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Semester 3 > Urinary Session 2 > Flashcards

Urinary Session 2 Flashcards

1
Q

Where does the urinary system derive from?

A

Hindgut region of primitive gut tube

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2
Q

What are nephrotomes?

A

Segmental cell clusters of intermediate mesoderm which are functional basic units

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3
Q

How do nephrotomes change as the pronephros disappears?

A

Regress and are replaced by more caudal ones

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4
Q

What do nephrotomes contain?

A 
Glomerulus
Bowman's capsule
PCT
DCT
Collecting duct
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5
Q

Which is the first and most cranial kidney system to develop?

A

Pronephros

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6
Q

Is the pronephros functional in humans?

A

No

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7
Q

Where is the duct in the pronephros located?

A

Extends from cervical region to cloaca

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8
Q

Why does the primary nephric duct have no function?

A

It doesn’t reach the cloaca

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9
Q

Where does the pronephros fit into the timeline of embryonic development?

A

Develops and regresses in the fourth week

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10
Q

In what order (both sequentially and from cranial to caudal) do the kidney systems arise?

A

Pronephros
Mesonephros
Metanephros

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11
Q

What is the urogenital ridge?

A

Area of intermediate mesoderm surrounding the mesonephric duct which gives rise to both the embryonic kidney and gonad from primitive nephrotomes

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12
Q

When does the mesonephros appear?

A

4th week

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13
Q

Describe the development of mesonephric tubules.

A

Develop caudal to pronephric region early in the 4th week as the pronephros system regresses. Lengthen rapidly –> S shape and acquire capillary tuft

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14
Q

What do the mesonephric tubules and mesonephric duct form?

A

Embryonic kidney

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15
Q

Does the embryonic kidney function?

A

May for a short time during the early foetal period

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16
Q

Why is the mesonephric duct essential?

A

Sprouts the ureteric bud which induces development of the definitive kidney

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17
Q

What does the mesonephric duct make contact with?

A

Cloaca

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18
Q

What part of the mesonephros has an important role in the male reproductive system?

A

Mesonephric duct

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19
Q

What is the final outcome for kidney development?

A

Paired retroperitoneal organs either side of vertebral column at T12-L3
Arterial supply from direct branch of abdominal aorta
Produces urine that drains to bladder via ureter

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20
Q

Describe the development of the metanephros.

A

Ureteric bud releases differentiating factors –> factors act on surrounding intermediate mesoderm of caudal region –> metanephric blastema which the ureteric bud expands to meet –> ureteric bud expands and branches

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21
Q

What does ureteric bud expansion and branching form?

A

Widened renal pelvis and future major calyces

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22
Q

When does the metanephros appear during development?

A

5th week

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23
Q

In which region of the developing kidney does the renal functional unit develop?

A

Metanephros

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24
Q

What does the ureteric bud form in the renal functional unit?

A

Collecting system: urethral, calyces and collecting tubules

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25
Q

What does the intermediate mesoderm under ureteric bud influence form in the renal functional unit?

A

Excretory component: nephron from Bowman’s capsule to DCT

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26
Q

Where does the metanephric kidney first appear in the body?

A

Pelvic region

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27
Q

Why does the metanephric kidney first appear in the pelvic region?

A

Ureteric bud sprouts very caudal, close to the cloaca

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28
Q

What is most of the ‘ascent’ of the kidney due to?

A

Relative elongation of the embryo

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29
Q

How does the vascular supply of the kidneys change as they ascend?

A

Pick up new arterial supply as they cross the arterial fork formed by vessels returning blood from the foetus to the placenta

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30
Q

Early in development where do the GI, urinary and repro tracts end?

A

Cloaca

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31
Q

What basic components of the male and female external genitalia are common to both?

A

Genital tubercle
Genital folds
Genital swellings

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32
Q

At 9 weeks, how does genital fold fusion differ in males and females?

