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HHP > Urinary System > Flashcards

Urinary System Flashcards

1
Q

What is the functional and structural unit of the kidney?

A

Nephron

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2
Q

What components does the nephron include?

A

Renal corpuscle, convoluted tubules, straight tubules, connecting tubules

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3
Q

What does the medullary ray consist of?

A

Straight tubules, cortical collecting duct

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4
Q

What does the cortical labyrinth consist of?

A

Convoluted tubules, renal corpuscles, connecting tubules, interlobular arteries and veins, peritubular capillary network

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5
Q

What does renal column anchor cortex to?

A

Medulla

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6
Q

What does renal column contain?

A

Interlobular vessels, lymphatics, supportive CT

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7
Q

Renal pyramids are separated by what?

A

Renal columns/Columns of Bertin

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8
Q

Renal pyramids contain?

A

Straight tubules, medullary collecting ducts, blood vessels vasa recta

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9
Q

What are the three structures that form the Countercurrent Multiplier System?

A

Loop of Henle, Vasa Recta, Medullary collecting duct

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10
Q

What is function of Countercurrent Multiplier System?

A

Creates hyperosmotic urine

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11
Q

What is role of Loop of Henle in Countercurrent Multiplier System?

A

Acts as countercurrent multiplier, creates and maintains gradient of ion concentration in medulla

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12
Q

What is role of vasa recta in Countercurrent Multiplier System?

A

Acts as countercurrent exchangers of water and solutes, helps maintains osmotic gradient

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13
Q

What is role of medullary collecting duct in Countercurrent Multiplier System?

A

Acts as an osmotic equilibrating device

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14
Q

What does a renal LOBE consist of?

A

One renal pyramid, and associated cortical tissue at base and sides

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15
Q

What does a renal LOBULE consist of?

A

A medullary ray, surrounding cortical labyrinth on either side

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16
Q

Explain sequence of branching renal arteries

A

Renal arteries-interlobar arteries-arcuate arteries- interlobular arteries- Afferent arterioles- Glomerular capillary network- Peritubular cortical capillaries- Efferent arteriole- Vasa Recta

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17
Q

What are two parts of vasa recta?

A

Descending arteriolae ractae
Ascending venulae rectae

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18
Q

What does renal corpuscle consist of?

A

Glomerulus and bowmans capsule

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19
Q

Where does glomerulus arise from and drain to?

A

Arise from afferent arterioles, drains by efferent arterioles

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20
Q

What are two layers of bowmans capsule?

A

Visceral layer, parietal layer

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21
Q

What is parietal layer of bowmans capsule lined with?

A

Simple squamous epithelium

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22
Q

What is visceral layer of bowmans capsule lined with?

A

Epithelial cells called Podocytes

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23
Q

Where are Podocytes found?

A

Covering the glomerulus

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24
Q

Where is Bowmans space/urinary space found?

A

Between bowmans parietal and visceral layer

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25
Q

What does urinary space receive?

A

Ultrafiltrate urine

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26
Q

What are renal corpuscles two poles?

A

Urinary pole, vascular pole

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27
Q

What happens at vascular pole?

A

Afferent and efferent arterioles penetrate and exit capsule

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28
Q

What happens at urinary pole?

A

Beginning of proximal convoluted tubule

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29
Q

What is another name for proximal straight tubule?

A

Thick descending limb

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30
Q

What is another name for distal straight tubule?

A

Thick ascending limb

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31
Q

What forms the Macula Densa?

A

Distal straight tubule/thick ascending limb

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32
Q

What composes Loop of Henle?

A

Proximal straight tubule
Thin descending limb
Thin ascending limb
Distal straight tubule

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33
Q

What are the 3 types of nephrons?

A

Cortical or Subscapular, Juxtamedullary, Intermediate

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34
Q

What are 3 structures that make up filtration apparatus?

A

Endothelial glomerular capillaries, GBM, visceral layer of bowmans capsule

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35
Q

Describe structure of endothelial glomerular capillaries

A

Large fenestrations, no diaphragm, restricts movement of blood cells and formed elements

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36
Q

What channels does the endothelial glomerular capillaries have?

A

Aquaporin-1 water channels, allows fast movement of water through epithelium

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37
Q

What is glomerular basement membrane made of?

A

Fused basement membrane of endothelial cell and basement membrane of podocyte

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38
Q

Describe GBM structure

A

Thick, type 4 collagen that creates extensive network of lamina densa, Type 17 collagen, lamin, nidogen, entactin, proteoglycans, glycosaminoglycans like Heparan Sulfate*

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39
Q

What does the structure of GBM provide for the cell?

