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Yr 2 - Renal > Embryology of Kidney > Flashcards

Embryology of Kidney Flashcards

1
Q

What does the mesoderm become highly organised into?

A
  1. Paraxial mesoderm
  2. Intermediate mesoderm
  3. Lateral plate mesoderm
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2
Q

What does the paraxial mesoderm develop into?

A

Majority of skeleton, skeletal muscles and dermis of skin

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3
Q

What does the intermediate mesoderm develop into?

A

Gonads, internal reproductive tracts, kidneys

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4
Q

What does the lateral plate mesoderm develop into?

A

Lining of body cavities

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5
Q

What makes up the urinary system?

A
  • Kidneys
  • Ureteres
  • Urinary bladder
  • Urethra
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6
Q

What are the pronephros?

A

Pronephros is the most basic of the three excretory organs that develop in vertebrates, corresponding to the first stage of kidney development

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7
Q

When does the pronephros form?

A

4th week

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8
Q

What does the pronephros form from? Where do they develop?

A

Intermediate mesoderm in the cervical region condenses an reorganises to form a number of epithelial buds

Development begins in the cervical region of the embryo

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9
Q

When do pronephros disappear?

A

Around day 25

They develop and regress in humans, with no function except kicking off cascade of kidney development

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10
Q

What begins to form lateral to pronephros in the lower cervical region?

A

A solid duct - mesonephric duct

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11
Q

Where does mesonephric duct form from?

A

Intermediate mesoderm

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12
Q

What is the 2nd kidney structure to form? Where does it develop?

A

Mesonephros

Develops caudally to the prenephros

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13
Q

How does the mesonephric duct develop?

A

Develops caudally and fuses with the walls of the cloaca

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14
Q

When does the mesonephric duct fuse with the cloaca?

A

Day 26

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15
Q

What is the cloaca?

A

Common point of emptying of GI and urinary system

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16
Q

After fusion with the cloaca, what happens to the mesonephric duct?

A

Starts to form a lumen inside of it –> canalisation commences from caudal end and moves cranially

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17
Q

When does the mesonephros develop?

A

As pronephros is regressing (overlapping process)

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18
Q

Where is the mesonephros derived from?

A

Intermediate mesoderm in the upper thoracic to the upper lumbar regions

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19
Q

What does the development of the mesonephric duct induce?

A

Formation of mesonephric buds from mesenchyme

I.e. pronephros stimulates mesonephric duct to form which stimulates mesonephros to form

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20
Q

What do the mesonephric buds elongate to form?

A

Mesonephric tubules (tubules formed in a craniocaudal direction)

As the caudal tubules differentiate, the cranial tubules regress (mesonephros is transient)

I.e. ones in lumbar (caudal) region develop more than those in cranial region that regress

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21
Q

As the mesonephric tubules differentiate and lengthen rapidly, what forms?

A

An S-shape and Bowman’s capsule

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22
Q

How does the mesonephros form the 1ary excretory system?

A

Lateral edges of mesonephros joins to mesonephric duct

Forms collecting system –> joins with amniotic fluid

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23
Q

What forms at medial surface of tubule?

A

Tuft of capillaries –> Glomerulus

Grown into Bowman’s capsule

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24
Q

What is the renal corpuscle?

A
  • Bowman’s capsule
  • Glomerulus

Primitive excretory system

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25
Q

What happens to mesonephric duct after week 10?

A

Male –> develop into reproductive structures

Female –> regress

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26
Q

What is the mesonephric ridge (urogenital ridge)?

A

Formed from development of mesonephros

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27
Q

What takes place on medial aspect of mesonephric ridge?

A

Gonadal development

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28
Q

When the mesonephros regresses, what then forms?

A

Metanephros

Goes on to form definitive (adult) kidney

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29
Q

Where does the excretory portion of the kidney form from?

A

Specialised mesoderm around pelvic region –> is undifferentiated (mesenchyme)

Metanephric mesenchyme

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30
Q

What forms at caudal end of mesonephric duct?

A

A ureteric bud is formed

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31
Q

What does the ureteric bud then form?

A

The collecting portion of the kidney

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32
Q

What makes up the excretory portion of the kidney?

A
  • Bowman’s Capsule
  • Proximal convoluted tubule
  • Loop of Henle
  • Distal convoluted tubule
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33
Q

What makes up the collecting portion of the kidney?

