SUGER Flashcards

1
Q

What is the glomerulus like?

A

Tuft of convoluted fenestrated capillaries

Glomerular basement membrane

Lined by podocytes

Supported by mesangial cells

Encased in Bowman’s capsule

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2
Q

What are the components of the juxtaglomerular apparatus?

A

2 Components:

Afferent arteriole
Distal convoluted tubule

Afferent arteriole contributes Granular cells

Secrete renin in response to low blood pressure

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3
Q

What is the function of the juxtaglomerular apparatus?

A

Distal convoluted tubule contributes the Macula Densa

Patch of closely packed endothelial cells along tubule

Senses NaCl concentration and regulates tubuloglomerular feedback

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4
Q

What is the function of the juxtaglomerular apparatus?

A

Distal convoluted tubule contributes the Macula Densa

Patch of closely packed endothelial cells along tubule

Senses NaCl concentration and regulates tubuloglomerular feedback

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5
Q

What is the structure of the PCT?

A

Cuboidal epithelium

Round central/basal nuclei

Brush border of microvilli at apical end

Many mitochondria
so appears eosinophilic

Reabsorption of NaCl, proteins, polypeptides, amino acids, glucose

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6
Q

What is the loop of henle like?

A

Descending and ascending limbs
Both with thick and thin segments
Thin - simple squamous
Thick - low cuboidal
Supplied by a rich vasa recta

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7
Q

What is the DCT?

A

Low cuboidal epithelium
Scanty microvilli
Numerous mitochondria
Regulates acid base by secreting H+ and absorbing HCO3-
(Via cellular carbonic anhydrase)
Regulates Na level by exchanging Na for K

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8
Q

What is the CD like?

A

Cuboidal epithelium

Principal cells
Respond to aldosterone and ADH

Intercalated cells
Exchange H+ for HCO3-

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9
Q

What is the blood supply of the kidneys?

A

Abdominal aorta

Renal artery at L1

Anterior & posterior division

Interlobar artery

Arcuate artery (corticomedullary)

Interlobular artery

Afferent arteriole

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10
Q

What is the loop of henle and vasa recta path of blood?

A

After glomerulus blood drains:
Efferent arteriole (from renal corpuscle)
Peritubular capillaries
Descends into medulla
Vasa recta
Renal veins
Inferior vena cava

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11
Q

What is the renal pelvis like?

A

Lined by urothelium

Transmits filtrate from nephron to ureter

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12
Q

What is urothelium?

A

Specialised epithelium found in the collection/drainage parts of the urinary tract

Complex stratified epithelium

Layer of umbrella cells overlies a pseudostratified layer of polygonal cells

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13
Q

What are ureters like?

A

Transitional epithelium

Spiral muscular tube
Inner longitudinal
Outer circular

No serosa
Loose adventitia

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14
Q

What is the bladder composed of?

A

Urothelium

Lamina propria

Muscularis Mucosa

Submucosa

Muscularis Propria

Subserosa and Serosa

Functional valve prevents reflux into ureter

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15
Q

What is the female urethra like?

A

4-5cm long

Proximally transitional epithelium

Distally squamous epithelium

Paraurethral and periurethral glands open into the urethra

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16
Q

What is the male urethra like?

A

20cm long

1.Prostatic urethra

  1. Membranous urethra lined by urothelium
  2. Penile urethra
    Pseudostratified epithelium proximally
    Stratified squamous epithelium distally
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17
Q

What lining does the renal pelvis, ureter, bladder and urethra?

A

The renal pelvis, ureter, bladder and urethra all have the same urothelial lining

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18
Q

What is the urothelium like?

A

Urothelium is a complex stratified epithelium unique to the urinary tract.

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19
Q

What is the testis?

A

The testis

Paired organ in the scrotum

Average weight 15-19g

Capsule
Tunica vaginalis

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20
Q

What are the testis structure?

A

Three layers forming a capsule

Tunica vaginalis
Flattened layer of mesothelial cells

Tunica albuginea
Collagen fibres with some fibroblasts, myocytes, nerve fibres.

Tunica vasculosa
Loose connective tissue containing blood vessels and lymphatics.

