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1 SUGER > SUGER: anatomy and histology of the kidney and adrenal glands > Flashcards

SUGER: anatomy and histology of the kidney and adrenal glands Flashcards

1
Q

where is the left kidney located?

A

T11-L2

retro-peritoneal

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2
Q

where is the right kidney located?

A

T12-L3
(lower due to presence of the liver)
retro-peritoneal

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3
Q

what is the deepest fascia layer covering the kidney

A

the renal capsule (touch fibrous capsule)

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4
Q

where is the perineal and paraneal fat?

A

perineal fat -
in between capsule and main fascia layer (2nd deepest layer)

paraneal fat-
superficial layer on posterolateral aspect of kidney

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5
Q

what is the renal fascia? what is it also known as?

A

= Gerota’s fascia/perirenal fascia

a layer of connective tissue encapsulating the kidneys and the adrenal glands

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6
Q

what are the renal columns?

A

columns in between the renal pyramids

in the cortex of the kidney

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7
Q

what structures compose the renal cortex?

A
  • renal corpuscles
  • the proximal and distal convoluted tubules
  • medullary rays
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8
Q

what are the medullary rays?

where are they found within the kidney?

A
  • specialised areas

- within cortex of kidney (near outer border, close to renal capsule)

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9
Q

what structures do the medullary rays contain?

A
  • a collection of loops of henle and collecting ducts

- from nephrons that have their renal corpsecules in outer parts of the cortex (close to renal capsule)

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10
Q

why are medullary rays named so if they are located in the cortex not medulla?

A

because they transport substances into the medulla

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11
Q

how are the medullary rays orientated?

A

radially orientated tubules

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12
Q

what is the inner part of the kidney formed from?

A

inner part = medulla + calyces

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13
Q

what shapes is the medulla arranged in?

A

inverted pyramids

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14
Q

where are the renal papilla?

A

at the end of the renal pyramids

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15
Q

where are the renal calyces?

A

allow urine to drain from renal pyramids into the renal pelvis (via renal papilla)

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16
Q

what is the difference between minor and major calyx?

A

minor connect to base of pyramids (renal papillae)

minors merge to form a major

major are bigger, and merge to form the renal pelvis

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17
Q

describe the pathway of urine from the cortex of the kidney to the ureters?

A

urine drains from:

  • produced in collecting ducts
  • travels down the renal pyramids
  • through renal papilla at bases
  • enter a minor calyx
  • goes to a major calyx
  • to the renal pelvis
  • to the ureter
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18
Q

what structure is located on the medial border of the kidney and is where the renal vessels, nerves, lymphatics and ureter enter/exit the kidney?

A

the renal hilum

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19
Q

what is the arterial supply to the kidneys?

A
  • L&R renal arteries

- from abdominal aorta

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20
Q

what is the venous drainage of the kidneys?

A

L&R renal veins

- drain directly into IVC

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21
Q

which renal vein (L or R) is bigger? why?

A

LEFT renal is bigger than right

because drains blood from left adrenal vein and left gonadal vein as well as left kidney

right only drains right kidney

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22
Q

what are nephrons?

A

= functional units of the kidney

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23
Q

what are nephrons responsible for?

A

filtering blood

  • reabsorbing the necessary water and solutes
  • secreting and excreting waste products as urine.
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24
Q

what parts of the nephron are in the cortex of the kidney?

A

renal corpuscle (the filter)
PCT
DCT
part of collecting duct

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25
Q

what are the parts of the renal corpsecule?

A
  • a glomerulus

- a bowmans capsule

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26
Q

what is a glomerulus?

A

a tuft of capillaries surrounded by bowmans capsule

has the filtration barrier

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27
Q

what is the glomerular filtration barrier made of? (4)

A
  • capillary endothelial cells
  • Glomerular BM
  • Podocytes
  • mesangial cells (lie in between capillaries)
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28
Q

where are the glomeruli found?

A

cortex

NOT medulla

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29
Q

what structures compose the renal medulla?

A
  • tubules orientated radially
  • vessels
  • loops of henley
  • collecting ducts
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30
Q

how do you describe a tuft of capillaries that make up a glomerulus?

A
  • convoluted
  • fenestrated (leaky)
  • have many capillary endothelial cells
  • has mesangial cells in between
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31
Q

which histological stain shows the glomerular basement membrane?

A

period acid shift stain

32
Q

what do the thin foot processes of podocytes do in the glomerulus?

A

create the podocyte slit membrane

  • foot processes interdigitate along the BM
  • leave small gaps
  • so filtrate can pass through BM
33
Q

what is the role of the mesangial cells in the glomerulus?

A
  • they create a matrix called the mesangium
  • supports the glomerular capillary loops
  • plays a role in tuboglomeruluar feedback and GFR
34
Q

how many layers is the glomerular basement membrane?

A
  • 2 layers
  • essentially 2 BM back-to-back
  • capillary layer + podocyte layer
35
Q

what is the charge of the glomerular basement membrane? why is this important?

A

negative

so repels negative ions

36
Q

what is the JGA?

A

the juxtaglomerular apparatus

37
Q

where is the JGA located in a nephron ?

A

next to glomerulus

in between the afferent arterioles and the distal convoluted tubule

38
Q

what 3 cell types make up the JGA?

