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UROGENITAL > 2. Gross and functional anatomy of urinary system (HARC) > Flashcards

2. Gross and functional anatomy of urinary system (HARC) Flashcards

1
Q

FUNCTION of the urinary tract

A

maintain HOMEOSTASIS by regulating VOLUME and COMPOSITION of BLOOD

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2
Q

Urinary Tract has huge BLOOD SUPPLY coming directly from the..

A

ABDOMINAL AORTA

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3
Q

how is HOMEOSTASIS achieved (4)

A
  • EXCRETION of waste (urea, creatinine, uric acid etc.)
  • REGULATING WATER and SALT BALANCE in blood
  • REGULATE PLASMA CONC. of Na+, K+, Cl- etc
  • STABILISE BLOOD pH
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4
Q

URINARY TRACT consists of

A
  • KIDNEYS
  • URETERS
  • BLADDER
  • URETHRA

(NOT suprarenal glands)

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5
Q

where are the KIDNEYS

A

POSTERIOR ABDOMINAL WALL

RETROPERITONEAL

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6
Q

LEFT and RIGHT KIDNEY are ASSYMETRICAL because ..

A

of the LIVER

RIGHT KIDNEY lies lower due to liver
LEFT kidney ascends higher, below Spleen

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7
Q

where is the UPPER POLE of the RIGHT KIDNEY

A

TRANSPYLORIC PLANE (T12)

below liver

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8
Q

where is the UPPER POLE of the LEFT KIDNEY

A

at 11TH RIB

closely related to (below) SPLEEN

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9
Q

KIDNEYS rest on 3 MUSCLES:

A
  • DIAPRAGM
  • QUADRATUS LUMBORUM
  • TRANSVERSUS ABDOMINIS
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10
Q

which MUSCLE do the KIDNEYS lie MOSTLY on

A

DIAPHRAGM

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11
Q

KIDENY HILUM faces medially towards..

A

RENAL VESSELS & top of PSOAS MAJOR

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12
Q

what are KIDNEYS COVERED by

A

RENAL FASCIA

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13
Q

KIDNEYS are embedded in FASCIA and which THICK FAT pads

A
  • PERINEPHRIC FAT (inside fascia)
  • PARANEPHRIC FAT (outside fascia)

fascia and fat keep kidneys in place

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14
Q

KIDNEYS lie between … and …

A

MUSCLES / musculature
and
PERITONEUM (thin layer that coats walls of abdomen)

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15
Q

KIDNEY 3 layers:

A
  • THIN FIBROUS CAPSULE
  • CORTEX
    (renal columns)
  • MEDULLA
    (pyramids and papillae)
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16
Q

CORTEX of KIDNEY extends to form

A

RENAL COLUMNS

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17
Q

MEDULLA of KIDNEY is ARRANGED into..

A

RENAL PYRAMIDS

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18
Q

RENAL PYRAMIDS have what on their ends

A

PAPILLAE
(where urine is released from renal pyramids to renal sinus)

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19
Q

what SURROUND PAPILLAE of medulla of kidney and what do they JOIN to form..
to.. to..

A

MINOR CALYCES (minor calyx)

several join to form MAJOR CALYCES

which then form RENAL PELVIS to URETER

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20
Q

BLOOD FLOW through KIDNEYS starting from AORTA to the nephron associated blood vessels

A

RENAL ARTERY

-> SEGMENTAL ARTERY (1 in each segment)

-> INTERLOBAR ARTERY (in renal columns)

-> ARCUATE ARTERY (around the base of pyramids)

-> CORTICAL RADIATE ARTERY (cortex out towards capsule

-> NEPHRON-ASSOCIATED (AFFERENT ARTERIOLE)

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21
Q

NEPHRON-ASSOCIATED BLOOD VESSELS

A

AFFERENT ARTERIOLE

GLOMERULUS

EFFERENT ARTERIOLE

-> PERITUBULAR CAPILLARIES / VASA RECTA

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22
Q

BLOOD FLOW through KIDNEYS starting from NEPHRON ASSOCIATED (peritubular capillaries) back to the heart
(VENOUS RETURN)

A

CORTICAL RADIATE VEIN

-> ARCUATE VEIN

-> INTERLOBAR VEIN

-> RENAL VEIN

-> INFERIOR VENA CAVA

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23
Q

how is the LUMEN of the URETERS

A

SMALL

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24
Q

approx length of URETERS

A

25-30 CM long

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25
Q

URETERS begin at..

