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Pelvis and Abdomen A&P > Kidney > Flashcards

Kidney Flashcards

(80 cards)

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1
Q

who has a longer urethra

A

males

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2
Q

role of the urethra

A

females: urination
males: reproduction and urination

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3
Q

location

A

either side of the VC, on the post abdominal wall
behind the peritoneum, below the diaphragm
T12 and L3
lies obliquely upper pole 2.5cm closest to the spine and lower poles 7.5cm away from the kidney
right kidney lies slightly lover due to the liver

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4
Q

left kidney relations

A

sup: left adrenal gland
ant: spleen, stomach, pancreas and jejunum, splenic flexure of colon
post: diaphragm, post abdominal wall

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5
Q

right kidney relations

A

sup: right adrenal gland
ant: right liver lobe, duodenum, hepatic flexure of colon
post: diaphragm, post abdominal wall

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6
Q

renal capsule

A

inner most layer
made of collagen fibres, maintains shape and aids protection

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7
Q

adipose capsule

A

surrounds the kidney
fat people have a thicker layer
helps attach the kidney posteriorly to the abdominal wall, protecting the kidney

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8
Q

renal fascia

A

composed of dense connective tissue, final attachment of the kidney to the abdominal wall
encloses the kidney and the renal fat

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9
Q

renal cortex

A

lies next to the capsule
reddish in colour, granular appearance

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10
Q

renal medulla

A

inner most layer found deep in the cortex, consists of 6-18 renal pyramids due to the CD in the nephron

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11
Q

renal cortex + medulla =

A

renal parenchyma
(functional part)

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12
Q

how many nephrons inside the kidney

A

1-2 million

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13
Q

where does CD transport urine

A

from the pyramids to the calyces

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14
Q

what are the CD supported by

A

connective tissue containing blood vessels, nerves and lymph vessels = diffusion of nutrients and waste

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15
Q

what does the nephron consist of

A

PCT, LoH, CD, DCT and glomerulus

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16
Q

what is the nephron

A

a tubule which is closed at one end that joins a CD at the other end
the closed end is indented to form a glomerular capsule, which almost encloses a network of capillaries
the CD unites forming larger ducts which empty into minor calyces

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17
Q

where does the renal artery enter

A

hilum

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18
Q

what happens to the renal artery

A

it divides into smaller arteries and arterioles, the afferent arteriole enters the casks and subdivides into smaller artery capillaries forming the glomerulus

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19
Q

what are the capillary loops

A

made up of connective tissue, phagocytic mesogial cells which are part of the monocyte macrophage system

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20
Q

describe the difference in arteriole in the glomerulus

A

the afferent is larger in diameter increasing the hydrostatic pressure, this then drives the filtration across the capillary walls
maintaining oxygen and nutrient and removes waste

efferent arteriole subdivides into the peritubular network allowing for the exchange of fluid and blood

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21
Q

what happens to the venous drainage at the glomerulus

A

leaves the kidney at the renal vein into the IVC

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22
Q

glomerulus and GC composed of

A

composed of single layer of flattened epithelium

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23
Q

what are renal blood vessels supplied by

A

sympathetic and parasympathetic
controls diameter and blood flow independent of auto-regulation

