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VAP > Urinary > Flashcards

Urinary Flashcards

1
Q

what clinical conditions are associated with the kidney?

A

kidney failure (acute and chronic), calculi (stones), tumours, incontinence, infection, injuries

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2
Q

shape of kidneys in the dog?

A

‘kidney’ shaped

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3
Q

characteristics of kidneys in cat?

A

capsular, lots of veins

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4
Q

which animals have similar kidneys to sheep?

A

goats, rabbits

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5
Q

shape of pig kidney?

A

flattened

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6
Q

characteristics of ox kidney?

A

lobated, unusual looking

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7
Q

characteristics of horse kidney?

A

left is J shape/L shape, right is heart shape/r shape

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8
Q

which species has a lobated kidney?

A

ox

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9
Q

which species has a flattened kidney?

A

pig

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10
Q

which kidney is cranial?

A

right

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11
Q

in which species may the left kidney be cranial?

A

pigs

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12
Q

location of carnivore left kidney?

A

L2-4

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13
Q

location of carnivore right kidney?

A

L1-3

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14
Q

location of ox left kidney?

A

L2-4, on right

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15
Q

location of ox right kidney?

A

L1-3

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16
Q

location of horse left kidney?

A

last T vertebra- L3

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17
Q

location of horse right kidney?

A

T16-L1

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18
Q

location of pig left kidney?

A

last thoracic vertebra-L3

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19
Q

location of pig right kidney?

A

last thoracic vertebra-L3

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20
Q

which kidney is mobile/pendulous?

A

left

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21
Q

in which species does the left kidney rotate 90 degrees?

A

ox

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22
Q

how is the mobile left kidney useful in cat euthanasia?

A

helpful to hold left kidney through left body wall and inject euthanasia directly into kidney- veins usually collapsed so this is useful and quicker

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23
Q

what is the additional attachment of the kidney in the horse?

A

nephrosplenic ligament

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24
Q

which species has a nephrosplenic ligament?

A

horse

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25
Q

what does the equine nephrosplenic ligament attach?

A

left kidney to spleen

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26
Q

what happens in nephrosplenic entrapment?

A

colon (left ventral and dorsal) distends, becomes buoyant, floats up L flank to hook over nephrosplenic ligament- leads to pain and can cut off blood supply to spleen causing splenic engorgement

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27
Q

what are the treatments for nephrosplenic entrapment?

A

fluids, food restriction, exercise, rolling, phenylephrine to cause splenic contraction, surgery

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28
Q

how does the kidney start in embryonic development?

A

starts multilobar and multipyramidal

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29
Q

what happens to the kidney as the embryo develops?

A

progressive fusion of lobes and pyramids

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30
Q

which species have unipyramidal (fusipyramidal) kidneys?

A

dog, cat, horse, sheep, rabbit

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31
Q

which species have multipyramidal, unilobar kidneys?

A

human, pig

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32
Q

which species have multilobar, multipyramidal kidneys with a pelvis?

A

no domestic animals, dolphins

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33
Q

which species have multilobar, multipyramidal kidneys with no pelvis?

A

ox

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34
Q

appearance of the kidney cortex?

A

granular, brown

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35
Q

appearance of the kidney medulla?

A

paler than cortex

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36
Q

where do ureter, artery and vein connect to kidney?

A

at hilus

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37
Q

what is a pyramid?

A

cone of medullary tissue

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38
Q

what is a papilla/apex?

A

tip of pyramid

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39
Q

what is a calyx?

A

diverticulum of the pelvis

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40
Q

what do the pyramids fuse into in unipyramidal kidneys?

A

renal crest

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41
Q

what surrounds the kidneys?

A

fibrous capsule

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42
Q

what is the renal crest?

A

ridges of medulla running from both ends of kidney

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43
Q

what are pseudopapillae?

A

lobar pattern still evident as bulges along the renal crest

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44
Q

what is the pelvis? (kidney)

A

cavity that contains urine before it goes into ureter

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45
Q

why is there a void down the middle of pelvic casts? (kidney)

A

where renal crest sticks in

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46
Q

what does the ox have instead of a pelvis? (kidney)

A

separate calyces that don’t drain into one cavity

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47
Q

what are the terminal recesses in the horse kidney?

A

large tubes, extension of either end of renal pelvis

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48
Q

what is a renal corpuscle?

A

a glomerulus and Bowman’s capsule

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49
Q

where does urine drain from Bowman’s capsule?

A

PCT -> LoH -> DCT -> CD -> papillary duct then into calyx then into pelvis

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50
Q

what is the first branch of arteries in the kidney medulla?

A

interlobar

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51
Q

what branches off interlobar arteries?

A

arcuate arteries

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52
Q

what branches off arcuate arteries?

A

interlobular arteries

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53
Q

what branches off interlobular arteries?

