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DT3-Exam 3 > Renal Embryo-- Melissa > Flashcards

Renal Embryo-- Melissa Flashcards

1
Q

From what layer of embryonic tissue are the kidneys derived?
When in development does this happen?

A

DAY 22:

INTERMEDIATE mesoderm–> Forms lateral and medial urogenital ridge around aorta

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2
Q

What does the medial urogenital ridge ultimately become?

A

Genital system

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3
Q

What does the lateral urogenital ridge ultimately become?

A

Lateral general ridge–> nephrogenic cords–> renal system

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4
Q

What are the 3 tissue types that derive from the Nephrogenic cords and when in development do they from?

A

Pronephros (Week 4/ Day 28)
Mesonephros (Day 21-28)
Metanephros (Day 32)

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5
Q

Describe the function of the pronephros.

Where is it located and what does it form?

A

Located in CERVICAL region

Pronephros–> Nephrotomes (vestigal excretory units from by WEEK 4)–> Complete regression by WEEK 5

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6
Q

Where is the Mesonephros located?
What does it form?
Describe the timeline of development:

A

Located UPPER THORACIC–>L3
Mesonephros–>
FIRST EXCRETORY TUBULES (Week 4/Day 28)–>
Rudimentary GLOMERULUS w/ Bowman’s Capsule–>
Consumed by Mesonephric Duct–>
Forms URETERIC BUDS–> penetrate Metanephros

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7
Q

What are the derivatives of the Ureteric Buds? (4)

A
  • Collecting tubules
  • Major/Minor Calyces
  • Renal Pelvis
  • Ureters
  • *Forms the drainage system around Day 28; continues developing for 5 mos
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8
Q

How does the Metanephros contribute to renal development? Describe the timeline:

A

(Day 32) METANEPHRIC BLASTEMA penetrated by ureteric buds (via mesonephros) –>
Structures form DEFINITIVE ADULT KIDNEY

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9
Q

What are the derivatives of the Metanephric Blastema? (4)

A
  • Glomeruli
  • Bowman’s Space (parietal layer + capillary podocytes)
  • Proximal and Distal Convoluted tubules
  • Loop of hence
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10
Q

Where are the mature kidneys located?

How did they get here?

A

Located at T12-L3; Right lower than left because of Liver

Sacral region grows faster than caudal region–> kidneys move up

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11
Q

How does orientation of the kidney change on its ascent to T12-L3?

A

Hilum faces Ventral–> Rotates 90 degrees medially–> Hilum faces medial

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12
Q

What would cause a transient hydronephros?

A

If the metanephros forms urine before complete canalization of ureteric bud

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13
Q

When is the definitive functional kidney formed?

A

Week 12/ 4 mos!

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14
Q

Describe how urine production and removal occur in the fetus:

A

Urine excreted into amniotic cavity–> Fetus drinks–> Goes into GI then CV system–> PLACENTA excretes waste

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15
Q

What is happens if the inferior renal vessels fail to degenerate?

A

Arteries obstruct urine flow at pelvitoureteral junction–> Dilation of calyces–> Hydronephrosis
*Similar to aortic ring and trachea

*note that if any rudimentary arteries from aorta to kidney fail to degenerate, obstruction will cause ischemic injury to location it supplies in kidney

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16
Q

What is a horseshoe kidney?

What are some potential complications?

A 
Fused kidney (usually at lower poles)--> U Shaped Kidney   --> Isthmus lies anterior to aorta + IVC, Inferior to IMA*** (Stops Ascent)
**Patients have higher risk nephroblastoma (Wilms Tumor)
17
Q

What is a Multicystic Dysplastic Kidney?

Is it compatible with life?

A

Ducts surrounded by undifferentiated tissue–> No Nephron development/ Ureteric Bud formation–> NO COLLECTING DUCTS–> NONFUNCTIONING Kidney replaced by CYSTS

  • Bilateral = NOT compatible with life
  • # 1 cause of mass in newborn; most not palpable at birth
18
Q

ARPKD: Age, Gene, sequele

A

PKHD1, Chrom 6, Fibrocystin

  • cysts in collecting ducts
  • enlarged kidneys
  • adult or childhood renal failure ensue
19
Q

ADPKD: Age, Gene, sequele

A

PKD1 (Chrom 16), PKD2 (Chrom 4) : Polycystin 1, 2

  • cysts throughout nephron
  • adulthood renal failure
  • more common and less progressive than ARPKD
20
Q

Pelvic Kidney: What happens?

A

Caudal end of embryo grows too fast in proportion to sacral–> Kidneys stuck in pelvis

21
Q

Renal Agenesis: What Happens?

A

Ureteric Bud fails to form from Mesonepnric bud–> Kidney fails to develop bilaterally–> Potter’s syndrome/ Compression of developing fetus–> NOT COMPATIBLE WITH LIFE

**POTTER**
Pulmonary hypoplasia 
Oligohydraminos (low amniotic fluid)
Twisted face
Twisted skin 
Extremity defects 
Renal Failure
22
Q

What is a wilms tumor and when does it present?

What is the cause?

A

Mutation on WT1, 11p13–> Kidney cancer arising in fetus or kids under 5yoa

23
Q

What is WAGR syndrome?

A
  • Wilms tumor
  • Aniridia (no iris!)
  • genital anomalies
  • mental retardation
  • Hemihypertrophy
24
Q

What is Denys Drash Syndrome?

A
  • Wilms Tumor
  • Renal Failure
  • Pseudohermaphridism
25
Q

How does a bifid ureter form?

A

Early division of urogenic bud–> two distinct ureters–> fuse along courses or have two distinct entrances into bladder

26
Q

What is a double renal pelvis and how does it form?

A

Two renal pelvises from from renal hilum–> immediate fusion to form one ureter

27
Q

What is an ectopic ureteric orifice? How does it present?

A

Ureter aberrantly enters seminal vesicle/ prostatic urethra/ vagina–> patient has chronic incontinance

28
Q

What is the most common way a megaloureter forms?

A

Obstruction downstream–> Abnormally enlarged ureter upstream

29
Q

What is a postcaval ureter?

A

Ureter traverses behind IVC

30
Q

What are posterior urethral valves? What are the consequences (3)?

A

Obstructing membrane in posterior male urethra–> Bladder outlet obstruction, ~lung hypoplasia, ~respiratory failure

31
Q

What is a ureteropelvic junction obstruction?
What are the consequences?
How is it diagnosed and treated?

A

1 SITE OF OBSTRUCTION at area between kidney and ureter (last segment of fetal ureter to canalize)–> Hydronephrosis, palpable abdominal mass

Dx: Diuretic venography
Tx: Pyeloplasty and reattachment of ureter

DT3-Exam 3 (9 decks)

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