Renal Final Review

What does it mean for an organ to be retroperitoneal?

It is outside the peritoneum

Which organs are retroperitoneal?

(ISADPUCKER)

IVC

Suprarenal glands

Arorta

Duodenum (distal 2/3)

Pancreas

Ureters

Colon - Ascending and descending

Kidneys

Esophagus

Rectum

At what vertebral level are the kidneys?

T12-L3

Why does the left kidney sit higher than the right?

The liver is on the right side

What is a good way to distinguish kidney problems from low back pain?

Changes in urination

How big are the kidneys?

3 x 6 x 12 cm

What is the name of the area of an organ where everything enters and exits?

Hilum

What are the 3 layers of protection of the kidney?

Inner: renal capsule

Middle: fat pad

Outer: Renal fascia

What is the renal fascia made of?

Dense fibrous connective tissue

What is the name of the outer layer of the kidney that contains the nephrons?

Cortex

What is the name of the lighter area between the pyramids of the kidney that contains nephrons?

Medulla

What part of the kidney contains collecting ducts?

Pyramids

What do collecting ducts collect?

Urine

What is the name of the drainage tube associated with each individual pyramid?

Minor calyx

What is the name of the drainage tube formed by 2 minor calyces?

Major calyx

What is the name of the conjunction of all the calyces that drains into the ureter?

Renal pelvis

What is the pathway of drainage from the pyramids out of the body?

Minor Calyx -> Major calyx -> Renal pelvis -> ureter -> bladder -> urethra

What type of epithelium lines the pathway of kidney drainage except for the urethra?

Transitional epithelium

What angle does the renal artery enter the kidney at?

90 degrees

At any given point in time, how much of the body's blood is flowing through the kidneys?

90%

What is the pathway of blood flow to the kidneys?

Aorta -> Renal arteries -> segmental arteries -> interlobar arteries -> arcuate arteries -> afferent arteriole -> glomerulus -> efferent arteriole -> peritubulular capillaries

At what point do blood vessels of the kidneys start to get microscopic?

Afferent arterioles

What is the pathway of blood flow from the kidneys?

Vasa recta -> interlobar veins -> arcuate veins -> interlobar veins -> segmental veins -> renal veins -> inferior vena cava

What does it mean to be juxtamedullary?

Between the pyramids

What is the composition of urine?

95% water, 5% solute

What solutes make up urine?

Urea

Uric acid

Sodium

potassium

magnesium

creatinine

What are the 3 layers of the filtration membrane?

Fenestrated endothelium

Basement membrane

Visceral membrane

Where are podocytes (foot cells) found?

Visceral membrane of the filtration membrane

Which layer of the filtration membrane filters blood cells?

Fenestrated endothelium

Which layer of the filtration membrane filters large proteins?

Basement membrane

What is the primary protein filtered by the basement membrane?

albumin

Which layer of the filtration membrane filters small protein?

Visceral membrane

What is the term for moving urine to the external environment?

Micturition

What is the term for passing urine through a tube?

Urination

What are the peritubular capillaries associated with?

proximal and distal convoluted tubule

What is filtrate made of?

Blood plasma

What are the mechanoreceptors of the kidney?

Juxtaglomerular cells

What are the chemoreceptors of the kidney?

Macula densa cells

What senses pressure in the proximal convoluted tubule?

What is GFR per minute?

120-125 ml

What is GFR per hour?

7500 ml

T or F: GFR is used as a measure of kidney failure

True

What is Glomerular hydrostatic pressure?

55 mmHg out of the glomerulus

(Hpg)

What is Capsule hydrostatic pressure?

15 mmHg into the glomerulus

(HPc)

What is Colloid osmotic pressure in the bowman's capsule?

30 mmHg into the glomerulus

(Opg)

T or F: When Hog is less than HPc + OPg, kidney filtration stops

True

What is the equation for net filtrate pressure?

