RENAL PATHOLOGY Flashcards
Kidney
_______-shaped paired organs.
Weight: ____gm and ____gm in the adult male and female respectively.
Hilium of kidney: _____ of ______ aspect where the artery, vein, lymphatics and ureter are located.
Bean
150; 135
midpoint of medial
Kidney
Surrounded by a (thin or thick?) fibrous capsule adherent at the ______.
Cut surface of kidney made up of a well-demarcated peripheral ______ and inner ______.
Thin ; hilium
cortex; medulla
Kidney
Cortex: ___ to ____ cm in thickness.
Medulla: composed of several _____-shaped renal _______.
The apex of each pyramid called the ______ is related to a ______.
1.2 to 1.5
cone; pyramids
papilla; calyx
Kidney
Septa of Bertin: ______ tissue that extends ________________________
Pelvis:_______-shaped (proximal or distal?) part of the _________ formed by the union of _______________________.
cortical
into the space between adjacent pyramids.
funnel; proximal; ureter
2 to 3 major calyces
NORMAL STRUCTURE - HISTOLOGY
Parenchyma of each kidney is composed of approx. _______ microstructures called ____________.
one million
nephrons
NORMAL STRUCTURE - HISTOLOGY
Nephrons consist of _____ major parts having a functional role in urine formation;
The glomerular capsule ( ______ and ————-).
The ___________________
The __________________
The ______________________
_______________
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Glomerulus and Bowman’s capsule
proximal convoluted tubule (PCT).
loop of Henle.
distal convoluted tubule (DCT).
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NORMAL STRUCTURE - HISTOLOGY
Four components of renal parenchyma from point of view of kidney diseases;
_________
__________
________
___________
Renal vasculature
Glomeruli
Tubules
Interstitium
Renal vasculature
Each kidney is supplied with blood by a renal artery, arising from the aorta at ____.
It usually divides into _____ and ______ divisions at the hilium, sometimes they arise _______________
L2; anterior and posterior
directly from the aorta.
Renal vasculature
The anterior and posterior divisions divide into _______ branches from which the ___________ arteries arise which course within the lobes.
These arteries along their course, they give off the ________ arteries which arch between the ___________________________
These arteries in turn, give off _________ arteries which lie in the ______ , (parallel or perpendicular ?) to the capsular surface in the part overlying the pyramids and are called ______ arteries.
segmental
interlobar
arcuate; cortex and medulla.
interlobular; cortex; perpendicular
Straight
Renal vasculature
Afferent arterioles take their origin from _______ arteries each supplying ________________.
Efferent arterioles emerge from the _______. The arteries and arterioles are _______________
interlobular; a single glomerulus
glomerulus; end vessels.
Renal vasculature
Efferent arterioles leaving the glomerulus supply ________________ plexus which anastomoses with the ________ of another nephron.
The _______________, give off a series of parallel vessels called ________ which descend to the inner medulla supplying the __________ and _________ and anastomose at all levels throughout the medulla with the _______________
peritubular capillary
capillary plexus
juxtamedullary glomeruli
Vasa recta ; loop of Henle and collecting ducts
ascending vasa recta.
Renal vasculature
Theses drain into arcuate veins and finally through veins that accompany corresponding arteries and finally a _________ vein into the ____________.
single renal ; inferior vena cava
Renal vasculature cont’d
Lymphatic drainage occurs likewise through lymphatics associated intrarenal vasculature leaving the kidney hilum and draining to _______ lymph nodes.
The renal cortex receives about ______% of the total renal blood supply, so the pressure in the capillaries are (low or high?) .
lateral aortic
90; high
the renal _______ is more prone to the effects of hypertension.
cortex
The renal medulla is (well or poorly?) perfused and any interference in blood supply results in ____________
poorly
Medullary necrosis.
Renal vasculature
The divisions and subdivisions of the renal artery up to arterioles are __________ and have _________, therefore occlusion of any of the branches will result in ______________________________________.
end arteries; no anastomoses
infarction of the renal parenchyma supplied by it
Renal vasculature
The tubular capillary beds are derived from the _________ arterioles leaving the _______, thus dieases affecting the ________ tuft affect the tubules significantly.
efferent arterioles
glomeruli
glomeruli
Glomerulus
The glomerulus consists of invagination of the _____ end of the _______ and contains a ___________ fed from the afferent arteriole and drained by the efferent arteriole.