A

Negatively charged basement membrane that repels negatively charged ions trying to pass through

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40
Q

Describe structure of visceral layer of bowmans capsule?

A

Contains podocytes

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41
Q

What happens with GBM in diabetes?

A

Thickens, loose effective filtration barrier, Heparan sulfate reduces and allows larger negatively charged ions to pass through, like albumin in urine
This can eventually lead to diabetic nephropathy

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42
Q

What is Alport Syndrome?

A

Occurs due to type 4 collagen gene mutation, results in thickening of GBM and fails to serve as effective filtration barrier

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43
Q

What are some symptoms of Alport Syndrome?

A

Hematuria, Protein in urine, progressive renal failure

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44
Q

What is autoimmune glomerulonephritis?

A

Example can be Good pasture syndrome
Autoantibody cells attack the GBM, becomes ineffective filtration barrier

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45
Q

What do endothelial cells have that help prevent cells in blood from passing through?

A

Glycocalyx coat

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46
Q

What are podocytes?

A

Epithelial cells, polarized and rest on basal lamina, similar to smooth muscle, contain actin filaments in cytoplasm

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47
Q

What is important filament in podocytes?

A

Actin filaments

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48
Q

What processes do podocytes extend around glomerular capillaries?

A

Primary processes

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49
Q

What do primary processes branch into?

A

Secondary processes called Foot processes

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50
Q

Which podocyte processes is involved in filtration?

A

Foot processes

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51
Q

What do foot processes create when they interdigitate with other podocyte foot processes?

A

Filtration slit

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52
Q

What is the podocyte filtration slit lined with?

A

Filtration slit diaphragm

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53
Q

What is function of filtration slit?

A

Allows filtrate to enter urinary space, acts as physical barrier to bulk flow and free diffusion

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54
Q

What is key functional and structural component in filtration slit diaphragm?

A

Nephrin transmembrane protein

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55
Q

What does nephrin form when it interacts with neighboring foot processes nephrin proteins?

A

Central destiny with pores on both sides

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56
Q

What is filtration slit diaphragm anchored to ?

A

Actin filaments in foot processes of podocytes

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57
Q

Regulation and maintenance of actin cytoskeleton of podocytes is critical for?

A

Regulating patency and selectivity of filtration slits

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58
Q

What does GBM act as?

A

Physical barrier and ion selective filter

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59
Q

What are the 3 components of GBM?

A

Lamin Rara Externa
Lamina Densa
Lamina Rara Intera

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60
Q

What is lamina rara externa rich in?

A

Heparan sulfate, impedes passage of negatively charged molecules

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61
Q

What provides attachment of lamina rara externa to podocyte?

A

Laminin

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62
Q

What is lamina densa?

A

Fused portion of two basal laminae, contains type 4 collagen network that acts as physical barrier, type 17 collagen, perlecan, these provide anionic charge

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63
Q

What are mesangial cells?

A

Group of cell sin renal corpuscle, located in vascular stalk of glomerulus, derived from smooth muscle precursors

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64
Q

What do mesangial cells secrete?

A

Their extracellular matrix

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65
Q

What is a mesangium?

A

Extracellular matrix and mesangial cells together

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66
Q

What are mesangial cells enclosed by?

A

Basal lamina of glomerular capillaries

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67
Q

What are the cells located outside of the renal corpuscle along the vascular pole?

A

Lacis cells, component of juxtamedullary apparatus

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68
Q

What are some functions of mesangial cells?

A

Phagocytosis of trapped molecules in GBM, endocytose immune complexes deposited
Structural support where GBM is incomplete
Secretion of interleukin-1 and PDGF, respond to glomerular injury
Modulation of glomerular distention

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69
Q

Describe modulation of glomerular distention in mesangial cells?

A

They regulate distention when blood pressure increases with their contractile abilities

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70
Q

When do mesangial cells proliferate?

A

In kidney diseases where abnormal amounts of protein are deposited in GBM, ex. diabetic nephropathy, lupus nephritis

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71
Q

What are the components of the JGA?

A

Macula densa, JG cells, Lacis cells

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72
Q

What point of contact does JGA make?

A

Between distal tubule and vascular pole of its glomerulus

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73
Q

Where is macula densa located?

A

Distal straight tubule

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74
Q

What forms the JG cells?

A

Modified smooth muscle cells of afferent arterioles tunica media

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75
Q

What kind of cell is a JG cell?

A

Mechanoreceptor

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76
Q

What do JG cells cytoplasmic secretory granules contain?

A

Protease called Renin

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77
Q

What activates the RAAS system?

