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Histology > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

Divisions of kidney

A

Pale outer cortex
Darker inner medullary tissue

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2
Q

Thickness of healthy cortex

A

At least 7mm

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3
Q

Medullary pyramids- structure

A

10-15 whose apices point towards the hilum of the kidney
Each pyramid is surrounded on 3 sides by cortex

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4
Q

What does the renal cortex contain

A

All of the glomeruli of the kidney
Convoluted parts of the proximal and distal tubules
Proximal parts of collecting duct

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5
Q

Number of medullary pyramids in each kidney

A

10-15

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6
Q

What do the medullary pyramids contain

A

Straight portions of the proximal and distal tubules
Loops of Henle
Distal parts of collecting duct

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7
Q

Where does the filtrate from the medullary pyramids drag into

A

From up to 20 pores into a funnel-shaped calyx from where the urine is collected into the widened pelvic portion of the ureter for transport to the bladder

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8
Q

What enters and exits the kidney at the hilum

A

Renal artery
Renal vein

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9
Q

Branches of renal artery

A

Divides into 5 or 6 main branches that give off arcuate arteries at the corticomedullary junction
These then form the interlobular arteries

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10
Q

Where do the arcuate arteries form interlobular arteries

A

At the corticomedullary junction

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11
Q

Interlobular arteries

A

Penetrate the cortex at regular intervals dividing the cortex into lobules
Give off Afferent arterioles that supply the glomeruli

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12
Q

Which arteries give off the afferent arterioles of the glomeruli

A

Interlobular arteries

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13
Q

How does the filtered blood return to systemic circulation

A

Arcuate veins

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14
Q

Straight arterioles- vasa recta

A

Near the corticomedullary junction arcuate arteries give off straight arterioles that penetrate deep into the medulla (vasa recta) before returning blood to the arcuate veins

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15
Q

Structure of glomerulus

A

A parallel array of fenestrated capillaries ensheathed by podocytes

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16
Q

What forms the filtration barrier of the kidney

A

Basement membrane between endothelial cells of capillaries and podocytes of epithelium

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17
Q

Function of renal glomerulus

A

Blood enters the kidney where it is filtered
Primary filtrate then passed to the rest of the nephron for selective reabsorption of solutes

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18
Q

What lies between the coiled loops of glomerular tuft

A

Matrix-forming mesangial cells

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19
Q

What do the walls of the afferent arteriole contains

A

Specialised renin-producing cells

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20
Q

Macula densa location

A

Specialised palisade cells in the segment of distal tubule that sits alongside the glomerulus

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21
Q

Where does the glomerular tuft arise from

A

The vascular pole- the point of entry into the glomerulus of the afferent arteriole and point of exit of the efferent arteriole

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22
Q

The vascular pole

A

the point of entry into the glomerulus of the afferent arteriole and point of exit of the efferent arteriole

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23
Q

Structure of the glomerulus tuft

A

Capillary loops supported by podocytes
Surrounded by the Bowman’s capsule- separates it from the glomerular capsule

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24
Q

What lies in the angle between the afferent and efferent arterioles

A

The returning distal loop of the same nephron

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25
Q

Structure of filtration barrier

A

Fenestrated endothelial cells
Podocytes ‘stand off’ from the membrane by complex foot processes

Arrangement forms physical pores between the cells guarded only by the filtration membrane

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26
Q

Charged nature of filtration barrier

A

Restricts passage of some molecules
Water and solutes up to about 50000 daltons are able to pass into the urinary space and constitute the primary filtrate

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27
Q

What constitutes the primary filtrate

A

Water and solutes up to about 50000 daltons

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28
Q

Structure of proximal tubules

A

Most highly coiled segment although a straight distal portion projects in some cases into the medulla
Cells have a prominent brush border and complex invaginations of baso-lateral membrane

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29
Q

Function of proximal tubules

A

Extensive re-absorption of filtrate
Sodium is actively transported in with glucose/amino acids
Cells take up proteins and polypeptides by Endocytosis

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30
Q

Function of lysosomes in proximal tubule cells

A

Break down proteins and polypeptides before returning constituents to circulatiom

