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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
What are the relations of the left kidney? (6)
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)
26
What are the structures superior to the kidneys?
Right kidney --> Right lobe of liver and suprarenal gland Left kidney --> Spleen and suprarenal gland
27
What are the strictures anterior to the right kidney?
The right lobe of the liver Right colic flexure 2nd part of duodenum
28
What are the structures anterior to the left kidney?
Spleen Left colic flexure Stomach Pancreas
29
What are the structures posterior to the kidneys?
Diaphgram Psoas major Quadratus lamborum
30
What are the structures posterior to the right kidney?
The 12th rib
31
What are the structures posterior to the left kidney?
The 11th and 12th rib
32
What is the Psoas major?
The innermost muscle, closest to the vertebral column
33
What is the location of Quadratus Lamborum?
Lateral to the Psoas major
34
Why is the right kidney only in contact with the 12th rib?
Because of its lower location, due to the presence of the liver
35
What is the renal hilum?
The point of entrance/exit of the kidneys, arteries, veins and lymphatic vessels
36
At which level is the renal hilum found?
At the level of the transpyloric plane (L1/L2)
37
The renal hilum is part of the?
Renal sinus
38
What are the structures of the renal hilum starting from most anterior to most posterior?
Renal vein (most anterior) Renal Artery Ureter (most posterior)
39
What happens if there is one singular renal aretry?
It will be posterior to the renal vein and anterior to the ureter
40
What happens to the renal artery some times?
It divides into segmental arteries. Thus, there usually will be a renal artery anterior and posterior to the ureter These variations are considered normal
41
What are the renal columns?
Extensions of cortex into medulla
42
What are the two internal structures of the kidney?
Cortex and medulla
43
What is the cortex?
The outermost part of the kidney
44
What is the medulla?
The innermost part of the kidney
45
What are the different structures of the cortex?
Renal corpuscles Cortical labyrinth Medullary rays
46
What is the cortical labyrinth made of?
Proximal convoluted tubule Distal convoluted tubule
47
What are the medullary rays?
Continuation of the medulla they are considered collecting ducts
48
What are the two zones of the medulla?
Outer and inner zones
49
What are the structures of the outer zone of the medulla?
Collecting ducts Loop of Henle
50
What are the structures of the inner zone of the medulla?
Papillary ducts Deep loop of Henle
51
What is the function of the draining system of the kidneys?
To collect urine from the nephrons and pass it all the way to the ureter
52
What is the draining system of the kidneys like?
Collecting ducts Papillary ducts of Bellini Renal papilla Minor calyx Major calyx Renal pelvis Ureter
53
What is the purpose of collecting ducts?
Collect urine from nephrons
54
What is the epithelium like all the way up to the minor calyx?
Simple columnar
55
What is the start point of the ureter?
The minor calyx
56
What is significant about the minor calyx?
The first part of the uroepithelium, the start of transitional epithelium
57
What is special about the uroepithelium?
It has the ability to stretch
58
What is the renal pelvis?
The upper extended part of the ureter
59
How many nephrons are there in each kidney?
About 1 million in each kidney
60
What is special about the blood supply of the kidneys?
Very rich in vasculature Kidneys receive about 25% of the cardiac output
61
What is the main blood supply to the kidneys?
Renal arterial blood supply
62
What kind of branch is the renal artery?
The lateral branch of the aorta
63
At what point does the renal artery enter the hilum of the kidneys?
L2
64
Which renal artery will be shorter and why?
The left renal artery will be shorter because the aorta is located slightly to the left
65
What is the path of the renal arterial blood supply?
Renal arteries --> segmental arteries --> lobar arteries --> interlobar arteries --> arcuate arteries --> interlobular arteries --> afferent arterioles --> glomerulus --> efferent arterioles
66
Where do the lobar arteries run?
Between the pyramids, supply the whole lobe
67
Where are the interlobar arteries located?
Between the lobes
68
Where are the arcuate arteries located?
Between the medulla and the cortex
69
Which arteries give rise to the interlobular?
Arcuate arteries
70
Where is the glomerulus?
Inside the Bowman's capsule
71
Why are there afferent and efferent arterioles?
The glomerulus has no veins, so there are efferent arterioles inside
72
What is the path of the renal venous drainage?
