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Histology - Exam 3 > Urinary System - Part 2 > Flashcards

Urinary System - Part 2 Flashcards

1
Q

describe DCT

A
  • continuous w/ macula densa
  • similar histologically to the ascending thick limb of LOH
  • shorter cells and wider lumen than PCT
  • NO brush border
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2
Q

DCT function

A
  • resorbs Na+ ions from the filtrate and actively transports them into the renal interstitium
  • transfers K+, ammonium, H+ ions into filtrate from interstitium
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3
Q

what stimulates the DCT to actively transport sodium ions into renal interstitium?

A

aldosterone

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4
Q

where is the JG apparatus located?

A

at the renal corpuscle vascular pole

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5
Q

contents of JG apparatus

A
  • juxtaglomerular cells mainly in wall of afferent a. (some in efferent)
  • macula densa cells
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6
Q

juxtaglomerular cells description

A

-modified smooth muscle cells

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7
Q

macula densa cells description

A
  • tall, narrow, epithelial distal tubule cells

- elongated, closely packed nuclei

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8
Q

fxn of macula densa cells

A

-sense changes in [NaCl]

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9
Q

JG cell fxn

A
  • sense BP decreases

- synthesize renin stored in secretory granules

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10
Q

what stimulates secretion of renin in JG cells?

A
  • low salt levels

- norepinephrine, dopamine from adrenergic nerve fibers (sym)

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11
Q

how do macula densa cells transmit info to JG cells?

A

via gap jxns (possibly)

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12
Q

fxn of JG apparatus

A

maintain BP by stimulating JG cells to release renin

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13
Q

action of renin and describe pathway it activates

A

renin converts angiotensinogen in plasma to angiotensin I -> converted to angiotensin II in lung capillaries -> AT-II stimulates release of aldosterone in the adrenal cortex

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14
Q

fxn of aldosterone in adrenal cortex?

A

stimulates DCT epithelial cells to resorb Na and water -> raises blood volume and pressure

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15
Q

lacis cells

A

extraglomerular mesangial cells / pole cushion

-found b/w afferent and efferent glomerular arterioles

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16
Q

how are lacis cells connected to each other and JG cells?

A

gap jxns

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17
Q

what is the tubuloglomerular feedback system to maintain system BP?

A

renin-angiotensin-aldosterone system

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18
Q

what does a decrease in vascular volume cause?

A

decrease in glomerular filtration rate, decrease in amount of filtered NaCl -> sensed by macula densa -> renin secretion

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19
Q

3 factors that stimulate the renin-angiotensin-aldosterone feedback system

A
  1. decrease in extracellular fluid
  2. decrease in renal BP
  3. decrease in NaCl in macula densa
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20
Q

what does angiotensin II stimulate release of other than aldosterone?

A

vasopressin/ ADH from hypothalamus -> increases permeability of collecting tubule and DCT to water

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21
Q

5 regions of collecting duct/tubule

A
  • connecting tubule
  • cortical collecting duct
  • outer medullary collecting duct
  • inner medullary collecting duct
  • papillary duct (duct of Bellini)
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22
Q

what are cell membranes of the collecting duct rich in?

A

aquaporins

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23
Q

what portions of the kidney do collecting tubules have segments in?

A

both cortex and medulla

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24
Q

cortical collecting tubules

A
  • located mainly in medullary rays

- lined by simple epithelium w/ 2 types of cuboidal cells: principal (light) and intercalated (dark) cells

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25
Q

principal (light) cells

A
  • round, centrally located nucleus
  • single, central cilium
  • many basal plasma membrane infoldings
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26
Q

fxn of cilium of principal cells

A

mechanosensor

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27
Q

fxn of principal cells

A
  • remove Na+ ions from filtrate

- secrete K+ ions into filtrate

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28
Q

what do principal cells respond to?

A

aldosterone from adrenals

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29
Q

intercalated (dark) cells

A
  • less numerous than principal cells
  • many apical cytoplasmic vesicles
  • microplicae (folds) on surface
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30
Q

fxn of intercalated cells

A
  • remove K+ from filtrate

- secrete H+ into it

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31
Q

medullary collecting tubules: cell types in outer and inner medulla

A

outer: both principal and intercalated cells
inner: only principal cells

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32
Q

papillary collecting tubules

A

ducts of Bellini

-large collecting tubules - 200-300 um diameter

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33
Q

lining of ducts of Bellini

A

simple cuboidal/columnar epithelium w/ single central primary cilium (may be a sensor)

34
Q

where do ducts of Bellini empty?

A

at the area cribrosa at the apex of each renal pyramid

35
Q

how many openings does each renal pyramid have where urine flows into a minor calyx?

A

10-25 openings

36
Q

why does the countercurrent multiplier and exchanger fxn?

A

due to the fact that different portions of the nephron vary in their permeability to NaCl, water, and urea

37
Q

what is resorbed in PCT?

A 
2/3 of filtrate: 
-glucose
-aa's
-small proteins
-80% of NaCl and water from filtrate
-Ca and water absorbed in parallel to Na
(no osmolarity change)
38
Q

permeability of descending thick limb of LOH

A
  • water resorbed

- NaCl NOT

39
Q

permeability of descending thin limb of LOH

A

-perm to water -> ultrafiltrate equilibrates w/ renal interstitium

40
Q

permeability of ascending thin limb of LOH

A
  • water NOT resorbed

- NaCl resorbed

41
Q

where does urea move into tubule?