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21
Q

What are the testicular parenchyma like?

A

The testis

Testicular parenchyma is divided into lobules by septa originating from the capsule.

~ 250 lobules

Each lobule contains 1-4 seminiferous tubules.

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22
Q

What do seminiferous tubules contain?

A

The testis
Seminiferous tubules contain germ cells in varying stages of maturation and Sertoli cells.

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23
Q

What is the structure of a spermatazoon?

A

Spermatagonia -> primary spermatocyte -> secondary spermatocyte -> spermatid -> spermatazoon

Type A darkly stained stem cells (Ad) and pale stained (Ap) cells

Type B differentiating progenitor cells have spherical nuclei with densely stained masses of chromatin.

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24
Q

What are Sertoli cells like?

A

Columnar cells on the basement membrane of the tubule.

Send cytoplasmic projections around the germ cells.

Nuclei are irregularly shaped, folded and have a prominent nucleolus (helps to distinguish from germ cells)

Supportive , phagocytic and secretory functions

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25
Q

What is teh structure of spermatozoa?

A

Spermatozoa
Head
Acrosomal cap
Nucleus

Midpiece
Spiral mitochondria

Tail
Neck – centrioles
Axoneme
Plasma membrane

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26
Q

What are leydig cells?

A

Leydig cells
Present singly and in clusters in the interstitium between tubules

Abundant cytoplasm containing lipid

Reinke’s Crystalloids

Produce testosterone.

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27
Q

What are Rete testis?

A

Anastomosing network of tubules at the hilum of the testis

Receive luminal contents from seminiferous tubules

Lined by simple squamous or low columnar epithelium on a relatively thick basement membrane.

Have cilia at the luminal surface

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28
Q

Rete testis

A

Mixing chamber for contents of seminiferous tubules

Possible secretions

Reabsorption of protein from the luminal contents

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29
Q

What are efferent ducts like?

A

ducts
12-15 convoluted tubules which empty into epididymis

Lined by ciliated and non ciliated simple columnar epithelium with interspersed cuboidal cells (basal cells) giving a pseudostratified appearance.

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30
Q

What is the epididymis structure?

A

Epididymis

A tubular structure 4-5cm long containing a highly convoluted epididymal duct (5m!)

Lined by tall columnar cells with long atypical cilia

Epithelium supported by a thick basement membrane surrounding which is a well defined muscular coat.

31
Q

What is the vas deferens?

A

Vas deferens

30-40cm tubular structure arising from the caudal portion of epididymis.

Distal part enlarged to form the ampulla which joins the excretory duct of the seminal vesicle to form the ejaculatory duct.

Lined by pseudostratified columnar epithelium
comprising columnar and basal cells.

Has thick muscular wall of 3 layers.

32
Q

What is the prostate like?

A

Pear shaped glandular organ

Weighs up to 20g in young adult

Surrounds the bladder neck and prostatic urethra

Lobes-anterior, middle, posterior and two lateral lobes

Peripheral, central, transitional and peri-urethral gland regions

33
Q

What is the composition of the prostate?

A

Prostate

Covered by a an ill-defined fibro-connective tissue capsule.

Glandular and non glandular components

Ducts
Large primary and small secondary

Acini
30-50 tubuloalveolar glands with convoluted edges

34
Q

What cells are present in the prostrate?

A

Prostate
Acini are lined by secretory cells, basal cells and neuroendocrine cells

Secretory cells located in the luminal side of the glands secrete PSA and PAP into the seminal fluid

Basal cells form a continuous layer

Cells rest on a basement membrane

35
Q

What comprises the stroma of the Prostate?

A

Prostate

Stroma
Smooth muscle
Fibroelastic fibres
Blood vessels
Nerves

Both the stroma and the glands undergo hyperplasia with increasing age.

36
Q

What are the seminal vesicles?

A

Seminal vesicles

Paired highly coiled tubular structures posterolateral to the bladder

The duct empties into the ejaculatory duct

Lined by tall non-ciliated columnar epithelium

Vacuoles and lipofuscin

Mucosa is folded
Smooth muscles (2 layers) and adventitia

37
Q

What is the penis like?

