Psl2 - Exam 4 - Lectures 24-25

Front 1

5 functions of the kidney

Back 1

ultrafiltration of plasma

reabsorption

regulation of blood pressure

hormone production

formation of urine

Front 2

3 functions of urine excretory passages

Back 2

direct flow of urine from kidney to bladder

protect tissues from toxic substances in urine

accomodate large changes in urine volume

Front 3

site of formation of ultrafiltrate

Back 3

cortex of kidney

Front 4

what region of kidney is renal corpuscle found in?

Back 4

cortex

Front 5

are long loops of Henle and collecting ducts found in kidney cortex?

Back 5

no

Front 6

in what region of kidney are medullary rays found?

Back 6

cortex

Front 7

what are medullary rays?

Back 7

parallel clusters of tubules

extend up from base of medullary pyramids

Front 8

renal lobule

Back 8

one medullary ray + adjacent cortical tissue

Front 9

medullary (renal) pyramids consist of...

Back 9

long, straight portions of some nephrons

Front 10

are renal corpuscles found in the medulla?

Back 10

no

Front 11

apex of medulla =

Back 11

renal papilla

projects into minor calyces

Front 12

renal colmns

Back 12

cortical tissue (including corpuscles) extending between the adjacent pyramids

Front 13

renal lobe

Back 13

region of one renal pyramid
+ overlying cortex
+ adjacent renal column tissue

Front 14

urine excretion involves what 3 structures?

Back 14

minor calyces

major calyces

pelvis

Front 15

where does renal pelvis end?

Back 15

in ureter

Front 16

hilum of kidney contains what 5 things?

Back 16

ureter

renal artery

renal vein

nerves

lymphatics

Front 17

renal corpuscle

Back 17

tuft of capillaries

provides blood to be filtered

Front 18

Bowman's capsule

Back 18

hollow capsule surrounding capillaries

Front 19

where does Bowman's capsule end?

Back 19

in proximal tubule

Front 20

ultrafiltrate

Back 20

fluid and small molecules exit glomerular capillaries


enter Bowman's capsule

Front 21

proximal tubule

Back 21

reabsorbs water and other molecules from ultrafiltrate

secretes other molecules into ultrafiltrate

Front 22

initial portion of proximal tubule

Back 22

convoluted

Front 23

thick descending loop of Henle

Back 23

straight part of proximal tubule

Front 24

Loop of Henle

Back 24

involved in concentrating urine

adjusts Na+ excretion to maintain Na+ and water balance

Front 25

3 regions of Loop of Henle

Back 25

descending thin loop of Henle

Henle's loop

ascending thin loop of Henle

Front 26

distal tubule function

Back 26

part of mechanism for Na+ balance

Front 27

3 regions of distal tubule

Back 27

straight, ascending thick loop of Henle

macula densa

convoluted

Front 28

what structure ends the nephron proper?

Back 28

pars convoluta of distal tubule

Front 29

first structure beyond nephron proper

Back 29

collecting tubule

Front 30

what is the collecting tubule?

Back 30

several tubules flow into a single collecting duct

Front 31

collecting duct

Back 31

ducts flow into larger ducts of the papillae

Front 32

function of collecting duct

Back 32

participate in Na+/K+/water balance

participate in acid/base balance

Front 33

T/F: collecting tubules and ducts are derived from different embryonic tissue than the nephron

Back 33

TRUE

Front 34

what induces formation of the nephron during embryonic development?

Back 34

tubule tissue

Front 35

juxtamedullary nephrons

Back 35

renal corpuscle is in the cortex, but located near corticomedullary junction

loops of Henle are very long & penetrate deep into medullary pyramid

Front 36

function of juxtamedullary nephrons

Back 36

formation of concentrated (hyperosmotic) urine

Front 37

2 poles of glomerular capillaries

Back 37

vascular pole

urinary pole

Front 38

pathway of fluid through Glomerular capsule

Back 38

afferent arteriole --> glomerular capillaries --> efferent arteriole ultrafiltrate --> proximal tubule

Front 39

forms a cup around the capillary network in renal corpuscle

Back 39

Bowman's capsule

Front 40

epithelium of parietal layer of Bowman's capsule

Back 40

simple squamous

Front 41

epithelium of visceral layer of Bowman's capsule

Back 41

podocytes with tentacle like processes (1* processes) ending in small processes (pedicles, feet)

Front 42

podocyte pedicles interdigitate with...

Back 42

pedicles of adjacent podocytes

Front 43

spaces between pedicles form....

