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Renal System > Structure of the kidneys > Flashcards

Structure of the kidneys Flashcards

1
Q

Which structures make up the upper urinary tract?

A

Two kidneys
Two ureters

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2
Q

Which structures make up the lower urinary tract?

A

One urinary bladder
One urethra

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3
Q

What are the functions of the kidneys? (4)

A
  1. Maintainance of homeostasis
  2. Site of production
  3. Regukare the fluid and electrolyte balance
  4. Hydroxylates vitamin D3 to its active form
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4
Q

How do the kidneys maintain homeostasis?

A

Through filtration, absorption, and secretion

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5
Q

What are kidneys the site of production of?

A

Renin (causes it to be considered part of the endocrine system)
Erythropoietin

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6
Q

What is the function of erythropoietin?

A

Stimulates production of red blood cells

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7
Q

Which other organ is responsible for the production and hydroxylation of vitamin D3?

A

The skin

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8
Q

What are the kidneys?

A

Reddish brown bean-shaped organs on each side of the vertebral column

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9
Q

What is the location of the kidneys?

A

Posterior abdominal wall, primary retroperitoneal

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10
Q

Why is the right kidney lower than the left?

A

Because of the location of the liver on the right side

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11
Q

What is the movement of the kidneys like?

A

Limited, about 3cm in vertical dimension

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12
Q

Why is the movement of the kidneys limited?

A

Because of the diaphragm’s location

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13
Q

What are the coverings of the kidneys? (4)

A

Fibrous capsule
Perirenal fat
Renal fascia
Pararenal fat

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14
Q

Which organs have a fibrous capsule?

A

Presnet in all organs, naming just changes

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15
Q

What is the purpose of the perirenal fat?

A

Separates the kidneys from the adrenal glands (suprarenal gland)

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16
Q

Where is the perirenal fat located?

A

Perirenal is also known as perinephric fat, and it is located directly around the kidney

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17
Q

What is the renal fascia?

A

A continuous layer of the abdominal fascia covers both the kidneys and the suprarenal glands

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18
Q

What is the pararenal fat?

A

The outermost layer, continuous with retroperitoneal fat

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19
Q

In the case of perirenal abscess or injured kidney what is the direction/path of pus or blood?

A

Towards the infrarenal space, every other region is covered with renal fascia.

Infrarenal space will end up accumulating in the pelvis

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20
Q

What determines the direction of pus or blood determined by in the case of a perirenal abscess or injured kidney?

A

Attachments of the renal fascia

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21
Q

Which kind of organs have no direct contact with the kidneys?

A

Intraperitoneal they are covered by the peritoneum, examples are the spleen and stomach

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22
Q

What kind of structure is the suprarenal gland? (intra, retro, infra)

A

Retroperitoneal –> direct contact with the kidneys

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23
Q

What kind of structure is the second part of the duodenum? (intra, retro, infra)

A

Retroperitoneal

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24
Q

What are the relations of the right kidney? (5)

A

Right suprarenal gland (direct contact)
2nd part of duodenum (direct contact)
Liver (not direct contact)
Colon (direct contact)
Small intestine (not direct contact)

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25
Q

What are the relations of the left kidney? (6)

A

Left suprarenal galnd (direct contact)
Stomach (not direct contact)
Spleen (not direct contact)
Tail of pancreas (direct contact)
Colon (direct contact)
Small intestine (not direct contact)

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26
Q

What are the structures superior to the kidneys?

A

Right kidney –> Right lobe of liver and suprarenal gland
Left kidney –> Spleen and suprarenal gland

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27
Q

What are the strictures anterior to the right kidney?

A

The right lobe of the liver
Right colic flexure
2nd part of duodenum

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28
Q

What are the structures anterior to the left kidney?

A

Spleen
Left colic flexure
Stomach
Pancreas

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29
Q

What are the structures posterior to the kidneys?

A

Diaphgram
Psoas major
Quadratus lamborum

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30
Q

What are the structures posterior to the right kidney?

A

The 12th rib

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31
Q

What are the structures posterior to the left kidney?

A

The 11th and 12th rib

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32
Q

What is the Psoas major?

A

The innermost muscle, closest to the vertebral column

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33
Q

What is the location of Quadratus Lamborum?

A

Lateral to the Psoas major

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34
Q

Why is the right kidney only in contact with the 12th rib?

A

Because of its lower location, due to the presence of the liver

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35
Q

What is the renal hilum?

