Urinary System Flashcards
1
Q
Urinary system organs
paired vs unpaired
A
paired=kidneys and ureters
unpaired=bladder and urethra
2
Q
Amount filtered per day?
how long for all circulating blood to pass through kidney?
A
150 quarts blood plasma/day
4-5 mins.
3
Q
Urinary system helps regulate
A
- electrolyte and acid/base balance
- blood pressure & volume
- Endocrine function (renin)
- excretion of bioactive substances and metabolic wastes
4
Q
Kidney capsule
Any other organ(s) with capsule(s)?
A
thin CT with 2 layers 1. inner myofibroblast (not real SM) 2. dense irregular CT Liver= glissen capsule= fibroconnective tissue pancreas= CT capsule gallbladder---NO CAPSULE!
5
Q
2 Main divisions of kidney
A
- Outer cortex= 90% of blood
2. Inner medulla
6
Q
- Functional unit of kidney? How many?
2. Cardiac output % that goes to kidney
A
- 2 million nephron/kidney
2. kidneyS (BOTH) about 20-25% of cardiac output
7
Q
Uniferous tubule?
A
Nephron + collecting tubule
8
Q
Kidney is
1. ___ lobed
A
- multi-lobed, each lobe has its own blood supply. If blocked, focal death.
9
Q
Renal Hilum
A
concave part of kidney with renal pelvis= arteries, veins, lymph and nerves
10
Q
Renal pelvis
A
cone-shaped extension of ureter that opens into major calyces (branch into minor calyces)
11
Q
Major histological difference between cortex and medulla
A
cortex has glomeruli
12
Q
Parts of renal cortex and artery that runs in the area
1.
2.
A
- Renal column- between renal pyramids of medulla, extension of cortical tissue. Interlobar artery runs here
- medullary rays= straight tubules from base of each pyramid into cortex. Interlobular arteries run between medullary rays
13
Q
Renal corpuscle
- What is it made of
- what are the contents for (big picture)
A
- Glomerulus + bowman’s capsule (including urinary space)
- glomerulus= capillaries
Bowmans capsule surrounds the glomerulus and is a double layer.
14
Q
Main component(s) of renal cortex=
A
renal corpuscle (glomerulus and bowman’s capsule) and convoluted tubules.
15
Q
Parts of renal medulla
A
- pyramids (bulk, 10-18/kidney)
- medullary rays (from base into cortex)
- Renal papilla (apex of pyramid) with area cribrosa
16
Q
Components of renal medulla
A
Thin limbs of henle and collecting tubules
17
Q
Area cribrosa
A
part of papilla (apex of pyramid) that is perforated and projects into minor calyx
18
Q
Kidney CT- where, what?
A
SPARSE, found in extravascular and intertubular spaces
19
Q
Renal interstitium
A
mainly fibroblasts and mononuclear cells
20
Q
Erythropoietin production
A
Fibroblasts near peritubular capillaries (interstitial tissue in cortex and medulla)
Endothelial cells of peritubular capillaries in cortex and medulla
21
Q
Cells in medulla of kidney
A
- Pericytes lining blood vessels that supply loops of henle
- interstitial cells- found between loops of henle and collecting ducts and vasa recta
- -elongated nuclei
- -have lipid droplets
- -might make medullipin I->II (in liver) = vasodilator
22
Q
renal lobule
- borders
- characteristics?
A
- part of CORTEX bound by interlobular artery on each side
2. all nephrons in this area drain into the same collecting duct.
23
Q
Arterial circulation
A
Renal artery (at hilum)–>interlobar artery (between pyramids) –>arcuate a (between cortex and medulla) –>interlobular a (define renal lobule, enter cortical tissue and travel between medullary rays) –> afferent glomerular arteriorole –>efferent arteriole (exit glomerulus)
24
Q
Pericytes
1. location
A
cells found in the medulla along the blood vessels that supply the loops of henle
25
Interstitial cells
1. location
2. characteristics
3. function
1. medulla cells that are found between the loops of henle, collecting ducts and vasa recta.