A

JG cells

78
Q

Can JG cells be found in efferent arterioles?

A

Occasionally

79
Q

How is angiotensin I produced?

A

Renin catalyzes hydrolysis of circulating angiotensinogen in blood

80
Q

What produces Angiotensin II?

A

Angiotensin I is converted to angiotensin II in lung capillaries

81
Q

What is angiotensin II?

A

A vasoconstrictor

82
Q

What is function of angiotensin II?

A

Regulated renal and systemic vascular resistance

83
Q

What does angiotensin II stimulate?

A

The adrenal glands to synthesize and release aldosterone

84
Q

What does aldosterone do?

A

Increases reabsorption of Na+ from connecting tubules and collecting ducts

85
Q

What is function of macula densa?

A

Function as osmoreceptors, monitor Na+ concentration in distal convoluted tubule
Also regulate renin secretions from JG cells

86
Q

What is another name for Lacis cells?

A

Extraglomerular mesangial cells

87
Q

How do Lacis cells communicate with each other and with JG cells?

A

GAP Junctions

88
Q

How is blood pressure maintained?

A

JGA cells and RAAS System

89
Q

Explain process of blood pressure increase

A

Low Na+ concentrations in distal convoluted tubules stimulate macula densa cells, macula densa cells then secrete mediators like ATP, NO, prostaglandins, these mediators act in paracrine matter and send signals to Lacis cells, Lacis cells then distribute mediators to JG cells via gap junctions, JG cells secrete renin and RAAS is activated. RAAS activation results in aldosterone secretion from adrenal gland, aldosterone increases Na+ reabsorption from the connecting tubules and collecting ducts, this increases blood serum Na+ concentration which increases blood pressure.

90
Q

Where is proximal convoluted tubule located?

A

Cortical labyrinth

91
Q

What does PCT receive from bowmans capsule?

A

Ultrafiltrate, most is reabsorbed here

92
Q

What is PCT lined with?

A

Simple cuboidal or columnar

93
Q

Structural features of PCT

A

Acidophilic cytoplasm from abundant mitochondria, apex has long microvilli that form brush border, zonula occludens and zonula adherens junctional complexes, numerous pits and vesicles at base of microvilli, basal striations and invaginations

94
Q

What do zonula occludens do for PCT?

A

Seals off intercellular space from the lumen of tubule

95
Q

What do zonula adherens do for PCT?

A

Maintains adhesion between cells

96
Q

What do pits and vesicles indicate in PCT?

A

Active endocytosis and pinocytosis, vesicles contain small reabsorbed proteins which will be degraded in lysosomes, amino acids will be released into circulation

97
Q

How are basal striations formed?

A

By vertically arranged mitochondira, parallel to basal folds

98
Q

What does basolateral domain of PCT show?

A

Basolateral folds show lateral interdigitations/plicae with neighboring cells, basal membrane invaginations forming basal striations

99
Q

What do the transmembrane proteins located in basolateral folds and brush border do?

A

Mediate tubular reabsorption and secretion

100
Q

Functions of the PCT?

A

Reabsorption of water and electrolytes, reabsorption of organic molecules like glucose and amino acids, endocytosis of proteins and large peptides, secretions of organic cations and anions not filtered in renal corpuscle, *Hydroxylation of Vitamin D

101
Q

What two transmembrane proteins does PCT use for water and electrolyte reabsorption?

A

Na+/K+ ATPase pump localized in lateral folds and reabsorb Na+
Aquaporin-1 water channel located in plasma membrane

102
Q

How does PCT secrete unfiltered ions from renal corpuscle?

A

Taken up by peritubular capillaries and secreted into filtrate, ex. bile salts, antibiotics

103
Q

How does PCT hydroxylize Vitamin D?

A

Inactive Vitamin D is converted to active form called Calcitiol, regulated by PTH

104
Q

Define tubular reabsorption?

A

Absorption of selected materials from nephric filtrate into blood of peritubular capillaries

105
Q

What two actions does tubular reabsorption use?

A

Diffusion and active transport

106
Q

Define Tubular secretion?

A

Removal of selected materials from blood of peritubular capillaries into nephric filtrate

107
Q

What action does tubular secretion use?

A

Active transport only

108
Q

Example of tubular reabsorption?

A

Glucose, amino acids, water, sodium, potassium

109
Q

Example of tubular secretion?

A

Removal of ammonia, urea, uric acid, penicillin, harmful drugs

110
Q

Proximal straight tubule is also called what?

A

Thick descending tubule

111
Q

Where is PST found?

A

Medullary rays

112
Q

What is PST lined with?