A

afferent arterioles

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54
Q

what route does blood take from afferent arterioles in the kidney?

A

-> glomerular capillaries -> efferent arterioles ->vasa recta

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55
Q

why do kidneys get wedge-shaped infarcts?

A

no anastomoses/collateral circulation between any of the blood vessels so if any blockage then whole wedge will die off

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56
Q

what provides sympathetic innervation to kidneys?

A

aorticorenal ganglia

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57
Q

what provides parasympathetic innervation to kidneys?

A

vagus -> renal plexus

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58
Q

what is parasympathetic kidney innervation responsible for?

A

kidney pelvis and ureter motility

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59
Q

what is sympathetic kidney innervation responsible for?

A

controls BP

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60
Q

what provides pain sensory innervation to kidneys?

A

splanchnic nerves

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61
Q

what is the parenchyme? (kidney)

A

cortex and medulla of kidney

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62
Q

what is the sinus? (kidney)

A

pelvis, fat, vessels (anything that isn’t cortex and medulla)

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63
Q

why is equine urine turbid (cloudy)

A

glands discharging into pelvis of equine kidney secrete mucus

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64
Q

the kidneys are said to be retro-…?

A

retroperitoneal

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65
Q

in which species does the left kidney particularly seem to hang on a mesentery?

A

ruminants and cats

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66
Q

what is the layer outside the fibrous capsule around the kidneys?

A

the perirenal fat- thick protective fatty layer

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67
Q

what is suet?

A

perirenal fat

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68
Q

what does the perirenal fat lie in?

A

the sublumbar fascia

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69
Q

what does the usefulness of plain radiographs for imaging kidneys depend on?

A

fat contrast

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70
Q

lagomorph calcium metabolism?

A

uncontrolled gut absorption, high plasma concentration, little liver/gut excretion, used for continual tooth growth and preventing osteodystrophy, excess excreted in urine- calcium carbonate sludge precipitates in alkaline urine

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71
Q

which environment causes species to adapt to have a larger kidney medulla?

A

arid conditions

72
Q

where are the adrenal glands located?

A

cranial/medial to kidneys, further than in humans, dorsal to phrenico-abdominal vein in dog

73
Q

what does the zona glomerulosa (adrenal gland) release?

A

mineralocorticoids

74
Q

what does the zona fasciculata (adrenal gland) release?

A

glucocorticoids

75
Q

what does the zona reticularis (adrenal gland) release?

A

sex steroids

76
Q

what does the medulla of the adrenal gland release?

A

catecholamines

77
Q

what does the medulla of the adrenal gland develop from?

A

neural crest

78
Q

what does the cortex of the adrenal gland develop from?

A

intermediate mesoderm

79
Q

what is a condition caused by hyperadrenocorticism?

A

Cushing’s disease

80
Q

symptoms of Cushing’s disease in dogs?

A

bilateral symmetrical alopecia, polyuria/polydipsia, potbellied, slack tendons and skeletal muscle wasting, weight gain (increased appetite), immune suppression

81
Q

symptoms of Cushing’s in horses?

A

shaggy coat, laminitis, polyuria/polydipsia, sweating

82
Q

what is a condition caused by hypoadrenocorticism?

A

Addison’s disease

83
Q

what is Addisonian crisis?

A

collapse, hypotension, bradycardia

84
Q

what are the symptoms of Addison’s disease if glucocorticoids, mineralocorticoids and sex hormones decreased?

A

decreased BP, Na+ decrease, K+ increase causing arrhythmia, glucagon decreases

85
Q

what does the kidney develop from?

A

intermediate column of mesoderm

86
Q

what is the earliest phase of kidney development?

A

pronephros (primitive tubules) develop in the cervical region, serves as starting point for mesonephric duct

87
Q

what is the template on which the kidney is built?

A

the mesonephric duct

88
Q

what develops in the second phase of kidney development?

A

mesonephros

89
Q

what does the mesonephros consist of?

A

mesonephric duct that runs cranio-caudal and opens into the cloaca, and the nephric tubules

90
Q

in what order do the nephric tubules form?

A

cranio-caudal succession with cranial ones first, then thoracic then abdominal

91
Q

why are they usually 30 nephric tubules at any 1 time during development?

A

the earlier ones degenerate as the later ones form

92
Q

what is the function of the mesonephros in the embryo?

A

acts as intermediate kidney, produces dilute urine important in maintaining the composition of the amniotic fluid

93
Q

what is mesonephros size in inverse proportion to?

A

permeability and excretory effect of the placenta

94
Q

in which species is the mesonephros large due to less well-developed placenta?

A

pigs

95
Q

where do the true kidneys (metanephroi) develop?

A

sacral region

96
Q

where do the ureteric buds form?

A

on the caudal end of the mesonephric duct

97
Q

what do the ureteric buds grow out into?