A
  1. granular cells
  2. the Macula Densa
  3. lacis cells
39
Q

what are granular cells?

where are they found?

A

aka. the Juxtaglomerular cells (JG cells)

  • specialised smooth muscle cells
  • in the walls of the afferent arterioles that deliver blood to the glomerulus.
40
Q

what is the role of the granular cells in the JGA?

A

to sense BP

+ secrete renin when low BP

41
Q

what are the macula densa?

where are they found?

A
  • they are a patch of closely packed endothelial cells
  • along the distal convoluted tubule (DCT)
  • next to the glomerulus
42
Q

what is the role of the macula densa?

A
  • they sense NaCL concentration and regulate tubuloglomerular feedback
  • interact with granular cells to cause renin secretion
43
Q

what are the lacis cells of the JGA?

where are they found?

A

= tiny cells at base of gloemulus

no identified role

44
Q

what is the epithelium that makes up the proximal convoluted tubules? (PCT)

A

simple cuboidal epithelium

45
Q

what features make the epithelium of the PCT identifiable?

A
  • central and round nuclei

- prominent brush border

46
Q

what is the role of the PCT?

A
  • to actively transport ions from glomerular filtrate

- at PCT, there is reabsorption of NaCl, protein, polypeptides, AAs, glucose

47
Q

which parts of the loop of henle are thick/thin?

A

3 segments

  1. thin descending limb
  2. thin ascending limb
  3. thick ascending limb
48
Q

what is the epithelium of the THIN segment of the loop of henle?

A

simple squamous epithelium

has a rich vasa recta in between cells

49
Q

what is the epithelium of the THICK segment of the loop of henle?

A

cuboidal epithelium

has a rich vasa recta in between cells

50
Q

what is the epithelium of the DCT?

A

simple cuboidal epithelium

51
Q

what are the similarities between the epithelium of the PCT and the DCT?

A
  • both simple cuboidal
  • both are rich in mitochondria
  • both are eosinophilic
52
Q

how do you tell the difference between the epithelium of the PCT and the DCT?

A
  • DCT is shorter

- PCT has a brush border but DCT has no microvilli

53
Q

what is the role of the DCT?

A
  • it regulates acid/base concentration (by secreting H+ and absorbing HCO3-)
  • regulates Na (exchanges with K)
54
Q

what are the identifiable features of the epithelium of the collecting duct?

A
  • cuboidal

- round central nuclei

55
Q

what does the collecting duct do?

A

plays role in:

  • water reabsorbition,
  • Na balance
  • acid/base balance
56
Q

what 2 types of epithelial cell does the collecting duct have?

A

the principal cells

the intercalated cells

57
Q

what are principal cells?

A
  • within collecting duct

- respond to ADH and aldosterone

58
Q

how do principal cells in the collecting ducts respond to Aldosterone ?

A
  • they absorb Na+

- they excrete K+

59
Q

how do principal cells in the collecting ducts respond to ADH? (antidiuretic hormone)

A
  • ADH binds to receptors on principal cells
  • it increases no. aquaporin-2 channels on cell membrane
  • these increases water permeability of these cells
  • allows water to leave nephron and be reabsorbed into blood plasma
  • decreases urine vol
60
Q

what do the intercalated cells in the collecting ducts do?

A

involved in acid base balance

exchanges H+ for HCO3-

61
Q

what vessels supply blood to glomerulus?

A

afferent arterioles

62
Q

what vessels transport blood out of the renal corpsucule ?

A

efferent arterioles

63
Q

what is the role of the renal pelvis?

A

collecting ducts in medulla drain urine into renal pelvis

pelvis transports this filtrate to ureters

64
Q

what is urothelium?

A

specialised multilayered epithelium found in the collection and drainage parts of the urinary tract

65
Q

what is the single surface layer of urothelium made of ?

A

umbrella cells

  • large and dome shaped
66
Q

how Is the umbrella cell layer of urothelium urine proof?

A
  • tight junctions between cells precent urine passing through
67
Q

how is urothelium structure suited to expansion ?

A

made of pseudo stratified layers of polygonal cells

and these can expand easily

(except for surface layer)

68
Q

where is the right adrenal gland?

A
  • close to upper pole of right kidney
  • in a separate envelope of renal fascia
  • lies behind liver and IVC
69
Q

where is the left adrenal gland?

A
  • close to upper pole of left kidney
  • in a separate envelope of renal fascia
  • lies behind the stomach and pancreas
70
Q

what shape is the right adrenal gland?

A

tetrahedral

71
Q

what shape is the left adrenal gland?

A

crescent shaped

72
Q

what is the arterial supply to the adrenal glands?

A 
superior adrenal 
-off inferior phrenic artery
middle adrenal 
- off aorta 
inferior adrenal
-off renal artery
73
Q

what is the venous drainage to the adrenal glands?

A

R.adrenal vein → direct into IVC

L.adrenal vein → into renal vein → IVC

74
Q

what are the 2 sections of the adrenal glands?

A
  • outer cortex

- inner medulla

75
Q

what is the role of the cortex of the adrenal glans?

A

to produce steroid hormones

76
Q

give 3 examples of steroid hormones

A

cortisol
aldosterone
testosterone

77
Q

what is the role of the medulla of the adrenal glans?

A

to produce adrenaline

1 SUGER (9 decks)

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