A

Males: steroidal testicular hormones drive genital fold fusion to form spongy urethra
Females: no genital fold fusion

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33
Q

Other than genital fold fusion, what do steroidal testicular hormones drive in the male embryo?

A

Genital tube to move cranially

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34
Q

What separates the cloaca during embryonic development?

A

Urogenital septum

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35
Q

What will develop if the median umbilical ligament remains patent?

A

Urachal cyst

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36
Q

What does formation of the urogenital septum create?

A

Urogenital sinus

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37
Q

What separates the pelvic parts of the urogenital sinus from the future bladder?

A

Rough level of peritoneum

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38
Q

Which parts of the urogenital sinus will form the future urethra?

A

Phallic and pelvic

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39
Q

Is the cloacal membrane complete when the urogenital sinus forms?

A

Yes, doesn’t rupture until ~6.5 weeks

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40
Q

What happens when the mesonephric ducts each the urogenital sinus in males?

A

Ureteric bud sprouts from them –> smooth musculature begins to appear –> UGS begins expansion –> ureteric buds and mesonephric ducts make independent openings as UGS increases –> male androgens cause mesonephric duct to become vas deferens and prostate and prostatic urethra formation

41
Q

Which section of the male urethra is most similar to the female urethra and why?

A

Membranous as it passes through the peritoneum

42
Q

What happens when the mesonephric ducts reach the UGS in a female?

A

Ureteric bud sprouts from mesonephric duct –> UGS increases and mesonephric duct regresses –> ureteric bud opens into UGS

43
Q

Why does the mesonephric duct regress and no prostate form in female urinary bladder and urethra development?

A

No tropic androgens

44
Q

What forms the female urethra?

A

Pelvic part of the UGS as it passes through the peritoneum

45
Q

What happens if the ureteric bud fails to interact with the intermediate mesoderm?

A

Renal agenesis

46
Q

What will the ascending kidneys get caught on in pelvic kidneys?

A

Umbilical arteries

47
Q

How does horseshoe kidney arise?

A

Lower poles of kidney touch as they are pushed through the arterial fork

48
Q

How do accessory renal arteries form?

A

Embryonic vessels, usually from aorta to superior/inferior poles, persist

49
Q

What is Wilm’s tumour?

A

Genetic mutation causing malignant tumour of metanephric blastema

50
Q

Is the prognosis of Wilm’s tumour good or bad?

A

Good

51
Q

What happens if the ureteric bud splits into two or two buds are formed during kidney development?

A

Two induction events happen so there are two ureters and an additional lobe on the affected kidney

52
Q

When might supplication defects be symptomatic?

A

If there is an ectopic ureteral orifice which bypasses the urinary sphincters thus causing incontinence

53
Q

What is the pathogenesis of multicystic kidney disease?

A

Atresia of ureter leads to cysts forming in kidney

54
Q

How is renal function maintained in multicystic kidney disease?

A

Unaffected kidney takes over function

55
Q

Is multicystic kidney disease heritable?

A

No

56
Q

Compare the two inheritance patters of polycystic kidney disease.

A

Autosomal recessive: more progressive

Autosomal dominant: more common

57
Q

Why does polycystic kidney disease have a poor prognosis?

A

Due to effects of ciliopathies

58
Q

What is exstrophy of the bladder?

A

Where it opens onto the anterior abdominal wall

59
Q

Where might you find an ectopic urethral orifice?

A

Vagina

60
Q

What is the pathogenesis of hypospadia?

A

Lack of response/level of androgen causes defect in urethral fold fusion so urethra opens onto ventral surface instead of the glans

61
Q

Is hypospadia a major or minor defect?

A

Minor

62
Q

Describe the flow of filtrate in the kidney.

A

Renal corpuscles –> tubule system –> medullary Ray’s –> ducts of Bellini –> renal papillae –> minor calyx

63
Q

What are medullary rays created by?

A

Tubules of increasing diameter

64
Q

What converges to form renal papillae?