A

the surrounding caudal part of the intermediate mesoderm

98
Q

what do the cells surrounding the ureteric buds form?

A

condense to form the metanephric blastema

99
Q

what develops from the ureteric buds?

A

the final kidneys

100
Q

what evidence is there that communication between the ureteric bud and surrounding cells via secreted proteins is needed for the kidney to develop?

A

artificially placing a barrier that prevents the proteins from moving between cells stops kidney development

101
Q

what proteins are released by ureteric buds for kidney development?

A

Wnt signalling proteins

102
Q

how does the metanephros develop?

A

ureteric bud branches, fusion and resorption of the earliest branches creates terminal expansion (pelvis and calyces), further branching creates collecting ducts, tips of branches induce tubule formation in surrounding cells

103
Q

where is ureteric bud branching and growth greater? what does this cause, particularly in horses?

A

at the poles- leading to kidney shape- in horse more pronounced- more heart shaped

104
Q

what causes lobed appearance of the ox kidney?

A

tubules/medulla associated with one branch remain distinct

105
Q

what are the stages of tubule development in the kidneys?

A

induced by tips of ureteric bud branches, aggregations of metanephric mesenchyme, basement membrane on outer surface of epithelial cells, polarisation of cells, final functional nephron

106
Q

what is located in the kidney cortex?

A

renal corpuscles and most of the nephric tubule

107
Q

what is located in the kidney medulla?

A

many renal tubules and collecting ducts

108
Q

what animals have a mesonephros as the functional mature kidney?

A

fish, amphibians

109
Q

what causes agenesis of the kidney?

A

failure of the ureteric bud to reach the caudal mesoderm at the right time

110
Q

what are ectopic ureters?

A

when the ureter empties urine into another location other than the bladder

111
Q

what causes ectopic ureters?

A

premature branching of the ureteric bud

112
Q

what problems can ectopic ureters cause?

A

incontinence, infection due to reflux of urine from main ureter into secondary ureter and back into kidney

113
Q

which sex is more likely to have ectopic ureters?

A

females

114
Q

where do ectopic ureters terminate in the female?

A

vagina, urethra or uterus

115
Q

where do ectopic ureters terminate in the male?

A

urethra

116
Q

which is more common, unilateral or bilateral ectopic ureter?

A

unilateral

117
Q

why may some males with ectopic ureters be continent?

A

longer length of the male urethra

118
Q

how can ectopic ureters be diagnosed?

A

endoscopy to visualise ureteral opening into vagina or radiographic contrast studies + intravenous pyelogram

119
Q

what are polycystic kidneys?

A

when dividing cells of ureteric bud have random orientation rather than alignment

120
Q

when will dogs typically exhibit symptoms of juvenile kidney disease?

A

when less than 25% of renal function remains

121
Q

early symptoms of juvenile kidney disease?

A

drinking copiously, frequent urination, dilute urine, puppies may fail to thrive

122
Q

what are indicators of renal disease?

A

elevated blood urea nitrogen, protein in urine

123
Q

what can happen to the bones of young dogs with hereditary kidney disease?

A

fibrous osteodystrophy- softening of the bones

124
Q

what happens once the kidneys develop in the pelvic region?

A

have to ascend into abdominal region- as they ascend they receive blood supply from more rostrally up aorta, caudal branches usually regress, may persist giving extra renal arteries

125
Q

where does the bladder develop from?

A

the cloaca (caudal region of gut tube, endoderm)

126
Q

what separates the cloaca into the urogenital sinus and the rectum?

A

growth of the urorectal septum

127
Q

where is the perineal body?

A

in between the urogenital sinus and the rectum

128
Q

what is the upper part of the urogenital sinus?

A

urinary bladder

129
Q

what is the urinary bladder initially continuous with?

A

the allantois

130
Q

what happens to the connection of the bladder and allantois?

A

closes off leaving thick fibrous cord- the urachus

131
Q

what forms from the most caudal part of the urogenital sinus?

A

the urethra (only the pelvic part in males, penile urethra develops from external genitalia)

132
Q

what is entry into the bladder from the kidney initially via?

A

the mesonephric duct which links to the ureter and forms part of the male reproductive tract (the vas deferens)

133
Q

what happens to the entry of the kidney into the bladder as the bladder grows?

A

caudal portion of mesonephric duct becomes incorporated into dorsal wall of bladder so ureters open directly into bladder

134
Q

what causes the vas deferens to be looped over the ureter?

A

ureters pulled rostrally as kidneys ascend, mesonephric openings move caudally and closer together

135
Q

what is the trigone?

A

triangular part of the dorsal region of the bladder made from the mesoderm of the incorporated duct region

136
Q

where does the ureter go between?

A

renal pelvis to bladder

137
Q

what does the ureter develop from?

A

intermediate mesoderm

138
Q

outer layer of the ureter?