Pertibular capillaries --> Interlobular veins --> Arcuate veins --> Interlobar veins --> Lobar veins --> Segmental veins --> Renal veins
73
Which veins drain into the left renal vein specifically? Why?
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
What is the location of the IVC in relation to the renal veins?
More towards the right, so the right renal vein drains directly to IVC as it is closer to it
75
Where is the left renal vein located?
Between the superior mesenteric artery and aorta, higher pressure compared to the right renal vein
76
What is the pathological name of the renal vein entrapment syndrome?
Nutcracker syndrome
77
What is the Nutcracker syndrome?
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
What are the clinical manifestations of the Nutcracker syndrome?
Hematouria / proteinuria Left flank pain Nausea and vomiting Left testicular pain in men
79
What are juxtamedullary nephrons? What are they supplied by?
Deep nephrons, supplied by longer vessels known as vasa recta
80
What is a renal lobe?
Each medullary pyramid with its superimposed cortical part & adjacent regions of cortical columns
81
What is a renal lobule?
A group of nephrons draining into the same single collecting duct
82
What are the different structures that make up the nephron?
Renal corpuscle Renal tubules
83
What are the two parts of the renal corpuscle?
Vascular pole Urinary pole
84
What makes up the corpuscle?
Glomerulus Bowman's capsule
85
What is the glomerulus?
Tuft of fenestrated capillaries
86
What are the two layers of the Bowman's capsule?
Visceral and parietal layers
87
What is the visceral layer of the Bowman's capsule formed of?
Podocytes
88
What is the parietal layer of the Bowman's capsule formed of?
Simple squamous epithelium
89
What are the renal tubules of the kidneys?
PCT Loop of Henle DCT
90
What structure marks the start of the urinary pole?
PCT
91
What is the space between the parietal and visceral layers?
The urinary space
92
What are the filtration barrier membranes of the renal corpuscle?
Fenestrated endothelial cells of the capillary Thin layer of basal lamina Visceral layer of Bowman's capsule
93
What do two basal laminae form?
A basal membrane
94
Where is the filtration slit diaphragm located? Why are they important?
Between the pedicels Important for filtration capability
95
What is the fenestrated endothelium covered by?
Basal lamina
96
What is the epithelium of the PCT like?
Simple cuboidal epithelium, absorption and secretion functions
97
Why does the PCT have high profiles?
Due to its tortious structure, more of them in a cross section
98
What are the characteristics present on the PCT?
Brush border Well-defined basement membrane Few basally placed nuclei Indistinct layer membrane (no clear boundaries) A lot of mitochondria
99
Why do the PCTs have a lot of mitochondria?
They require a lot of energy for transport
100
What is the epithelium of the loop of Henle like?
Simple squamous epithelium
101
Why are there not a lot of mitochondria in the loop of Henle?
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
What is the function of juxtamedullary nephrons?
Establishing the gradient of hypertonicity in the medullary interstitium
103
What do the juxtamedullary nephrons consist of?
Short thick descending limb Long, thin, descending, and ascending limbs Thick ascending limb
104
What is the epithelium of DCT like?
Simple cuboidal epithelium
105
What are the profiles of DCT like in comparison to PCT?
Less
106
What are the characteristics of the DCT epithelium?
Low cuboidal Apical nuclei Few short blunt microvilli No brush border
107
Why do DCTs stain lighter than PCTs?
Not as many mitochondria, less eosinophilic
108
What are the components of the juxtaglomerular apparatus?
Macula densa Juxtaglomerular granular cells Extraglomerular mesangial cells
109
What is the macula densa?
Part of the DCT
110
What are the juxtaglomerular granular cells part of?
The afferent arterioles
111
What is the function of the juxtaglomerular apparatus?
Regulate blood flow to the kidney, according to the blood pressure
112
What are the kinds of collecting tubules?
Cortcical and medullary
113
Where are the cortical collecting ducts?
In medullary rays
114
Where are the medullary collecting ducts?
In the outer layer of the medulla
115
What is the epithelium of the collecting ducts?
Simple columnar, very clear borders Aqua chorea, a lot of water reabsorbed
116
What are collecting tubules affected by?
ADH
117

Renal System (24 decks)

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