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Renal Exam > Renal Histology > Flashcards

Renal Histology Flashcards

1
Q

Three functions of the kidney

A

Excretory
homeostatic
endocrine

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2
Q

How does the kidney participate in excretory functions

A

makes an ultra filtrate; extra water, ions, drugs and metabolic breakdown products get excreted in the urine

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3
Q

How does the kidney participate in endocrine fnxs?

A

Monitoring the O2 carrying capacity of the blood via erythropoietin, regulating blood pressure through the renin-angiotensin system

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4
Q

What is the apperance of the cortex?

What are the linear arrays of tubles that extend into the cortex?

A

granular in appearance and homogeneous in consistency.

Medullary Rays.

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5
Q

has a striated appearance and consists of 6-18 Renal Pyramids.

A

Medulla

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6
Q

The apex or tip of a renal pyramid is called a

A

Renal Papilla

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7
Q

a macroscopic subdivision consisting of a renal pyramid and its surrounding cortex.

A

A Kidney Lobe

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8
Q

a microscopic subdivision consisting of a medullary ray and the cortical tissue (primarily nephrons) on either side.

A

A Kidney Lobule

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9
Q

The Capsule consists mainly of

A

fibrous connective tissue and surrounds the kidney.

*The parenchyma is not subdivided by septa.

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10
Q

The kidneys receive _____ of the total cardiac output/minute. The total blood volume of
the body passes through the kidneys every_____ minutes

A

20-25%

4-5

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11
Q

_____ ml of fluid is extracted from the blood each minute as filtrate [180 L/day].
•_____ ml is reabsorbed in the kidney tubules
• ___ml is excreted as urine

A

125 extracted
124 reabsorbed
1 ml excreated

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12
Q

The order of arterial supply to the kidney

A

Renal a.–> Lobar a.–>Interlobar a.–> arcuate a. –> Interlobular a. –> Afferent arteriole

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13
Q
  • supplies tubules of the cortical nephrons

- long capillary loops supplying tubules of juxtamedullary nephrons

A
  • Tubular Plexus

* Vasa Recta

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14
Q

Glomerulus is a two capillary system consisting of:

A

Tubular plexus and Vasa recta

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15
Q

Components of the Nephron

A

Renal Corpuscle

Renal Tubule

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16
Q
  • an epithelial-lined Tubule that varies in size, shape and function along its length
A

Renal tubule (part of nephron)

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17
Q

• The kidney produces an_________ of the blood, but
it recycles many components that are in the filtrate.
Other compounds are added to the filtrate as it goes
through the tubular system

A

ultrafiltrate

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18
Q

If primarily from a Developmental Viewpoint, a nephron consists of

A

Renal Corpuscle, Proximal Tubule, Loop of Henle, Distal Tubule [collecting ducts not included]

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19
Q

If primarily from a Functional Viewpoint, a nephron consists of:

A

Renal Corpuscle, Proximal Tubule, Loop of Henle, Distal Tubule & Collecting Duct

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20
Q

Renal Corpuscle has Four Components

A

Glomerulus
Visceral Layer of the Renal Capsule (Bowman’s)
Parietal Layer of the Renal Capsule
Mesangium

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21
Q

is a spherical, double-layered sac (Renal Capsule) that surrounds a network of capillaries (Glomerulus -ball of thread).

A

The renal corpuscle

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22
Q

_____ where the arterioles enter and exit and a _______ that is continuous with the proximal convoluted tubule.

A

Vascular Pole

Urinary Pole

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23
Q

a network of capillary loops supplied and drained

by an arteriole.

A

Glomerulus

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24
Q 
The Afferent (supplying) Arteriole is larger in 
diameter than Efferent (draining) Arteriole. Why?
A

This size difference creates a pressure differential that

drives glomerular filtration.

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25
Q

a double-layered epithelial sac surrounding the glomerulus.

A

Bowmans capsule

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26
Q

The outer or Parietal Layer is a _______epithelium.

• The Visceral Layer is also ______epithelium composed of cells called Podocytes.

A

simple squamous

a simple squamous

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27
Q

The space between the two epithelial layers is called the ________ and is continuous with the proximal tubule. The glomerular filtrate enters this space.

A

Urinary Space

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28
Q

Capillary Endothelium is discontinuous, containing numerous 70-100 nm pores . The pores are freely
permeable to

A

water and solutes ≤ 6-8 kD and moderately permeable to molecules 8-16kD.