A

external loose adventitia

139
Q

describe the muscle of the ureter?

A

outer circular muscle, inner longitudinal muscle

140
Q

function of the outer longitudinal muscle layer of the ureter?

A

peristalsis

141
Q

what type of epithelium is the urothelium?

A

transitional

142
Q

describe the urothelium?

A

thickened membrane in surface cells, impermeable to anything larger than water, interdigitating cell junctions to allow stretching, coated with protective glycoprotein layer

143
Q

course of ureter?

A

exits renal pelvis, passes directly caudally, runs dorsal to gonadal artery, ventral to external iliac, deep to circumflex iliac arteries

144
Q

what drives contraction of the ureter?

A

sympathetic and mainly parasympathetic nerves (parasympathetic supply from vagus and pelvic nerves)

145
Q

location of bladder in carnivores vs ungulates?

A

mainly abdominal in carnivores, more pelvic/retroperitoneal in ungulates

146
Q

characteristics of the bladder muscle?

A

complex 3 layered intermingling smooth detrusor muscle

147
Q

what smooth muscle structure is present at the outlet of the bladder into the urethra?

A

internal bladder sphincter (really just part of proximal urethra)

148
Q

what is the site of urothelial carcinoma?

A

the bladder

149
Q

what is the bladder wall made of?

A

muscular with urothelium surface

150
Q

where do the ureters enter the bladder?

A

dorsally into bladder ceiling

151
Q

where does the urethra exit the bladder?

A

caudally

152
Q

how does the bladder hold the ureters closed at rest? what issue could this cause?

A

pressure in bladder blocks ureter- if bladder blocked then ureter blocked- urine builds up backwards into kidney

153
Q

which end of the bladder swells as it fills?

A

the more mobile cranial end

154
Q

what and where is the trigone?

A

stretched region of incorporated intermediate mesoderm in the bladder, from ureteric orifices to where vas deferentia would enter in males

155
Q

attachment of rectum to dorsal body wall?

A

mesorectum

156
Q

attachment of uteri to lateral body wall?

A

broad ligament

157
Q

attachment of broad ligament of uteri to bladder? what does this develop from?

A

lateral vesical ligament - from umbilical arteries

158
Q

what attaches the bladder to the ventral body wall? what does this develop from?

A

ventral vesical ligament- from old ventral mesentery of hindgut- contains urachal remnant which was originally fetal connection of hindgut to allantoic cavity

159
Q

what is patent urachus?

A

opening of fetal connection of hindgut to allantoic cavity remains as tube emptying through navel, urine drips out

160
Q

what positive contrast medium is used for the bladder?

A

iodine- barium is for intact gut only

161
Q

difference in urethra lining between females and males?

A

in females all of urethra lined with urothelium, in male lined by stratified squamous epithelium at penis

162
Q

what sort of muscle is the cranial ‘internal bladder sphincter’?

A

smooth muscle

163
Q

what sort of muscle is the caudal ‘external bladder sphincter’?

A

striated urethralis muscle

164
Q

difference in length of urethra in male and female?

A

longer in males

165
Q

where does the urethra discharge in females?

A

the vestibule- common egress of urinary and reproductive tracts

166
Q

where does the urethra discharge in males?

A

tip of penis

167
Q

where does the urethra discharge in rams + billy goats?

A

urethral process

168
Q

urethra issue common in males?

A

obstruction

169
Q

urethra issues common in females? why aren’t they common in males?

A

cystitis and incontinence, cystitis more likely to be flushed out in males and have more urethralis muscle to clamp down to stop incontinence

170
Q

what are the regions lateral to the cloacal/urethral folds called?

A

labrioscrotal swellings

171
Q

what is at the bottom of the developing penile urethra?

A

genital tubercle

172
Q

steps of development of the penile urethra?

A

urorectal septum forms and separates anus off- forms perineum which becomes scrotum in males. urethra folds lengthen in males- grow down and seal over to seal in tube- cord of ectoderm invades into glands- links to rest of urethra

173
Q

what nerve is most important for urine retention?

A

pudendal nerve (S1-3) is somatic, causes urethralis contraction

174
Q

what is the nerve supply to the alpha 1 and beta 2 receptor of the cranial bladder sphincter? what does it do?

A

hypogastric nerve, for detrusor relaxation, contributes to retention

175
Q

role of pelvic nerve in urinary tract?

A

contributes to detrusor contraction to void urine

176
Q

what non-nervous processes cause urine retention?

A

intra-abdominal pressure/bladder position and interlocking of urothelial folds in urethra

177
Q

4 pharmacological treatments for incontinence?

A

alpha agonists increase urethral resistance, alpha antagonists decrease urethral resistance, cholinergics increase detrusor contraction, anticholinergics decrease detrusor contraction

VAP (10 decks)

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