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Medical Physiology > Renal Histology I & II > Flashcards

Renal Histology I & II Flashcards

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USMLE® Step 1 flashcards
1
Q

Juxtamedullary nephrons extend deep into the ____ and have long loops of henle

A

medulla

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2
Q

which are more numerous? cortical or juxtamedullary nephrons?

A

Cortical. Cortical have short loops of Henle and are found mainly in the cortex.

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3
Q

filtration occurs where?

A

in the Renal corpuscle only, also sometimes called Malpighian corpuscle.

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4
Q

the Bowmans capsule, also referred to as glomerular capsule has two layers… what are they?

A

visceral layer is attached to the capillary glomerulus & lined by podocyte cells

parietal layer is lined by simple squamous.

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5
Q

podocytes are flattened stellate cells that envelop capillaries. They have extensions that interdigitate with other podocytes called?

A

Pedicles

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6
Q

the parietal layer is lined by what kind of epithelium?

A

simple squamous ( this is continue with the simple cuboidal of the PCT)

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7
Q

twhat is the Bowmans space?

where does it exist>

A

the Bowmans or urinary space exists between visceral and parietal layer which contains the ultra filtrate.

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8
Q

the point where the urinary space is continuous with the lumen of the PCT is called

A

the urinary pole

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9
Q

the renal corpuscle contains other endothelia cells called?

A

mesangial cells

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10
Q

functions of mesangial cells are?

A
  1. Physical support of capillaries with in the glomerulus .
  2. Adjusted contractions in response to blood pressure changes , which help maintain an optimal filtration rate .
  3. Phagocytosis of protein aggregates adhering to the glomerular filter e.g. antigen – antibody complexes
  4. Secretion of several cytokines , prostaglandins and other factors important for immune defense and repair of glomerulus .
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11
Q

the area of the glomerulus from which both afferent and efferent arterioles arrive is called

A

the vascular pole

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12
Q

the glomerular filtration barrier consists of 3 layers, what are they?

A

fenestrated capillary endothelium

the basement membrane

the podocyte filtration slits

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13
Q

pores of the fenestrated capillaries are the first component of the filter. these are _____ in diameter and allow passes of all_____

A

70-90nm and move all non cellular formed elements of blood.

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14
Q

the basement membrane is juxtaposed between the ____ and the capillary endothelium. it is _____ thick and composed of type Iv collagen and laminin, etc.

A

between the pedicles and the capillaries.

0.1-0.5micrometers

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15
Q

the basement membrane is negatively charged which serves an ____ barrier preventing charged particles entering.

A

electrostatic

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16
Q

what is considered the glomerular ultra filter?

A

the basement membrane. Considered the primary filter. it contains the meshwork of basement membrane that allows passage of molecules like myoglobe (18kD) but NOT albumin (68kD)

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17
Q

the podocyte filtration slit are spaces ___ in diameter between interdicting pedicles

A

25nm

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18
Q

spanning adjacent pedicles and bridging the slit pores like a zipper is the

A

slit diaphragm,

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19
Q

the slit diaphragm is composed of _____ and other proteins, glycoproteins and proteoglycans.

A

nephrins

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20
Q

filtrate is considered….

A

blood plasma minus large molecules

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21
Q

in regard to renal disease, one of the earliest signs of diabetic nephropathy is_____ characterized by the presence of ______

A

proteinuria

albumin

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22
Q

a microscopic feature of renal disease is _______

Also called diabetic glomerularsclerosis

A

thickening of mesangia basement membrane, an increase in mesangial matrix

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23
Q

the PCT is lined with ______ epithelium. it contains an extensive ______

A

simple cuboidal

brush border

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24
Q

the function of the brush border is to ____

A

increase the absorptive surface, increases capacity of glomerular filtrate reabsorption

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25
Q

the cells in the PCT are very active and contain large amounts of ____ thus making it stain more intensely

A

mitochondria

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26
Q

why can the lateral edge of the PCT not be seen as clearly?

A

high degree of interdigitation between the cells

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27
Q

the functions of the PCT include

A

reabsorb glucose, 75% of water and NaCl in the filtrate

also secretes NH4+ ions in to the filtrate and indirectly absorbs most of the HCO3- from the filtrate

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28
Q

the NaCl, water and glucose reabsorption are all highly dependent on the

A

Na K+ atpase activity

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29
Q

where is the Na K ATPASE transporter located?

