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30 Cards in this Set

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  • Back
What are the precursor structures to the kidney?
- Pronephros (until week 4)
- Mesonephros (1st trimester)
- Metanephros (permanent)
- Pronephros (until week 4)
- Mesonephros (1st trimester)
- Metanephros (permanent)
When is the fate of the Pronephros?
Renal precursor structure that is present until week 4 when it degenerates
Renal precursor structure that is present until week 4 when it degenerates
When is the fate of the Mesonephros?
- Functions as interim kidney for 1st trimester
- Later contributes to male genital system
- Functions as interim kidney for 1st trimester
- Later contributes to male genital system
When is the fate of the Metanephros?
- Permanent renal structures, first appears at 5th week of gestation
- Nephrogenesis continues through 32-36 weeks of gestation
- Permanent renal structures, first appears at 5th week of gestation
- Nephrogenesis continues through 32-36 weeks of gestation
What structure is derived from the caudal end of the mesonephric duct? What does it become?
Ureteric Bud
- Gives rise to ureter, pelvises, calyces, and collecting ducts
- Fully canalized by 10th week
Ureteric Bud
- Gives rise to ureter, pelvises, calyces, and collecting ducts
- Fully canalized by 10th week
What structure interacts with the ureteric bud to induce differentiation and formation of the glomerulus through to the distal convoluted tubule?
Metanephric Mesenchyme
What structures form the permanent tubular system of the kidney? How?
- Metanephric Mesenchyme: forms glomerulus through distal convoluted tubule
- Ureteric Bud: forms collecting ducts, calyces, pelvises, and ureter
- These form through interaction of the two structures
What happens if there is aberrant interaction between the ureteric bud and metanephric mesenchyme?
May result in several congenital malformations of the kidney
What is the last part of the renal structures to canalize? Implications?
Ureteropelvic Junction - most common site of obstruction (hydronephrosis) in fetus
What is the most common site of obstruction, leading to hydronephrosis, in the fetus?
Ureteropelvic Junction
What syndrome occurs in babies who can't pee in utero?
Develop Potter Syndrome
Develop Potter Syndrome
What syndrome is associated with Pulmonary hypoplasia, Oligohydramnios, Twisted face, Twisted skin, Extremity defects, and Renal failure (in utero)? Cause?
Potter Syndrome
- Causes: ARPKD, posterior urethral valves, bilateral renal agenesis
- Leads to oligohydramnios → compression of developing fetus → limb deformities, facial anomalies (low set ears and retrognathia), and compression of chest ...
Potter Syndrome
- Causes: ARPKD, posterior urethral valves, bilateral renal agenesis
- Leads to oligohydramnios → compression of developing fetus → limb deformities, facial anomalies (low set ears and retrognathia), and compression of chest → pulmonary hypoplasia (cause of death)
What can cause Potter Syndrome?
Causes:
- ARPKD
- Posterior Urethral Valves
- Bilateral Renal Agenesis

Leads to:
- Oligohydramnios → compression of developing fetus → limb deformities, facial anomalies (low set ears and retrognathia), and compression of chest → pulmonary hypoplasia (cause of death)
What are the consequences of ARPKD, posterior urethral valves, or bilateral renal agenesis?
Potter Syndrome:
- Pulmonary hypoplasia
- Oligohydramnios
- Twisted face
- Twisted skin
- Extremity defects
- Renal failure (in utero)
What facial abnormalities are associated with Potter Sequence?
- Low-set ears
- Retrognathia (posterior positioning of mandible)
- Low-set ears
- Retrognathia (posterior positioning of mandible)
What happens in horseshoe kidney? Consequences?
Inferior poles of both kidneys fuse
- As the kidneys ascend from the pelvis during fetal development, horseshoe kidneys get trapped under the inferior mesenteric artery
- Remain low in abdomen
Inferior poles of both kidneys fuse
- As the kidneys ascend from the pelvis during fetal development, horseshoe kidneys get trapped under the inferior mesenteric artery
- Remain low in abdomen
How do kidneys that are fused at the inferior poles function?
Horseshoe kidneys function normally, but there is an increased risk of ureteropelvic junction obstruction, hydronephrosis, renal stones, and rarely renal cancer (Wilms tumor)
What is horseshoe kidney associated with?
Turner Syndrome
What kidney problem are patients with Turner Syndrome associated with having? Risk of?
Horseshoe kidney, increased risk of:
- Ureteropelvic junction obstruction
- Hydronephrosis
- Renal stones
- Rarely renal cancer (Wilms tumor)
What does this axial CT of abdomen with contrast show?
What does this axial CT of abdomen with contrast show?
Enhancing midline fused kidney (horseshoe kidney)
Enhancing midline fused kidney (horseshoe kidney)
What kidney problem is often diagnosed prenatally via ultrasound with a unilateral cystic kidney and a contralateral hypertrophic kidney? Cause?
Multicystic Dysplastic Kidney - abnormal interaction between ureteric bud and metanephric mesenchyme → non-functional kidney
What is wrong if a patient has a Multicystic Dysplastic Kidney?
- Abnormal interaction between ureteric bud and metanephric mesenchyme
- Leads to a non-functional kidney consisting of cysts and connective tissue
- If unilateral (most common), generally asymptomatic with compensatory hypertrophy of the contralateral kidney
When is Multicystic Dysplastic Kidney typically diagnosed?
Prenatally with ultrasound
Which kidney is usually taken during living donor transplantation? Why?
Left kidney - longer renal vein
What is the branching pattern of the arteries in the kidney?
Renal artery → Segmental artery → Interlobar Artery → Interlobular Artery → Arcuate Artery
Renal artery → Segmental artery → Interlobar Artery → Interlobular Artery → Arcuate Artery
What does blood need to flow through to enter the kidney tubules?
Glomerulus:
- Endothelial cells of blood vessel
- Basement membrane
- Podocytes (visceral layer)
Glomerulus:
- Endothelial cells of blood vessel
- Basement membrane
- Podocytes (visceral layer)
What are the labeled components of this glomerulus?
What are the labeled components of this glomerulus?
- A: Macula Densa
- B: Afferent arteriole
- C: Efferent arteriole
- D: Bowman Capsule
- A: Macula Densa
- B: Afferent arteriole
- C: Efferent arteriole
- D: Bowman Capsule
Where is the Macula Densa?
Distal Renal Tubule - adjacent to glomerulus and juxtaglomerular cells
Distal Renal Tubule - adjacent to glomerulus and juxtaglomerular cells
What is the course of the ureters?
- Ureters pass UNDER uterine artery and UNDER ductus deferens (retroperitoneal)
- Water (ureters) are under the bridge (uterine artery and vas deferens)

(But pass over the iliac arteries
- Ureters pass UNDER uterine artery and UNDER ductus deferens (retroperitoneal)
- Water (ureters) are under the bridge (uterine artery and vas deferens)

(But pass over the iliac arteries
What can happen in gynecologic procedures involving ligation of the uterine vessels?
May damage the ureter → ureteral obstruction or ureteral leak
May damage the ureter → ureteral obstruction or ureteral leak