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Clinical Microscopy > Renal Anatomy & Physiology > Flashcards

Renal Anatomy & Physiology Flashcards

1
Q

functional unit of the kidney

A

nephron

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2
Q

kidney’s location

A

12th thoracic vertebrae &
3rd lumbar vertebrae

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3
Q

Which kidney is situated higher? (Left or right)

A

left kidney

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4
Q

main excretory organ responsible for urine formation

A

kidney

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5
Q

liver conjugates ___ to convert it into water soluble

A

B1 (bilirubin monoglucuronide)

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6
Q
  • funnel like structure
  • collects all nephron
  • calculi (stones) formation
A

renal pelvis

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7
Q

connects the kidneys to the urinary bladder

A

ureter

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8
Q

stores urine and is sterile

A

urinary bladder

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9
Q

passageway out of urine

A

urethra

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10
Q
  • biggest cell
  • lower origin
  • block relevant structures
A

Squamous epithelial cells

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11
Q
  • caudale
  • upper origin
  • more common with catheterized specimens
A

Transitional Epithelial cells/Urothelial cells

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12
Q
  • found in the nephron
    • collecting duct
    • distal convoluted tubule
    • proximal covoluted tubule
    • loop of Henle
  • tubular necrosis
A

Renal Tubular Epithelial cells

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13
Q

Identify the apperance of RTEs in the following:

  • collecting duct:
  • distal convoluted tubule:
  • proximal convoluted tubule:
A
  • collecting duct: cuboidal
  • distal convoluted tubule: round
  • proximal convoluted tubule: cast-like/rectangular
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14
Q

Give the 2 types of nephrons

A
  1. Cortical nephrons
  2. Juxtamedullary nephrons
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15
Q

Which nephron is located in the kdiney’s cortex?

A

Cortical nephrons

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16
Q

Cortical or Juxtamedullar nephron?

  • removes waste products
A

Cortical nephron

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17
Q

Cortical or Juxtamedullar nephron?

  • urine/renal concentration
A

Juxtamedullary

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18
Q

Cortical or Juxtamedullar nephron?

  • reabsorbs nutrients
A

Cortical nephron

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19
Q

Give 2 renal functions

A
  1. clearing waste products from blood
  2. water & electrolyte balance maintenance
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20
Q

It carries blood from the heart

A

renal artery

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21
Q

It takes blood away from the kidneys.
It carry blood filtered by the kidney.

A

renal vein

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22
Q

It carries unfiltered blood.

A

renal artery

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23
Q

kidneys receive _____ of blood via the heart

A

20-25%

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24
Q

Complete the ff:

  1. blood enters nephron’s capillaries via ___(1)___.
  2. flows through ___(2)___ and into __(3)___
  3. before returning to renal vein, blood enter __(4)__ & __(5)__
  4. flows slowly through the __(6)__ & __(7)___.
A
  1. blood enters nephron’s capillaries via afferent arteriole
  2. flows through glomerulus and into efferent arteriole
  3. before returning to renal vein, blood enter peritubular capillaries & vasa recta
  4. flows slowly through the kidney’s cortex & medulla
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25
Q

lower the efferent arteriole size,
___ glomerular capillary pressure

A

increases

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26
Q

unfiltered blood passageway

A

afferent arterioles

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27
Q

receives filtered blood

A

efferent arterioles

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28
Q
  • provide immediate reabsorption of essential substances
  • passage of substances from blood to tubular filtrate (secretion)
A

peritubular capillaries

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29
Q

surround proximal & distal convoluted tubules

A

peritubular capillaries

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30
Q

adjacent to ascending & descending loops of Henle

A

vasa recta

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31
Q
  • maintains osmotic gradient (salt concentration) in medulla
  • necessary for renal concentration
A

vasa recta

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32
Q

It is the volume of blood delivered to the kidneys per unit time

A

Total Renal Blood Flow (TRBF)

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33
Q

It is a measurement for the exact amount of blood flowing through the kidney

A

Effective Renal Plasma Flow

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34
Q

1st process in urine formation

A

Glomerular filtration

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35
Q

plasma substances’ non-selective filter

A

glomerulus

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36
Q

glomerulus’ walls are known as

A

glomerular filtration barrier

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37
Q

Where is the glomerulus located?

A

Bowman’s capsule

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38
Q

What factors affect the actual filtration?

*There are four infuences

A
  1. Bowman’s capsule & capillary walls’ cellular structure
  2. hydrostatic pressure
  3. oncotic pressure
  4. RAAS
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39
Q

inflammation of the kidney’s filters

A

glomerulonephritis

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40
Q

What are the 3 glomerular filtration barrier that plasma filtrate must pass?

