Urinary System Part 2 Flashcards by sophie rosen

Distal convoluted tubule is a continuation of

thick ascending limb of Loop of Henle

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Distal convoluted tubule is present within the

cortex

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Distal convoluted tubule is lined with

simple cuboidal epithelium with short apical microvilli

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what does the DCT lack?

distinct brush border

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DCT is responsible for (2)

active resorption of Na and Cl

secretion of H and K ions

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DCT is controlled by 2 cell types

principal cells

intercalated cells

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principal cells—resorb (2), secrete (1)

Na & water

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• intercalated cells—resorb (1), secrete (1)

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DCT is controlled by

aldosterone (adrenal mineralcorticoid)

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collecting tubule is the — portion of nephron

terminal

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several tubules converge to form larger

collecting duct

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collecting tubule is visible as — —, lined with

medullary rays

thick, simple cuboidal to columnar epithelium

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collecting tubule converge at

renal papilla

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Collecting tubule function in (3)

Na resorption,
maintenance of acid-base balance,
K secretion & resorption

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Collecting tubule contains both (2)

principle and intercalated cells

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Epithelial cells of collecting duct are normally impermeable to —

water

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However, in presence of ADH (=vasopressin), secreted by posterior pituitary, collecting tubules

become permeable & will resorb water

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In conjunction with Loop of Henle & vasa recta forms counter-current exchange mechanism to

concentrate urine

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Proximal convoluted tubule ~2X as long as distal convoluted
tubule (& much more convoluted), so most tubules in cortex
are

proximal convoluted tubules

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proximal convoluted tubules appear — in cross section, with — epithelium (+/- — —)

round
cuboidal
brush border

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Distal convoluted tubules more —, with —epithelium

oval to elongate

thinner, flatter (but still cuboidal)

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DCT staining

Lighter staining cytoplasm, nuclei more prominent

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In medulla, see mostly —, fewer —, & occasional —, & surrounding —

Loop of Henle (smallest tubules, with squamous to cuboidal epithelium)
collecting tubules (medium sized)
collecting ducts (largest, with simple cuboidal epithelium)
blood vessels (vasa recta)

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Juxtaglomerular apparatus (JGA)

combined baroreceptor (pressure) & chemoreceptor ([ion])

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JGA are specialized areas of

affarent arteriole and distal convoluted tubule

JGA are used to regulate systemic BP via

renin-angiotensin-aldosterone system

three components of JGA

macula densa juxtaglomerular cells extraglomerular mesangial cells

Macula densa—

thickened region on one side of distal convoluted tubule

macula densa contains

densely packed cuboidal to columnar epithelial cells

macula densa- chemoreceptor sensitive to changes in

[Na] in filtrate

Juxtaglomerular cells—

modified smooth Mm cells in wall of afferent arteriole

juxtaglomerular cells act as

baroreceptors; detect changes in blood pressure

juxtaglomerular cells produce --- in response to

renin | decrease in blood pressure (converts angiotensinogen to angiotensin I)

Extraglomerular mesangial cells—

(= Goormaghtigh cells or Lacis cells) | Flattened cells surrounding afferent and efferent arterioles

function of extraglomerular mesangial cells (2)

Exact function unclear; provide structural support & phagocytosis May assist in tubular glomerular feedback (by transmitting signals from cells of macula densa to glomerular mesangial cells)

decrease in bp (detected by JG cells) results in

renin release | from JG cells in afferent arteriole

decrease in bp results in decrease of GFR which results in

decrease in Na in distal convoluted tubule (macula densa)

Angiotensin II increases blood pressure 3 ways:

* Vasoconstriction (↑ bp) * Release of aldosterone from zona glomerulosa of adrenal cortex results in resorption of Na & water from distal convoluted tubule which ↑ bp * ADH secretion from posterior pituitary results in ↑ water resorption from collecting tubule (↑ bp)

--- prevent conversion of angiotensin I

ACE-inhibitors

ACE inhibitors result in..

angiotensin II by blocking action of ACE, preventing bp increase

Ureters are muscular tubes, conduct urine from

kidneys to bladder

Ureters: --- shaped lumen in X-S, | lined by

stellate or star | transitional epithelium thrown into folds

Ureters are fairly ---, --- lamina propria

thick | fibre-elastic

Muscularis externa of ureters contains 3 layers of smooth Mm—

inner longitudinal & outer circular, plus third outermost | longitudinal layer in lower third of ureter

Ureters produce

peristaltic contractions to move urine

Ureters: surrounding --- --- of connective tissue

fibroelastic adventitia

Urinary bladder is lined by

transitional epithelium (urothelium) with underlying fibroelastic lamina propria

Urinary bladder: three openings define --- area of bladder, two for... one for...

trigone entry of urine from ureters exit of urine via urethra (surrounded by internal sphincter of smooth Mm)

Peritoneal or visceral surface of bladder covered by

fibroblastic adventitia (= serosa)

Urethra transfers urine from

bladder to outside world

length of bladder in humans,

~3-5 cm in female, 20 cm in male

Urethra is lined by ---, with ---

stratified or pseudostratified columnar epithelium (occasionally squamous), with paraurethral mucus glands

In male, urethra has 3 sections:

Prostatic, membranous, & spongy (penile)

Prostatic urethra lined by

transitional epithelium, like bladder

remaining portions of urethea lined by

columnar

Females more susceptible to bladder infections because of

short urethra

Bacterial/fungal (yeast) infection (cystitis, pyelonephritis) results in (2)

rbc’s, wbc’s, bacteria in urine, | painful/ burning urination

how to diagnose yeast infection

urine culture (c.f. sensitivity)

treatment of yeast infection

antibiotics/antifungals

Urination =

micturition

Excretion of protein (usually albumin) =

proteinuria

Excretion of glucose =

glucosuria

Excretion of glucose = glucosuria results in

diabetes mellitus (insulin deficiency)

increase frequency of urination (polyuria—PU) & drinking (polydypsia—PD) results in

diabetes insipidus

diabetes insipidus is due to -- insufficiency

ADH | high volume, dilute (hypotonic) urine

Various drugs or metabolites concentrated in urine, may precipitate as

crystals; basis of drug testing

Crystal, stone formation results in

urinary calculi (nephrolithiasis/urolithiasis)

~80% of stones =

calcium oxalate

components of nephrolithiasis (2)

genetic | dietary

Nephrolithiasis may loge in (3)

renal pelvis ureters urethra

treatment of Nephrolithiasis

ultrasound (illithotripsy)

complications of Nephrolithiasis (2)

hydronephrosis | hydrometer (usually unilateral)

BUN (blood test) measures

renal function

BUN is an indirect measure of

renal disease

Doesn’t increase until ~75% of functional nephrons lost, known as

uremia