A

ascending thin limb of LOH

42
Q

permeability of DCT and part of collecting tubule

A

-reabsorb NaCl

43
Q

what happens in the collecting duct?

A

urea moves from interstitium into duct

44
Q

glomerulonephritis

A
  • inflammation of the glomeruli
  • often have hematuria, proteinuria or both
  • oliguria
45
Q

what can cause glomerulonephritis (4 things)?

A
  • proliferation of podocytes and mesangial cells and leukocyte infiltration
  • streptococcal infection elsewhere in body due to deposition of immune complexes in the GBM
  • from immune or autoimmune disorders (lupus)
  • autoimmune disorder where glomerular components are targeted (anti-GBM antibodies against type 4 collagen)
46
Q

time course of glomerulonephritis

A

can be acute, subacute and chronic

47
Q

what can chronic glomerulonephritis cause?

A

destroys glomeruli - leads to renal failure and death

48
Q

acute tubular necrosis

A

destruction of epithelial cells lining a specific area of the nephron - as cells die, they slough, forming casts that occlude the lumen

49
Q

two types of acute tubular necrosis

A
  • ischemic: shock, crush injuries, bacterial infection

- toxic: ingestion of renal poisons

50
Q

what are some renal poisons?

A
  • heavy metals (Hg)
  • organic solvents
  • antibacterial/antifungal agents/ nonsteroidals
51
Q

what does acute tubular necrosis cause?

A

severe loss of kidney fxn (acute renal failure)

52
Q

is recovery from tubular necrosis possible?

A

yes if damage is not too severe - if too severe-> death

53
Q

chronic renal failure

A

multifactorial disease where reduced blood flow to kidneys causes decreased glomerular filtration and tubular ischemia

54
Q

symptoms w/ chronic renal failure?

A
  • changes to glomeruli (hyalinization)
  • tubular atrophy of the tubules
  • lack of acid/base balance -> acidosis, hyperkalemia, uremia due to inability to eliminate metabolic waste
55
Q

what happens if chronic renal failure goes untreated?

A

neurologic problems, coma, death

56
Q

some causes of chronic renal failure?

A
  • diabetes mellitus
  • HTN
  • atherosclerosis
57
Q

diabetes insipidus

A

decreased ability of kidney to concentrate urine in the collecting tubule due to reduced levels of ADH

58
Q

what causes diabetes insipidus?

A

destruction of the paraventricular and supraoptic nuclei in hypothalamus (which synthesize antidiuretic hormone (ADH))

59
Q

symptoms of diabetes insipidus

A
  • dehydration
  • polydipsia
  • excretion of large amounts of dilute urine
60
Q

renal calculi

A

kidney stones - calcium stones due to elevated urinary levels of Ca, oxalic acid, uric acid

61
Q

what are kidney stones usually made of?

A

calcium oxalate

62
Q

struvite stones

A

stones of Mg ammonium phosphate and calcium carbonate - usually result from UTIs

63
Q

what is the ureter?

A

muscular tube that conducts urine to bladder from renal pelvis

64
Q

innervation of ureter?

A

sympathetic and parasympathetic

65
Q

epithelium of ureter?

A

transitional

66
Q

smooth muscle of ureter?

A
  • prox 2/3: 2-layered muscularis (inner longitudinal, outer circular)
  • distal 1/3: has an additional layer
67
Q

how does the ureter move urine to the bladder?

A

peristaltic waves -> urine enters bladder in spurts

68
Q

epithelium and lamina propria of urinary bladder

A
  • epith: transitional - 3 layers (basal layer, 2-3 cell deep intermediate layer, superficial layer “umbrella cells”)
  • LP: thin, made of fibroelastic CT
69
Q

how many layers does the muscularis of the urinary bladder have?

A

3

70
Q

appearance of relaxed bladder

A
  • epithelium has rounded cells w/ scalloped contour

- umbrella cells contain plaques (thickened PM) in luminal PM and flat elliptical vesicles in cytoplasm

71
Q

fxn of the elliptical vesicles in relaxed bladder?

A

reserve surface membrane

72
Q

appearance of distended bladder

A
  • superficial cell layer appears squamous and number of cell layers reduced
  • due to insertion of elliptical vesicles into the luminal plasma membrane of the surface cells
73
Q

fxn of urethra

A

moves urine from bladder to outside - carries semen in males

74
Q

muscularis of urethra

A

2 layers - inner longitudinal and outer circular smooth muscle

75
Q

what allows voluntary closure of the urethra and where is it located in males?

A

external skeletal muscle sphincter - in membranous urethra region

76
Q

male urethra parts

A
  • prostatic
  • membranous
  • cavernous (penile)
77
Q

prostatic urethra

A
  • transitional epithelium
  • passes through prostate
  • ducts from prostate open into urethra
78
Q

membranous urethra

A

-short segment of urethra in b/w prostatic and penile

79
Q

penile urethra

A
  • pseudostratified or stratified columnar epithelium
  • switches at end to stratified squamous epithelium
  • receives ducts of bulbourethral glands
  • has mucus secreting glands of Littre in lamina propria
80
Q

female urethra lining

A
  • starts lined by transitional epithelium
  • changes to pseudostratified columnar
  • then stratified squamous nonkeratinized epithelium
  • may also have glands of Littre in lamina propria

Histology - Exam 3 (12 decks)

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