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Histo > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Anatomy of kidney

A

Lobe: a pyramid + associated cortex

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2
Q

Describe the arteries of the kidney

A
  • Renal artery enters the kidney and divides into segmental arteries
  • Interlobar arteries between the lobes
  • Arcuate arteries run on the horizontal aspect of the lobes, between cortex and medulla
  • Interlobular artery betwen the lobules.
  • Afferent arterioles is where the blood enters the glomerulus (loose not of capillaries) for filtration
  • Efferent arterial network (where nutrients get reabsorbed):
    • Peritubular capillaries in the cortical nephron
    • Vasa recta capillaries in the medulla
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3
Q

Renal corpuscles vs Nephron

A
  • Renal corpuscle (red blob)
    • Glomerular capsule: podocytes, parietal epithelium, urinary space
    • Glomerulus: fenestrated capillaries, arterioles, mesangial cells
    • Filtration apparatus: fenestrated endothelium, basal lamina, filtration slits between pedicles
  • Nephon (bigger circles)
    • renal corpuscle
    • proximal tubule
    • loop of Henle
    • distal tubule
    • collecting tubule/duct
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4
Q

Describe the venous system of hte kidney

A

Interlobular

  • > arcuate
  • > interlobar
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5
Q

Functions of the kidney

A
  • Remove cellular wastes from the blood
    • Filtration, selective reabsorption of water and solutes, excretion of wastes & excess water
  • Regulates blood pressure
  • Regulates cid-base balance
  • Produce hormones (e.g. Epo)
  • Assists in vitamin D production
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6
Q

Are renal corpuscles in the cortex or medulla?

A
  • Cortex
    • Renal corpuscles
    • Convoluted tubules, straight tubules, collecting tubules
  • Medulla
    • Collecting ducts
    • Straight tubules
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7
Q

Lobe vs Lobule

A
  • Lobe: pyramid + associated cortical tissue
  • Lobule: medullar ray (collection of straight tubules in cortex) + associated cortical tissue
  • Nephron: functional unit of the kidney
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8
Q

How to find a lobule on a histology slide?

A
  • First find the medullary ray (in the middle)
  • Then find an interlobular artery (blue arrow)
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9
Q

Wheres the medullary ray?

A
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10
Q

What is the bottom blue arrow pointing to in this singular lobe?

A

Arcuate artery because it’s between the cortex (left arrow) and the medulla (right arrow)

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11
Q

Wheres the medulla?

A

Where the rays are draining into

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12
Q

Identify a lobule

A

The white blood vessels in the cortex are interlobular arteries. the distances between two of them that contain a medullar ray are a lobule (horizontal line)

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13
Q

Point out the arcuate artery

A

between cortex and medulla

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14
Q

the glomerular capsule has how many layers of epithelial cells?

A

two.

Parietal layer (yellow) is simple squamous epithelium.

Visceral layer (yellow on the glomerulus) is a podocyte, which has a lot of processes that divide into pedicles that wrap around the capillaries, forming a filtration barrier.

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15
Q

What kind of capillaries make up the glomerulus?

A

fenestrated

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16
Q

Glomerular Mesangial cells

A

Pericytes associated with the endothelial cells; they turn over basal lamina, control capillary diameter, secrete vasoactive compounds.

Only podocytes’ foot processes actually attach to the capillary; whereas, mesangial cells do share a basal lamina w it.

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17
Q

How can you differentiate betwen proximal and distal tubule cells on a slide?

A

Proximal tubule cells are thicker and taller cells than the distal, which are smaller and flatter.

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18
Q

How do collecting ducts appear in the medulla?

A

The cells’ nuclei don’t have a consistent color; it’s light and dark, kinda alternating

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19
Q

Podocytes

A
  • visceral epithelial cells of Bowman’s capsule
  • pedicles/foot processes of podocytes with filtration slits
  • synthesizes nephrin
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20
Q

Two poles of a renal corpuscle

A

Urinary pole (lighter): filtrate leaves glomerulus and leaves via this pole to the proximal convoluted tubule

Vascular pole (darker) blood comes in, leaves via efferent arteriole

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21
Q

Describe the layers of the filtration apparatus

A
  • Fenestrated endothelium
    • Only proteins that can pass are albumin and anything smaller than that
  • Glomeruluar basement membrane
    • ​collagen IV*
    • fibronectin, laminin, heparin sulfate
    • charge barrier against anions
  • Podocytic filtration slits between podocyte processes (pedicles)
    • nephrin-containing diaphragms
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22
Q

Which side is the urinary space and which side is the capillary? How do you know?