A

Penis - Erectile tissue arranged into 3 components

  1. Left and right corpora cavernosa on the dorsal side
  2. Corpus spongiosum on the inferior side (surrounds urethra)
  3. Erectile tissue comprises irregular vascular spaces separated by fibroelastic tissue and smooth muscle.
  • Rich nerve supply.
38
Q

What does the testis contains?

A

The testis contains seminiferous tubules that produce spermatazoa

39
Q

What does the testis contains?

A

The testis contains seminiferous tubules that produce spermatazoa

40
Q

What do leydig and Sertoli cells do?

A

Leydig cells produce testosterone
Sertoli cells are polyfunctional

41
Q

What do leydig and Sertoli cells do?

A

Leydig cells produce testosterone
Sertoli cells are polyfunctional

42
Q

Where is seminal fluid made?

A

The prostate, seminal vesicles and Cowper’s glands produce the bulk of the seminal fluid

43
Q

Where is seminal fluid made?

A

The prostate, seminal vesicles and Cowper’s glands produce the bulk of the seminal fluid

44
Q

What is the ovary?

A
  • Covered by a single layer of modified mesothelium
  • Under this is a poorly defined connective tissue layer called tunica albuginea
  • Stroma divided into cortex and medulla
45
Q

What is the ovarian cortex like?

A

Ovarian cortex

Spindle stromal cells arranged in whorls /storiform pattern.

Ovarian follicles.

Some leutinised cells.

46
Q

What is the ovarian medulla like?

A

Ovarian medulla

Loose fibroelastic tissue with blood vessels,lymphatics and nerves.
Rete ovarii - analogue of rete testis-present at the hilum

47
Q

What are the primordial follicles?

A

Primary follicles

Cyclic FSH secretion from the ant. pituitary stimulates follicular development.

Follicular epithelial cells proliferate (granulosa cells)

Oocyte enlarges

Stromal cells become organised into connective tissue sheath.

Zona pellucida forms directly around the oocyte.

48
Q

What are secondary follicles?

A

Secondary follicles

Formation of antrum (space filled with follicular fluid)

CT differentiates into inner Theca interna and outer Theca externa

Oocyte is supported in the antrum by a stalk of granulosa cells (Cumulus oophorus)

49
Q

What are mature (Graafian follicles?)

A

Mature (Graafian) follicles

Ovum is surrounded by a thick zona pellucida

A layer of granulosa cells surround the oocyte - corona radiata

Basal lamina

Theca interna and Theca externa

50
Q

What happens to primordial follicles?

A

Approximately 400,000 primordial follicles are present at birth. Out of these only approx 400 mature to ovulate. 99% of the remaining undergo atresia

51
Q

What is the corpus luteum?

A

Corpus luteum

Follicle converts into a corpus luteum

Leutinisation of the granulosa and theca cells occurs (become polygonal, larger in size, have abundant cytoplasm containing lipid.)

Secrete progesterone and oestrogen

If pregnancy does not occur, they regress.

52
Q

What occurs in the corpus luteum?

A

Corpus luteum

Regression starts 8-9 days after ovulation of pregnancy does not occur.

Granulosa cells decrease in size, develop pyknotic nuclei, and accumulate abnormal lipid.

Cells undergo dissolution and are phagocytosed.

There is progressive fibrosis by ingrowth of connective tissue

53
Q

What is the corpus albicans?

A

Corpus albicans
Well circumscribed structure with convoluted borders, almost entirely composed of densely packed collagen with occasional follicles.

Eventually they may be resorbed/ replaced by ovarian stroma

54
Q

What is the fallopian tube like?

A

Run throughout the length of the broad ligament

Transports ovum to the uterus

Fertilization occurs here.

4 segments
Intramural - inside uterine wall

Isthmus - 2-3 cm, thick walled

Ampulla - expanded area

Infundibulum - Trumpet - shaped opening to peritoneum, has fimbriae.

55
Q

What do fallopian tubes contain?

A

Mucosa
Thrown into branching folds (plicae)

2 cell types
- Secretory
- ciliated
(peg cell – effette secretory)
(basal – lymphocytes)

Muscularis (myosalpinx)
- Inner circular layer
- Outer longitudinal layer.

