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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
a double-layered epithelial sac surrounding the glomerulus.
Bowmans capsule
26
The outer or Parietal Layer is a _______epithelium. | • The Visceral Layer is also ______epithelium composed of cells called Podocytes.
simple squamous | a simple squamous
27
The space between the two epithelial layers is called the ________ and is continuous with the proximal tubule. The glomerular filtrate enters this space.
Urinary Space
28
Capillary Endothelium is discontinuous, containing numerous 70-100 nm pores . The pores are freely permeable to
water and solutes ≤ 6-8 kD and moderately permeable to molecules 8-16kD.
29
The luminal | surface of the capillary endothelium has a negative charge because it is coated with a
glycocalyx consisting of negatively charged proteoglycan molecules.
30
is the primary barrier that prevents protein from entering the glomerular filtrate.
Basement Membrane
31
consists of epithelial cells called Podocytes because of their 1o and 2o foot processes (pedicles).
The Visceral Layer of Bowman’s Capsule
32
The space between pedicles is called the_____ and is bridged by an electron dense Filtration Slit Diaphragm, a modified ______ consisting of the protein _____
Filtration Slit adherens junction Nephrin.
33
Four functions of the mesangium
Functions: • physical support • regulation of glomerular blood flow • turnover of glomerular basement membrane
34
• cells and ECM that abut the inner surface of the glomerular basement membrane
Glomerular Mesangium
35
ECM contains
fibronectin and collagen
36
specialized pericyte/smooth muscle cells: • contain receptors for • secrete
(ANP) and antiotensin II | endothelin, cytokines and PGEs
37
Location of convoluted portion of proximal tubule
begins at the urinary pole | and located in cortex
38
convoluted portion of proximal tubule Fnx: Cell Type: Mitochondria?
substantial reabsorption cuboidal/columnar cells with granular cytoplasm and basal nuclei Numerous mitochondria at base of cell provide energy for transport
39
Straight Portion: also Thick Descending Limb of | Henle has what cell type?
• cuboidal epithelium
40
Loop of Henle: Length is determined by the location of its renal corpuscle with respect to the:
corticomedullary junction
41
_________located external to the juxtamedullary zone, have short loops that have only a Descending Thin Limb
Cortical Nephrons
42
_______ are long looped and | have Ascending and Descending Thin Limbs
Juxtamedullary Nephrons
43
thick portions of the loop are lined with _______, but the thin segments are lined with simple ______
cuboidal epithelium squamous epithelium
44
cell membranes in the ascending thin limb between | epithelial cells are interdigitated, resulting in
water impermeability
45
``` Straight portion: Thick Ascending • lined with • scant microvilli,______junctions • Lateral & basal membane interdigitations •______ mitochondria ```
cuboidal epithelium efficient tight abundant
46
Straight portion: thick ascending - What's reabsorbed? - relationship with water - What's secreted?
* Impermeable to water * Na2+, Cl-, and water reabsorbed * glucose, amino acids, proteins reabsorbed through facilitated transport * H+ions secreted
47
``` Convoluted Portion (Early Distal Tubule) • lined with •_____ microvilli •_____ basal interdigitations •______ mitochondria ```
cuboidal epithelium scant fewer fewer
48
Convoluted Portion: early distal tubule: What is reabsorbed? What is secreted>
* Na2+ (Aldosterone responsive), Cl-, K+, HCO3 reabsorbed | * K+, urate, H+ions, N3H secreted
49
Contains Cuboidal cells (Principal [light] & | Intercalated [dark] cells) with Distinct cell borders
``` Collecting Tubules (Late Distal Tubule) & Collecting Ducts ```
50
transition segment between the nephron and the collecting duct
Collecting Tubules (Late Distal Tubule)
51
epithelium contains principal cells
Collecting tubules: late distal tubules
52
``` Collecting tubules: late distal tubules Antidiuretic Hormone (ADH) dependent segment where: ```
Na2+ is reaborbed and K+ | is secreted
53
Renal Tubular Disease: Caused by: How reabsorptive secreatory functions affected:
* Caused by toxins, drugs, infections, metabolic disturbances, ischemia * Affects reabsorptive and secretory functions resulting in either polyuria or oligo/anuria
54
Acidosis in renal failure results because of failure of
H ion excretion
55
Collecting ducts are lined with
Lined with cuboidal to columnar epithelium
56
have one primary cilium and Antidiuretic Hormone (ADH) sensitive AQP-2 water channels.