Back 43

slits, covered by a diaphragm

Front 44

urinary space

Back 44

fluid within Bowman's capsule

Front 45

urinary space is continuous with fluid in...

Back 45

proximal tubule

Front 46

urinary pole is defined by...

Back 46

proximal tubule

Front 47

vascular pole is defined by...

Back 47

arterioles

Front 48

filtration barrier

Back 48

fenestrated endothelium of glomerular capillaries

Front 49

GBM

Back 49

glomerular basement membrane

Front 50

what is the glomerular basement membrane

Back 50

fused basal lamina of the endothelium of podocyte cells in the filtration barrier

Front 51

3 lamina of GBM

Back 51

lamina rara externa

lamina densa

lamina rara interna

Front 52

which lamina of the filtration barrier serve as a charge barrier

Back 52

lamina rara externa and interna

Front 53

what characteristic of lamina rara externa and interna allow them to act as a charge barrier

Back 53

numerous polyanions

Front 54

which filtration barrier lamina includes adhesive glycoproteins?

Back 54

lamina densa

Front 55

filtration barrier is very permeable to what?

Back 55

water

small solutes: Na+, K+, glucose

Front 56

filtration barrier is impermeable to what?

Back 56

solutes greater than 69kD

smaller but negatively charged molecules (most proteins)

Front 57

appearance of significant amounts of albumen or other proteins suggests?

Back 57

renal disease

Front 58

mesangium

Back 58

intraglomerular mesangial cells + ECM

Front 59

function of mesangium

Back 59

provides physical support of the capillary network

synthesizes surrounding matrix

phagocytotic: may help mantain basal lamina

Front 60

GFR

Back 60

glomerular filtration rate

Front 61

GFR =

Back 61

GFR = Kf(Pgc - Pbs) - (Pi)(gc)

Kf = filtration constant, depends on basal lamina
(Pi)(gc) = osmotic pressure gradient from capillary to Bowman's space
(Pgc-Pbs) = hydrostatic pressure difference btw capillary and Bowman's space

Front 62

Kf affects what?

Back 62

alterations in the ionic or molecular composition of the basal lamina will affect the type and size of molecules allowed to pass from capillaries into Bowman's space

Front 63

glomerular basement membrane pathology in DM

Back 63

basal lamina is thickened, but layered s.t. more proteins are able to pass into ultrafiltrate & are consequently lost in the urine

Front 64

normal regulation of GFR

Back 64

(Pgc - Pbs) can separately regulate smooth muscle of afferent and efferent arterioles

Front 65

function of proximal tubule

Back 65

reabsorption

Front 66

what proportion of glucose is reabsorbed by the proximal tubule?

Back 66

100%

Front 67

what proportion of water and salt in tubular fluid is reabsorbed by the proximal tubule?

Back 67

70%

Front 68

what does proximal tubule secrete into its lumen?

Back 68

H+

part of acid/base homeostasis

Front 69

describe cells of proximal tubule

Back 69

large, cuboidal cells

central nucleus

intensely eosinophilic cytoplasm

Front 70

5 proximal tubule specializations for absorption

Back 70

increased apical surface area

many and v. long microvilli (apical brush border)

apical canaliculi (endocytosis of proteins)

apical water channels (AQP-1)

digestive enzymes on glycocalyx

Front 71

specializations for active transport in the proximal tubule

Back 71

tight junctions, separating lumen from intercellular space

apical and basal mitochondria

increased basolateral area from infolding

Front 72

2 EM characteristics of proximal tubule cells

Back 72

apical brush border

basal striations

Front 73

pump in basolateral membrane of proximal tubule cells supplying gradient for active transport

Back 73

Na+/K+ ATPase

Front 74

cotransporters & exchangers in apical membrane of proximal tubule cells

Back 74

cotransporters of Na+ and glucose

exchangers (Na+/H+)

Front 75

thin walled, straight tube, lined by squamous epithelium

found in nephron

Back 75

thin loop of Henle

Front 76

permeabilities in thin descending limb of Henle's loop

Back 76

always permeable to water

less permeable to NaCl and urea

Front 77

permeabilities in thin ascending limb of Henle's loop

Back 77

always IMPERMEABLE to water

permable to NaCl

Front 78

thick ascending loop of Henle, aka:

Back 78

straight distal tubule

Front 79

location of thick ascending loop of Henle

Back 79

extends up to the region of macula densa

Front 80

describe cells of straight distal tubule (5 characteristics)

Back 80

cuboidal

less eosinophilic than proximal tubules

some microvilli, but no brush border

apical nucleus

basal striations

Front 81

water permeability of distal tubules

Back 81

IMPERMEABLE to water

Front 82

NKCC2

Back 82

Na/K/Cl co-transporter found in straight distal tubule

Front 83

NKCC2 regulated by which hormone?

