Week 4/Lab 4 Flashcards
Kidney function general
- excrete most of the waste products of metabolism
- control water and electrolyte balance
- maintain acid-base balance
Right Kidney anterior relationships
- the suprarenal gland
- liver
- second part of the duodenum
- right colic flexure
Kidney posterior relationship
- diaphragm(posterior and inferior)
- costodiaphragmatic recess of pleura
- 12th rib for R and 11th rib for L
- psoas, quadratus lumborum, and transversus abdominis mucles
- subcostal(T12) nerves
- iliohypogastric and ilioinguinal nerves(L1)
Left Kidney anterior relationships
- suprarenal gland
- the spleen
- stomach
- the tail of the pancreas
- left colic flexure
- coils of jejunum
Kidney Hilum
- medial concave border of each kidney
- extends into renal sinus
- transmits renal vein, 2 branches of renal artery, ureter, third branch of renal artery
- lymph and sympathetic fibers pass through
Para vs. Peri
Para-beside
Peri-around
Fibrous capsule
-surrounds kidney and is closely applied to its outer surface
Perirenal fat
-covers the fibrous capsule
Renal fascia
- condensation of connective tissue that lies outside the perirenal fat and encloses the kidneys and suprarenal glands
- continuous laterally with fascia transversalis
Pararenal fat
- lies external to the renal fascia
- often in large quantity
- forms part of the retroperitoneal fat
Renal sinus
- space within the hilum
- contains upper expanded end of ureter(renal pelvis)
Renal pelvis
- upper expanded end of the ureter
- divides into 2-3 major calyces
- those divide into 2-3 minor calyces
- minor calyces indented by renal papilla
Renal papilla
-apex of the renal pyramid
Lobar arteries
- arise from segmental artery, one from each renal pyramid
- each divides into 2-3 interlobar arteries
Interlobar arteries
- run towards the cortex on each side of the renal pyramid
- at the junction of cortex and medulla, interlobar arteries give rise to interlobular arteries
Interlobular arteries
- ascend in the cortex
- give rise to afferent glomerular arterioles
Renal artery
- arise from aorta at L2
- each one divides into 5 segmental arteries that enter the hilum
Renal cortex
contains. ..
- renal corpuscles
- proximal and distal convoluted tubules
- cortical collecting tubules
- blood vessel
Renal medulla
- made up of renal pyramids
- descending (thick–>thin) limb
- ascending (thin–> thick) limb
- cortical collecting tubules
- collecting ducts
- papillary duct
Renal pyramids
divided into 3 zones…
- outer medulla
- inner medulla
- renal papillae
Direction of urine
Papillary ducts->minor calyces->major calyces->make renal pelvis->renl ureter
Nephron
-basic functional unit of the kidney comprised of... -renal corpuscle -proximal convoluted tubule -loop of henle -distal convoluted tubule
Renal corpuscle
- glomerulus and bowman’s capsule
- allows water, metabolic waste, ions, and small molecules to pass through the capillary wall
- prevent circulating cells and plasma proteins from leaving the blood
Glomerulus
- spherical knot of capillaries
- fed in by afferent glomerulus arterioles
- drained by efferent glomerulus arterioles
Bowman capsule: parietal layer
-hollow spherical structure lined by simple squamosous epithelium
Bowman capsule: visceral layer
- made up of podocytes that cover capillaries
- long, interdigitating cellular process that help in blood filtration
Intraglomerular mesangial cells
-interstitial tissue surrounding the glomerular capillaries contain these
Bowman space
-space between parietal and visceral layers of Bowman’s capsule
Proximal convoluted tubules
- drain filtration from renal corpuscle to the loop henle
- lined by a simple cuboidal epithelium with abundant long microvili bordering the lumen
- connects renal corpuscle to urinary pole
Brush border
-microvili lining the proximal convoluted tubules
Descending limb of the loop of henle
- permeable to water, chloride and sodium ions
- reabsorb salts and water
- reduce the volume of the filtrate
- absorption of particles
Ascending limb of the loop of henle
- impermeable to water!
- actively pumps chlorine and sodium ions for the tubes back into the medullary interstitum
- acid/base balance
Distal convoluted tubules
- lined by simple cuboidal epithelial cells
- no brush border
- macula densa
- remove sodium ions and ass potassium ions to filtrate IF aldosterone stimulation is present.
- reabsorb bicarbonate ions and secrete ammonium to adjust pH balance
Macula densa
- tightly packed group of cells within distal convoluted tubules
- sense and monitor ionic content and water volume of filtrate
Collecting system
- cortical collecting tubules, collecting ducts, and papillary ducts.
- all have cytoplasm and cell boundaries
ADH
- antidiuretic hormone
- collecting tubules/ducts become water permeable in its presence
- triggered by macula densa
- low levels, tubules.ducts diffuse water from lumen to interstitium to increase concentration of urine
Ureters
- lie in extraperitoneal connective tissue on each side of the vertebral column
- lined by transitional epithelium(cuboidal->squamosal)
- surrounded by layer of smooth muscle and connective tissue
- thinner wall than bladder
- mucosa, muscularis, and adventitia tissue layers
Ureter draining
superior: drain renal pelvis
Inferior: empty into the bladder by penetrating its posterior wall
Urinary bladder
- located in pelvic cavity
- temporarily stores urine
Urinary bladder openings
- 2 for ureters
- 1 for emptying urine into the urethra
Urinary bladder lining
- mucosa, muscularis, adventitia layers
- wall is thicker than ureters
- three layers of smooth muscle in the muscularis
Urinary bladder muscularis
- 3 layers
- contracts in different directions to enable bladder to empty urine
Suprarenal glands
- retroperitoneal organs
- surrounded by renal fascia
- separated from kidneys by perirenal fat
- each has cortex and medulla
Suprarenal cortex
- secrete mineral corticoids
- secrete glucocorticoids
- secrete small amount of sex hormones
mineral corticoids
-concerned with the control of fluid and electrolyte balance
Glucocorticoids
-control of the metabolism of carbs, fats, and proteins
Suprarenal medulla
- secrete catecholamines: epinephrine and norepinephrine
- sympathetic
Suprarenal arteries
- 3 that come from…
- inferior phrenic artery
- aorta
- renal artery
Suprarenal vein
- emerges from hilum of each gland
- drains into IVC on the right
- drains into the renal vein on the left
Preganglionic sympathetic fibers
- derived from splanchnic nerves
- synapse inside the gland, no ganglion
- white
- signal from brain straight to the medulla. no time for synapse because fight or flight