A

in the basolateral membra

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30
Q

where is the Na Glucose transporter located?

A

in the brush border membrane

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31
Q

HCO- is filtered at the ______

A

glomerulus (key word is filtered)

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32
Q

the HCO- filtration is dependent on the Na/H exchanger. The Na/H exchanger is present where?
What goes out of the tubule and what goes in?

A

in the brush border membrane

It uses Na gradient to drive H ions IN to the tubule, where it can combine with HCO- to form H2CO3

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33
Q

Carbonic anhydrase is also present where?

A

in the brush border membrane

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34
Q

the Na/NH4 exchanger is also located in the brush border membrane and uses the Na gradient to put NH4 ions where?

A

into the filtrate.

35
Q

the straight proximal tubule is also known as the thick descending limb of the loop of henle. Its epithelium is continuous with the PCT so it is….

A

simple cuboidal et

36
Q

what arises straight from the descending thick limb? and lies in the kidney’s outer____

A

descending thin limb

outer medulla

37
Q

the thin descending limb along with the thin ascending limb are composed of _____ and have what kind of nuclei?

A

simple squamous epithelium
round bulging nuclei

they both are comparable to capillaries but can be distinguished by their lack of RBC and bulging nuclei

38
Q

Then coursing back up is the thick ascending limb. What kind of epithelium would you expect it to have?

A

simple cuboidal ( just like the thick descending and the rest of the PCT prior to the thin limbs)

39
Q

counter-current exchange is an important function along the entire PCT in providing______ urine

A

hypertonic

40
Q

the descending thin limb has high permeability to _____ where as the thin ascending limb has high permeability to _____

A

tDLH-water

tALH-solutes

41
Q

Under the effect of aldosterone, the DCT is impermeable to ____ but reabsorbs____

A

impermeable to Urea

reabsorbs NaCl

42
Q

in the absence of ADH the fluid entering the collecting ducts is____ due to the fact that NaCl is reabsorbed without water

A

hypo osmotic with respect to plasma

43
Q

the DCT is lined by _____ epithelium. The cells are ____ than the PCT cells and lack a _____

A

Simple cuboidal

shorter, lack brush border

44
Q

these are modified cells of the DCT located adjacent to the renal corpuscle at the vascular pole

A

Macula Densa

45
Q

Macula Densa cells are ______ cells and tightly packed. They have special ______ sensitive to Na levels of DCT filtrate

A

thin columnar

chemoreceptors

46
Q

what provides the DCT with the means to reabsorb nearly all remaining NaCl filtrate

A

the Na/K ATPase activity

47
Q

if the collecting tubule is a continuation of the DCT what kind of cells would you expect it to have?

A

simple cuboidal with NO brush border

48
Q

Formed by the merging of the collecting tubules the collecting ducts converge to form parallel arrays that begin in the ____ and continue to the _____. These parallel bundles of ducts in the cortex are called_______

A

begin in the cortex
continue to medulla
medullary rays

49
Q

two cell types are found in the cortical ducts what are they

A 
principal cells(most abundant)
intercalated cells*** only principal cells are seen in the medullary portion of the ducts
50
Q

The role of principal cells is critical in water reabsorption from the filtrate. They can also reabsorb ___ & ____.

A

Na & K

51
Q

What hormone released from the pituitary gland controls the principal cells water permeability?

A

ADH

52
Q

what stimulates ADH release?

A

dehydration. it causes increases permeability of collecting ducts to water leading to conservation of water and forming a HYPERtonic urine.

53
Q

without ADH the collecting tubules remain impermeable to ___ and large amount of _____ urine are produced

A

water, hypotonic

54
Q

the intercalated cells have _____ and abundant ______.

A

apical microvilli

abundant mitochondria

55
Q

what do intercalated cells secrete? ( they regulate acid base balance)

A

H+ or HCO-

56
Q

these are large(100-200micrometers) straight collecting ducts in the inner medulla, each formed by several smaller collecting ducts

A

Papillary ducts of Bellini

57
Q

papillary ducts empty into…

A

minor calyces

58
Q

an_______ is present on each renal papilla and consists of about 25 pores that represent the ends of the papillary ducts

A

area cribrosa

59
Q

describe the flow of filtrate/production of urine

A

affarent arteriole»glomerulus> PCT>descending limb> ascending limb> DCT> collecting tubules> collecting duct> papillary duct> minor calyx>major calyx>penal pelvis>ureter….. PEE!! urine my thoughts <3

60
Q

the Juxtaglomerular Apparatus JGA is made up of what two things ?

