SUGER Flashcards
KIDNEY
- pale cortex / dark medulla / 10-15 meduallary pyramids
- cortex contains glomeruli and coils of proximal/distal tubules
- medulla contains pyramids with straight parts proximaal/distal tubule, loop of Henle, collecting duct
Blood
- 5/6 branches renal artery
- arcuate arteries at medullary/cortical border (give off vasa recta - deep to medulla)
- then interlobular arteries penetrate cortex at regular intervals
- affertent to glomerulus
- efferent from glomerulus (filtered blood) - thin walled and between tubules
- acquire fluid and ions -> drain to arcuate veins -> systemic
GLOMERULUS
- blood to glomerulus for filtration
- passes primary filtrate to nephron for selected reabsorption
- parallel array of fenestrated capillaries ensheathed by podocytes
- between loops = mesangiel cells (matrix forming)
- afferent arteriole wall produces renin
- next to glomerulus = segment of distal tubule with macula densa
GLOMERULAR TUFT (PAS)
- arise from vascular pole of glomerulus = entrance afferent and exit efferent
- in this angle lies a distal loop of nephron with palisade of macula densa
- capillary loop surrounded by podocyte
- surrounded by urinary space - separates glomerulus from bowman’s capsule
- arrow to distal tubule
- MACULA DENSA - around blood vessels regulate blood flow, provides framework for glomerulus.
FILTRATION BARRIER
- basement membrane
- synthesised and maintaiend by endothelial capillary cells and epithelial cells (podocytes) that ensheath them
- endothelial = fenestrated
- podocytes stand off membrane with foot processes
- creates physical pores
- pores guarded by filtration membrane
- membrane is charged and resists passage of some molecules
- water and solutes may pass to urinary space = primary filtrate
PROXIMAL TUBULES (PAS)
- highly coiled (sometimes with straight projection to medulla)
- prominent brush border and complex invaginations @ basolateral membrane dark pink
- extensive reabsorption here
- Na+ active transport with glucose (cotransporter - GLUT)
- take up protein and polypeptide by endocytosis
- cells contain lyzosomes which break down proteins before returning to circulation
- any small negatively charged protein can enter primary filtrate
PROXIMAL TUBULES 2 (PAS)
- this slide - straight portion of proximal tubule
- leads to loop of Henle
- if glomeruli present = cortex
- some project to medulla
LOOP OF HENLE (PAS)
- mostly @ medulla
- thick/straight descending, thin loop, thick ascending
- thick descend = similar to proximal tubule
- thick ascend = similar to distal tubule
- longest thin loop penetrate deepest to medulla when glomerulus = cortico-medulla junction
- thin descending portion = low permeability to ions and urea, high permeability to water
- thin ascending portion retains water, reabsorption Na+ and Cl-
- this produces dilute/hypotonic filtrate but a hypertonic interstitium
- vasa recta (straight capillaries) run alongside tubules
this slide - thick and thin limbs and vasa recta
DISTAL TUBULE (PAS)
- from medulla to cortex then to vascular pole of glomerulus
- macula densa here monitors sodium levels to influence intitial filtration of glomerulus
- paler than proximal
- deep invaginations of basal plasma membrane with numerous mitochondria
- mitochondria indicative of control acid/base balance and concentration of urine (ATP)
- with aldosterone sodium reabsorbed, potassium excreted
- bicarbonate ions reabsorbed, hydrogen excreted - acidic urine
@ cortex both proximal and distal tubules present
proximal more tightly coiled therefore appear to be more numerous
COLLECTING DUCTS (PAS)
- pale cuboidal cells
- wide lumen
- starts at cortex, filtrate to collecting tubules than larger ducts
- collecting tubules from many nephrons coalesce to larger ducts and form visible streaks - medullary rays
- few organelles
- collecting tubules - dark intercalated cells with high mitochondria
- surrounded by hypertonic medium interstitial from loop of Henle
- ADH increases permeability to water (concentrates urine)
prone to kidney stones and infection
JUXTAGLOMERULAR APPARATUS (PAS)
- afferent/efferent arterioles, macula densa, lacis cells
- afferent - cells produce renin - granules in cytoplasm
- renin catalyses angiotensin 1 (liver) -> angiotensin 2 (conversion at lungs) -> aldosterone release by suprarenal cortex -> reabsorption of sodium and water @ distal tubules and collecting ducts
- lacis cells and macula densa regulate renin secretion by monitoring sodium levels
this slide - obvious macula densa
UROTHELIUM
- ureters, bladder and most urethra
- pseudo-stratified epithelium
- surface cells adapted to withstand prolonged urine exposure
- 3-8 layers (distension dependent)
- basal cells = cuboidal
- above = columnar (relaxed)
- surface = large, binucleate umbrella cells
umbrella cells:
- thickened membrane plates joined by thin membrane bands
- lipid composition (unique)
- relaxed plated = perpendicular to membrane
- stretched = drawn to surface of cell
URETER
- epithelial tube with 2 helical layers of smooth muscle
- star shaped lumen
- towards bladder = longitudinal smooth muscle
-
3 constrictions (kidney stones will lodge here)
- origin (pelvis of kidney)
- at sacro-iliac joint (passes to true pelvis)
- as enters postero-inferior bladder surface
- reflux prevented by compression of ureter by muscular wall bladder
- contains blood vessels and adipose
- smooth muscle for peristaltic contraction
URINARY BLADDER
- wall = thick bundles of smooth muscle with no preferred direction except neck = 3 distinct layers