2. elongated nuclei with lipid droplets
3. MIGHT make medullupin I, which is coverted to medullupin II by the liver. Medullupin II=vasodilator
26
1. What type of artery passes between medullary rays?
| 2. What artery passes in renal columns?
1. Interlobular arteries
| 2. Interlobar arteries
27
1. More detailed circulation explanation- start at afferent arteriole
2. How is the kidney circulation different than typical circulation in body?
1. Afferent arteriole (from interlobular a)-->capillary of glomerulus -->efferent arteriole -->capillary network --> venule
2. In body: arteriole-->capillary-->venule
(extra part is the afferent-->glomerulus cap-->efferent)
28
Two types of nephron classification?
Cortical nephrons- renal corpuscle is located in outer part of cortex
Juxtamedullary nephrons- renal corpuscle is closer to cortico-medullary junction
29
What efferent arteriole is associated with each type of nephron?
1. Cortical nephron= peritubular capillaries
| 2. Juxtamedullary nephron= vasa recta
30
Do juxtamedullary nephrons and cortical nephrons have the same blood supply?
NO NO NO
31
What creates the interstitial concentration gradient in the medulla?
Juxtamedullary nephrons with the LONG LOOPS OF HENLE.
32
Vasa recta
1. Where do they come from?
2. Path they take?
3. any other characteristics?
4. Supply?
1. from efferent arterioles of juxtamedullary nephrons
2. STRAIGHT into medulla and renal papilla--> Form capillaries and loop back (as veins, I think)
3. increase in diameter close to corticomedullary boundary.
4. Blood and nutrients to loop of henle (countercurrent exchange?)
33
Venous drainage of Kidney (by region)
1. outer cortex =superficial cortical veins drain to STELLATE VEINS
2. deep cortex=DEEP CORTICAL VEINS
3. Between medullary rays= INTERLOBULAR V (stellate + deep cortical v)
4. Cortico-med jct= ARCUATE
5. between pyramids= INTERLOBAR (arcuate + interlobular)
34
Interlobular veins drain from ____ and into _____
Interlobular veins drain from deep cortical and stellate veins. InterloBULAR veins join arcuate veins --> interloBAR veins.
35
Blood movement through renal corpuscle
Blood enters via afferent arteriole and leaves via efferent. In the glomerulus, stuff moves out of the blood into the urinary space and out the renal corpuscle via the proximal convoluted tubule.
36
Bowman's capsule
| -description of layers
2 layers
1. Visceral layer of podocytes chilling on the Glomerular arterioles
2. Parietal layer that lines the outer wall
37
Urinary space?
AKA BOWMAN'S space=
| Area between two layers of bowman's capsule
38
Cells of bowman's capsule
1. Visceral layer= podocytes= modified simple squamous epithelial cells
2. Parietal layer= simple squamous epithelium
39
Glomerular arteries are ____ with _____ charge epithelium (neutral/pos/neg)?
1. FENESTRATED
| 2. negatively charged (due to pedicles from podocytes)
40
Basal lamina of renal glomerulus is? Produced by?
THICK and SHARED WITH PODOCYTES!
| Production by podocytes and capillary endothelial cells.
41
Podocytes-
1. type of cell?
2. Location
3. Characteristics
1. modified epithelial cell
2. Around glomerular capillaries in renal corpuscle
3. primary process gives rise to 2ndary process=pedicle
42
Renal Corpuscle contents
glomerulus, bowman's capsule (with two layers) AND mesangium
43
1. What is mesangium?
2. Location
3. type of cell?
1. Interstitial tissue (mesangial cells)+ amorphous ECM
2. in the space between arterioles of glomerulus
3. Mesangial cells= type of smooth muscle cell.
44
Renal corpuscle poles
Urinary-where continuous with proximal convoluted tubule
| Vascular= afferent and efferent arterioles enter/leave corpuscle.