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29
Q

The luminal

surface of the capillary endothelium has a negative charge because it is coated with a

A

glycocalyx consisting of negatively charged proteoglycan molecules.

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30
Q

is the primary barrier that prevents protein from entering the glomerular filtrate.

A

Basement Membrane

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31
Q

consists of epithelial cells called Podocytes because of their 1o and 2o foot processes (pedicles).

A

The Visceral Layer of Bowman’s Capsule

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32
Q

The space between pedicles is called the_____ and is bridged by an electron dense Filtration Slit Diaphragm, a modified ______ consisting of the protein _____

A

Filtration Slit
adherens junction
Nephrin.

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33
Q

Four functions of the mesangium

A

Functions:
• physical support
• regulation of glomerular blood flow
• turnover of glomerular basement membrane

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34
Q

• cells and ECM that abut the inner surface of the glomerular basement membrane

A

Glomerular Mesangium

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35
Q

ECM contains

A

fibronectin and collagen

36
Q

specialized pericyte/smooth muscle cells:
• contain receptors for
• secrete

A

(ANP) and antiotensin II

endothelin, cytokines and PGEs

37
Q

Location of convoluted portion of proximal tubule

A

begins at the urinary pole

and located in cortex

38
Q

convoluted portion of proximal tubule
Fnx:
Cell Type:
Mitochondria?

A

substantial reabsorption
cuboidal/columnar cells with granular cytoplasm and basal nuclei
Numerous mitochondria at base of cell
provide energy for transport

39
Q

Straight Portion: also Thick Descending Limb of

Henle has what cell type?

A

• cuboidal epithelium

40
Q

Loop of Henle: Length is determined by the location of its renal corpuscle with respect to the:

A

corticomedullary junction

41
Q

_________located external to the juxtamedullary zone, have short loops that have only
a Descending Thin Limb

A

Cortical Nephrons

42
Q

_______ are long looped and

have Ascending and Descending Thin Limbs

A

Juxtamedullary Nephrons

43
Q

thick portions of the loop are lined with _______, but the thin segments are lined with simple ______

A

cuboidal epithelium

squamous epithelium

44
Q

cell membranes in the ascending thin limb between

epithelial cells are interdigitated, resulting in

A

water impermeability

45
Q 
Straight portion: Thick Ascending
• lined with 
• scant microvilli,\_\_\_\_\_\_junctions
• Lateral & basal membane interdigitations
•\_\_\_\_\_\_ mitochondria
A

cuboidal epithelium
efficient tight
abundant

46
Q

Straight portion: thick ascending

  • What’s reabsorbed?
  • relationship with water
  • What’s secreted?
A
  • Impermeable to water
  • Na2+, Cl-, and water reabsorbed
  • glucose, amino acids, proteins reabsorbed through facilitated transport
  • H+ions secreted
47
Q 
Convoluted Portion (Early Distal Tubule)
• lined with 
•\_\_\_\_\_ microvilli
•\_\_\_\_\_ basal interdigitations
•\_\_\_\_\_\_ mitochondria
A

cuboidal epithelium
scant
fewer
fewer

48
Q

Convoluted Portion: early distal tubule:
What is reabsorbed?
What is secreted>

A
  • Na2+ (Aldosterone responsive), Cl-, K+, HCO3 reabsorbed

* K+, urate, H+ions, N3H secreted

49
Q

Contains Cuboidal cells (Principal [light] &

Intercalated [dark] cells) with Distinct cell borders

A 
Collecting Tubules (Late Distal 
Tubule) & Collecting Ducts
50
Q

transition segment between the nephron and the collecting duct

A

Collecting Tubules (Late Distal Tubule)

51
Q

epithelium contains principal cells

A

Collecting tubules: late distal tubules

52
Q 
Collecting tubules: late distal tubules
Antidiuretic Hormone (ADH) dependent segment where:
A

Na2+ is reaborbed and K+

is secreted

53
Q

Renal Tubular Disease:
Caused by:
How reabsorptive secreatory functions affected:

A
  • Caused by toxins, drugs, infections, metabolic disturbances, ischemia
  • Affects reabsorptive and secretory functions resulting in either polyuria or oligo/anuria
54
Q

Acidosis in renal failure results because of failure of

A

H ion excretion

55
Q

Collecting ducts are lined with

A

Lined with cuboidal to columnar epithelium

56
Q

have one primary cilium and Antidiuretic Hormone (ADH) sensitive AQP-2 water channels.

