Renal Anatomy/Physiology Flashcards
What limits the ascent of a horseshoe kidney?
Inferior Mesenteric Artery
What space do the kidney’s occupy?
Retroperitoneal
At what level do the kidney’s lie?
Left kidney - T12-L2
Right kidney - L1-L3 (lower down do to liver)
Layers of fascia surrounding kidney
Kidney capsule –> perirenal fat –> renal fascia –> pararenal fat
What is the arterial blood supply of the kidneys?
5 renal arteries –> interlobar artery –> arcuate artery –> interlobular arteries
How does the Left Renal Vein differ from the Right Renal Vein?
Left Renal Vein is longer, and receives left gonadal and left suprarenal veins
What is the positioning of vessels at the kidney hilum?
Vein anterior to artery anterior to ureter
Where are the lymphatic plexuses of the kidney located?
In the kidney, under the fibrous capsule, and in perirenal fat
What supplies the parasympathetic tone to the kidney?
Vagus nerve, CN X, vasodilation
What are the three areas of constriction of the ureters?
- Ureteropelvic junction
- Iliac vessels
- Ureterovesical junction
Characteristics of an epithelial cell
Polarized
Stable Adhesions
Arranged in layers
Characteristics of a mesenchymal cell
Undifferentiated, Unpolarized
Transient adhesions
Mobile
What is the function of the urinary system prenatally?
Maintaining amniotic fluid
What is oligohydramnios?
Lack of amniotic fluid
(Can impair growth and cause lung problems
Which germ layer later becomes the kidneys and ureter?
Intermediate mesoderm
What are the three nephric structures that from from the intermediate mesoderm (in order)?
Pronephros –> Mesonephros –> Metanephros
What is an aberrant location for an un-ascended kidney?
Pelvic kidney
Which arteriole of the renal corpuscle has the larger diameter?
Afferent arteriole
What is the function of mesangial cells?
Filtration, support, phagocytosis
Which cells make up the filter of the glomerulus?
Fenestrations of the endothelial cells
Basal Lamina of glomerulus
Slit membrane formed by foot processes of podocytes
What are the two types of nephrons?
- Cortical nephron
2. Juxtaglomerular nephron
What cells secrete renin?
Juxtaglomerular
What part of the nephron abuts the efferent and afferent arterioles?
Distal convoluted tubule
Where is the macula densa?
Distal convoluted tubule
Where are the juxtaglomerular cells?
Smooth muscle cells of the afferent arteriole
What are renin’s actions at the level of the nephron?
Increase blood pressure and GFR
What epithelium lines the ureter?
Transitional
What muscle lines the urinary bladder?
Detrusor muscle
Which kidney is easier to palpate?
Right
Are there anastomoses in the kidney?
No
Describe the flood flow within the kidney
Renal artery –> segmental artery –> interlobar artery –> arcuate artery –> interlobular artery –> afferent arteriole –> glomerular capillary –> efferent arteriole –> peritubular capillary/vasa recta –> interlobular vein –> arcuate vein –> interlobar vein –> renal vein
What is the sympathetic tone to the kidneys?
T10 –> L1
What is the region of referred pain of the kidney?
T10 (umbilicus) to L1 (superpubic)
What is the region of referred pain of the ureter?
T11 to L2
What is the region of referred pain of the bladder?
L1 to L2
What is the treatment for kidney stones?
Extracorporeal shock wave lithotripsy
How do kidney transplants usually occur?
Transplant left kidney to right pelvis
What is the function of the proximal convoluted tubule?
Bulk transporter of most things
What is the function of the loop of henle?
Creation of interstitial concentration gradient and important in urine concentration and water reabsorption
What is the function of the distal tubule?
Sodium reabsorption
What is the function of the collecting duct?
Fine tuning of fluid balance, electrolytes, acid/base balance