45
Review-- basement membrane
basal lamina + reticular lamina connected by Collagen VII + fibrillin
46
Mesangial Cells
| 1. Location
1. Found in the mesangium on same side of BM as endothelial cells. (BM separates mesangial cells and podocytes)
47
Mesangial cells
| FUNCTIONS X6
1. mechanical support of capillaries,
2. turnover of BM material (phagocytic activity),
3. regulate blood flow of filtrate
(contraction= decreased filtration SA)
4. source of endothelins and prostaglandins-->constriction of efferent and/or afferent arterioles
5. respond to angiotensin II (contraction) and ANP (vasodilator)
6. cytokine production (if induced)
7. matrix and collagen production
48
Mesangial cells can produce?
matrix material and collagen.
Cytokines can be produced (=immune response) if Immunoglobins enter matrix.
can proliferate
Prostaglandins and endothelins ( to regulate eff/aff cap)
49
1. Pedicle of ___ cells.
2. interaction?
3. additional property?
4. space between pedicles?
1. Podocytes
2. interdigitate with other pedicles.
3. pedicles (=2ndary process) that have TRANSMEMBRANE sialoglycoprotein that extends into glycocalyx coating called podocalyxin which gives glomerular epithelium a NEGATIVE charge.
4. filtration slits
50
Filtration slits
1. What are they?
2. Anything else/
1. Space between adjacent pedicles
| 2. Have filamentous diaphragm that bridge slits?
51
What are the layers of filtration for blood inside the renal corpuscle? (this is the renal filtration barrier)
**extra from book, what each layer filters
1. Glomerular capillary fenestrated epithelium, *blocks blood cells and platelets
2. basal lamina (SHARED) *large proteins and organic anions
3. Filtration slits and associated diaphragm made by podocytes pedicles **small proteins and organic anions**
52
What CAN pass through (glomerular filtration)? what CANNOT?
| not extra, you do need to know this
CAN: water, ions and small molecules <3.5nm
CANNOT: large or negatively charged proteins
53
Structure of pedicle, filtration slit, and diaphragm
Pedilces have actin filament running down them.
Adjacent pedicles are connected:
actin filaments --> linker protein, CD2AP--> and nephrin-->CD2AP -->actin.
(nephrin is probably the "diaphragm")
A1B3 integrin links podocyte to basal lamina...donno if this has the high glycosaminoglycan content that makes it negative...
54
Where does the filtrate go after leaving bowman's capsule?
Proximal convoluted tubules
55
Proximal convoluted tubule
1. cell characteristics
2. plasma membrane
3. Staining?
1. cuboidal central nucleus, with apical microvillus brush border, pinocytic vesicles (absorption) and lysosomes (acid phosphatase activity)
2. plasma membrane has lots of infoldings near base of cell
3. acidophilic cytoplasm (from mitochondria)
56
Proximal convoluted tubule
| FUNCTION?
1. lysosomes have acid hydrolase for breaking down peptides and uptaking amino acids.
2. reabsorption of glucose, amino acids, small proteins and 80% of NaCl, Ca+2, and water
3. Secretion of organic acids-creatinine- and bases, H+ and NH4+
4. Exchange H+ (from interstitium) for HCO3 (absorbs HCO3 in exchange for H+)
5. Hydroxylation of Vit D
6. Production of erythropoietin
57
What allows H20 reabsorption in proximal convoluted tubule?
Osmotic gradient created by absorption of NaCl and glucose
| This means NO NET OSMOLARITY CHANGE in PCT
58
What is proximal convoluted tubule exchanging stuff with?
