Renal Anatomy and Histology - Brauer

Question 1

Transpyloric Plane

Answer 1

L1 or spinous process of T12
superior to left hilum
through right kidney superior pole

Question 2

inferior pole of the right kidney

Answer 2

one index finger width from the superior iliac crest

Question 3

ureter travels how

Answer 3

out from hilum
over the common iliac, beginning of external iliac
into bladder

Question 4

common constriction points on the ureter

Answer 4

where stones can form more
1. uretopelvic junction (just leaving hilum)
2 over the common/ beginning of external iliac
3. uretovesical junction (entrance to bladder)

Question 5

Renal Blood supply in order to Glomerular capillaries

Answer 5

1. Aorta
2. Renal A
3. Segmental A
4. Interlobar A (between pyramids in cortex)
5. Arcuate A
6. Interlobular A (ascending to branch)
7. AFFERENT ARTERIOLE
8. Glomerular capillaries

Question 6

Renal Blood supply in order from Glomerular capillaries

Answer 6

1. Glomerular Capillaries
2. EFFERNT ARTERIOLE
3. PERITUBULAR CAPILLARIES
4. VASA RECTA
5. interlobular veins
6. arcuate veins
7. interlobar vein
8. Renal vein
9. IVC

Question 7

Kindney nerve supply

PARA and SYMPA

Answer 7

SYMPA: AORTICORENAL GANLION * (T10- T12), lesser and least splanchnic nerves
PARA: CN10

Question 8

Cortex has what structures

Answer 8

1. Renal Corpuscles (glomerulus)
2. Convoluted tubule
3. Straight tubule
4. CD

Question 9

Medulla has what structures

Answer 9

1. renal columns and pyramids

Question 10

Cortical (Medullary) rays

Answer 10

CDs and straight tubules running in the cortex

Question 11

Renal intertitium

Answer 11

fibroblasts making erythropoietin (based on O2 levels)

Question 12

uriniferous tubule

Answer 12

carries urine

NEPHRON + CD in the medullary ray

Question 13

nephron consists of

Answer 13

renal corpuscle (glomerulus)
renal tubules

Question 14

cortical and medullary CDs are what

Answer 14

final urine collectors

Question 15

Glomerular capillary is like what

Answer 15

1. fenestrated and truly open pores (no diaphragm covering it)
2. AQP-1 aquaporins
3. secrete NO and PGE
4. Glycocaylx

Question 16

Bowman’ scapsule layers

Answer 16

1. Parietal simple squamous
2. visceral layer (podocytes) on top of the capillaries
3. glomerular space = ultrafiltrate

Question 17

glomerular filtration 3 layers

Answer 17

1. Glomerular capillary endothelium
2. 3 layes of BM
3. Podocytes

Question 18

Podocytes are like what

Answer 18

filtration slits that are sensitive to charge and size (40mn)
has NEPHRIN* (charge selection)

Question 19

Glomerular BM has what important things

Answer 19

selective for charge and size (70mn) also
heparin sulfate
X ALBUMIN or CELLS

Question 20

between the parietal layer and the visceral later of the renal corpuscle is what

Answer 20

the glomerular space = urine collects

Question 21

Mesangial cells location

Answer 21

renal corpuscle
near vascular stalk
(also some in the JG apparatus)

Question 22

Mesangial cells in certain kidney diseases

Answer 22

proliferate into a bulge (can happen in uncontrolled diabetes)

Question 23

mesagium

Answer 23

mesangial cells and ECM

Question 24

Meangial cells function

Answer 24

1. phagocytosis
2. support
3. secrete IL1, PGE, PDGF
4. CONTRACTILE based on BP (regulate glomerular distention

Question 25

how much is reabsorbed in proximal convoluted tubule

Answer 25

65% (120L/day)

Question 26

proximal convoluted tubule histology

Answer 26

simple cuboidal ----> simple columnar | BRUSH BOARDER

Question 27

proximal convoluted tubule function

Answer 27

1. Na/K/ATPase reabsorb Na+, Cl-, H2O 2. AQP-1 : also H2O 3. sGLT2 : reabsorb sugars, aa, that could have passed, high capacity, low affinity