Back 83

aldosterone

Front 84

In straight distal tubule, Na+/H+ exchange fuled by...

Back 84

basolateral Na+/K+ ATPase

Front 85

what happens to Na+ in the distal CONVOLUTED tubule?

Back 85

Na is reabsorbed by apical Na_ transporter

Front 86

describe apical Na+ transporter in distal convoluted tubule

Back 86

Na/Cl co-transporter (NCC)

Front 87

NCC is regulated by which hormone?

Back 87

aldosterone

Front 88

In the distal convoluted tubule,

K+ is ____
HCO3- is ____
NH4+ is _____

Back 88

In the distal convoluted tubule,

K+ is secreted
HCO3- is reabsorbed
NH4+ is secreted

Front 89

variation in water permeability of collecting duct and tubular cells depends on what hormone?

Back 89

ADH/AVP

Front 90

3 functions of collecting tubule and ducts?

Back 90

water balance

Na+ reabsorption

acid/base balance

Front 91

principal cells of collecting tubule/ducts, aka:

Back 91

light cells or CD cells

Front 92

histological characteristics of CD cells

Back 92

pale staining

single cilium

Front 93

2 types of apical channels found in CD cells

Back 93

water channels (AQP-2)

Na+ channels that increase with aldosterone

Front 94

intercalacted cells of collecting tubule/ducts, aka:

Back 94

dark cells or IC cells

Front 95

histological characteristics of IC cells

Back 95

fewer in number than principal cells

more darkly stained cytoplasm (more mitochondria)

Front 96

IC cells secrete ____ and reabsorb ____

Back 96

IC cells secrete H+ and reabsorb HCO3-

Front 97

interstitium of cortex

Back 97

very little between tubules and capillary networks

Front 98

greater amount of CT in which part of kidney?

Back 98

medulla

Front 99

2 characteristics of fibroblast-like cells in kidney interstitium

Back 99

withstand extreme osmotic gradients

may produce PGs

Front 100

which region of kidney most susceptible to toxin damage?

Back 100

tubular cells of medullary pyramids

Front 101

specialized region at the vascular pole of the renal corpuscle

Back 101

juxtaglomerular apparatus

Front 102

juxtaglomerular cells are modified ...

Back 102

smooth muscle cells of the afferent arteriole

Front 103

renin catalyzes the conversion of ____ to _____

Back 103

RENIN catalyzes the conversion of

ANGIOTENSINOGEN to ANGIOTENSIN I

Front 104

3 modes of JG cell regulation

Back 104

macula densa

response to stretch (arteriolar volume)

SNS innervation

Front 105

macula densa is part of what structure?

Back 105

distal tubule - short segment between straight and convoluted portions

Front 106

histological characteristics of macula densa cells

Back 106

tall and narrow

apical nuclei

appear "crowded"

located near glomerular portion of tubule

Front 107

macula densa is in direct contact with which cells?

Back 107

JG cells

Front 108

possible function of macula densa cells

Back 108

monitor osmolarity of tubular fluid?

part of regulation of renin secretion?

Front 109

extraglomerular mesangial cells, aka:

Back 109

lacis, Polkissen cells

Front 110

Extraglomerular mesangial cells

Back 110

network of cells between macula densa and arterioles

Front 111

renal bloodflow pathway

Back 111

renal artery --> interlobar artery --> arcuate artery --> interlobular artery

Front 112

where is interlobar artery found?

Back 112

between pyramids

Front 113

where is arcuate artery found?

Back 113

at base of pyramids

Front 114

where is interlobular artery found?

Back 114

at margins of renal lobules

Front 115

are there anastomoses in renal blood flow?

Back 115

no

Front 116

more common cause of renal failure

Back 116

inadequate blood flow

Front 117

which portion of the kidney has NO direct arterial supply?

Back 117

medulla

Front 118

where does blood in medulla come from?

where does it go

Back 118

arterial blood goes through cortex to reach medulla

exits by way of venous circulation in the cortex

Front 119

return path of renal blood flow

Back 119

interlobular vein --> arcuate vein --> interlobar vein --> renal vein --> IVC

Front 120

capillary system and venous return in kidney

Back 120

see p. 136

Front 121

possible source of erythropoieten

Back 121

peritubular capillaries in cortex

Front 122

efferent arterioles of juxtamedullary nephrons end in ______

Back 122

peritubular capillaries

Front 123

Vasa Recta

Back 123

network of arterioles, capillary plexus and venules that parallel loops of Henle

Front 124

what changes occur in urine composition in the urine excretory passages?