A
  1. capillary endothelial fenestrations
  2. basal lamina/basement membrane
  3. podocyte
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41
Q

capillary wall’s endothelial cells contain ____

A

fenestrated pores

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42
Q

pores increase

A

capillary permeability

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43
Q

True or False

Glomerulus’ cellular structure has barrier which repels molecule with a (+) charge such as albumin.

Shielf of negativity

A

True

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44
Q

In when hydrostatic pressure, filtration enhances through:

A

In when hydrostatic pressure, filtration enhances through:

  • smaller efferent arterioles
  • smaller glomerular capillaries

*glomerular capillary pressure will increase

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45
Q

maintains glomerular capillary’s pressure consistency

A

hydrostatic pressure

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46
Q

overcomes opposition pressures from Bowman’s capsule fluid & unfiltered plasma proteins’ oncotic pressure

A

hydrostatic pressure

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47
Q

Given that blood pressure drops, what will the arterioles do to prevent decreased blood flow

A

dilate afferent

constrict efferent

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48
Q

Given that blood pressure rises, arterioles will do what to prevent overfiltration/glomerulus damage

A

constrict afferent

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49
Q

regulates blood flow to and within the glomerulus

A

Renin-Angiotensin-Aldosterone System (RAAS)

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50
Q

responds to blood pressure & plasma sodium content changes

A

Renin-Angiotensin-Aldosterone System (RAAS)

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51
Q

justamedullary apparatus consists of?

A

juxtamedullary cells & macula densa

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52
Q
  • enzyme produced by juxtaglomerular cells
  • secreted and reacts with blood-borne substrate angiotensinogen
A

renin

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53
Q

Explain RAAS’ chemical reaction

A

renin + angiotensinogen → alveoli: angiotensin I (angiotensin-converting enzyme) → angiotensin II

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54
Q 
aldosterone:
antidiuretic hormone (ADH):
A 
aldosterone: **_adrenal cortex_**
antidiuretic hormone (ADH): **_hypothalamus_**
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55
Q

filtrate’s specific gravity (plasma ultrafiltrate)

A

1.010

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56
Q

filtrate & plasma difference

A

plasma protein absence

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57
Q

Active or Passive:

substance + carrier protein

A

active transport

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58
Q

Active or Passive

gradients/physical difference

A

passive transport

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59
Q

Active or Passive:

renal tubular epithelial cells

A

active trasnport

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60
Q

In active transport, these substances are reabsorbed:
*There are 5 substances.

A
  1. glucose: p. CT
  2. amino acids: p. CT
  3. salts: p. CT
  4. chloride (Cl): a. Henle
  5. sodium (Na): p & d CTs
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61
Q

In passive transport, molecules move across a membrane as a result of differencen in:

A
  • concentration
  • electrical potential
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62
Q

Passive transport absorbs what substances?

*There are 3 substances.

A
  1. water: all nephron parts except ascending loop
  2. urea: proximal CT & ascending loop
  3. sodium (Na): ascending loop
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63
Q

Renal concentration begins in?

A

ascending & descending loops of Henle

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64
Q

Tubular Concentration

  • descending loop of Henle:
  • ascending loop of Henle:
A
  • descending loop of Henle: water is removed
  • ascending loop of Henle: NaCl is reabsorbed
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65
Q
  • selective reabsorption
  • maintains osmotic gradient of medulla
  • Na & Cl leaving the filtrate in the ascending loop prevent dilution of medullary interstitium by water reabsorbed from descending loop
A

countercurrent mechanism

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66
Q

collecting duct receives ____ of urine

A

1 mL/min

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67
Q
  • anouria:
  • oliguria:
  • polyuria:
A
  • anouria: no urine release (heart disease and blockage)
  • oliguria: little amount of urine (≤ 400 mL) is release (hydration)
  • polyuria: excessive urination (x > 2500 mL)
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68
Q

ADH is determined by

A

body’s hydration

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69
Q

↓ body hydration:

  • __ ADH
  • __ permeability
  • __ H2O reabsorption
  • __ urine volume
A

↓ body hydration:

  • ↑ ADH
  • ↑ permeability
  • ↑ H2O reabsorption
  • ↓ urine volume
70
Q

↑ body hydration:

  • __ ADH
  • __ permeability
  • __ H2O reabsorption
  • __ urine volume
A

↑ body hydration:

  • ↓ ADH
  • ↓ permeability
  • ↑ urine volume
71
Q
  • eliminate waste products not filtered by the glomerulus
  • regulate acid-base balance through hydrogen ion secretion
A

tubular secretion

72
Q

major removal site of non-filtered substances

A

proximal convoluted tubule

73
Q

True or False

cellular respiration creates CO2 and makes urine acidic

74
Q

Which process is indicated below?

glomerular filtration barrier

A

Glomerular filtration

75
Q

Which process is indicated below?

glomerulus cellular structure

A

glomerular filtration

76
Q

Which process is indicated below?

hydrostatic pressure

A

glomerular filtration

77
Q

Which process is indicated below?