A
  • Collecting ducts
  • Major and minor calyces
  • Renal pelvis
  • Ureter
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34
Q

How does the ureteric duct grow?

A

Penetrates the metanephric mesenchyme (forms communication between the 2)

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35
Q

What is important of connection between ureteric duct and metanephric mesenchyme?

A

Signal to each other and induce each other to grow

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36
Q

How does the ureteric bud bifurcates (sprouting pattern) as it penetrates the mesonephric mesenchyme?

A

Renal ampulla –> renal pelvis –> major calyces –> minor calyces –> collecting ducts

These collecting ducts are all connected

37
Q

What are the 2 structures that the definitive kidney comes from?

A
  • Ureteric bud (collecting)

- Metanephric mesenchyme (excretory)

38
Q

What forms in the mesenchyme at the end of the collecting ducts (in the metanephric caps)?

A

Condensements of cells (of mesenchyme)

Called renal vesicles

39
Q

What then happens to the renal vesicles?

A

Elongate (due to signals from collecting system)

Elongate and form the nephron (excretory portion) –> forms S-shape tubule and Bowman’s capsule

40
Q

What forms in the proximal end of this tubule?

A

Capillaries to form the glomerulus

Proximal end of the tubule then forms the Bowman’s capsule

41
Q

How do the collecting and excretory parts of the kidney connect?

A

Distal end of tubule connects with collecting tubule. Tissue breakdown between 2 embryological origins

42
Q

What can cause duplication of the ureter?

A

Premature bifurcation of ureteric bud (before piercing mesenchyme)

Bifurcation can be partial or complete

43
Q

What can result from duplication of ureter?

A
  • Bifid ureter

- Ectopic ureter

44
Q

What are the potential options for a bifid ureter?

A
  1. Only proximal part of ureter has 2 parts

2. 2 separate ureters coming from kidney (if bifurcation happens very early)

45
Q

What is an ectopic ureter?

A

Takes a different course to normal ureter and attaches to structures that it shouldn’t

46
Q

What is renal agenesis?

A

A newborn is missing one or both kidneys (unilateral or bilateral)

47
Q

What is renal agenesis caused by?

A

Caused by early degeneration of ureteric bud or failed interaction between ureteric bud and metanephric tissue cap

48
Q

What are symptoms of unilateral renal agenesis?

A
  • Generally asymptomatic

- Remaining kidney grows a little bigger

49
Q

What are symptoms of bilateral renal agenesis?

A

Usually incompatible with life

50
Q

What are dangers of a deficient volume of amniotic fluid?

A

Baby swallows amniotic fluid to help with development of muscles. Kidneys filter this out and excretes it into amniotic cavity.

A deficiency in amniotic fluid leads to Oligohydraminos (usually due to bilateral renal agenesis)

51
Q

What are symptoms of Oligohydraminos?

A

Potter sequence

52
Q

What is the autosomal dominant version of polycystic kidney disease?

A

Cysts form in kidneys from all parts of nephron

Presents in adulthood

53
Q

What is the autosomal recessive version of congenital polycystic kidney disease?

A

Congenital

Cysts form from the collecting ducts

54
Q

What are dangers of congenital polycystic kidney disease?

A

Kidneys enlarge and renal failure occurs in childhood

55
Q

How do kidneys relocate? What happens to the blood supply?

A

Develop in pelvic region but reside in more cranial position in adults

As the kidney ascends it establishes a new blood supply more cranially. The original lower vessels normally degenerate

56
Q

What is the ascent of the kidney caused by?

A

Growth and elongation of developing foetus

57
Q

When is the adult position of the kidneys attained?

A

By week 9

58
Q

What is a horseshoe kidney? When does this occur?

A

As kidneys ascend, inferior poles of kidneys fuse. Therefore, cannot ascend past IMA and resides lower in lumbar region.

Occurs if kidneys become too close together during their ascent, and they become fused.

Usually asymptomatic, may be prone to obstruction

59
Q

What does the cloaca divide into? When does this happen? What causes this division?

A
  • Urogenital sinus (anterior)
  • Anal canal (posterior)

Weeks 4-7

Separated by urorectal septum (mesoderm derivative)

60
Q

What can the urogenital sinus be separated into?