Back 124

none

Front 125

structure of urine excretory passages (except for urethra)

3 layers

Back 125

mucosa

muscularis

adventitia

Front 126

epithelium of urine excretory passage mucosa

Back 126

transitional epithelium

apical cells rounded, often bulging into lumen

Front 127

plaques

Back 127

thickened regions of mucosa membranes

in relaxed state, plaques fold inward, forming vesicles of add'l membrane that can be incorporated in stretched state

Front 128

what layer of mucosa is fused to submucosa?

Back 128

dense, fibroelastic lamina propria

Front 129

muscularis of urine excretory passages

Back 129

smooth muscle,

arranged in bundles, rather than sheets,

with intervening CT

Front 130

layers formed by muscularis in excretory passages

Back 130

inner longitudinal

outer circular

Front 131

adventitia

Back 131

loose CT external to muscularis

Front 132

shape of ureter lumen

Back 132

stellate

Front 133

3 layers of muscularis of ureter

Back 133

inner longitudinal

outer circular

thired, outer longitudinal added near juction with bladder

Front 134

physiologic sphincter

Back 134

if properly angled at insertion into the bladder, the ureter is occluded by bladder contraction and urine reflux does not occur

Front 135

2 circumstances in which urine reflux can occur

Back 135

if angle is inappropriate (congenital malformation)

bladder is not completely emptied (occurs especially with age)

Front 136

urine reflux is more common in the elderly of which gender

Back 136

women

Front 137

2 functions of bladder

Back 137

reservoir

pump

Front 138

muscularis of bladder

Back 138

interlaced spiral muscle

inner & outer longituidinal with middle circular

Front 139

smooth muscle of bladder, aka:

Back 139

destrusor muscle

Front 140

length of female urethra

Back 140

4-5 cm

Front 141

female urethra is embedded in...

Back 141

anterior wall of vagina

Front 142

epithelium of female urethra

Back 142

transitional epithelium near bladder

non-keratinized stratified squamous elsewhere

Front 143

glands of Littre

Back 143

mucus secreting glands found in female urethra

appear as epithelial outpouchings

Front 144

glands of Littre are homologous to which male gland?

Back 144

prostate

Front 145

lamina propria of female urethra has what distinct characteristic?

Back 145

very vascular

Front 146

lamina propria of female urethra is homologous to what penile region?

Back 146

corpus spongiosum

Front 147

external sphincter of female urethra

Back 147

skeletal muscle surrounding urethra as it exits UG diaphragm

Front 148

length of male urethra

Back 148

15 - 20 cm

Front 149

are glands of Littre found in male urethra?

Back 149

yes

Front 150

epithelium of...

prostatic:
membranous:
penile:

Back 150

prostatic - transitional epithelium

membranous - stratified columnar and pseudostratified columnar

penile - non-keratinized stratified squamous

Front 151

3 age-related clinical issues wrt urethra

Back 151

loss of elasticity of CT

loss of muscular tone, resulting in involuntary micturition

incomplete bladder emptying and increase in likelihood of bladder infections

Front 152

Body Fluids module

Back 152

p. 146 - 160

DO PROBLEMS!

Front 153

Listen to lectures 25-32

Back 153

Listen to lectures 25-32

Front 154

Do the cells of collecting ducts and tubules have clear lateral borders? Why?

Back 154

Yes - because no interdigitations between cells.

Front 155

what cells secrete renin?

in what form?

Back 155

JG cells

store renin in cytoplasmic granules

Front 156

no basement membrane between which 2 cell types of the JGA?

Back 156

JG cells & macula densa

Front 157

function of EXTRAglomerular mesangial cell?

Back 157

unknown

Front 158

What type of nephron takes fluid through vasa recta?

Back 158

juxtamedullary only

Front 159

efferent arterioles of juxtamedullary nephrons end in ...

Back 159

peritubular capillaries, which supply the convoluted tubules

Front 160

which vascular structures often end in the vasa recta?

Back 160

peritubular capillaries

Front 161

Glucose is reabsorbed from the tubular fluid by the _____ cells and transported to blood via the _____

Back 161

Glucose is reabsorbed from the tubular fluid by the PROXIMAL TUBULE cells and transported to blood via the PERITUBULAR CAPILLARIES

Front 162

where does filtration take place

Back 162

CORTEX (only)