RAAS

A

glomerular filtration

78
Q

Which process is indicated below?

active & passive transports

A

tubular reabsorption

79
Q

Which process is indicated below?

countercurrent mechanism

A

tubular reabsorption

80
Q

Which process is indicated below?

collecting duct concentration

A

tubular reabsorption

81
Q

Which process is indicated below?

tubular/renal concentration

A

reabsorption

82
Q

Give the 3 different urine formation processes

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
83
Q

crystals found in urine

A

crystalluria

84
Q

Types of Urine Specimens

routing screening only

A

random specimen

85
Q

Types of Urine Specimens

  • routine screening
  • pregnancy tests
A

first morning specimen

86
Q

Types of Urine Specimens

  • orthostatic proteinuria
  • ideal screening specimen
A

first morning specimen

87
Q

Types of Urine Specimens

quantitative chemical tests

A

24-hour (or timed)

88
Q

Types of Urine Specimens

  • bacterial culture
  • specimen is forwarded first to Bacteriology section before urinalysis
A

catheterized specimen

89
Q

Types of Urine Specimens

  • routine screening
  • bacterial culture
  • alternative to catheterized specimen
A

Midstream clean-catch specimen

90
Q

Types of Urine Specimens

bladder urine for bacterial culture

A

suprapubic specimen

91
Q

Types of Urine Specimens

cytology

A

aspiration

92
Q

Types of Urine Specimens

prostatic infection

A

three-glass collection

93
Q

contains solutes that affect the movement of water

A

interstitial space/interstitium

94
Q
  • represents the plasma portion (55%) of the TRBF
  • 55% of 1200 mL = 660 mL
  • usually 600-700 mL/min
A

Effective Renal Plasma Flow

95
Q
  • represents the 45% of 1200 mL = 540 mL
A

Packed Cell Volume

96
Q

What is the Gomerular Filtration rate?
*reference value

A

120-125 mL/min

97
Q
  • releases ultrafiltrate
    • cell-free filtrate
    • protein-free
A

glomerulus

98
Q
  • positive pressure which promotes blood filtration
  • pressure coming from water
A

hydrostatic pressure

99
Q
  • negative pressure coming from the proteins in the blood
  • counteracts hydrostatic pressure
A

oncotic pressure

100
Q

receives newly formed filtrate

A

Bowman’s capsule

101
Q

filtrate passes to series of renal tubules

A

tubular reabsorption

102
Q

movement of essential substances out of the tubule
and returns them to the blood for them to be used
once more

A

reabsorption

103
Q
  • 15% of reabsorption partakes in this region
  • hairpin-like appearance
A

loop of Henle

104
Q

transverses the medullary interstitium

A

descending loop of Henle

105
Q

membrane is impermeable to water

A

ascending loop of Henle

106
Q
  • remaining 19% of the filtrate is reabsorbed
  • far from glomerulus
A

distal convoluted tubule

107
Q

inflammation of the bladder

108
Q

Urine is slightly acidic due to the presence of more ____.

109
Q

Tubular Secretion

  • Kidney maintains the blood pH ____
  • ___ & ___ are secreted to prevent blood from becoming acidic
A
  • pH 7.35-7.45
  • H+ & CO2
110
Q

ERPF’s 55% of 1200 mL range

A

600-700 mL/min

111
Q

normal urine excreted per day

A

1200-1500 mL/day

112
Q

In glomerular filtration, what pressure is needed to form a filtrate?

113
Q

Identify which part contributed to the ff:

65% reabsorption:
15% reabsorption:
19% reabsorption:

A

65% reabsorption: proximal convoluted tubule
15% reabsorption: loop of Henle
19% reabsorption: distal convoluted tubule

114
Q

glucose’s renal threshold range

A

160-180 mg/dL

115
Q

What is the 1st filtration mechanism?

A

size exclusion
(capillary endothelial fenestrations)

116
Q

What is the 2nd filtration mechanism?

A

charge exclusion
(basement membrane)

117
Q

What is the 3rd filtration mechanism?

