem cell (epithelial)

Fusiform vesicle

  • fuse with plasma membrane when cell is distended
  • endocytosed when nondistended

Urothelial plaque

  • form impermeable barrier
  • uroplakin proteins
31
Q

Ureters (location, function, tissue, layer)

A
  • long fibromuscular tube
  • carry urine from kidney to bladder
  • renal pelvis-> bladder
  • goes oblique to prevent backflow of urine
  • transitional epithelium

Muscularis ( 3 layers)

1) inner longitudinal layer
2) outer circular layer
3) outer longitudinal layer

Adventitia
- typical connective tissue

32
Q

Urinary Bladder ( characteristic, function, location, content)

A
  • muscular sac
  • posterior to pubis
  • anterior to uterus/rectus
  • expands into abdominal cavity while empty bladder lies entirely within pelvis
  • store and expel urine

Trigone

  • inferior/posterior wall
  • ureter and urethra open

Bladder wall

  • transitional epithelium
  • 3 layer thick smooth muscle (detrusor muscle)
  • fibrous adventitia
33
Q

Urethra ( General function, tissue)

A
  • connect bladder with exterior

Epithelium depends on location

  • Transitional epithelium- near bladder near origin (proximal)
  • Pseudo stratified columnar- majority of Urethra
  • Stratified Squamous Epithelium- at distal end
34
Q

female urethra (length, path, components (3), function)

A

size: 3-5 cm

external urethral orifice (female perineum)

1) Membranous urethra- through urogenital diaphragm
2) Internal urethral sphincter- INVOLUNTARY SMOOTH muscle, part of bladder wall
3) external urethral sphincter- VOLUNTARY SKELETAL muscle inhibit urination , part of pelvic floor

Function

  • restrict release of urine until pressure in urinary bladder is high enough
  • voluntary activity to release urine
35
Q

Male Urethra ( size, function (2), regions (3))

A

size: 20cm in length

function

1) transport urine
2) transport semen

Regions

1) Prostatic urethra- passes through prostate gland
2) Membranous urethra- through urogenital diaphragm ( same in female)
3) spongy (penile) urethra
- passes length of penis
- encased in cylindrical erectile tissue (corpus spongiosum) in penis to reach external urethral oriface

36
Q

polycystic kidney disease

A

Autosomal Dominant

Cysts form
- crush tissue and impede drainage

  • kidney failure/ infection
  • BP mis-regulation
  • asymptomatic
  • first seen at 30-40 yr

Tx:

  • major diet change
  • kidney transplant
  • dialysis

Renal 1 (8 decks)

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