Hug - (Opg + Hoc)

What type of epithelium is the proximal convoluted tubule made of?

Cuboidal epithelium

What is the function of the Proximal convoluted tubules?

Reabsorption of sodium, amino acids, potassium, water, and glucose

What type of epithelium is the loop of hence made of?

Cuboidal - simple squamous - cuboidal epithelium

What is the function of the loop of henle?

reabsorption of sodium and water

What type of epithelium is the distal convoluted tubule made of?

cuboidal epithelium

What is the function of the distal convoluted tubule?

secretion of urine and some resorption of H2O

Where is angiotensinogen produced?

Liver

Where is renin produced?

Kindeys

What is the function of renin?

Converts angiotensinogen to angiotensin-1

What is the function of ACE?

Converts angiotensin-1 to angiotensin-2

Where is ACE produced?

lungs

What is the effect of Angiotensin-2 on the kidneys>

Resorption of sodium and chloride, secretion of potassium, retention of water

What is the function of angiotensin-2 on the blood vessels?

Causes vasoconstriction (increases BP)

What is the function of angiotensin-2 on the pituitary gland?

Signals secretion of ADH

What organ releases ANP?

The heart (cardia cells)

What is the function of ANP?

Reduces sodium levels (water will leave with it)

Decreases blood pressure/ blood level

What are some examples of Diuretics?

Caffeine and alcohol

What organ do diuretics act on?

Hypothalamus and posterior pituitary gland

What are the mechanoreceptors of the nephron?

Juxtaglomerular cells

What are the chemoreceptors of the nephron?

Macula densa cells

What ion do macula dense cells sense the concentration of?

Sodium

What is the function of the collecting ducts?

It is the last site of water reclamation

Where does ADH have its greatest effect?

Collecting ducts

Which organs are made of transitional epithelium?

Minor Calyx

Major Calyx

Renal pelvis

Ureters

Bladder

What is the outer muscle layer of the ureter made of?

Circular muscle

What is the inner muscle layer of the ureter made of?

Longitudinal muscle

What is an AKA for kidney stones?

renal calculi

What is the tunica intimate of the ureter made of?

transitional epithelium

What is the inner layer of the tunica media of the ureter made of?

Longitudinal muscle

What is the outer layer of the tunica media of the ureter made of?

Circular muscle

What is the tunica adventitia of the ureter made of?

Fibrous connective tissue

What is the term for the muscle of the bladder?

Detrussor muscle

What layers of the bladder are the same as in the ureter?

Tunica intima and adventitia

What is the inner layer of the tunica media of the bladder made of?

Longitudinal muscle

What is the middle layer of the tunica media of the bladder made of?

Circular muscle

What is the outer layer of the tunica media of the bladder made of?

Longitudinal muscle

What is the name of the part of the bladder where two tubes enter and one leaves?

Trigone

What is a moderately full capacity of the bladder?

300 ml

What is the maximum capacity of the bladder?

500 ml

What type of muscle is the internal sphincter made of?

Smooth muscle

What type of muscle is the external sphincter made of?

Skeletal muscle

What is the AKA for micturation?

Voiding the bladder

What is the term for inability to control the external urethral sphincter?

Incontinence

What are the potential causes of incontinence?

Pregnancy

Infancy

Trauma

Old age

What is the most common abnormality of the urethra in males?

Hypospadias

What is the term for when the urethra exits along the ventral surface of the penis rather than the glans?

Hypospadias

What is the term for when the kidneys form fused together?

Horseshoe kidney

What causes polycystic kidneys?

Abnormally formed collecting ducts

What complication does polycystic kidney lead to in children?

Renal failure

How old do people with polycystic kidney usually live to?

40 yo

What is the AKA of Nephroblastoma?

Wilm's tumor

What is the chemical found in cranberries that helps prevent UTIs?

Proanthocyanidine

What does the urachus connect?

Bladd and umbilicus