A

RENAL PELVIS

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26
Q

URETERS end at

A

VESICOURETERIC JUNCTION
(end of BLADDER)

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27
Q

3 POINTS of CONSTRICTION of URETERS

A
  1. PELVIURETERIC JUNCTION (where ureters form)
  2. crosses the PELVIC BRIM / COMMON (external) ILIAC ARTERY
  3. VESICOURETERIC JUNCTION
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28
Q

from constriction URETERS are a common place for … to form

A

CALCULI

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29
Q

what do URETERS cross

A

PELVIC BRIM

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30
Q

URETERS run externally adjacent to which artery

A

EXRERAL ILIAC ARTERY
(common iliac artery)

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31
Q

URETERS enter PELVIS ANTERIOR to which joint

A

SACROILIAC JOINT

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32
Q

on which abdominal structure do the URETERS MAINLY LIE

A

PSOAS MAJOR MUSCLE

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33
Q

how is the URETERS BLOOD SUPPLY

A

COMPLEX from VARIOUS SOURCES:
- gonodal artery
- common iliac artery
- internal iliac artery
- superior vesicle artery
- middle rectal artery

means very DIFFICULT to MANAGE surgically

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34
Q

in which vessel does BLOOD FLOW when LEAVING the GLOMERULUS

A

EFFERENT ARTERIOLE

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35
Q

UPPER POLE of the LEFT KIDNEY is associated with which RIB

A

11TH RIB

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36
Q

what is the FUNCTIONAL UNIT of the KIDNEY

A

NEPHRON

37
Q

NEPHRON transverses which areas of the KIDNEY

A

CORTEX and MEDULLA

38
Q

NEPHRON consist of 2 PARTS:

A
  • RENAL CORPUSCLE
  • RENAL TUBULE
39
Q

RENAL CORPUSCLE of nephron consists of

A

GLOMERULUS
surrounded by
BOWMAN’S CAPSULE

40
Q

RENAL TUBULE of Nephron consists of

A

PROXIMAL CONVOLUTED TUBULE
LOOP of HENLE
DISTAL CONVOLUTED TUBULE

41
Q

what is the GLOMERULUS

A

Ball of CAPILLARY VESSELS from AFFERENT ARTERIOLE

42
Q

what is the GLOMERULUS UNITED by

A

MESANGIAL CELLS and MATRIX

43
Q

BOWMAN’S CAPSULE is invaginated by the

A

GLOMERULUS (pushes into BC)

44
Q

the JUXTAGLOMERULAR WALL of the BOWMAN’S CAPSULE is lined by..

A

PODOCYTES

45
Q

what are PODOCYTES

A

line juxtaglomerular wall of BOWMAN’S CAPSULE

have FOOT PROCESSES that WRAP AROUND / surround CAPILLARY LOOPS

46
Q

what do PODOCYTES have coming out for FILTRATE to PASS through and what are they like

A

PEDICELS

TIGHTLY INTERDIGITATED with 25nm GAPS that filtrate must pass through

Gaps covered by ‘DIAPHRAGMS’ of cell-surface PROTEINS (nephrin, podocin etc.)

