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33 Cards in this Set

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  • Back
Which kidney is superior? Where are they located?
The left kidney is superior to the right kidney and is situated anterior to the 11th and 12th ribs.
The right kidney is situated anterior to the 12th rib.
What muscles are the kidneys in contact with?
Diaphragm and transversus abdominis, quadratus lumborum, and the psoas major muscles.
In the hilus, which structure is anterior to the other?
At the hilus, the renal vein is anterior to the renal artery.
The renal artery is anterior to the renal pelvis.
At what level do the renal arteries arise from?
Renal arteries arise from the abdominal aorta at the level of the upper part of the L2 vertebra.
The right renal artery passes posterior to the IVC and the left renal artery passes anterior to the abdominal aorta just inferior to the origin of the SMA.
What do the renal arteries branch into?
Renal arteries give rise to interlobar arteries that branch into arcuate arteries at the juncture between the medulla and the cortex; arcuate arteries give rise to interlobular arteries. The interlobular arteries give rise to the afferent arterioles of the glomerulus.
What might an aberrant renal artery, arising inferior to the renal artery, compress?
The proximal part of the ureter may be compressed by an aberrant renal artery. This may cause hydronephrosis of the renal pelvis.
When might a varicocele occur?
Compression of the left renal vein by an aneurysm of the superior mesenteric artery near the origin of the artery from the abdominal aorta.
What nerves innervate the kidneys?
Preganglionic sympathetic axons in the lower thoracic or lumbar splanchic nervers from the T11 to L2 segments, which synapse mainly in aorticorenal ganglia.
Where do the ureters arise from?
Ureters arise from the renal pelvis of each kidney at about the level of the L2 vertebra.
What does the intermediate mesoderm form?
The intermediate mesoderm forms a longitudinal elevation along the dorsal body wall called the urogenital ridge.
What does the urogenital ridge form?
A portion of the urogenital ridge forms the nephrogenic cord, which gives rise to the urinary system.
What are the nephric structures? What forms them?
The nephrogenic cord develops into three sets of nephric structures: the pronephros, mesonephros, and metanephros.
What is the fate of the pronephros?
Pronephros develops to form pronephric tubules and pronephric duct. It is a transitory structure that regresses completely by week 5. It is not functional in humans.
What is the fate of the mesonephros?
The mesonephros forms the mesonephric tubules and the mesonephric duct (Wolffian duct). The mesonephros is the middle nephric structure and is partially transitory. Most of the mesonephric tubules regress, but the mesonephric duct persists and opens into the urogenital sinus. The mesonephros is functional for a short period.
Where does the metanephros form from? What is the fate of the metanephros?
The metanephros develops from an outgrowth of the mesonephric duct (ureteric bud) and from the mesoderm within the nephrogenic cord. The metanephros is the caudalmost nephric structure. The metanephros begins to form at week 5 and is functional in the fetus at about week 10. The metanephros develops into the definitive adult kidney.
What gives rise to the collecting system of the kidneys? What structures does this include?
The ureteric bud, which is an outgrowth of the mesonephric duct.
The ureteric bud initially penetrates the metanephric mesoderm and then undergoes repeated branching to form the ureters, renal pelvis, major calyces, minor calyces, and collecting ducts.
What regulates the formation of the collecting system?
The outgrowth of the mesonephric duct, the ureteric bud, is regulated by WT-1 (an antioncogene), GDNF (glial cell line-derived neurotrophic factor), and c-Ret (a tyrosine kinase receptor).
What gives rise to the nephron?
The inductive influence of the collecting ducts causes the metanephric mesoderm to differentiate into metanephric vesicles. The metanephric vesicles give rise to primitive S-shaped renal tubules, which differentiate into the connecting tubule, distal convoluted tubule, loop of Henle, proximal convoluted tubule, and Bowman's capsule. Nephron formation is complete at birth, but functional maturation of nephrons continues throughout infancy.
What happens during the "ascent" of the kidneys?
The kidneys rotate 90 degrees, causing the hilum, which initially faced ventrally, to finally face medially.
What is the urinary bladder formed from?
The urogenital sinus, which is continuous with the allantois. The lower ends of the mesonephric ducts become incorporated into the posterior wall of the bladder to form the trigone of the bladder. The mesonephric ducts eventually open into the urogenital sinus below the bladder. The transitional epithelium lining the urinary bladder is derived from endoderm because of its etiology from the urogenital sinus and gut tube.
What forms the urethra?
Lower portion of the urogenital sinus.
What are the components of the renal glomerulus?
Mesangium: extracellular matrix between capillaries
Mesangial cells: Phagocytic and contractile function; have receptors for angiotensin II and atrial natriuretic peptide.
Juxtaglomerular (JG) cells: modified smooth muscle cells of the afferent arteriole that secrete renin.
What composes the Bowman's capsule?
Simple squamous epithelium (Parietal layer)
Podocytes (Visceral layer)
What composes the proximal convoluted tubule? What is the PCT sensitive to?
Proximal convoluted tubule (PCT) consists of simple cuboidal epithelium with a brush border (microvilli), apical endocytic vesicles, lateral interdigitations, and basal infoldings (with numerous mitochondria and Na--K ATPase). The PCT is atrial natriuretic peptide sensitive.
What parts of the loop of Henle consist of simple squamous epithelium?
Descending thin limb and ascending thin limb
What composes the distal convoluted tubule? What about thick ascending limb?
DCT consists of simple cuboidal epithelium with basal infoldings (with numerous mitochondria and Na-K ATPase).

Thick ascending limb is similar in morphology to the DCT. In the region of the afferent and efferent arterioles, it contains specialized macular densa cells.
What does the collecting duct consist of? What are the different collecting ducts sensitive to?
The collecting duct consists of principal cells and intercalated cells.
Cortical CDs are ADH and aldosterone sensitive.
Medullary CDs are ADH and ANP sensitive.
What are the components of the glomerular filtration barrier?
a) Glomerular capillary endothelium
b) Basal lamina
c) Filtration slits of podocytes
What are the components of the basal lamina in the glomerular filtration barrier?
Basal lamina contains fibronectin, laminin, type IV collagen, and heparin sulfate (important in maintaining the negative charge).
What are the components of the juxtaglomerular complex?
a) JG cells: modified smooth muscle cells of the afferent arteriole and secrete renin
b) Extraglomerular mesangial cells (Lacis cells): located between the afferent and efferent arterioles and have receptors for angiotensin II and ANP.
c) Macula densa (MD) cells: located in the wall of the distal straight tubule and monitor a decrease in Na+ in the DST fluid.
How is Wilms' tumor characterized histologically?
Wilms' tumor has three components that attempt to recapitulate embryonic development of the kidney:
1) metanephric blastema elements
2) stromal elements
3) epithelial elements (tubules or glomeruli)
How is Rapidly Progressive Glomerulonephritis characterized histologically?
RPGN is characterized histologically by the accumulation of cells in the urinary space in the form of "crescents". The crescents are formed by proliferation of the parietal layer (simple squamous epithelium) of Bowman's capsule and by monocytes, macrophages, neutrophils, and lymphocytes.
How is Diabetic glomerulosclerosis characterized histologically?
Basement membrane thickening, a diffuse increase in mesangial matrix, and Kimmelstiel-Wilson nodules (hyaline masses situated at the periphery of the glomerulus)