HIS: Urinary tract

● Bilateral kidneys ● Bilateral ureter ● Bladder ● Sphincter ● Urethra

The urinary system is composed of the following components:

● Elimination of nitrogenous waste products (urea and creatinine)

● Elimination of excess water and regulation of plasma osmolarity via filtration, excretion, and reabsorption of small solutes and electrolytes

● Maintenance of acid-base balance by selective secretion of H+

● Misc: Renin (BP regulation), EPO or erythropoietin (RBC production), calcitriol production

Whata r ethe functions of teh urinary tract?

Capsule (Geroto’s Fascia) -

___________ is the Fibrous covering over the kidney

Medullary pyramid -

____________ are part of the kidney that are pyramidal or triangular in shape and striated because it is made up of straight tubules.

Calyx

____________ is where urine flows after it leaves the medullary pyramids.

Minor calyx

_____________ is a calyx that drains one medullary pyramid.

true

(T/F) Each minor calyx will drain to a major calyx. There are 3-4 minor calyces draining to each major calyx. In the Kidney, there are 2-3 major calyces.

Renal Papilla -

___________ is in the tips of the medullary pyramids.

Base of medullary pyramids

____________is where the corticomedullary junction is

Hilum

_________ is the entry point of renal blood vessels and ureter

Renal pelvis

___________ is the most dilated proximal part of the ureter that receives all the urine from the major calyces

Renal sinus-

_____________ is the space inside the kidney that surrounds your entering blood vessels, major and minor calyces, and renal pelvis.

Columns of Bertin

__________ are extensions of the cortex to the renal medulla that demarcate a renal lobe.

nephron

The _________ has a single medullary pyramid with the tip surrounded by a minor calyx

0.6 to 1.2 x10 ^6; 20

A normal adult has _____________nephrons per kidney that receive about ___% of the cardiac output per minute (1.25L of blood per min)

Blood first passes through the glomerulus, the glomerular blood vessels, then an ultrafiltrate of the blood → Bowman’s space of the Bowman’s capsule → proximal convoluted tubule → Loop of Henle → Distal convoluted tubule → Collecting tubule → Collecting duct

What is the blood flow in the kidney?

○ Pars recta/Straight proximal tubule/Thick descending limb

○ Thin descending limb

○ Thin ascending limb

○ Thick ascending limb

Loop of Henle is composed of the

Renal Lobule

______________ contains nephrons grouped around a medullary ray and drain into a single collecting duct

Medullary Ray

___________ is a bundle of straight cables in the cortex that is composed of collecting ducts and parts of the loops of Henle

multiple

Renal lobe is composed of ______renal lobules

Renal Corpuscle

___________ is the first part of the nephron

Bowman’s capsule

Glomerulus

Renal Corpuscle is made up of

Bowman’s capsule

__________covers the glomerulus and is lined on one side by parietal epithelial cells (simple squamous epithelium)

Glomerulus

___________ are blood vessels receiving blood from the afferent arteriole and blood leaves it via the efferent arteriole

visceral epithelial cells (podocytes)

Glomerulus are covered by _____________________, which are continuous with parietal epithelial cells (simple squamous epithelium)

1. Pitting Edema

2. Ascites

3. Puffy Eyelids

What are the signs of Nephrotic Syndrome can develop

● Reabsorbs 65% of the glomerular filtrate

○ Almost 100% of glucose and amino acids

○ Sodium-glucose co-transporter 2 (SGLT-2)

● Active ion transport mediated by an Na+, K+–activated ATPase pump

What are the functions of the Proximal Convoluted Tubule ?

Cuboidal cells with a brush border

Proximal Convoluted Tubule is made up of __________________

activated calcitriol production

PCT is responsible for ______________ also called activated Vitamin D

thick descending limb

The _______________ of the loop of Henle, or proximal straight tubule (pars recta of the PCT), is a histological continuation of the PCT with basolateral interdigitations and fewer microvilli.

simple squamous epithelium

The thin limbs of the loop of Henle form a hairpin loop and are lined by ________________

F. The thin descending limb is permeable to water, while the thin ascending limb is permeable to salt (NaCl).

(T/F) The thin descending limb is permeable to salt (NaCl), while the thin ascending limb is permeable to water.

distal convoluted tubule

The thick ascending limb of the loop of Henle, also called the distal straight tubule, is histologically similar to the _________.

simple cuboidal epithelium

The thick ascending limb of the loop of Henle is lined by __________________________with scant or absent microvilli and has basolateral interdigitations.

surface areas

The basolateral interdigitations of THAL is to serve as ___________that hold in the case of proximal convoluted tubules, sodium potassium ATPase pumps

countercurrent exchange mechanism

The _________________maintains a concentration gradient in the kidney by allowing fluid and solutes to flow in opposite directions in adjacent tubules or vessels.

distal convoluted tubule (DCT

The __________________ is lined by simple cuboidal epithelium with basolateral interdigitations and has no brush border

macula densa.

Distal convoluted tubule (DCT) cells are shorter than those of the PCT, and it contains the ______________

macula densa, juxtaglomerular cells and extraglomerular cells

The Juxtaglomerular Apparatus is made up of the ___________, ___________, __________

renin release

Near the macula densa are juxtaglomerular cells for _____________

tubuloglomerular feedback

JXGA apparatus is responsible for ____________

cuboidal → columnar

In the Collecting Tubule and Duct there is a gradual transition from a _________ → ____________

Renal Artery and Vein

______________ divides into anterior and posterior branch which further divides into number of interlobar arteries

Interlobar Arteries → ascends through the columns of Bertin → branch into Arcuate arteries which run around the corticomedullary junction

blood flow in renal vasculalture

cortical radial artery

The arcuate artery branch into _________________ (commonly known as interlobular artery) → radiate upwards in the cortex

Peritubular capillaries (PCTs)

The efferent arteriole give rise to _______________

vasa recta

Juxtamedullary nephrons branch further down and ramify throughout the tubules and are called _____________for the juxtamedullary nephrons

takes away the solutes and water

The vasa recta wraps through both limbs of the loop of Henle all throughout its length because it __________________ generated by the countercurrent multiplier mechanism

Starts from the calyx → renal pelvis → ureters → renal bladder → urethra

What is the flow of the lower urinary tract?

ureter

The ________________is a tubular structure with a lumen lined by transitional epithelium (urothelium), underlain by a lamina propria, surrounded by muscularis propria, and covered externally by an adventitia

○ Inner longitudinal

○ Outer circular

What are the layers of the Upper ⅔ has smooth muscle of the ureter

○ Inner longitudinal

○ Middle circular

○ Outer longitudinal

What are the layers of the lower 1/3 has smooth muscle of the ureter

Muscularis propria in bladder is much thicker than ureter

What is the main histological difference between bladder and ureter

Transitional Epithelium

The urinary bladder has a _____________ which is a 3-6 layers, stretchable to accommodate urine flow and volume

F. The more proximal you go in the ureter → the thinner the layers

(T/F) The more proximal you go in the ureter → the Thicker the layers

Umbrella cells

_______________ in the bladder make up the most superficial layer of the transitional epithelium and are mpermeable to urine extravasation

Plaques; uroplakins

____________ in the bladder are formed by the aggregation of hexagonal intramembranous proteins, called ____________, to which cytoskeletal proteins are anchored on the cytoplasmic side

Intraplaque region

__________ acts as a hinge and can be pulled inward when the urinary bladder is contracted