A

the Affarent arteriole

a portion of the DCT

61
Q

The JGA is responsible for regulating blood pressure. It does this by the help of what cells found within the JGA

A

Juxtaglomerular cells(contain mechanoreceptors sensing pressure near the arteriole)

Macula Densa cells(contain chemoreceptors that are sensitive to Na+ concentration)

62
Q

the Juxtaglomerular cells are surrounded around the affarent arteriole and possess what two things?

A

Renin & Mechanoreceptors

63
Q

the macula dense cells are found within the DCT at the vascular pole. They are ____ cells and have what property

A

thin columnar cells

chemoreceptors sensitive to Na level of the filtrate.

64
Q

there is one other cell type found within the JGA in addition to JG cells and macula densa cells. What kind of cells are they and what is their function

A

Extraglomerular mesangial cells. These lie between the macula dense and Bowmans capsule.
They function the same as other mesangial cells and provide supportive, contractile, defensive functions.

65
Q

How is blood pressure changes sensed?

A

decrease in BP is sensed by :
macula densa cells which sense the drop in Na+

JG cells sensing pressure changes in the affarent arteriole

66
Q

how is blood pressure regulated?

A

drop in BP>JG cells release renin> Renin acts on plasma globulin>angiotensinogen>angiotensin I

67
Q

there are other molecules responsible for regulating BP. What does ACE do?

A

Angiotensin converting enzyme- enzyme in the blood secreted by pulmonary endothelial cells. angiotensin I»angiotensinII.

68
Q

what is angiotensin II

A

a powerful vasoconstrictor which increases BP.
also stimulates release of aldosterone from adrenal cortex resulting in the reabsorption of Na+ in the DCT.. water follows…increasing volume.. increasing BP

69
Q

the blood supply of the kidney is (starting with the renal artery at the hilum of kidneys)

A

renal a>segmental a.>interlobar a.>arcuate a>interlobular a.>affarent arteriolies.

70
Q

what arteries travel up renal columns between pyramids?

A

interlobar arteries

71
Q

what arteries are formed of interlobar arteries at the corticomedullar junction

A

arcuate arteries

72
Q

efferent arterioles exiting each renal corpuscle differ depending of its a cortical nephron or Juxtamedullary. what are the main differences

A

Cortical nephron efferent arterioles are smaller in diaper and give rise to peritubular capillary network.

Juxtamedullary nephron efferent arterioles are larger and give rise to the vasa recta.

73
Q

the descending portion of the vasa recta is ____ & the ascending side is…

A

arterial

venous.. much larger diameter with fenestrations.

74
Q

The ureter is composed of the first layer of mucosa with contains ______ epithelium lining the lumen surface. the lamina propria is composed of ______ connective tissue

A

transitional epithelium

dense irregular fibroelastic CT

75
Q

the Next layer, the muscular is composed of 2 smooth muscle layers in the _____
& 3 layers near the _____

A

proximal 2/3

near the bladder

76
Q

the undistended bladder has transitional epithelium that is ____ layers thick, while the distended full bladder the cell become flat and epithelium appears____

A

5-6 layers

3-4 layers thick

77
Q

what special feature does the bladder contain that protect the transitional epithelium from damage when they flatten?

A

plaques, composed of uroplakin.

78
Q

the bladder has an osmotic barrier which is found there

A

between urine and tissue fluids ( plaques are part of th cosmetic barrier because tehey are impermeable to salt and water)

79
Q

the bladder rests on lamina propria and deep to this is the ____ of the bladder

A

muscular coat

80
Q

muscle fibers run in various directions without easily distinguishable layers except at the _____ where a thick middle _____ layer is sandwiched between two longitudinal layers

A

neck

circular

81
Q

the outer covering adventitia is dense irregular _____connective

A

collagenous

82
Q

name all the parts of the male urethra

A

prostatic ( transitional et)

membranous (stratified squamous or pseudo stratified columnar epithelium )

Spongiosum(stratified squamous epithelium with patches of pseudo stratified columnar epithelium)

83
Q

the female urethra is made of ____ epitherlium

A

stratified squamous with patches of pseudo stratified columnar.

Medical Physiology (21 decks)

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