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Microanatomy > Unit 7 - Urinary System > Flashcards

Unit 7 - Urinary System Flashcards

1
Q

functions of kidneys

A
  1. clear blood of metabolic waste products
  2. regulate fluid and electrolyte balance
  3. produce renal erythropoietic factor and renin
  4. hydroxylate vit D to active calcitriol
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2
Q

kidney location

A

retroperitoneally on posterior wall of abdominal cavity on either side of vertebral column

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3
Q

kidney hilus

A

concave medial border w/ ureter, nerves, blood, and lymphatic vessels

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4
Q

renal sinus

A

large cavity surrounded by kidney parenchyma

-contains renal pelvis, loose CT, adipose, blood vessels, and nerves

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5
Q

renal pelvis

A

expansion of upper end of ureter that subdivides into minor and major calyces

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6
Q

kidney capsule

A

consists of dense irregular cT

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7
Q

renal cortex

A

darker, granular tissue

  • broad outer zone
  • inward extensions (renal columns of Bertin)
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8
Q

minor VS major calyces

A

major: arise from renal pelvis
minor: arise from major

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9
Q

renal medulla

A

lighter, striated tissue

-made of renal pyramids and medullary rays

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10
Q

renal pyramids

A

in medulla

  • apices (renal papillae) project into minor calyces
  • tip is perforated by openings of collecting ducts (area cribosa)
  • each pyramid together with its surrounding cortical tissue constitutes a renal lobe
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11
Q

renal lobe

A

renal pyramid + cortical tissue overlying its base and covering its sides
-each kidney contains 6 to 18 lobes

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12
Q

medullary rays

A

medullary tissue that projects up into cortex, consisting of collecting tubules and their accompanying proximal and distal tubules
-do NOT include renal corpuscles

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13
Q

renal lobule

A

medullary ray + surrounding cortical tissue

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14
Q

nephrons

A

functional unit of kidney

  • first part (Bowman’s capsule to distal tubule) forms urine
  • second part (collecting system) carries out final concentration of urinary solutes
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15
Q

components of nephron

A
  1. Bowman’s capsule
  2. Proximal convoluted tubule
  3. Loop of Henle
  4. Distal convoluted tubule
  5. Collecting tubules
  6. Collecting ducts
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16
Q

Bowman’s capsule components

A

thin-walled expansion at proximal end of nephron

  • deeply indented by glomerulus
  • visceral layer = podocytes and covers glomerular capillaries
  • parietal layer = simple squamous epithelium
  • urinary (capsular) space between both layers gets glomerular filtrate
  • glomerular filtration barrier
  • vascular pole = afferent arteriole enters, efferent arteriole leaves
  • urinary pole = proximal tubule begins
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17
Q

components of glomerular filtration barrier

A

in Bowman’s capsule

  1. capillary endothelium (fenestrated, w/o diaphragms)
  2. shared basement membrane (endothelium + podocytes)
  3. filtration slits between secondary processes of podoccytes
  4. produces glomerular filtrate (similar to blood, except little protein)
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18
Q

what is proteinuria caused by?

A

release of protein into urine due to defect in glomerular filtration barrier (usually doesn’t let PRO in)

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19
Q

where is urinary space continuous with proximal tubule lumen?

A

at urinary pole of Bowman’s capsule

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20
Q

proximal tubule composition

A

convoluted (close to renal corpuscle of origin) and straight part (enters medullary ray)

  • lined by simple cuboidal epithelium with brush border
  • eosinophilic cytoplasm
  • extensive lateral extensions (cell boundaries indistinct b/c large cells)
  • lumen has fine precipitated material
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21
Q

how many segments can the proximal tubule be subdivided into by electron microscopy?