Plasma from peritubular capillaries
59
after proximal convoluted tubule, filtrate moves into _____
descending thick limb of henle= proximal tubule straight portion
60
Descending thick limb
1. lining
2. characteristics
3. job
1. simple cuboidal epithelium
2. less lysosomes, smaller mitochondria, prominent brush border **very similar to PCT**
3. Absorption of water, no NaCl absorption
61
Descending Thick limb-->
Thin limb of henle
62
Thin limb of henle- parts
depends on type of nephron:
In Juxtamedullary: descending part, loop and ascending segment
Cortical nephrons- only thin descending portion
63
Descending thin limb of henle
1. epithelium
2. f(x)
1. Simple squamous epithelium with bulging nuclei-- few organelles= passive transport
2. Reabsorption of water
64
Thin ascending limb?
Passive transport
| reabsorption NaCl, excretion of urea
65
Thick ascending limb
1. Characteristics
2. distal portion is?
1. cuboidal epithelial cells with apical nucleus. mitochondria in basal plasma membrane infoldings.
2. Distal portion become macula densa
66
Plasma membrane infoldings found?
PCT, thick ascending limb, DCT, and principle light cells of collecting tubule
* Lumen in PCT= occluded
* Lumen in DCT=empty
67
Thick ascending limb leads into?
DCT and macula densa
68
Distal convoluted tubule
1. Comparison to PCT
2. Comparison to thick ascending lib
1. wider lumen, shorter cells, shorter microvilli than PCT and NO BRUSH BORDER. Less reabsorption, less mitochondria= less acidophilic.
2. Similar to Thick ascending limb (cuboidal, plasma membrane infolding)
69
DCT function
| Regulation?
Reabsorbs Na+ actively and moves it into interstitium
Secretes K+, NH3+, and H+ ions into filtrate from interstitium
Regulated by aldosterone
70
Aldosterone
stimulates reabsorption of Na+ from filtrate to interstitium in DCT
71
Juxtaglomerular apparatus
Found at renal corpuscle vascular pole.
72
Countercurrent flow---what is it? what's it's significance?
Thick descending actively transports ions out of tubule (resorb). The thin descending (passive) compensates by moving water out of tubule, making the stuff in the tubule more concentrated the further down you go. Thin ascending move NaCl out un-concetrating the filtrate. the deeper in the medulla you go, the more concentrated the filtrate.
*this is probably over-emphasis on physio*
73
Juxtaglomerular apparatus-parts
Major function?
1. Macula densa (from thick ascending limb)
2. juxtaglomerular cells (on afferent arteriole)
3. Extraglomerular mesangial cells
regulates blood pressure
74
Macula densa
1. location
2. Cells are?
3. function
1. distal part of thick ascending limb
2. cells are more columnar (still epithelial), and packed nuclei
3. send information about NaCl concentration and low salt to juxtaglomerular cells via GAP JUNCTIONS
75
Juxtaglomerular cells
1. location?
2. cell type?
3. Function
4. Communications?
1. in the wall (tunica media) of afferent arteriole and SOME in efferent arteriole
2. "modified smooth muscle cells"
3.
A. sense blood pressure drops.
B. Make renin (stored in vesicles)
C. release it in response to signals from macula densa cells, sympathetic innervation via norepeinephrine and dopamine
4. Gap junctions between JG cells and extraglomerular cells and macula densa cells
76
Extraglomerular mesangial cells
1. AKA
2. Location
3. In contact with? Via?
1. Pole cushion of lacis cells
2. between afferent and efferent arterioles
3. Connected each other and juxtaglomerular cells by GAP JUNCTIONS
77
What happens when renin is released?
Renin (from JG cells) converts angiotensinogen--> angiotensin 1. Angiotensin 1--> 2 somewhere else.
Angiotensin 2 stimulates release of aldosterone
78
Aldosterone
1. release initiated by? from?
2. function
1. initiated by angiotensin II. released from adrenal cortex.
2. Aldosterone causes DCT to resorb H20 and Na= increased blood volume= increased blood pressure. Also affects collecting tubules (cortical ones)
79
Blood volume is decreased---what happens?