Question 28

Proximal Straight Tubule | function

Answer 28

THICK decsending limb of loop of henle Shorter has sGLT1 : low capacity, high affinity for Na+ = NA reabsorption

Question 29

descending thin loop of henle

Answer 29

HIGH H2O REABSORPTION X Na and urea permeability = concentrates urine

Question 30

ascending thin loop of henle

Answer 30

NA and CL REABSORPTION (out from urine | X H2O permeability

Question 31

thin LOH histology

Answer 31

simple squamous with NO BRUSH BOARDER or microvilli, | nuclei bulge into lumen

Question 32

Distal Straight Tubule | Histology

Answer 32

THICK part of ascending LOH | simple cuboidal with some microvilli NOT visible

Question 33

Distal Straight Tubule | function

Answer 33

NA+, Cl, K+ REABSORPTION (out from urine) X H2O permeability nucleus bulges into lumen

Question 34

Distal Convoluted Tubule | Histology

Answer 34

simple cuboidal with NO cilia NA + , HCO-3 REABORPTION K, NH+4 SECRETION (into urine)

Question 35

Distal Convoluted Tubule | function

Answer 35

Aldosterone : changes reabsorption amount of NA and H2O

Question 36

Collecting Duct | histology

Answer 36

CORTICAL : simple squamous --> simple cuboidal MEDUALLRY : simple cuboidal --> simple columnar * you can see cell boundaries on histology slides*

Question 37

Collecting Duct | 2 cell types

Answer 37

1. Light cells (PRINCIPAL) : single cilium, ADH target--> AQP2 2. Dark cells (intercalated) : a-intercalated = secrete H+ B-intercalated = secrete HCO-3 (into urine)

Question 38

Collecting Duct major function

Answer 38

reabsorb H2) with aldosterone and ADH regulation

Question 39

Peritubular capillaries

Answer 39

around convoluted tubules REASBSORB H2O and NA has fenestrations

Question 40

Vasa Recta capillaries

Answer 40

around LOH descending one = continuous ascending one = fenestrated

Question 41

Histology of bladder and proximal urethra

Answer 41

Transitional epithelium = umbrella an dome shaped : empty = flat to accomodate distention : full

Question 42

transitional epithelium has 3 layers | what are they and function

Answer 42

1. Superficial : stretching 2. Intermediate : sliding 3. Basal : stem cells

Question 43

what prevents urine to get into the cells in the bladder

Answer 43

the plasma membrane has plaques = UROPLAKIN proteins that they secrete to prevent the diffusion (in fusiform vesicles) gives rigid and thicker surface

Question 44

ureter is what type of hitology

Answer 44

lumin = transitional epithelium SM (3 layers) outer = adipose

Question 45

3 layers of SM of ureter

Answer 45

1. inner long 2. middle circ 3. outer long

Question 46

urine reflux is prevented by what

Answer 46

1. Bladder distetion = compresses ureter opening 2. SM contraction of bladder wall = compresses ureter opening 3. Ureter enters bladder obliquely: compress ureter opening

Question 47

urinary bladder has 2 types of SM what are they and function

Answer 47

1. DETRUSOR muscle = contraction of bladder to squeeze out urine 2. Internal urethral sphincter : around internal urethra orifice (INVOLUNTARY control)

Question 48

what is the voluntary control to let pee out

Answer 48

external urethral sphincter | striated muscle

Question 49

urethral histology

Answer 49

1. Transitional : proximal 2. Psudostratified columnar : majority and middle 3. stratified squamous : distal end

Question 50

female urethra

Answer 50

shorter | posterior to clitoris

Question 51

male urethra 3 parts and type of histology

Answer 51

1. prostatic : transitional (where ejaculatory and prostatic duct enter) 2. Membranous : psudostratified columnar (1cm long + has external sphincter****) 3. Penile spongy : psudostratified columnar----> strat squamous (15cm, through the penis, urethral glands, erectile tissue)

Question 52

Polycystic Kidney Disease

Answer 52

``` autosomal dominant (ADPKD) intrarenal cysts over time develop = damage and crush normal renal tissue = Kidney failure, HTN or hypotension (BP problems), increased UTI asymptomatic until average of 30 -40 years ```