A

can be subdivided into 3 segments by electron microscopy

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22
Q

loop of Henle composition

A

descending straight proximal (simple cuboidal epithelium with brush border, like convoluted), thin segment (simple squamous, like capillary w/o blood), and ascending straight distal
-located in medulla

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23
Q

distal tubule composition

A

ascending straight portion (last part of LoH), portion adjacent to renal corpuscle of origin, and convoluted part

  • mainly in cortex
  • simple cuboidal epithelium that lacks brush border
  • cells smaller than proximal tubule, with apical nuclei
  • less eosinophilic than proximal tubule
  • no precipitate in lumen
  • same extensive lateral extensions (indistinct boundaries) like in proximal
24
Q

collecting tubules and ducts composition

A

tubules in cortex, and ducts in medulla

  • cuboidal epithelium in tubules, columnar in ducts
  • cells have clear, pale-staining cytoplasm
  • intercellular boundaries are clearly visible
  • largest ducts (papillary ducts) communicate with minor calyx at area cribosa)
25
Q

3 types of nephrons

A

classified according to position of renal corpuscles in cortex

  1. superficial (cortical) nephrons - short LoH that extend short distance into medulla
  2. juxtamedullary nephrons - long LoH penetrate deep in medulla (most important for hypertonic urine)
  3. intermediate (midcortical) nephrons have intermediate characteristics
26
Q

what does the juxtaglomerular apparatus do? its components?

A

responsible for renin production

  • located where distal tubule returns to its renal corpuscle of origin
  • components:
  • -macula densa in wall of distal tubule
  • -juxtaglomerular cells: modified smooth muscle cells in tunica media of afferent arteriole
  • -extraglomerular mesangial cells (lacis cells): pale staining cells in angle between afferent and efferent arterioles
27
Q

explain the renin-angiotensin system

A

regulates fluid and electrolyte balance and blood pressure

  • when BP falls, juxtaglomerular cells release renin, that converts angiotensinogen (from liver) to AI to AII (by ACE in capillary endothelial cells of lungs)
  • AII stimulates zona glomerulosa of adrenal cortex to make aldosterone to stimulate distal tubule to reabsorb Na and H2O
  • -reabsorption increases intravascular fluid volume, which raises blood pressure
  • -AII is also a vasoconstrictor
  • renin also has localized effect on afferent arterioles (provides for single nephron GFR control)
28
Q

what does the macula densa do?

A

senses changes in NaCl concentration in distal tubule

  • high [NaCl] inhibits renin secretion
  • low [NaCl] stimulates renin secretion
29
Q

what are extraglomerular mesangial cells?

A

play a supportive role in the renin-angiotensin system

-may provide signal integrating system

30
Q

how much of total cardiac output goes to kidneys?

A

25%

31
Q

what are the 8 components of the arterial supply of the kidneys?

A
  1. renal artery
  2. interlobar arteries
  3. arcuate arteries
  4. interlobular arteries
  5. afferent arterioles
  6. glomerular capillaries
  7. efferent arterioles
  8. vasa recta
32
Q

renal artery?

A

enters at hilus and divides into anterior and posterior divisions

33
Q

interlobar arteries?

A

arise from anterior and posterior divisions of renal artery

  • run peripherally in renal columns
  • form arcuate arteries at corticomedullary junction
34
Q

arcuate arteries?

A

arise from interlobar arteries

  • run parallel to kidney surface
  • give rise to interlobular arteries
35
Q

interlobular arteries

A

arise from arcuate arteries

  • run radially through cortex
  • give rise to afferent arterioles
36
Q

afferent arterioles

A

arise from interlobular arteries

  • enter renal corpuscles at vascular poles
  • supply glomerular capillaries
  • site of juxtaglomerular cells
37
Q

glomerular capillaries?

A

arise from afferent arterioles

-unite to form efferent arterioles

38
Q

efferent arterioles?

A

arise from united glomerular capillaries

  • leave renal corpuscle at vascular pole
  • give rise to peritubular capillary network that nourishes proximal and distal tubules from cortical nephrons
  • give rise to vasa recta from juxtamedullary nephrons
39
Q

vasa recta

A

arise from efferent arterioles of juxtamedullary neprhons

-make hairpin loops in medulla to form countercurrent system of vessels

40
Q

what are the 5 components of venous drainage of the kidney?