Principal (light) Cells in collecting ducts
57
In the presence of ADH, urea and water diffuse out of the collecting duct and into the renal interstitium. What is the result?
This increases urine tonicity
58
in the absence of ADH, water is | excreted from the collecting ducts leading to
Polyuria and hypotonic urine (Diabetes Insipidus).
59
acts as a flow sensor in collecting ducts. This function is mediated by two proteins Polycystin 1 & 2.
The single, nonmotile Primary Cilium
60
– Defects in these proteins result in polycystic kidney disease.
Polycystin 1 & 2.
61
the Space Between the Tubules
Renal Interstitium
62
• interstitial (stromal) tissue is | found in the
renal cortex & medulla
63
Renal interstitium components has what 2 componements?
* interstitial CT | * interstitial cells (fibroblasts) in cortex & medulla
64
Tubular-Interstitium-Vascular Interaction provides a mechanism for modifying and concentrating urine and as what three components?
* Collecting ducts * Loops of Henle * Vasa Recta
65
________- urine concentration | _________- protects ion gradient
Countercurrent Multiplier | Countercurrent Exchanger
66
three components of JG apparatus
Renin producing Extraglomerular mesangial cells Macula densa
67
Renin producing JG cells are what type of cell and located where?
special smooth muscle cells | in wall of afferent arteriole
68
Extraglomerular mesangial (lactis) cells are connected to JG cells via _________
gap junctions
69
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
columnar cells | Na2+ and Cl-
70
JG apparatus components can increase systemic blood pressure (BP) & blood volume (BV) through the
angiotensin system
71
_____ stimulates angiotensin | conversion/increase in aldosterone secretion/increased Na and water reabsorption
Renin
72
Function of erythropoietin
* increase mitosis of red blood cell precursors | * increase release of red cells from marrow
73
Erythropoietin is mostly likely made by _______ and transported to __________
* Probably produced by cortical interstitial cells | * Transported to bone marrow
74
What stimulates production of Erythropoietin?
• Production stimulated by - high altitude - hemorrhage - impaired pulmonary function
75
What are clinical indications for acute kidney fail?
oligouria <400ml/day, unexpected weight gain or edema, increased toxins in blood *Prognosis depends on cause, severity, treatment, age
76
Progression of End Stage renal disease
Irreversible injury-->ESRD--> uremia + hematuria
77
Nephrons are connected to a collecting duct system found mostly in the
medulla
78
collect urine and transport it to the urinary bladder | hollow organs with lumen and wall with several layers
Calyces, Pelvis, Ureters
79
Mucosa in calyces,pelvis, ureters • _____ (uro)epithelium • lamina propria contains
transitional | abundant elastic tissue
80
Muscular organization of Calyces, Pelvis, Ureters
• smooth muscle • in ureter -2 layers in the upper 2/3 of the ureter; 3 layers lower 1/3 of the ureter
81
Urinary Bladder •______ epithelium • ____layers of smooth muscle
Transitional | 3
82
Male Vs female urethra
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
Benign Prostatic Hypertropyhy | also known as nodular hyperplasia seen in:
* Older males >45 years | * Can cause urethral obstruction
84
Common in USA (7-21/1000), Increased in men, sedintary individual • Hereditary disposition • Hypercalcemia, pH change, supersaturation of ions encourage it
Kidney stones
85
Bladder Cancer • Associated with_____ • Majority in US involve the ______
smoking | uroepithelium

Renal Exam (22 decks)

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