Skin and kidneys 1 Flashcards
Normal proliferation of skin occurs just in what layer? Functions of the skin?
The basal layer
Barrier to infection Thermoregulation Protection against trauma Protection against UV Vitamin D synthesis Regulates H20 loss
3 basic layers of the skin?
Epidermis, dermis and subcutaneous tissue
What is the epidermis also known as? Made up of what 2 things? Corneo-desmosomes known as what? These increase in what diseases? These decrease when?
The stratum corneum
Corneo-desmosomes and desmosomes
Adhesion molecules- keeps the corneocytes together
Ones like psoriasis- striatum corneum thickens
In atopic eczema–> more inflammation
Filaggrin produces what factor? What are filled with NMF? Why is NMF also important? What happens to balance the intro of new cells in the basal layer? This involves what?
Natural moisturising factor (NMF)
Corneocytes- keeps H2O inside skin
Maintains acidic environment at outer surface
Corneocytes are shed in desquamation
Degradation of extracellular borneo-desmosomes under proteases
pH of normal skin? What component keeps water inside the skin cells?
5.5
Lipid lamellae
What is the brick wall model? What is vitamin D needed to make?
Corneocytes= bricks, corneodesmosomes= iron rods and lipid lamellae= cement.
Anti-microbial peptides needed to defend he skin from bacteria and viruses
What are skin flare ups? What causes red, itchy and dry skin?
Allergens penetrate into the skin, met with lymphocytes which release chemicals that induce inflammation
Red= dilation of blood vessels, itchy= nerve stimulation, dry= skin cells leaking due to lymphocytes activity.
What does reduced water retention lead to?
The pH will increase–> corneodesmosomes become damaged, so skin barrier breaks down and infection risk increases
What happens due to hypercornification during acne? What increases in production? Where does sebum go? Where does it stagnate and causes what?
Corneodesmosomes block entrance to hair follicles
Sebum–> greasy skin
Some becomes trapped in the narrowed hair follicle
In follicle pit–> anaerobic conditions so propionic bacteria can multiply
What do p.acnes do? What therefore forms? What 2 things can trigger acne?
Breakdown triglycerides in sebum into fatty acids– irritation, inflammation and neutrophil attraction
Pus forms and further inflammation
Cosmetics and oily hair gel
Level of kidneys? Hilum of R kidney? L kidney? What layer is the renal pyramids in? What layer contains the renal corpuscles (glomeruli and capsules) and tubules?
Between T12-L3
L2/ L1
Medulla= 20 upside down pyramids
Cortex
What are medullary rays? Give the cortex what appearance?
Collection of loop of Henle tubules and collecting ducts that come from nephrons which have corpuscles in outer part of cortex
Striated appearance
What things are in the medulla? What thing projects into the renal pelvis?
Tubules of loop of Henle, tubules of collecting duct and blood vessels
Tips of the medullary pyramids= purely collecting ducts at this point
What level does renal artery come off of abdominal aorta? Divides into what which leads to what? Arcuate arteries travel where and give off what?
L1
Segmental arteries–> arcuate arteries
Circumferentially at junction between cortex and medulla–> interlobar arteries
Interlobar arteries supply what and divide to form what?
Each lobe (medullary pyramid and overlying cortex)–> interlobular arteries–> afferent arterioles
What is within a renal corpuscle? Tuft is supported by what cells?
Glomerular tuft and bowman capsule
Smooth muscle mesangial cells
What is within the glomerular basement membrane? What stain can distinguish mesnagial cells from capillaries?
The capillary and podocyte basement membrane PAS stain(stains glycoproteins in basement membrane and mesangial cells in between)
3 main functions of Mesangial cells?
Structural support for capillary and produces extracellular matrix protein
Contraction of this modified smooth muscle reduces GFR
Phagocytosis of glomerular filtration membrane breakdown products
2 components involved in the juxtaglomerular apparatus? The endothelium of the afferent arteriole is expanded to form a mass of cells called what? Distal convoluted tubule has expansion of cells known as what?
Afferent arteriole and distal convoluted tubule
Granular cells- detect BP and secretes renin due to low BP
The macula dense- detect sodium levels
If filtration is slow, more what is absorbed and the macula dense sends a signal to do what?
More sodium absorbed–> macula densa sends a signal to reduce the afferent arteriole resistance and increase glomerular filtration
3rd group of cells in juxtaglomerular apparatus?
Lacis cells
Cells of proximal convoluted tubule actively transport how much of Na+ and K+ ions from glomerular filtrate? These cells also absorb what? In what convoluted tubule is there more lysosomes?
2/3
The small protein molecules that got through the glomerulus
In proximal than distal
What are the loops of Henle supplied by? What passes out of the thin descending limb?
A rich vasa recta
Water but not ions- concentrates urine going down
What happens going up the thick ascending limb? Where are the vasa recta far from?
Ions are actively pumped out of the ascending limb leaving water and waste products
The glomerulus- before blood reached, already lost some O2 carrying. Loop deep in medulla prone to ischemia.
Which convoluted tubule is shorter? How does it act to regulate the acid base balance? This is mediated by what hormone?
Distal is much shorter than proximal
Secretes H+ ions into it from an intracellular carbonic anhydrase and exchanges urinary Na+ for body K+
Aldosterone