A

closely paralleles arterial supply

  1. stellate veins
  2. interlobular veins
  3. arcuate veins
  4. interlobar veins
  5. renal vein
41
Q

stellate veins

A

drain capillaries in capsule and peritubular capillary network
-form interlobular veins

42
Q

what does EPO do? how is it used? downsides?

A

glycoprotein whose major function is to promote RBC formation in bone marrow by stimulating proliferation, differentiation, and precursor survival

  • used as anti-anemia drug in chronic and post-operative anemia, and cancer patients
  • -neuroprotection, CVD treatment, and induction of bone remodeling by OC activation
  • downsides: erythrocytosis and potentially tumor growth
43
Q

how is EPO made and stimulated by?

A

made by endothelial cells lining peritubular capillary plexus, and stimulated by hypoxia from:

  • hemorrhage
  • EPO destruction
  • pulmonary function compromise
  • CHF
  • high altitude
44
Q

motile VS non-motile cilia?

A

motile: 9+2 microtubule axoneme pattern that are coordinated in wave-like beats

non-motile: 9+0 microtubule axoneme pattern found singly on most cells

  • responsive to mechanical and chemical signals and sense fluid flow in uriniferous tubule
  • regulate cell proliferation
45
Q

what cilia type are defective in polycystic kidney disease?

A

non-motile

-leads to cellular over-proliferation and cyst formation

46
Q

what composes the extrarenal collecting system? their structure compared to each other?

A

minor and major calyces, renal pelvis, ureter, bladder, and urethra
-all but urethra are similar histologic structure

47
Q

mucosa of calyces, renal pelvis, ureter, and bladder

A

transitional epithelium with thin lamina propria of connective tissue

  • barrier to rapid salt and water diffusion
  • gives distensibility to lining layer
  • thickness increases from calyces to bladder
  • superficial cells are large and rounded (umbrella cells)
  • luminal surface has angular appearance (uroplakin particles)
  • apical cytoplasm rich in filaments and flattened vesicles
  • plasma membrane can stretch and contract triggered by ATP
  • 90% of urinary bladder tumors originate in epithelium
48
Q

muscularis of calyces, renal pelvis, ureter, and bladder

A

loose anastomosing strands of smooth muscle separated by abundant connective tissue
-thickest in bladder, where 3 layers are present (LCL)

49
Q

adventitia of calyces, renal pelvis, ureter, and bladder

A

composed of connective tissue

-upper part of bladder is covered by serosa (peritoneum)

50
Q

what is the urethra?

A

fibromuscular tube through which urine passes from the urinary bladder to the exterior

51
Q

three segments of the male urethra

A
  1. prostatic urethra
  2. membranous urethra
  3. penile urethra (spongy)
  4. glands of Littre (throughout)
52
Q

prostatic urethra?

A

first part of male urethra

  • from neck of bladder through prostate
  • lined by transitional epithelium
53
Q

membranous urethra

A

second part of male urethra

  • extends from lower pole of prostate to bulb of corpus spongiosum of penis
  • traverses urogenital and pelvic diaphragms
  • lining varies from transitional to pseudostratified columnar epithelium
  • surrounded by external sphincter of bladder (skeletal muscle)
54
Q

penile urethra

A

third part of male urethra

  • passes through corpus spongiosum of penis
  • lined by mostly pseudostratified columnar epithelium
  • fossa navicularis has lining of stratified squamous epithelium
  • contain most glands of Littre
55
Q

glands of Littre

A

mucous secreting glands that empty into male urethra

-most abundant in penile urethra

56
Q

female urethra

A

relatively short (3-5 cm)

  • lined by stratified squamous epithelium, plus some pseudostratified
  • staghorn shaped lumen
  • thick layer of smooth muscle in wall
  • urethra sphincter (skeletal muscle) in middle

Microanatomy (14 decks)

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