Decreased volume= decreased filtration rate.
Decreased filstration rate=decreased NaCl filtered
Macula densa senses decreased NaCl and triggers renin secretion.
Renin = angiotensinogen (from liver)-->angiontensin 1
Angiontensin 1->2 (elsewhere, lung usually)
Angiotensin 2= aldosterone release (from adrenal cortex)
Aldosterone= increased H20 and NaCl resorbtion= increased blood pressure
80
Angiotensin II Functions (from picture--may be tmi)
1. Aldosterone release from adrenal cortex
2. ADH release from hypothalamus = increased water uptake in collecting tubule and DCT
3. vasoconstriction
**all increase bp somehow
81
After DCT, filtrate moves into?
Collecting duct/tubule
82
Divisions of collecting duct?
| What do all cell membranes have?
1. connecting
2. Cortical
3. outer medullary
4. inner medullary
5. papillary duct
* *lots of aquaporins (regulation of H20 movement)
83
Cortical collecting tubule
1. Components
2. Location
3. Epithelium
4. Cells? which are more common?
1. connecting duct and cortical duct
2. medullary rays (of cortex?)
3. simple cuboidal epithelium
4. 2 types-- principal light cells (more common) and intercalated dark cells
84
Principal (light) cells
1. location?
2. characteristics
3. function
4. regulation
1. cortical collecting tubule of uriniferous tubules
2. round with central nucleus and central cilium (mechanoreceptor), plasma membrane infoldings
3. removes Na from filtrate and secretes K+
4. aldosterone
*more prevalent type of cell in cortical collecting tubule
85
Intercalated (dark) cells
1. location
2. characteristic
3. function
4. regulation
1. cortical collecting tubule
2. apical cytoplasmic vesciles and microplicae on surface
3. remove K+ from filtrate and secrete H+
4. None (mentioned)
86
Medullary collecting tubule
1. components
2. location
3. Epithelium
4. Cells
1. Inner and outer medullary collecting duct
2. medulla
3. simple cuboidal
4. Inner medulla= principal cells only
Outer medulla= principal and intercalated cells
87
Papillary Collecting tubule-AKA?
1. epithelium
2. location
3. characteristic
4. function
Duct of Bellini
1. simple cuboidal/columnar epithelium with single primary cilium
2. medulla
3. LARGER DIAMETER (200-300 micro meters)
4. Empties filtrate into area cribrosa (apex of pyramid)
88
Minor calyx
Renal pyramid has 10-25 openings that flow into single minor calyx
89
Why does the counter-current multiplier and exchanger work?
different parts of nephron have different permeabilities to H20, NaCl, and urea
90
Summary of nephron
1. PCT
2. Thick descending
3. thin descending
4. thin ascending
5. Thick ascending
6. DCT
7. CT
1. 2/3 of filtrate resorbed. Glucose, AA, small proteins, NaCl, H20, Ca. NO OSMOLARITY CHANGE
2. H20 reabsorption
3. H20 reabsorption (passive= equilibration of filtrate)
4. NaCl absorption, Urea excretion
5. Ion absorption (Na, Cl, Ca, Mg, K)
6. NaCl reabsorption
7. more urea excretion
91
Furosamide
Diuretic
| Inhibits reabsorption of NaCl in ascending limb = increased NaCl and H20 excretion.
92
Glomerulonephritis
1. What is it?
2. Symptoms?
3. Forms
4. Causes
1. inflammation of glomeruli
2. hematouria, proteinuria, oliguria (decreased urine),
3. Acute, subactue and chronic. Chronic= destruction of glomeruli= renal failure and death
4. infection in body (streptococcal) that causes immune deposits in renal corpuscle, immune or autoimmune disorders against GBM (anti GMB antibodies) or type IV collagen (ex lupus)
93
Acute tubular necrosis
1. What?
2. cause?