47
Q

in RENAL CORPUSCLE what passes INTO BOWMAN’S CAPSULE

A

WATER and SMALL MOLECULES

(Blood cells/ plasma proteins/ macromolecules are too LARGE)

48
Q

what causes the FILTRATION in the RENAL CORPUSCLE

A

PRESSURE

GLOMERULAR PRESSURE is always MAINTAINED (no matter what systematic pressure is)

49
Q

how many RENAL CORPUSCLES per KIDNEY

A

approx 1 MILLION

But DECREASE with AGE (IRREPLACEABLE)
therefore reduction in glomerular filtration rate over time

50
Q

what is the FIRST PART of the RENAL TUBULE and ORIGINATES from the BOWMAN’S CAPSULE

A

PROXIMAL CONVOLUTED TUBULE

51
Q

PROXIMAL CONVOLUTED TUBULE is LINED by a SINGLE LAYER of..

A

COLUMNAR EPITHELIAL CELLS

52
Q

what do you find in the COLUMNAR EPITHELIA lining the PROXIMAL CONVOLUTED TUBULE and why is it important

A

BRUSH BORDER of MICROVILLI

  • INCREASES CONTACT WITH TUBULAR FLUID
  • helps TRANSPORT of IONS and SMALL MOLECULES AGAINST STEEP CONC. GRADIENTS
53
Q

what is the PURPOSE of the BRUSH BORDER in the PROXIMAL CONVOLUTED TUBULE

A

increases CONTACT with tubular fluid

helps TRANSPORT of IONS and SMALL MOLECULES AGAINST STEEP CONC. GRADIENTS

(MICROVILLI)

54
Q

PROXIMAL CONCOLUTED TUBULE is ABUNDANT in..

A

MITOCHONDRIA

  • ENERGY SOURCE for TRANSPORT of IONS
55
Q

LOOP OF HENLE has 2 LIMBS

A

DESCENING LIMB
ASCENING LIMB

connected by abrupt U-turn

56
Q

when do the LIMBS of the LOOP OF HENLE become much NARROWER and THIN-WALLED

A

when in the MEDULLA

(as passes from cortex to medulla)

57
Q

THIN REGIONS of the LOOP OF HENLE (in MEDULLA) have what type of role in ION TRANSPORT

A

MORE PASSIVE ROLE in ION TRANSPORT than thicker segments (in cortex)

58
Q

DIFFERENCE between PCT and DISTAL CONVOLUTED TUBULE

A

DCT has FEW MICROVILLI

and more typical TUBULAR SHAPE
FLATTER EPITHELIAL CELLS lining the internal wall

59
Q

what is the MACULA DENSA in the DISTAL CONVOLUTED TUBULE

A

FOCAL THICKENING in the tubular wall NEAR the RENAL CORPUSCLE (at the junction between afferent and efferent arterioles)

60
Q

what does the MACULA DENSA of the DCT do

A

SENSORY apparatus concerned with Blood flow

REGULATES GLOMERULAR FILTRATION RATE as part of FEEDBACK loop

61
Q

what does the DISTAL CONVOLUTED TUBULE contain to help MAINTAIN BLOOD pH

A

SPECIALISED CELLS to RELEASE H+ INTO FILTRATE

62
Q

DCT leads into ..

A

COLLECTING TUBULE

then COLLECTING DUCT

63
Q

where does the COLLECTING DUCT SYSTEM BEGIN and where does it go

A

begins in CORTEX

DESCENDS THROUGH MEDULLA towards PAPILLAE (enters minor calyx)

64
Q

what is the COLLECTING DUCT LINED by

A

SINGLE CUBOIDAL or COLUMNAR EPITHELIAL CELLS

65
Q

what happens in the COLLECTING DUCT

A

REABSORPTION of WATER

using ADH (anti-diuretic hormone) / AQUAPORINS

66
Q

what are JUXTAGLOMERULAR APPARATUS

A

structures within KIDNEY that REGULATE NEPHRON ACTIVITY

67
Q

3 CELL TYPES of JUXTAGLOMERULAR APPARATUS (regulate nephron activity)

A
  • MACULA DENSA (regulate GFR)
  • JUXTAGLOMERULAR CELLS (secrete RENIN - RAAS system, surround afferent arteriole)

