1 Urinary Anatomy and Renal Histology

Question 0

Sympathetic innervation to the urinary system

Answer 0

Kidney T10-L1

Ureter and bladder T11-L2

Question 1

Progression of arteries in the kidney

Answer 1

Renal > Segmental> Lobar> Interlobar> arcuate> interlobular

Question 2

Parasympathetic innervation of the urinary system

Answer 2

Kidney: Vagus

Ureters and Bladder: Pelvic splanchnic

Question 3

Functions of the Kidney

Answer 3

Excretory: ions drugs
Homeostasis: acid base, CA/PO4, NA, K
Endocrine: Erythropoietin, ANGII

Question 4

What is a lobule

Answer 4

Medullary ray and surrounding cortex

Question 5

What is a lobe

Answer 5

Medullary pyramid and surrounding cortex

Question 6

Tubular plexus

Answer 6

Capillaries covering loop of cortical nephrons

Question 7

Vasa Recta

Answer 7

Capillaries that supply loop of juxtamedullary nephrons

Question 8

Glycocalyx

Answer 8

Proteoglycan layer that is negatively charged and blocks negatively charged molecules from passing on the endothelial side (podocyttes do this on the opposite side

Question 9

Mesangium

Answer 9

Cells and ECM of fibronectin and collagen that provide:
Physical support to the glomerulus
Regulate blood flow (through pericytes with ANP and ANGII receptors)
Create glomerular basement membrane

Question 10

Ureter blood supply

Answer 10

Small branches off the Renal arteries, testicular arteries, common iliacs, and internal iliacs.

Question 11

Kidney Size

Answer 11

10X6X2.5-3cm (left is narrower and longer)

150gm male, 135 female

Question 12

Sites of ureter narrowing

Answer 12

Ureteropelvic junction, external iliac artery, ureterovesicular junction

Question 13

How much CO is delivered to kidneys

Answer 13

20-25%

Question 14

How much fluid is filtered in the kidneys

Answer 14

125ml/ minute (124ml returns to the circulation)

Question 15

How often is total blood volume fltered?

Answer 15

Every 4-5 minutes

Question 16

Size of glomerular vasculature

Answer 16

Afferent arteriole is larger than efferent- this ceates a pressure difference that drives filtration

Question 17

Capillary epithelium specifics

Answer 17

70-100nm pores- permeable to water and 6-8 kDa solutes, partially permeable to 8-16kDa solutes

Question 18

Glomerular filtration barrier 3 parts

Answer 18

Capillary endothelium
Basement Membrane
Podocytes

Question 19

Mesangium definition/parts

Answer 19

ECM of fibronectin and collagen

Pericytes with receptors for ANGII and ANP. Secretion of endothelin cytokines, and prostaglandin.

Question 20

Proximal tubule histology

Answer 20

• Cuboidal/columnar epithelium
• granular cytoplasm
• basal nuclei
• Brush border obscures lumen
• Indistinguishable lateral borders (interdigitation)

** NaCl, H2O absorption, facilitated Glucose AA and protein resorption

Question 21

Loop of henle histo

Answer 21

• simple squamous epithelium in thin portions (differentiated with capillaries by lack of RBCs in the lumen
• Thick ascending limbs cuboidal epithelium

Question 22

Thick ascending histo

Answer 22

• Cuboidal epithelium
• Central nuclei
• Interdigitations
• impermeable to H20, absorb NaCl, glucose, AA, and proteins through facilitated diffusion. H+ secreted

Question 23

Distal tubule histo

Answer 23

• Cuboidal epithelium
• central oval nuclei
• interdigitations
• no brush border
• **NaCL, KHCO3 resoption, secretion of K+, H+, and N3H

Question 24

Late distal tubule

Answer 24

* cuboidal * Large lumen * Central nuclei * **ADH Na resorption and K secretion

Question 25

Polycystin 1&2

Answer 25

Flow sensing proteins on Primary cilium of collecting duct. Genetic defects causes polycystic kidney disease

Question 26

Macula Densa

Answer 26

Columnar cells on distal convoluted tubule | Detects NaCl concentation by releasing Renin

Question 27

Erythropoeitin functions

Answer 27

* ^ RBC precursors * ^ RBC release from BM * ** Increased production in high altitude, hemorrhage, impaired pulmonary function (hypoxia)

Question 28

Oliguria

Answer 28

<400 ml urine per day

Question 29

Ureter histo

Answer 29

mucosa epithelium (transitional), lamina propria (with abundant elastic tissue), muscularis (2 layers, 3 layers lower 1/3) inner longitudinal, outer is circular, adventitia (fibrous tissue)

Question 30

Bladder cancer

Answer 30

Associated with smoking, mainly uroepithelial in origin.