A

Simple cuboidal

113
Q

Structural features of PST?

A

Few short microvilli, randomly dispersed microvilli, few basolateral folds

114
Q

Functions of PST?

A

Reabsorption of remaining glucose

115
Q

What is descending thin segment lined with?

A

Simple squamous

116
Q

Where is descending thin segment located?

A

Inner medullar and outer medullar in inner stripe

117
Q

In which nephron are long descending thin segments found?

A

Juxtamedullary nephrons

118
Q

In which nephron are short descending thin segments found?

A

Cortical nephron

119
Q

Function of descending thin segment?

A

Highly permeable to water

120
Q

What are cell types found in descending thin segment?

A

Cell types I-IV

121
Q

What are specific functions of the 4 cell types in descending thin segment?

A

Role in the countercurrent multiplication part of urinary concentration by setting up concentration gradient

122
Q

What are cell types connected by in descending thin segment?

A

Tight junctions and desmosomes

123
Q

Where is type I cell in descending thin segment found?

A

Descending thin limb of cortical nephron, cortex

124
Q

Where is type II Cell in descending thin segment found?

A

Descending thin limb of juxtamedullary nephron, cortex

125
Q

Where is type III Cell in descending thin segment found?

A

Descending thin limb of juxtamedullary nephron, medulla

126
Q

Where is type IV Cell in descending thin segment found?

A

At bend of Loop of Henle, and thin ascending limb of juxtamedullary nephron, medulla

127
Q

What is ascending thin limb permeable to?

A

Na+ and Cl- ions

128
Q

Is ascending thin limb permeable to water?

A

Highly IMPERMEABLE to water

129
Q

What is main function of loop of henle?

A

Set up concentration gradient in medulla for countercurrent multiplier effect

130
Q

Where is distal straight tubule located?

A

In medullary to medullary rays in cortex

131
Q

What is distal straight tubule lined with?

A

Large cuboidal cells

132
Q

What do cells in distal straight tubule produce?

A

Uromodulin

133
Q

Function of uromodulin?

A

Protein that influences NaCl reabsorption, modulates cell adhesion and signal transduction, inhibits accumulation of calcium or oxalate crystals which prevent kidney stones, provides defense against UTIs

134
Q

Is distal straight tubule permeable to water?

A

No, impermeable to water

135
Q

What cells does distal straight tubule form, from cuboidal to columnar?

A

Macula densa cells

136
Q

Functions of distal straight tubule?

A

Reabsorbs Na+ and Cl- and transports to interstitium

137
Q

Where is distal convoluted tubule located?

A

Cortical labyrinth, extends to connecting tubule

138
Q

Is distal convoluted tubule permeable to water?

A

Relatively impermeable to water

139
Q

Which tubule has highest Na+/K+ ATPase activity?

A

Distal convoluted tubule

140
Q

Functions of distal convoluted tubule?

A

Reabsorption of Na+ and Cl- and HCO3 ions, Secretion of K+ H+ ammonium penicillin and toxic substances

141
Q

What is distal convoluted tubule under the influence of?

A

Vasopressin/ADH secreted by the neurohypophysis, also under influence of ANP/ANF atrial natriuretic factor

142
Q

What happens when ANP is released during stretching of atrial muscles?

A

ANP inhibits vasopressin ADH secretion, which inhibits reabsorption of water, and increases urination, ANP inhibits renin secretion and aldosterone secretion

143
Q

What are connecting tubules lined with?

A

Simple cuboidal epithelium with two types of cells
Cuboidal distal convoluted tubule cells
Cortical collecting duct cells

144
Q

What is connecting tubules under influence of?

A

Aldosterone

145
Q

Functions of connecting tubules?

A

Secretion of K+

146
Q

What are small cortical collecting ducts lined with?

A

Simple cuboidal

147
Q

How are medullary collecting ducts formed?

A

Merging of small cortical collecting ducts

148
Q

What is medullary collecting duct lined with?

A

Simple columnar

149
Q

What do medullary collecting ducts merge to form?

A

Papillary ducts or Ducts of Bellini

150
Q

Where do papillary ducts drain into?

A

Minor calyces

151
Q

What two tubules are under the influence of PTH?

A

Distal convoluted tubule and proximal convoluted tubule

152
Q

What are two cell types that form collecting duct epithelium?

A

Light cells/Principal cells and Dark cells/Intercalated cells

153
Q

What are Principal/Light cells?

A

Main cells of system, show basal membrane infoldings, posses water channel protein Aquaporin-2, under influence of aldosterone

154
Q

What are Aquaporin 2 channels regulated by?