Serosa
Connective tissue covered by mesothelium

56
Q

What is the uterus like?

A

Composed of three layers:
- endometrium
- myometrium
- serosa

Endometrium
Deep basal layer - stratum basalis

Superficial functional layer - stratum compactum (towards the surface) and stratum spongiosum

57
Q

What is the uterus like?

A

Composed of three layers:
- endometrium
- myometrium
- serosa

Endometrium
Deep basal layer - stratum basalis

Superficial functional layer - stratum compactum (towards the surface) and stratum spongiosum

58
Q

What is the proliferation phase of the endometrium?

A

Endometrium

Proliferative phase
Oestrogen stimulation

Straight proliferating glands with mitotic activity

No luminal secretions

Stromal cells are spindled and compact, and show mitotic activity

59
Q

What is involved in the secretory phase?

A

Secretory phase
Progesterone stimulation

Early - Sub-nuclear glycogen vacuoles

Mid - vacuoles above and below the nucleus and later intraluminal secretions, glands more rounded
Stroma-oedema

Late - Elongated and saw-toothed glands with more intraluminal secretions
Stroma - spiral arterioles, decidual change
(Image shows late-secretory endometrium)

60
Q

What is the menstrual phase of the endometrium?

A

Menstrual phase
Progesterone stimulation withdrawn

Stromal haemorrhage and granulocytes

Stromal and glandular fragmentation

61
Q

What is the myometrium like?

A

Thick muscular wall with 3 ill-defined layers of smooth muscle

Inner longitudinal
Middle circular
Outer longitudinal

62
Q

What is the endocervix like?

A

Loose fibromuscular stroma lined by simple columnar ciliated epithelium

Thrown into crypts

63
Q

What is the ectocervix like?

A

Ectocervix
Dense smooth muscle stroma lined by non-keratinised stratified squamous epithelium

Site of squamocolumnar junction varies

Atrophic in postmenopausal women

64
Q

What is the vagina like?

A

Vagina
Tubular structure

Mucosa
Lined by non keratinising stratified squamous epithelium.
Stroma contains elastic fibres and a rich vascular network.

Muscular wall
Smooth muscle cells
Inner circular
Outer longitudinal.

Adventitia
Loose connective tissue

65
Q

What is the vulva like?

A

Vulva
Mons pubis Clitoris
Labia minora Labia majora
Vulvar vestibula Hymen
Urethral meatus Skein’s gland
Bartholins gland Introitus.

Labia majora
Lined by keratinising stratified squamous epithelium and has skin adnexae.

Labia minora
Mostly non keratinising stratified squamous epithelium.

66
Q

What is bartholins gland?

A

Bartholin’s gland
Tubuloalveolar glands. Acini lined by mucus-secreting epithelium

67
Q

What are the minor vestibular glands?

A

Minor vestibular glands
Simple tubular glands lined by mucus-secreting epithelium

68
Q

What is the skeins glands?

A

Skein’s glands (periurethral glands)
•Analogous to prostate
•Lined by peudostratified columnar epithelium

69
Q

What is the hymen and clitoris like?

A

Hymen
•Lined by non-keratinising sqaumous epithelium

Clitoris
•Erectile tissue rich in blood vessels and nerves.

70
Q

How does the appearance of ovary and endometrium vary?

A

Histological appearance of the ovary and endometrium varies according to the phase of the menstrual cycle in reproductive life

71
Q

How is the female reproductive tract like in postmenopausal women?

A

In postmenopausal women the ovary, endometrium, cervix and vagina atrophy

72
Q

What is the function of the skin?

A

Barrier to infection
Waterproofing
Thermoregulation
Protect against trauma
Protect against UV-light
Vitamin D synthesis
Sensation

73
Q

What is the epidermis like?

A

Basement membrane - not typically visible in HandE
Made of type 4 (IV) collagen

Stratum basale

Melanocytes

Stratum spinosum

Stratum granulosum

Stratum corneum

74
Q

What is the stratum basale like?

A

Sits on BM
Basal epithelial cells (stem cells)
Melanocytes