-EXTRAGLOMERULAR MESANGIAL CELLS

68
Q

where are the EXTRAGLOMERULAR MESANGIAL CELLS located

A

between AFFERENT and EFFERENT ARTERIOLES

69
Q

4 SUGGESTED FUNCTIONS of EXTRAGLOMERULAR MESANGIAL CELLS

A
  • Support capillary loops
  • Alter GFR loop via Myosin-angiotensin mechanism
  • Phagocytic function
  • Maintain the Basement Membrane
70
Q

which component of the PODOCYTES are INTERDIGITATED around the CAPILLARY Loops

A

PEDICELS

71
Q

MACULA DENSA are found at which part of the NEPHRON

A

DISTAL CONVOLUTED TUBULE

Near renal corpuscle (between afferent and efferent arterioles)

72
Q

which type of EPITHELIAL CELLS are found LINING the PCT of the nephron

A

COLUMNAR EPITHELIAL

73
Q

RENAL CORPUSCLE is found where in the kidney

A

only in the CORTEX

74
Q

in HISTOLOGY what are the wavy networks that PCTs and DCTS are found in, between Corpuscles

A

CORTICAL LABYRINTHS (CL)

75
Q

NARROW LUMEN of URETER surrounded by..

A

DELICATE EPITHELIAL LAYER

76
Q

what do URETERS have in epithelia to PREVENT URINE BACKFLOW

A

MUCOSAL FOLDS

77
Q

MUSCLE LAYERS in URETERS

A

CIRCULAR and LONGITUDINAL

78
Q

how does URINE TRAVEL through URETER

A

very SLOW
SMALL VOLUMES by PERISTALSIS

79
Q

what is ADVENTITIA of URETER

A

FIBROELASTIC CONNECTIVE TISSUE

loaded with VASCULATURE, LYMPH VESSELS & NERVS

80
Q

3 STAGES of DEVELOPMENT for KIDNEY EXCRETORY System (EMBRYOLOGY)

A
  1. PRONEPHROS
  2. MESONEPHROS
  3. METANEPHROS
81
Q

KIDNEY DEVELOPMENT
PRONEPHROS:

A

Rudimentary CELL GROUPS in NECK region

DISAPPEAR by 5th WEEK

but DUCT PERSIST into next stage

82
Q

KIDNEY DEVELOPMENT
MESONEPHROS:

A

Functional from WEEKS 6-10

FORM in THORACOLUMBAR REGION

ESTABLISH CONNECTION to FUTURE BLADDER and GENITALIA - MESONEPHRIC DUCT

PRIMITIVE (early) FILTRATION

83
Q

KIDNEY DEVELOPMENT
METANEPHROS

A

DEVELOPING KIDNEYS
becomes adult kidney
(lower in the body)

FINAL stage

FUNCTIONAL FROM WEEK 9

84
Q

what does the UTERIC BUD do in KIDNEY DEVELOPMENT (embryology)

A

comes UP away from BLADDER and extends towards the METANEPHROS and invaginates

spreads IN METANEPHROS to form complex FILTRATION SYSTEM

85
Q

as the METANEPHROS GROWS and DEVELOPS..

A

MESONEPHROS SHRINKS and DISAPPEARS

86
Q

METANEPHROS begin forming LOW in the body. what happens to form ADULT KIDNEYS

A

MIGRATION
KIDNEYS ASCEND towards ADULT POSITION (and ureters get longer)

87
Q

what happens to RENAL ARTERIES to allow KIDNEY MIGRATION (ascent)

A

NEW RENAL ARTERIES FORM from HIGHER in the AORTA
- several times

so kidneys move up

88
Q

how do the KIDNEYS MOVE during ASCENT

A

ROTATE MEDIALLY as they SEPARATE (become more lateral)
HYLEM face each other

BLOOD SUPPLY ALSO CHANGES

89
Q

when does KIDNEY MIGRATION / ASCENT STOP

A

when come into contact with SUPRARENAL GLANDS

UROGENITAL (19 decks)

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