3. Area most affected?
4. Manifestation?
5. Prognosis?
1. Destruction of epithelial cells lining certain part of nephron. When they die casts form in their place and occlude the lumen
2. caused by toxins or ischemia
3. usually pars recta of proximal tubule affected (thick descending)
4. Acute renal failure
5. Recovery possible, if extensive damage-->death
94
Chronic renal failure
1. What?
2. Cause?
3. Manifestation?
4. Symptoms?
1. reduced blood flow to kidneys= decreased glomerular filtration-->tubular ischemia
2. DM, hypertension, atherosclerosis
3. hyalinization of glomeruli or tubular atrophy.
4. Acid/base balance cannot be maintained= acidosis, hyperkalemia (high K+), uremia -->neurologic problems, coma and death
95
Diabetes Insipidus
1. Cause
2. Symptoms
3. Explanation of symptoms
1. destruction of paraventricular and suproptic nuclei in hypothalamus= decreased ADH (antidiuretic hormone)
2. dehydration, polydipsia, dilute urine
3. Kidney cannot concentrate urine in collecting tubule
96
Types of Kidney stones
1.
2.
1. Calcium- elevated urinary Ca, oxalic acid, uric acid= calcium oxalate
2. Struvite stones= Magnesium ammonium phosphate and calcium carbonate **From UTIs
97
Ureter
1. epithelium
2. innervation
3. muscularis externa
4. Urine entry into bladder?
1. transitional epithelium
2. PNS and SNS
3.
upper 2/3= inner longitudinal and outer circular
lower 1/3= inner longitudinal, outer circular, outermost longitudinal **ALL SM**
4. Peristalsis, as spurts
98
Bladder
1. epithelium
2. lamina propria
3. Muscularis externa?
1. transitional epithelium with basal layer and superficial layer=umbrella cells
2. Lamina propria= thin fibroelastic CT
3. Muscularis externa= 3 layers (same as distal ureter?)
99
Umbrella cells
cells of Superficial layer of transitional epithelium
Their plasma membrane has PLAQUES (thickened portions).
their cytoplasm has ELLIPTICAL VESICLES (extra membrane reserve)
100
Distended vs Relaxed bladder.
Relaxed: rounded scalloped cells. Umbrella cells have plaques and elliptical vesicles
Distended: squamous looking cells. less cell layers, elliptical vesicles inserted into plasma membrane.
101
Urethra- MALE
1. Muscularis externa
2. membranous urethra
3. Epithelium
1. inner longitudinal layer and outer circular (SM)
2. external urethral sphincter= skeletal muscle
3.
Prostatic (transitional epithelium)-ducts from prostate
Membranous (pseudostratified columnar)-short
Penile/Cavernous (stratified columnar-->stratified squamous)-bulbourethral glands and glands of litter (mucous, in lamina propria)
102
Glandsof littre
mucus secreting glands in lamina propria
| penile urethra and maybe in female
103
Urethra- Female
1. Muscularis externa
2. Epithelium
3. Lamina propria
1. inner longitudinal, outer circular smooth muscle layers
2. transitional epithelium --> psuedostratified columnar --> stratified squamous NK
3. might have glands of littre that secrete mucus.
104
Nephron parts
Renal corpuscle (bowman's capsule + glomerulus) + Proximal convoluted tubule, loop of henle (thick descending, thin descending, thin ascending, thick ascending) + distal convoluted tubule
105
What parts of uriniferous tubule is found in the CORTEX
glomerulus, proximal convoluted tubule, distal convoluted tubule
106
Medulla can be divided into?
Outer medulla with 1) inner stripe 2) outer stripe
| Inner medulla
107
What can be found in each part of medulla?
Outer stripe of outer medulla: only thick limbs (descending and ascending)
Inner stripe of outer medulla: thin descending, thick ascending (loop of cortical nephron)
Inner medulla : none of cortical nephron. Juxtamedullary nephron will have thin descending, loop and thin ascending parts in inner medulla.