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24
Q

what is the hilum

A

entry and exit point for blood and lymph vessels, and ureters

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25
what are the calyx walls and pelvis wall composed of
transitional epithelium with smooth muscle peristalsis forces prune through the calyces renal pelvis and ureters into the bladder
26
where is urine stored
renal pelvis
27
describe the renal pyramids and calyces
minor calyx sits below the pyramid which collects urine from the CD several minor mere into a major with 2 or 3 major forming a renal pelvis, which narrow in shape as it leaves as the ureter renal columns separate the pyramids renal papillae is the pointed part of the pyramid as the nephron empties urine it goes into these structures
28
where does urine go
through the renal papilla at the pyramid apex into a minor calyx
29
how much cardiac output does a kidney recieve
1/4 or 20%
30
what renal artery is shorter
left the aorta lies left of the midline
31
what renal vein is shorter
right IVC sits on the RHS
32
what does the aorta give rise to
right and left renal arteries renal veins merge into the hilum
33
what is nephritis
inflamed kidney
34
what is the flow in lymphatics
follow the route of the renal vessels renal hilar nodes -> para aortic nodes
35
blood supply
AA -> L& R renal arteries -> afferent arteriole -> glomerulus -> efferent arteriole -> L&R renal veins -> IVC
36
what do the ureters do
carry urine from the kidney to the urinary bladder continuous with the renal pelvis, passes downed through the abdominal cavity behind the peritoneum and infront of the PSOAS muscle into the pelvic cavity passes obliquely through the posterior wall of the bladder
37
what happens as urine builds up
pressure increases, compressing the ureters and openings into the bladder are occluded, prevents back flow
38
structure of the ureters
outer layer = fibrous tissue, continuous with the fibrous covering middle muscle layer = smooth muscle fibres interlaced, additional longitudinal layer in the lower third inner mucosa = transitional epithelium
39
function of the ureters
smooth muscle creates peristalsis which propels urine along these increase in frequency with the amount of urine produced
40
what does low GFR impact
amount of water reabsorbed, accumulating waste
41
chronic kidney failure
gradual loss of kidney function/ nephron activity loss of nephrons = low GFR causing high levels of blood, urea and nitrogen causes: diabetes mellitus, glomerular nephritis and hypertension
42
what is stage 1 of CKF
nephron loss is compensated for by the present nephrons, which become enlarged 75% can be compensated for impact is only visible at stage 2
43
stage 2 of CKF
renal insufficiency, no longer able to adore to keep BUN levels stable
44
what is BUN
blood, urea, nitrogen
45
stage 3 of CKF
uraemia (high urea) sharp increase causes death CANT BE REVERSED ONLY MANAGED
46
why does end renal failure occur
ph imbalance function is lost endocrine function is disrupted
47
final stages cause
itching, vomiting, muscle twitching, seizures, drowsiness, coma
48
kidney functions
urine formation electrolyte balance production and secretion of erythropoietin water regulation ph balance maintenance of blood pressure
49
juxtaglomerular apparatus
exocrine structure which produces renin, erthropeotin, regulating BP, Hb and volume assists in the regulation of GFR close to the afferent arteriole
50
urine is composed of
water ammonia, Na, K, Cl, phosphates, sulphates, oxalates urea uric acid
51
what gives urine its colour
urobilin
52
what reflects urines composition
exchange of substances, between the nephron and the blood in the renal capillaries waste products of protein metabolism are excreted water and electrolytes are reabsorbed through the excretion of H +
53
what are the three processes within urine formation
filtration selective reabsorption tubular secretion
54
glomerular filtration
occurs in the renal corpuscle (glomerulus and the BC) the walls are porus which allows small molecules to pass through whilst plasma proteins remain in the capillaries. filtrate is high in solutes filtrate has a similar composition to plasma apart fromthe plasma proteins and blood cells filtration occurs due to the hydrostatic pressure difference, as the efferent is narrower it builds up the hydrostatic pressure
55
structure of the capsule
blind ended podocytes hug the capsule, with the gaps allowing the filtrate through single layer of flattened epithelium
56
is filtration passive or active
passive process, which follows a negative pressure difference gradient
57
GFR
volume of filtrate formed/ min tells us how quickly the kidneys can process chemo can be calculated by injecting a RS monitoring at regular intervals
58
what is filtration controlled by
1. renal auto regulation maintain GFR at a constant pressure operates independently to the NS, stimulated by pressure changes or fluctuating levels of metabolites diameter alters itself at the afferent (decrease blood flow = small diameter). If BP is too low auto regulation will stop 2. neural regulation - stimulation of fibres causes vasoconstriction, reducing flow, less blood will decrease urine formation blood is directed to other regions of the body
59
where does selective reabsorption occur
PCT
60
describe the structure of the PCT and LoH
PCT = cuboidal cells and microvilli LoH = after the descending limb it becomes squamous epithelium
61
what are reabsorbed at the LoH
sodium so the filtrate at the CD is dilute Na and Cl can be transported actively and passively
62
where does most water reabsorption occur
CD
63
what's the transport maximum
maximum capacity for reabsorption of a substance it takes into account the number of pumps
64
hormones which influence SR
parathyroid aldosterone ADH ANP
65
parathyroid
secreted by the parathyroid gland calcitonin regulates reabsorption of calcium and phosphate from the distal CD parathyroid increases Ca calcitonin decreases calcium levels
66
ADH
secreted by the posterior pituitary gland, which increases permeability in the DCT and CD
67
aldosterone
secreted by the adrenal cortex, which increases the reabsorption of Na and water, and excretion of K
68
ANP
atrial natriuretic petide secreted by the atria in response to stretching of the atrium, when the volume increase, reabsorption decrease of Na and water from the PCT and CD
69
tubular secretion
mainly in the DCT actively removes substances cuboidal epithelium, lack of microvilli secretion of H+ ions maintains normal blood pH
70
water balance
osmoreceptors in the hypothalamus detect changes in the OP in blood, which causes the release of ADH when OP is high, ADH increases reabsorption in the CD and DCT increases, OP decreases when BV increases, ANP is released which lowers reabsorption of sodium and water in the CD and PT so more is excreted, low blood volume and reduced atrial stretching high levels of ANP inhibits aldosterone and ADH
71
what is electrolyte conc dependent on
water levels and electrolyte levels
72
what is the most common extracellular cation
sodium
73
what is the most common intracellular cation
potassium
74
what does the renin-aldosterone system do for sodium and potassium
maintains the levels
75
what juice is high is sodium
gastric
76
what juice is high in potassium
pancreatic and intestinal
77
renin-angiotensin-aldostrone system
aldosterone regulates sodium excretion, secrete by the adrenal cortex cells in the afferent arteriole secrete renin in response to sympathetic stimulation, low BP or low BV renin converts angiotensinogen to angiotensin 1 angiotensin converting enzymes converts angiotensin 1 to angiotensin 2 which is a vasoconstrictor increasing BP renin and high potassium stimulates the adrenal gland to secrete aldosterone reabsoprtion of water and sodium increases BV which reduces renin secretion sodium reabsorption is high, potassium excretion is high reducing intracellular potassium
78
pH balance
PCT secrete H+ into the filtrate, combines with buffers H+ + HCO3 = H2CO3 (carbonic acid) H+ + NH3 = NH4+ H+ + HPO3 + H2PO3 carbonic acid dissociates into carbon dioxide and water carbon dioxide is reabsorbed maintaining the buffering system
79
acute renal failure
sudden loss in function especially GF can't remove waste, can't produce urine obstruction reduced renal flow (pre renal) renal: damage to kidney post renal: obstruction to outflow of urine reduction in GFR and kidney function oliguria and anuria accompanied by acidosis due to H+ retention, electrolyte balance and accumulation of nitrogenous waste
80
signs and symptoms
dysuria - oliguria (reduced urine), anuria (no urine) polyuria - large volumes of dilute urine anaemia - reduced RBC shortness in breath, fatigue, dyspnoea, cardiac failure high in creatinine over hydration: water retention, decrease in appetite, confusion acidosis: high urea therefore high potassium, pH and H+

Pelvis and Abdomen A&P (12 decks)

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