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31
Q

Which proteins pass into the filtrate before being reabsorbed

A

Almost any negatively charged small protein

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32
Q

Which proteins will not pass into the filtrate

A

Albumin and haemoglobin as are too large

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33
Q

Where is the loop of henle located

A

Medulla

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34
Q

Structure of loop of henle

A

A thick straight descending portion
A thin loop
A thick ascending portion

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35
Q

Thin loop of loop of henle

A

Vary in length

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36
Q

Ascending portion of thin limb of loop of henle function

A

Retains water
Chloride and sodium are reabsorbed
Produces a dilute (hypotonic) filtrate (urine) and a hypertonic interstitium

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37
Q

What runs alongside the loop of henle

A

Vasa recta - long straight capillaries

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38
Q

When are the thin loops longest

A

When glomeruli lie close to the cortico-medullary junction

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39
Q

Permeability of thin descending limb of loop of henle

A

Low permeability to ions and urea
High permeability to water

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40
Q

Permeability of thin ascending limb of loop of henle

A

Not permeable to water
Highly permeable to ions

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41
Q

Function of difference in permeability of 2 limbs of loop of henle

A

Creates a concentration gradient within renal medulla

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42
Q

Macula densa function

A

Monitor sodium levels and influence filtration process of glomeruli

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43
Q

Cells of distal tubule

A

Only a few short microvilli
No brush border
Deep invaginations of the basal plasma membrane with numerous mitochondria

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44
Q

Function of mitochondria in distal tubule cells

A

Control of acid/base balance and concentration of urea

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45
Q

Do proximal or distal tubule cells stain lighter

A

Distal

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46
Q

Influence of aldosterone on distal tubules

A

Sodium ion reabsorption
Potassium ion secretion
Bicarbonate ion reabsorption
Hydrogen ion section - urine acidoc

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47
Q

Within the cortex of the kidney, are proximal or distal tubules more numerous

A

Proximal tubule is normally longer and more tightly coiled so appears more numerous

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48
Q

Formation of collecting ducts

A

Collecting tubules from several nephrons coalesce to form larger ducts that pass into the medulla

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49
Q

Medullary rays

A

Visible streaks in the medulla formed by collecting ducts

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50
Q

Structure of thick ascending and descending limbs of loop of henle

A

Structurally similar to proximal and distal convoluted tubules respectively

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51
Q

Cells of collecting duct

A

Few organelles
Dark intercalated cells with high concentrations of mitochondria

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52
Q

What surrounds the collecting ducts

A

Hypertonic medium generated by the loop of henle

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53
Q

ADH function

A

Increases the permeability of the collecting ducts cells so water is reabsorbed into the hypertonic interstitium- concentrating the urine

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54
Q

What does the juxta-glomerular apparatus contain

A

Afferent and efferent arterioles
Macula densa
Lacis cells (specialised cells of the glomerular matrix)

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55
Q

Where is renin produced

A

Cells in the walls of the afferent arterioles- appears as granules in the cytoplasm

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56
Q

Function of renin

A

Catalyses conversion of angiotensinogen to angiotensin I

First step in stimulation of aldosterone release by the suprarenal glands

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57
Q

Role of lacis cells and mucula densa

A

Regulation of renin secretion through the monitoring of sodium ions in the distal tubule

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58
Q

Where is angiotensin II produced

A

Lungs

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59
Q

Which cells of the kidney are particularly responsive to aldosterone

A

Distal tubule and collecting ducts

60
Q

Function of aldosterone

A

Promote reabsorption of sodium ions and water - concentrating urine

61
Q

Where is angiotensinogen produced

A

Liver

62
Q

What stimulates the release of aldosterone by glomerular cells in the cortex of the suprarenal gland

A

Angiotensin II

63
Q

What is aldosterone secreted by

A

glomerular cells in the cortex of the suprarenal gland

64
Q

Structure of urothelium

A

Between the surface layer of umbrella cells and basement membrane there are several apparent layers of cells- all of which are in contact with the basement membrane
Number of layers varies between 3 and 8 according to location and degree of distension
Stratified with 2 layers but appears pseudostratified