A

The point of entrance/exit of the kidneys, arteries, veins and lymphatic vessels

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36
Q

At which level is the renal hilum found?

A

At the level of the transpyloric plane (L1/L2)

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37
Q

The renal hilum is part of the?

A

Renal sinus

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38
Q

What are the structures of the renal hilum starting from most anterior to most posterior?

A

Renal vein (most anterior)
Renal Artery
Ureter (most posterior)

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39
Q

What happens if there is one singular renal aretry?

A

It will be posterior to the renal vein and anterior to the ureter

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40
Q

What happens to the renal artery some times?

A

It divides into segmental arteries. Thus, there usually will be a renal artery anterior and posterior to the ureter

These variations are considered normal

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41
Q

What are the renal columns?

A

Extensions of cortex into medulla

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42
Q

What are the two internal structures of the kidney?

A

Cortex and medulla

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43
Q

What is the cortex?

A

The outermost part of the kidney

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44
Q

What is the medulla?

A

The innermost part of the kidney

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45
Q

What are the different structures of the cortex?

A

Renal corpuscles
Cortical labyrinth
Medullary rays

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46
Q

What is the cortical labyrinth made of?

A

Proximal convoluted tubule
Distal convoluted tubule

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47
Q

What are the medullary rays?

A

Continuation of the medulla they are considered collecting ducts

48
Q

What are the two zones of the medulla?

A

Outer and inner zones

49
Q

What are the structures of the outer zone of the medulla?

A

Collecting ducts
Loop of Henle

50
Q

What are the structures of the inner zone of the medulla?

A

Papillary ducts
Deep loop of Henle

51
Q

What is the function of the draining system of the kidneys?

A

To collect urine from the nephrons and pass it all the way to the ureter

52
Q

What is the draining system of the kidneys like?

A

Collecting ducts
Papillary ducts of Bellini
Renal papilla
Minor calyx
Major calyx
Renal pelvis
Ureter

53
Q

What is the purpose of collecting ducts?

A

Collect urine from nephrons

54
Q

What is the epithelium like all the way up to the minor calyx?

A

Simple columnar

55
Q

What is the start point of the ureter?

A

The minor calyx

56
Q

What is significant about the minor calyx?

A

The first part of the uroepithelium, the start of transitional epithelium

57
Q

What is special about the uroepithelium?

A

It has the ability to stretch

58
Q

What is the renal pelvis?

A

The upper extended part of the ureter

59
Q

How many nephrons are there in each kidney?

A

About 1 million in each kidney

60
Q

What is special about the blood supply of the kidneys?

A

Very rich in vasculature
Kidneys receive about 25% of the cardiac output

61
Q

What is the main blood supply to the kidneys?

A

Renal arterial blood supply

62
Q

What kind of branch is the renal artery?

A

The lateral branch of the aorta

63
Q

At what point does the renal artery enter the hilum of the kidneys?

A

L2

64
Q

Which renal artery will be shorter and why?

A

The left renal artery will be shorter because the aorta is located slightly to the left

65
Q

What is the path of the renal arterial blood supply?

A

Renal arteries –> segmental arteries –> lobar arteries –> interlobar arteries –> arcuate arteries –> interlobular arteries –> afferent arterioles –> glomerulus –> efferent arterioles

66
Q

Where do the lobar arteries run?

A

Between the pyramids, supply the whole lobe

67
Q

Where are the interlobar arteries located?

A

Between the lobes

68
Q

Where are the arcuate arteries located?

A

Between the medulla and the cortex

69
Q

Which arteries give rise to the interlobular?

A

Arcuate arteries

70
Q

Where is the glomerulus?

A

Inside the Bowman’s capsule

71
Q

Why are there afferent and efferent arterioles?

A

The glomerulus has no veins, so there are efferent arterioles inside

72
Q

What is the path of the renal venous drainage?

A

Pertibular capillaries –> Interlobular veins –> Arcuate veins –> Interlobar veins –> Lobar veins –> Segmental veins –> Renal veins

73
Q

Which veins drain into the left renal vein specifically? Why?

A

Left inferior phrenic vein
Left suprarenal vein
Left gonadal vein

They drain into the left because the left renal vein is further away from the IVC

74
Q

What is the location of the IVC in relation to the renal veins?

A

More towards the right, so the right renal vein drains directly to IVC as it is closer to it

75
Q

Where is the left renal vein located?

A

Between the superior mesenteric artery and aorta, higher pressure compared to the right renal vein

76
Q

What is the pathological name of the renal vein entrapment syndrome?