A

3 parts:

  1. Upper part
  2. Pelvic part
  3. Phallic part
61
Q

Initially, what is the bladder drained by? What then happens?

A

The allantois

Allantois is obliterated to form the urachus (fibrous cord) that connects the apex of the bladder with the umbilicus in the adult

62
Q

What does the caudal mesonephric duct grow into? What does this become? What is purpose of this?

A

The wall of the bladder (i.e. the bladder absorbs the caudal parts of the duct)

Becomes the trigone of the bladder

Ureteric bud now has opening into bladder

63
Q

Does the cranial or caudal end of the mesonephric duct grow quicker?

What is result of this?

A

Cranial

Differential growth means it looks like it migrates caudally

64
Q

What is the pronephric duct?

A

A duct that extends from the cervical region to the cloaca of the embryo (appears and regresses before the mesonephric duct)

This early system is non-functional and regresses completely by the end of week 4

65
Q

Describe the development of the mesonephros

A

The mesonephros develops caudally to the pronephros. First, the presence of the pronephric duct induces nearby intermediate mesoderm to form mesonephric tubules.

66
Q

What do the mesonephric tubules receive?

A

A tuft of capillaries from the dorsal aorta, allowing for the filtration of blood

67
Q

Where do the mesonephric tubules drain into? What does this system act as?

A

The mesonephric duct (a continuation of the pronephric duct)

They act as a primitive excretory system in the embryo, with most tubules regressing by the end of the 2nd month

68
Q

What does the mesonephric duct spout caudally?

A

The ureteric bud (which induces development of the definitive kidney)

69
Q

Where is the collecting system derived from?

A

The ureteric bud

70
Q

What does the ureteric bud form?

A

It dilates to create the ureter, renal pelvis, major and minor calyces and collecting tubules – terminating at the distal convoluted tubule.

71
Q

What can an early splitting of the ureteric bud cause?

A

Two ureters or two renal pelvices connected to one ureter

72
Q

What is the excretory system derived from?

A

Metanephric mesenchyme

73
Q

What is each collecting tubule from the collecting system covered by?

A

A metanephric tissue cap which gives rise to the excretory tubules

74
Q

What do the excretory tubules form?

A

Along with the developing glomeruli, they form the kidneys functional units –> the nephron

75
Q

What does the proximal and distal end of the excretory tubule form?

A

Proximal end forms the Bowman’s capsule around a glomerulus

Distal end elongates to form the proximal convoluted tubule, loop of Henle and distal convoluted tubule

76
Q

While the kidney is initially developing in the pelvic region, what is it supplied by?

A

Receives its blood supply from a pelvic branch of the abdominal aorta and as it ascends, new arteries from the abdominal aorta supply the kidney

77
Q

What happens to the pelvic vessels supplying the kidneys?

A

The pelvic vessels usually regress, but can persist as accessory renal arteries.

78
Q

What does the upper part of the urogenital sinus form?

A

Forms the bladder

79
Q

What does the pelvic part of the urogenital sinus form?

A

Forms the entire urethra and some of the reproductive tract in females, and the prostatic and membranous parts of the urethra

80
Q

What does the phallic/caudal part of the urogenital sinus form?

A

Forms the penile (spongy) urethra in males, vestibule in females

81
Q

What is a remnant of the urachus in adults?

A

The median umbilical ligament, which connects the apex of the bladder to the umbilicus

82
Q

What do the ureters form as?

A

Outgrowths of the mesonephric duct

83
Q

Where do the ureters enter the bladder?

A

At the base of the trigone

84
Q

What happens to the ureteric openings as the kidneys ascend?

A

They move cranially

85
Q

What happens to the mesonephric ducts in males?

A

Move caudally and closer together, entering the prostatic urethra to become the ejaculatory ducts

86
Q

What happens to the mesonephric ducts in females?

A

Degenerate due to a lack of testicular androgens

87
Q

How is the urethra formed in females?

A

Formed from the pelvic part of the urogenital sinus

88
Q

How is the urethra formed in males?

A

The pre-prostatic, prostatic and membranous urethra is formed from the pelvic part of the urogenital sinus.

The spongy urethra is formed from the phallic part of the urogenital sinus.

Yr 2 - Renal (16 decks)

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