65
Q

Shape of basal cells in urothelium

A

Cuboidal

66
Q

Shape of cells above basal cells in urothelium

A

Columnar in the relaxed state

67
Q

Umbrella cells

A

Large bi-nucleate cells
Surface composed of thick membrane plates joined by thinner membrane bands

68
Q

Composition of thick membrane plates of umbrella cells

A

Unique lipid composition
Rich in cerebrosides

69
Q

Number of layers of cells between umbrella cells and basement membrane

A

3-8 depending on location and degree of distension

70
Q

Location of membrane plates in relaxed state

A

Perpendicular to the membrane surface - giving it a fuzzy appearance

71
Q

Location of membrane plates when stretched

A

Drawn out onto the surface of the cell

72
Q

Umbrella cells function

A

specially adapted to resist attack by the urine in the lumen

73
Q

Number of layers of cells in urothelium when bladder is empty

A

4-6 ish due to the squashing up of cells when the bladder is emoty

74
Q

Number of layers of cells in urothelium when bladder is full

A

Epithelium is stretched so apparent number of layers of cells decreases
When most full- appears as a single layer of cells covered by the urine-proof umbrella cells

75
Q

Function of ureter

A

Conducts urine from pelvis of the kidney to the urinary bladder

76
Q

Length of ureter

A

20cm

77
Q

Structure of ureter

A

Star shaped lumen
Epithelial tube surrounded by 2 helical layers of smooth muscle
Towards the bladder the muscle fibres become predominantly longitudinal in orientation

78
Q

Where is the ureter constricted

A

Origin in pelvis of kidney
As it passes into the true pelvis anterior to the sacro-iliac joint
As it enters the postero-inferior surface of the bakdder

79
Q

Where does the ureter enter the bladder

A

Postero-inferior surface

80
Q

Where does the ureter pass into the pelvis

A

Anterior to the sacro-iliac joint

81
Q

Where are kidney stones likely to become lodged

A

3 points of constriction of ureter

82
Q

Number of points of constriction of ureter

A

3

83
Q

What prevents reflux of urine

A

Compression of the ureter as it passes obliquely through the muscular wall of the bladder

84
Q

Shape of ureter lumen

A

Star shaped

85
Q

What lines the lumen of the ureter

A

Urethelium

86
Q

What surrounds the urethelium of the ureter

A

2 helical layers of smooth muscle

87
Q

In which layer of the ureter do thin-walled venules lie

A

Lamina propria underneath urothelium of the ureter

88
Q

Structure of urinary bladder

A

Thick bundles of smooth muscle with no preferred direction except at the neck where 3 distinct layers are evident

89
Q

Innermost longitudinal layer of smooth muscle in neck of bladder

A

Projects inferiorly and turns transversely to form a sphincter around the prostatic urethra (males) and the external meatus (females)

90
Q

Cell structure of urinary bladder

A

Lining urothelium sits in a fibrous Lamina propria
Thrown into folds

91
Q

Prostatic urethra

A

Males

92
Q

External meatus

A

Females

93
Q

Nerve supply to the bladder

A

Autonomic

94
Q

Sensory nerve supply of bladder

A

Provide information about degree of distention

95
Q

Motor nerve supply of bladder

A

Contraction of muscle during micturition

96
Q

Parasympathetic nerve supply to bladder

A

Sacral outflow

97
Q

What nerves supply blood vessels to the bladder

A

Sympathetic

98
Q

Is the urethra longer in males or females

A

Males

99
Q

Divisions of urethra in males

A

Prostatic
Membranous
Bulbous
Pendulous

100
Q

Lining of urethra in males

A

Urothelium mainly except at the distal (penile) end
Mucous glands found along whole length

101
Q

Lining of urethra in females

A

Stratified squamous epithelium punctuated by areas of mucous glands

102
Q

What surrounds the membranous part of the urethra

A

A striated muscle sphincter derived from the muscles of the pelvic diaphragm

103
Q

What kind of tissue lies underneath the prostatic urothelium

A

Dense fibrous connective tissue which will restrict the distension of urothelium

104
Q

How is blood flow through the glomerulus regulated

A

Constriction of the afferent and efferent arterioles

105
Q

Why is the wall of the ureter composed mainly of smooth muscle rather than fibrous connective tissue