A

Nutcracker syndrome

77
Q

What is the Nutcracker syndrome?

A

Compression of the left renal vein at midline between the superior mesenteric and the abdominal aorta –> Increase of the hydrostatic pressure in the kidney

78
Q

What are the clinical manifestations of the Nutcracker syndrome?

A

Hematouria / proteinuria
Left flank pain
Nausea and vomiting
Left testicular pain in men

79
Q

What are juxtamedullary nephrons? What are they supplied by?

A

Deep nephrons, supplied by longer vessels known as vasa recta

80
Q

What is a renal lobe?

A

Each medullary pyramid with its superimposed cortical part & adjacent regions of cortical columns

81
Q

What is a renal lobule?

A

A group of nephrons draining into the same single collecting duct

82
Q

What are the different structures that make up the nephron?

A

Renal corpuscle
Renal tubules

83
Q

What are the two parts of the renal corpuscle?

A

Vascular pole
Urinary pole

84
Q

What makes up the corpuscle?

A

Glomerulus
Bowman’s capsule

85
Q

What is the glomerulus?

A

Tuft of fenestrated capillaries

86
Q

What are the two layers of the Bowman’s capsule?

A

Visceral and parietal layers

87
Q

What is the visceral layer of the Bowman’s capsule formed of?

A

Podocytes

88
Q

What is the parietal layer of the Bowman’s capsule formed of?

A

Simple squamous epithelium

89
Q

What are the renal tubules of the kidneys?

A

PCT
Loop of Henle
DCT

90
Q

What structure marks the start of the urinary pole?

A

PCT

91
Q

What is the space between the parietal and visceral layers?

A

The urinary space

92
Q

What are the filtration barrier membranes of the renal corpuscle?

A

Fenestrated endothelial cells of the capillary
Thin layer of basal lamina
Visceral layer of Bowman’s capsule

93
Q

What do two basal laminae form?

A

A basal membrane

94
Q

Where is the filtration slit diaphragm located?
Why are they important?

A

Between the pedicels
Important for filtration capability

95
Q

What is the fenestrated endothelium covered by?

A

Basal lamina

96
Q

What is the epithelium of the PCT like?

A

Simple cuboidal epithelium, absorption and secretion functions

97
Q

Why does the PCT have high profiles?

A

Due to its tortious structure, more of them in a cross section

98
Q

What are the characteristics present on the PCT?

A

Brush border
Well-defined basement membrane
Few basally placed nuclei
Indistinct layer membrane (no clear boundaries)
A lot of mitochondria

99
Q

Why do the PCTs have a lot of mitochondria?

A

They require a lot of energy for transport

100
Q

What is the epithelium of the loop of Henle like?

A

Simple squamous epithelium

101
Q

Why are there not a lot of mitochondria in the loop of Henle?

A

There are not a lot of mitochondria or organelles because of the passive movement or reabsorption, and not a lot of energy is required

102
Q

What is the function of juxtamedullary nephrons?

A

Establishing the gradient of hypertonicity in the medullary interstitium

103
Q

What do the juxtamedullary nephrons consist of?

A

Short thick descending limb
Long, thin, descending, and ascending limbs
Thick ascending limb

104
Q

What is the epithelium of DCT like?

A

Simple cuboidal epithelium

105
Q

What are the profiles of DCT like in comparison to PCT?

A

Less

106
Q

What are the characteristics of the DCT epithelium?

A

Low cuboidal
Apical nuclei
Few short blunt microvilli
No brush border

107
Q

Why do DCTs stain lighter than PCTs?

A

Not as many mitochondria, less eosinophilic

108
Q

What are the components of the juxtaglomerular apparatus?

A

Macula densa
Juxtaglomerular granular cells
Extraglomerular mesangial cells

109
Q

What is the macula densa?

A

Part of the DCT

110
Q

What are the juxtaglomerular granular cells part of?

A

The afferent arterioles

111
Q

What is the function of the juxtaglomerular apparatus?

A

Regulate blood flow to the kidney, according to the blood pressure

112
Q

What are the kinds of collecting tubules?

A

Cortcical and medullary

113
Q

Where are the cortical collecting ducts?

A

In medullary rays

114
Q

Where are the medullary collecting ducts?

A

In the outer layer of the medulla

115
Q

What is the epithelium of the collecting ducts?

A

Simple columnar, very clear borders
Aqua chorea, a lot of water reabsorbed

116
Q

What are collecting tubules affected by?

A

ADH

117
Q
A

Renal System (24 decks)

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