A
  • Podocytes project into the urinary space and are grounded to a nephrin-containing diaphragm (the right blue arrow)
  • Fenestrae (the left blue arrow) belong to the capillary side
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23
Q

Congenital nephrotic syndrome

A

Mutation in nephrin –> absence / malfunction of the podocyte’s slit filtration diaphragm

  • Proteinuria, hypoalbuminemia, hyperlipidemia, edema
    • Low albumin in your blood –> less osmotic pressure –> edema
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24
Q

Alport’s syndrome / Hereditary glomerulonephritis

A

Gene for collagen IV is faulty

  • proteinuria
  • RBCs in urine
  • thinner glomerular basement membrane
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25
Q

Describe the passage of filtrate from blood capillaries in the glomerulus through the filtration apparatus

A
  1. Fenestration
  2. Basal lamina of endothelial cell and the podocyte
  3. Filtration slit of the podocyte
  4. Filtration diaphragm of podocyte
  5. Bowman’s space
26
Q

What cell’s nucleus is this?

A

Podocyte. You can see its pedicles sent to the capillary

27
Q

What cell’s nucleus is the bottom blue arrow pointing to?

A

Mesangial cell.

Unlike podocytes, the nucleus is actually within the basement membrane

28
Q
A

The bottom right is the most abnormal: the pedicles are weird and meshed together, which would block filtration

29
Q

the proximal straight tubule is also known as

A

the thick limb of the descending loop of henle

30
Q

Characteristics of proximal tubules on a slide

A
  • In renal cortex or medullary ray
  • Simple cuboidal cells with brush border (for reabsorption) & microvilli
  • Luminal debris
  • Indistinct cellular outlines due ot numerous infoldings of plasma membrane
  • Eosinophilic bc mitochondria
31
Q

What happens in the proximal tubule?

A

Reabsorb 60-65% of water via passive diffusion

Reabsorb ions, amino acids, glucose

32
Q

What is this an EM of?

A

Proximal tubule because

  • microvilli
  • mitochondria
  • membrane infoldings
33
Q

Luminal proteins are absorbed via

A

endocytosis to form endosomes and lysosomes

34
Q

Polycystic Kidney Disease

A

Cysts from nephrons grow and compress interstitial tissue

  • Enlargement of kidney –> back pain
  • High blood pressure
  • Renal failure -> decreased RBCs -> anemia
  • Complications: infection of cysts, renal stones
35
Q

Erythropoietin is a ___ hormone produced by ___ in the kidney in close association with the __ and __

A

glycoprotein hormone produced by interstitial fibroblasts in close association w peritubular capillary and proximal convoluted tubule

36
Q

1-alpha hydroxylase

What part of the kidney produces and processes it?

What is it important for?

A

Proximal tubules

Performs Vitamin D hydroxylation (25-OH-D3 to 1,25(OH)D3) in the mitochondria of proximal tubule cells; turns pro-vitamin D into its active form

37
Q

What symptom will result from decreased vitamin D production in patients with CKD or end-stage kidney disease since the proximal tubules can’t make 1-alpha hydroxylase?

A

Osteoporosis

38
Q

What is the funciton of activated vitamin D?

A
  • Activates bone osteoblasts
  • Causes Ca2+ absorption in intestine to help bone mineralization
39
Q

Identifying the loop of Henle

A
  • Located primarily in medulla and also in inner cortex
  • Simple squamous* epithelia
  • Differentiated from capillaries (vasa recta) by the absence of blood cells
40
Q

Sodium pumps in the cell membranes of the ___ limb of the loop of Henle pumps sodium into/out of the tubule?

A

Sodium pumps in the thick ascending limb pump Na+ out of the tubule

41
Q

After _____, all water and ion regulation is determined by hormonal action

A

After loop of Henle

42
Q

Distal tubule identification

A
  • Located in renal cortex & medullary rays
  • Simple cuboidal (brush border not visible)
  • Smaller, flatter (nuclei closer together) than PCT
  • Fewer and smaller microvilli
  • Membrane infoldings
  • Little luminal debris
  • Indistinct cellular outlines due to infolding sof plasma membrane
  • Eosinophilic bc mitochondria

Compare the top arrow (PCT) to the bottom arrow (DCT)

43
Q

What are each these EM slides of?

A

The left is an EM of PCT because the mcirovilli are long and therse a lot of vesicles

The right is an EM of DCT becuase the microvilli are sparse

44
Q

The flow of filtrate in nephron is regulated according to..