1. innermost = longitudinal projects inferiorly and turns transversely to form a sphincter around prostatic urethre (male) and external meatus (female)
thrown into folds w/ umbrella cells
walls of bladder contains small nerves (autonomic)
sympathetic NS = mainly blood vessels at bladder
inset = nerves
micturition
when external sphincter relaxes (sympathetic) and muscle wall (detrusor) contracts (para)
PROSTATIC URETHRA
- urethra longer in males
- prostatic
- membranous
- bulbous
- pendulous
- urothelium (pseudo-stratified columnar) except at distal end
- mucus glands along length
- distal urethra = stratified squamous (male and female)
- both sexes = striated (voluntary) muscle sphincter from muscles of pelvic diaphragm around membranous part
- under prostatic urothelium = dense fibrous connective tissue to prevent distension
inset = U-shaped prostatic urethra
TESTES
- within collagenous capsule = tunica albuginea
- within fibrous septa to 250 lobules (each lobule with up to 4 germ cell producing semniferous (tubules)
- semniferous tubule = 50cm loop (open both ends)
- drain to rete testes (channels)
- Leydig cells between semniferous tubules
SEMNIFEROUS TUBULE
- stratified epithelium with support (sertoli) and germ line (developing spermatazoa)
- at periphery = germinal epithelial
- GE produces large cells with speckled chromatin = spermatagonis
- spermatogonia develop to spermatocytes
- spermatocytes pass blood testis barrier created by Sertoli
- Sertoli = blood testis barrier and nurture sperm
- production = 64 days
- maturation wave passes slowly down each tubule
SEMNIFEROUS TUBULES
- thin fibrous capsule
- closest to membrane = germinal epithelium with spermatogonia (speckled)
- between cells are smaller primary spermatocytes and Sertoli cells (pale irregular nuclei)
- towards centre depends on stage in cycle
- sometimes primary/secondary spermatocytes (small dense nuclei)
- otherms more mature (narrow and elongated heads)
- between tubules = leydig clumps
arrow to spermatid
reduction division (2n-1n -> first meiotic) takes place when primary to secondary @ luminal side of blood testis barrier i.e. not in contact with blood stream
EPIDIDYMIS
- rete testis = cuboidal ep
- rete testis to efferent ductules (similar)
- epididymis = single 5m coiled tube
- thick fibrous capsule attached to mediastinum of testes posteriorly - storage and maturation site for sperm aggregated within lumen
- tall pseudo-stratified columnar ep
- small rounded basal cells support tall columnar with microvilli (stereocilia)
- stereocilia (non-motile) reabsorb seminal fluid, phagocytose damaged sperm and cell debris. also nutrients for sperm
- thin layer of smooth muscle thicker as approaches vas
VAS DEFERENS
- spirally arranged smooth muscle
- similar to epididymis but shorter cells and microvilli
- sometimes has longitudinal folds - lamina propria
- sudden and rhythmical contraction expels sperm
thick muscular wall makes vas feel cord like
SEMINAL VESICLE
- highly coiled glands at postero inferior bladder
- double layered capsule of smooth muscle
- long narrow folds
- stimulated by testosterone - enlarge and secrete creamy opalescent fluid with acid pH. rich in globulin, vitamin C, amino acids and sugars
- contraction of smoooth muscle mixes with spermatozoa
- simple columnar epithelium
PROSTATE
- 50 branched tubular glands
- smooth muscle matrix
- smooth muscle capsule around all
- 3 layers (concentric) of glands - mucosal - submucosal - main
- @ ejaculation, contract and mix secretions @ ejaculatory duct
PROSTATIC EPITHELIUM
- glands varied - straight, coiled, branched
- epithelium thrown into broad, branching folds
- with testosterone, cells increase in height and secrete digestive enzymes - acid phosphatase (major component of seminal fluid) - (PSA) prostate specific antigen
- lumen often with sec product / calcified glycoprotein
PROSTATE 2
- this slide L - skeletal muscle at underside of prostate - pelvic diaphragm with levator ani
- this slide R - spiral tubular gland at submucosal level
PENILE URETHRA
- prostatic, membranous, penile
- membranous and penile = non-secreting pseudostratified columnar
- at distal end = stratified squamous epithelium (within glans)
- bulbo-urethral glands within membranous urethra produce watery galactose rich secretion, precedes main ejaculate - can sometimes be a problem with catheterisation
PENIS
- erectile compartments = large endothelium lined blood vessels supported by connective tissue
- each surrounded by compact collagen layer = tunica albuginea
- helicine branches of pudendal artery
- when flaccid arteries transmit very little blood due to artero-venous shunts
- para. stimulus shut shunts (point and shoot)
- most skin = hairy, loosely attached to columns - except prepuce and glans (non-kerat)
VAGINA
- stratified squamous thinly keratinised at vulval end
- thin pre-puberty and post menopause
- beneath epithelium = lamina propria with small blood vessels (moisture by diffusion)
- surrounding epithelium = fibro muschular tube with collagen/elastic and smooth muscle
- sphincter of skeletal muscle at lower end
- bartholin glands - mucus posterolaterally at lower end of vagina
- with age = weaker fibro-muscular tube
EPITHELIAL SQUAMES
- in menstrual cycle surface cells accumulate glycogen and flake off
- desquamated cells rupture and bacteria generate lactic acid
- low pH at vagina
pale green cells - outermost layer, predominate at first half of menstrual cycle
pink cells - deeper layer