A

Undergoes peristaltic contractions that help to conduct urine to the bladder

106
Q

Which nerves cause micturition

A

Occurs once the external sphincter of the bladder is relaxed= sympathetic stimulation
And the muscle wall of the bladder (detrusor muscle) contracts = parasympathetic

107
Q

Name of muscle wall of bladder

A

Detrusor muscle

108
Q

Which glands drain into the prostatic urethra

A

Prostate
Seminal vesicles
Deferent duct (sperm)

109
Q

Which glands drain into the penile urethra

A

Bulbo-urethral glands
Other small mucous glands

110
Q

What type of epithelium lines the distal end of both the male and female urethra

A

Stratified squamous epithelium

111
Q

Components of urinary tracts

A

Kidneys
Ureters
Bladder
Urethra

112
Q

Number of nephrons in each kidney

A

Roughly 1 million

113
Q

3 areas of kidney

A

Cortex
Medulla
Renal pelvis

114
Q

What encases the glomerulus

A

Bowman capsule

115
Q

What lines the glomerulus

A

Podocytes

116
Q

What supports the glomerulus

A

Mesangial cells

117
Q

What is commonly used to stain the glomerulus

A

PAS

118
Q

Function of mesangial cells

A

Provide structural support for capillary by producing extra-cellular matrix protein
Contraction of smooth muscle tightens capillaries and reduces glomerular filtration rate
Phagocytosis of glomerular basement membrane break down products

119
Q

How much albumin in urine is abnormal

A

More than 3g per day

120
Q

Loss of which proteins in the basement membrane are associated with kidney disease

A

Nephrin
CD2AP

121
Q

2 components of juxtaglomerular apparatus

A

Glomerulus
Distal convoluted tubule

122
Q

What lines the proximal convoluted tubule

A

Cuboidal epithelium
Round central/basal nucleus
Brush border of microvilli at apical end
Many mitochondria so appear eosinophilic

123
Q

Lining of thin part of loop of henle

A

Simple squamous

124
Q

Lining of thick part of loop of henle

A

Low cuboidal

125
Q

Lining of distal convoluted tubule

A

Low cuboidal epithelium

126
Q

Lining of collecting duct

A

Cuboidal epithelium

127
Q

Principal cells of collecting duct

A

Respond to aldosterone and ADH

128
Q

Intercalated cells of collecting duct

A

Exchange H+ for HCO3-

129
Q

How does ADH increase permeability of collecting duct

A

Insertion of aquaporin 2 into apical membrane of principal cells

130
Q

Alpha intercalated cells

A

Secrete acid

131
Q

Beta intercalated cells

A

Secrete bicarbonate

132
Q

Kidney blood supply

A

Abdominal aorta
Renal artery L1
Anterior and posterior division
Interlobar artery
Arcuate artery
Interlobular artery
Afferent arteriole

133
Q

At what level does the renal artery leave the abdominal aorta

A

L1

134
Q

Divisions of renal artery

A

Anterior and posterior division

135
Q

What do anterior and posterior divisions of the renal artery divide into

A

Interlobar arteries

136
Q

What do Interlobar arteries give rise to

A

Arcuate arteries

137
Q

What do the efferent arterioles give rise to

A

Peritubular capillaries

138
Q

What do peritubular capillaries give rise to

A

Vasa recta

139
Q

Lining of renal pelvis

A

Urothelium

140
Q

Arrangement of smooth muscle in ureter

A

Inner longitudinal
Outer circular

141
Q

Layers of bladder

A

Urothelium
Lamina propria
Muscularis mucosae
Submucosa
Muscularis propria
Subserosa and serosa

142
Q

Length of female urethra

A

4-5cm

143
Q

Which glands open into female urethra

A

Paraurethral
Periurethral

144
Q

Length of male urethra

A

20cm

145
Q

What has a lining of urothelium

A

Renal pelvis
Ureter
Bladder
Urethra

146
Q

Basement membrane of glomerulus

A

Double thickness- lamina lucida interna
Lamina densa
Lamina lucida externa

Contains collagen and negatively charged heparin sulfate molecules

147
Q

Bartholin’s glands

A

glands are located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina

Histology (17 decks)

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