The capillary tuft is covered by ____________(_________) which are continuous with those of the _________ epithelium at the vascular pole.
The transition of proximal tubular cells occurs at the __________________________
blind
proximal tubule ; capillary tuft
visceral epithelial cells (podocytes)
parietal
urinary pole of the glomerulus.
The visceral and parietal epithelial cells are separated by the ___________ or ___________
urinary space or Bowman’s capsule.
Glomerulus
The capillaries from the afferent arterioles form lobules of which there are not more than ____ in the glomerulus.
Each lobule of a glomerular tuft consists of __________________ stalk composed of ————- containing ______ cells and ___________ matrix.
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centrilobular supporting
mesangium; mesangial
mesangial matrix
Glomerulus
The mesangium is continuous at the _____ with the ______ of the _____________.
hilum; lacis cells
juxtaglomerular apparatus
The mesangial cells produce _________ and __________
mesangial matrix and glomerular basement membrane.
The mesangial cells produce mesangial matrix and glomerular basement membrane.
They function in __________ of leaked _______ and probably control ___________________ through contractile elements in their cells.
endocytosis
macromolecules
glomerular blood flow
Glomerulus
Main function of the glomerulus is ____________ from the _______ to the ___________
complex filtration
capillaries
urinary space.
Glomerulus
The barrier of the glomerulus consists of 3 components:
•__________ ————— cells lining the capillary loops.
•Glomerular _____________ on which the _________ rest
•___________________ between the ______________ of the _________________ external to ______.
Fenestrated endothelial
basement membrane ; endothelial cells
Filtration slit pores; foot processes
visceral epithelial cells (podocytes)
GBM
Glomerulus
Glomerular basement membrane
consists of 3 layers –central _________, bounded by ____________ and ____________\
lamina densa
lamina rara interna
lamina rara externa.
Glomerulus
The barrier to filtration of macromolecules of the size and molecular weight of albumin and larger depends upon :
A normal ___________, maintenance of ____________ on both lamina rarae, a healthy glomerular __________ covering.
lamina densa
negative charge
epithelial cells
Juxtaglomerular Apparatus (JGA)
Situated at the vascular pole of the glomerulus and is made up of 3 parts;
The ___________ cells
The __________
The ________ cells or _________ cells
juxtaglomerular
macula densa
lacis; non-granular
Juxtaglomerular Apparatus (JGA)
The juxtaglomerular cells: are modified __________________ cells in the media of
the ___________ and contain the hormone, _________
granular smoot muscle
afferent arteriole; renin
Juxtaglomerular Apparatus (JGA)
The macula densa: comprised by specialized region of the ________ when it returns to the ________ of its parent glomerulus.
distal tubule
vascular pole
Juxtaglomerular Apparatus (JGA)
The lacis cells or non-granular cells: occupy the space between the _________ and _________ and merge with the _________________
macula densa and the arterioles
glomerular mesangium.
__________ account for the amount of the renal parenchyma.
Tubules
Tubules
- Proximal convoluted tubule (PCT):
This is the _______ part arising from the glomerulus.
It is lined by _______ cells with a _______ composed of ___________.
Contains numerous _________,__________ and ______________
The major functions are (passive or active?) reabsorption of filtered _____,_____,_____,_____,_____,_____,_____,______ and (active or passive?) reabsorption of ___% of filtered water.
first
cuboidal; brush border; microvilli
mitochondria, Golgi apparatus and endoplasmic reticulum.
Active ; sodium, potassium, glucose, amino acids, proteins, phosphate, calcium and uric acid
Passive ; 80
The structure of the renal tubular epithelium varies in different parts of the
nephron and is correlated with the __________ of that part of the tubule.
functional capacity
Tubules
Loop of Henle.
The PCT drains into the ______ part of loop of Henle that consists of thin , descending and ascending limbs and the actual loop, all of which are found in the ________.
They are lined by a _______ type of epithelium
The thin ascending limb continues as _____________ in the ___________.
The major function is (passive or active?) reabsorption of _______ and ______ and (active or passive?) diffusion of _____ resulting in urinary concentration.
straight; medulla
flattened; thick ascending limb
medullary rays; active ; sodium and chloride
Passive ; water