A
  • the speed and concentration of sodium in the returning flow in the distal tubule
45
Q

Describe the juxtaglomerular apparatus: macula densa cells, JG cells, extraglomerular mesangial cells

A
  • Macula densa cells in the DCT epithelium can sense sodium concentration in the DCT
    • Ex) If it senses a high [NaCl], then that means the flow of the filtrate is too fast because more NaCl should have been rebasorbed earlier.
  • Sends signals to juxtaglomerular cells: smooth muscle cells in the walls of the afferent arterioles to release vasoconstrictors or vasodilators
  • Extraglomerular mesangial cells are outside the renal corpuscle
46
Q

Which arteriole does the macula densa associate with- afferent or efferent? Why?

A

Afferent arteriole

47
Q

In this photo of a DCT, which cells are the macula densa cells?

What is that pink triangle in the center?

A

The ones at the bottom (more columnar) are the macula densa cells

The pink triangle in the center are extraglomerular mesangial cells

48
Q

Idnetify the macula densa, the arteriole, and the extraglomerular mesangial cells and a podocyte.

A
49
Q

How does the juxtaglomerular apparatus respond when there is a decrease in renal perfusion (e.g. hypovolemia or hypotension)?

A
  1. Juxtaglomerular cells release renin, which will turn angiotensinogen to angiotensin I
  2. ACE (in lung and kidney) will turn angiotensin I to angiotensin II
  3. Angiotensin II will cause water & salt retention to increase the effective circulating volume –> increased perfusion of the juxtaglomerular apparatus
    • Increase sympathetic activity (general vasoconstriction)
    • Increase NaCl & H2O retention via
      • <strong>Aldosterone</strong> for NaCl & H2O retention
      • <strong>ADH</strong> from pituitary for H2O reabsorption in the collecting duct
    • Increase K+ excretion
    • Arteriole vasoconstriction
50
Q

Effects of angiotensin II

A
  • Increase sympathetic activity (general vasoconstriction)
  • Increase NaCl & H2O retention via
    • Aldosterone for NaCl & H2O retention
    • ADH from pituitary for H2O reabsorption in the collecting duct
  • Increase K+ excretion
  • Arteriole vasoconstriction
51
Q

How to identify collecting tubules and ducts

A
  • Simple cuboidal (gets taller approaching the papilla)
  • Light-staining principal cells w ADH-regulated aquaporins
  • Dark-staining intercalated cells secrete H+ and absorb HCO3-
    • Much fewer than the light-staining; may not even be present
  • Cellular outlines are clear
52
Q

ADH is produced by ___ and affects ___

A

Produced by posterior pituitary gland

Affects the principal cells of the late distal tubule & collecting duct to increase water reabsorption

53
Q

Label these

A

1: collecting duct

  • nothing in it
  • cuboidal
  • clear cell borders

2: loop of henle

  • nothing in it
  • simple squamous

3: capillary

54
Q

If the right side is a calyx and we magnified right in the center of this image, what would we see?

A

Renal papilla: projects into the calyx; large collecting ducts of Bellini (green arrows) open into the surface of the renal papilla.

55
Q

3 most common causes of kidney disease

A
  • Diabetic nephropathy: damage to glomerular filtration barrier due to excessive sugar entering urine
  • Hypertensive nephropathy: sclerosis of glomerular arterial wall
  • Glomerulonephritis: inflammation of glomerulus leading to nephrotic or nephritic syndrome
56
Q

Alport syndrome

A
  • Genetic mutation in collagen type IV synthesis –> glomerular basement membrane is thin and leaky, allowing blood and protein in the urine
  • Type IV collagen is also in the eye and ear
57
Q

Goodpasture syndrome

A

Antibodies to type IV collagen affects basement membrane in the lung

  • Cough, chest pain, shortness of breath
  • Blood & protein in urine
  • High blood prssure
58
Q

What is urothelium? Where do you find it?

A

Transitional epithelium surrounded by smooth muscle + connective tissue

Found in ureter, urinary bladder, urethra

Luminal epithelial layer of urothelium consists of umbrella cells

59
Q

Purpose of umbrella cells

A

Forms a seal of uroplatin protein so urine does not enter the tissue

Senses distension

60
Q

What is the middle arrow pointing at? What is the big arrow outside pointing at?

A

The middle arrow: lamina propria

Big arrow: 2 layers of smooth muscle (circular & longitudinal for peristalsis)

61
Q

Bladder on a slide

A

looks pretty similar to ureter, except its not in a perfectly enclosed star shape

62
Q

Contrast the female vs male urethra

A
  • Female
    • Shorter,
    • Covered in urothelium, but transitions to nonkeratinized stratified squamous as you get more external
  • Male
    • Longer
    • 3 types:
      • Prostatic
      • Membranous
      • Penile urethra
    • Also stratified squamous as it approaches the external surface

Histo (20 decks)

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