A

Ducts of Bellini

65
Q

What does a renal corpuscle consist of?

A

Vascular pole
Urinary pole
Bowman’s space

66
Q

What is the function of the renal corpuscle?

A

Produce ultrafiltrate

67
Q

What forms the filtration barrier in Bowman’s capsule?

A

Visceral layer of capsule and capillary endothelium

68
Q

How is the visceral layer of Bowman’s capsule organised with respect to the capillaries?

A

Wraps around them

69
Q

What is the function of the parietal layer of Bowman’s capsule?

A

Simple squamous epithelium creates funnel to collect ultrafiltrate and direct it to the urinary pole

70
Q

Where is the urinary pole located?

A

Start of the PCT

71
Q

How is the primitive renal tubule derived?

A

From the ureteric bud as a blind ending tube

72
Q

How is the double layer seen in the Bowman’s capsule formed?

A

Primitive renal tube grows into primordium of true kidney and envelopes a developing glomerulus

73
Q

Which part of the trilaminar layer do glomeruli develop from?

A

Mesoderm

74
Q

Describe the capillary endothelium in the filtration barrier.

A

Fenestrated

75
Q

Describe how podocytes contribute to the filtration barrier.

A

Invest capillary endothelium allowing filtration slits as spaces between pedicels overlap with capillary fenestrations

76
Q

What shares a basement membrane in the filtration barrier?

A

Endothelium and podocytes

77
Q

Which creates a finer mesh, the fenestrated capillary or the interdigitation of podocyte foot processes?

A

Interdigitation of podocyte foot processes

78
Q

Which is the longest section of the tubule in the nephron?

A

PCT

79
Q

What epithelium makes up the PCT?

A

Simple cuboidal with microvilli brush border

80
Q

What in the nephron consists of 4 parts described by their epithelial lining?

A

Loop of Henle

81
Q

What epithelium is found in the ascending and descending limbs of the Loop of Henle?

A

Simple squamous

82
Q

How is the epithelium of the thin limbs of the loop of Henle adapted to its function?

A

No active transport takes place here

83
Q

Which part of the loop of Henle has simple cuboidal epithelium and why?

A

Thick ascending limb for active transport

84
Q

Where are the thick ascending limbs of the loop of Henle Sen on the kidney?

A

Medulla interspersed with thin limbs, vasa recta and collecting ducts

85
Q

Does the epithelium of the thick ascending limb have a brush border?

A

No

86
Q

What are pars recta?

A

Straight tubules in the loop of Henle

87
Q

What does the DCT make contact with in the cortex?

A

‘Parent’ glomerulus

88
Q

How can the DCT be distinguished from the PCT on histology?

A

More mitochondria
No brush border
Larger lumen

89
Q

What forms the juxtaglomerular apparatus?

A

Macula densa of DCT
Juxtaglomerular cells of afferent arteriole
Extraglomerular mesangial cells

90
Q

Where are mesangial cells located?

A

Inside corpuscle but outside glomerulus near macula densa bound by afferent and efferent arterioles

91
Q

What does the collecting duct have a similar histological appearance to?

A

Thick limbs of Henle’s loop

92
Q

How can collecting ducts be distinguished from other tubules on histology?

A

Larger lumen

Irregular shape

93
Q

How many layers of smooth muscle does the ureter have?

A

Two

94
Q

Where is there greater muscle mass in the ureter due to a third layer of muscle appearing?

A

Lower 1/3

95
Q

What is fasciculation?

A

Contraction in one direction

96
Q

What epithelium lines the ureter?

A

Transitional epithelium (urothelium)

97
Q

Describe the structure of the bladder wall.

A

3 muscle layers, transitional epithelium and add outer adventitia

98
Q

How does transitional epithelium remain impermeable when distended?

A

Surface layer of ‘umbrella cells’ stretch out and overlap

Semester 3 (50 decks)

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