A

Principal (light) Cells in collecting ducts

57
Q

In the presence of
ADH, urea and water diffuse out of the collecting duct and into the renal interstitium.
What is the result?

A

This increases urine tonicity

58
Q

in the absence of ADH, water is

excreted from the collecting ducts leading to

A

Polyuria and hypotonic urine (Diabetes Insipidus).

59
Q

acts as a flow sensor in collecting ducts. This function is mediated by two
proteins Polycystin 1 & 2.

A

The single, nonmotile Primary Cilium

60
Q

– Defects in these proteins result in polycystic kidney disease.

A

Polycystin 1 & 2.

61
Q

the Space Between the Tubules

A

Renal Interstitium

62
Q

• interstitial (stromal) tissue is

found in the

A

renal cortex & medulla

63
Q

Renal interstitium components has what 2 componements?

A
  • interstitial CT

* interstitial cells (fibroblasts) in cortex & medulla

64
Q

Tubular-Interstitium-Vascular Interaction provides a mechanism for modifying and concentrating urine and as what three components?

A
  • Collecting ducts
  • Loops of Henle
  • Vasa Recta
65
Q

________- urine concentration

_________- protects ion gradient

A

Countercurrent Multiplier

Countercurrent Exchanger

66
Q

three components of JG apparatus

A

Renin producing
Extraglomerular mesangial cells
Macula densa

67
Q

Renin producing JG cells are what type of cell and located where?

A

special smooth muscle cells

in wall of afferent arteriole

68
Q

Extraglomerular mesangial (lactis) cells are connected to JG cells via _________

A

gap junctions

69
Q

Macula Densa
– _____ of the distal convoluted tubule.
– detects ____ and _____concentration for JG cells resulting in alterations of the
filtration rate and auto-regulation of blood volume

A

columnar cells

Na2+ and Cl-

70
Q

JG apparatus components can increase systemic blood pressure (BP) & blood volume
(BV) through the

A

angiotensin system

71
Q

_____ stimulates angiotensin

conversion/increase in aldosterone secretion/increased Na and water reabsorption

A

Renin

72
Q

Function of erythropoietin

A
  • increase mitosis of red blood cell precursors

* increase release of red cells from marrow

73
Q

Erythropoietin is mostly likely made by _______ and transported to __________

A
  • Probably produced by cortical interstitial cells

* Transported to bone marrow

74
Q

What stimulates production of Erythropoietin?

A

• Production stimulated by

  • high altitude
  • hemorrhage
  • impaired pulmonary function
75
Q

What are clinical indications for acute kidney fail?

A

oligouria <400ml/day, unexpected weight gain or
edema, increased toxins in blood
*Prognosis depends on cause, severity, treatment, age

76
Q

Progression of End Stage renal disease

A

Irreversible injury–>ESRD–> uremia + hematuria

77
Q

Nephrons are connected to a collecting duct system found mostly in the

A

medulla

78
Q

collect urine and transport it to the urinary bladder

hollow organs with lumen and wall with several layers

A

Calyces, Pelvis, Ureters

79
Q

Mucosa in calyces,pelvis, ureters
• _____ (uro)epithelium
• lamina propria contains

A

transitional

abundant elastic tissue

80
Q

Muscular organization of Calyces, Pelvis, Ureters

A

• smooth muscle
• in ureter -2 layers in the upper 2/3 of the ureter;
3 layers lower 1/3 of the ureter

81
Q

Urinary Bladder
•______ epithelium
• ____layers of smooth muscle

A

Transitional

3

82
Q

Male Vs female urethra

A

Male: 15-20 cm; 3 parts
(prostatic, membranous, penile)
• Transitional – pseudostratified sq. and Shared urinary &
reproductive systems
Female:
3-5 cm
• Transitional – pseudostratified sq. and Urinary system only

83
Q

Benign Prostatic Hypertropyhy

also known as nodular hyperplasia seen in:

A
  • Older males >45 years

* Can cause urethral obstruction

84
Q

Common in USA (7-21/1000), Increased in men, sedintary individual
• Hereditary disposition
• Hypercalcemia, pH change, supersaturation of ions encourage it

A

Kidney stones

85
Q

Bladder Cancer
• Associated with_____
• Majority in US involve the ______

A

smoking

uroepithelium

Renal Exam (22 decks)

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