A

size & charge exclusion

118
Q

term used for spaces in between the endothelial cells

A

fenestrations

119
Q

It prevents RBCs & proteins from passing through

A

capillary endothelial fenestrations

120
Q

term used for WBCs who are capable of passing through intact capillary walls and into surrounding tissue

A

diapedesis

121
Q

protein of interest

122
Q

It is the primary filter

A

basement membrane

123
Q

Goodpasture Syndrome is also known as?

A

Anti-glomerular basement membrane disease

124
Q

Antibody that attaches to the GBM and forms a complex

A

Anti-GBM antibody

125
Q

contains foot processes

126
Q

lipid nephrosis is also known as?

A

Minimal change disease

127
Q

Minimal change disease can cause?
*There are three.

A
  • edema
  • heavy proteinuria
  • transient hematuria
128
Q

Minimal change disease’s HLA-B12 stands for? It responds well to?

A

Human leukocyte antigen-B12
responds to corticosteroids

129
Q

What is ultrafiltrate’s pH & specific gravity?

A

pH: 7.4
SG: 1.010

130
Q

isosmotic with plasma (300 mOsm/L)

A

ultrafiltrate

131
Q

__(1)__ & __(2)__ are not reabsorbed throughout the renal tubule when passing through the glomerulus

132
Q

True or False

RBCs are hyposthenuric

A

False

*RBCs are isosthenuric.

133
Q

hyposthenuria’s SG & urine condition

A

< 1.010 SG & diluted urine

134
Q

RBC remnants due to bursting

A

Ghost cells

135
Q

hypersthenuria’s SG & urine condition

A

x > 1.010 SG & concentrated urine

136
Q

Renal Tubule

more solutes are inside the cell

A

hyposthenuria

137
Q

Renal Tubule

more solutes are outside the cell

A

hypersthenuria

138
Q

presence of intact RBCs in urine

139
Q

red & cloudy urine and indicative of glomerular damage/glomerulonephritis

140
Q
  • red & clear urine
  • RBCs burst along the way
  • Hb is present
  • no intact cell
A

hemoglobinuria

141
Q
  • found when RBCs burst along the renal tubule
  • deposits themselves on epithelial cells
A

hemosiderin deposits

142
Q

hemosiderin products can be identified through what stain?

A

Prussian blue stain

143
Q

Granules or Nuclei

WBCs in urine, which is more distinguishable?

144
Q

presence of WBC in urine

145
Q

Term used when WBC granules are suspended inside

A

Glitter cell

146
Q

presence of protein in urine

A

proteinuria

147
Q

Proteinuria

What color of foam is seen for presence of protein?

A

white foam

148
Q

concentration greater than 30 mg/dL

A

clinical proteinuria

149
Q

Bilirubinuria

presence of bilirubin in urine gives what color of foam?

A

yellow foam

150
Q

common finding in patients with jaundice

A

bilibinuria

151
Q

What is stasis?

A

slowdown in flow in the renal tubule which will form a matrix

152
Q

cylinder-like or rectangular like structures in urine

153
Q

simplest type of cast

A

hyaline cast

154
Q

cast initially forms where?

A

ascending loop of Henle

155
Q

presence of cast in urine

A

cylindruria

156
Q
  • primary coloring pigment
  • endogenous metabolism product
157
Q

urobilinogen’s oxidized form

158
Q

imparts a pinkish apperance from amorphous urates and specimen refrigeration

A

uroerythrin

159
Q

The darker the urine, the ____ specific gravity

A

higher SG

*Dark urine is a sign of dehydration

160
Q

Urine is ____ water + ____ solute

A

95-97% water + 3-5& solute

161
Q

Solutes: Cl + Na

A

inorganic solute

162
Q

Solutes: urea + creatinine

A

inorganic solutes

163
Q

markers that the sample is urine

A

urea & creatinine

164
Q
  • determines glomerulus’ integrity
  • measures clearance
A

Clearance test

165
Q

What type of specimen is used for Clearance test?

A

24-hour urine specimen

166
Q
  • measures volume completeness
  • requires substances that should neither be reabsorbed nor secreted
A

Clearance test

167
Q

products of metabolism

A

endogenous products

168
Q

Give 4 endogenous products

A
  • urea
  • creatinine
  • B-microglobulin
  • cystatin C
169
Q

Give 3 exogenous products

A
  • inulin
  • mannitol
  • iothalamate
170
Q
  • expressed in mL/min
  • requires:
    • 24-hour urine
    • blood
A

Creatinine clearance

171
Q

Give the formula for creatinine clearance

A

(U/P) (V/t) (1.73 m2/SA)

Clinical Microscopy (2 decks)

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