A

ADH

155
Q

What are Intercalated/Dark cells?

A

Few in number, have many scattered mitochondria, cytoplasmic folds, function in secreting H+ or HCO3 ions depending on the need to excrete acid or alkali

156
Q

What is renal interstitial tissue?

A

Connective tissue component of renal parenchyma, surrounds nephrons, collecting ducts, blood and lymphatic vessels

157
Q

Do healthy individuals have a lot of renal interstitial tissue?

A

No, minimal CT

158
Q

What percentage of rental interstitial tissue is in the cortex?

A

7%

159
Q

What percentage of renal interstitial tissue is in the medulla?

A

20%

160
Q

In renal interstitial tissue, in the cortex there are two cell types?

A

Cells resembling fibroblasts, found between basement membrane of tubules and adjacent peritubular capillaries
And occasional macrophages

161
Q

What are the two cell types of renal interstitial tissue called together?

A

Interstitial cells

162
Q

What is function of fibroblast like cells in renal interstitial tissue?

A

Synthesize and secrete type III collagen and GAGs, and evidence of erythropoietin production

163
Q

What is EPO primarily produced by?

A

Pericytes of peritubular capillaries

164
Q

What do interstitial cells resemble in the medulla?

A

Myofibroblasts, containing bundles of actin filaments

165
Q

Origin of fibroblasts in renal interstitium happens through a mechanism called?

A

Epithelial-mesenchymal transition EMT

166
Q

What is the epithelial mesenchymal transition?

A

Tubular epithelial cells transform to mesenchymal tissue, initiated by alteration of balance of local cytokine concentration

167
Q

Can mesenchymal tissue transform back to epithelial cells in EMT transition?

A

Yes

168
Q

What happens during persistent renal injury?

A

Fibroblasts increase and secrete excessive extracellular matrix, causing renal fibrosis and leads to irreversible damage and renal failure

169
Q

What is mucosa of urinary passages?

A

Transitional epithelium and lamina propria

170
Q

What are two muscularis layers in urinary passgaes?

A

Inner longitudinal and outer circular

171
Q

Is adventitia or serosa seen in urinary passages?

A

NO

172
Q

What is structure of ureter?

A

Transitional epithelium, thick muscular wall

173
Q

What layers are in upper 2/3 of ureter?

A

Inner longitudinal and outer circular

174
Q

What layers are in lower 1/3 of ureter?

A

Inner longitudinal, middle circular, outer longitudinal

175
Q

What kind of contractions move urine through ureters?

A

Peristaltic

176
Q

What does lamina propria in bladder contain?

A

Higher proportions of collagen and elastic fibers

177
Q

How many layers does muscularis of bladder have?

A

Three

178
Q

What is first layer of transitional epithelium?

A

Single layer of small basal cells resting on thin basement membrane

179
Q

What is second layer of transitional epithelium?

A

Intermediate regions containing one to several layers of cuboidal or low columnar cells

180
Q

What is third layer of transitional epithelium?

A

Superficial layer of large umbrella cells, sometimes binucleated

181
Q

What is function of umbrealla cells?

A

Protect underlying cells against cytotoxic effects of hypertonic urine

182
Q

What are structural features of umbrella cells?

A

Extensive intercellular junctional complexes, most of apical surface consists of asymmetric unit membrane, outer lipid layer is twice as thick as inner leaflet

183
Q

What are asymmetric regions in transitional epithelium composed with?

A

Lipid rafts that contain abundant uroplankins

184
Q

What do membranous plaques and tight junctions serve as in transitional epithelium?

A

An osmotic barrier, protect cells from urine and prevent dilution of stored urine

185
Q

What are membranous plaques hinged together by in transitional epithelium?

A

Narrow regions of typical membrane

186
Q

What happens when bladder is empty?

A

Mucosa folds, umbrella cells decrease apical surface area by folding membrane at the hinge regions and internalizing the folded plaques in discoid vesicles

187
Q

What happens when bladder fills?

A

Vesicles rejoin the apical membrane, increase surface area, tight junctions are reorganized

188
Q

What are the three distinct segments of male urethra?

A

Prostatic urethra, membranous urethra, penile urethra

189
Q

What is the prostatic urethra lined with?

A

Transitional epithelium

190
Q

What is membranous urethra lined with?

A

Stratified or psuedostratified columnar

191
Q

What is penile urethra lined with?

A

Bulbar and spongy urethra lined by psuedostratified columnar, glandular urethra is lined by stratified squamous keratinized

192
Q

What is female urethra lined with?

A

Transitional epithelium, and stratified squamous non keratinized before the end

HHP (17 decks)

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