kidneys 1

As early as the _______ of embryonic development, the kidneys begin to form from the columns of mesoderm (intermediate
mesoderm).

• second week

• third week

• fourth week

• first week

third week

What describes the following?:

• is the earliest nephric stage in humans, and constitutes the mature kidney in most primitive vertebrates.

• Consists of 6-10 pairs of tubules.

• Tubules then turn into cloaca

• The pronephros disappears completely by the 4th week of human embryonic life.

Pronephros

What develops by the formation of mesonephric tubules from the intermediate mesoderm, it is the principal excretory organ during early embryonic life (4—8 weeks)?

Mesonephros

In males, what develops into the rete testis, the ejaculatory ducts, the epididymis, the ductus deferens, and the seminal vesicles?

the Wolffian duct

What is one of the paired embryogenic tubules that drain the primitive kidney (mesonephros) to the claoaca?

The Wolffian duct also known as the mesonephric duct

What arises caudal to the mesonephros at five weeks of development; it is the permanent and functional kidney in higher vertebrates; It is derived from the intermediate mesoderm?

Metanephros

What is the functional units of the kidney, arise from the intermediate mesoderm around each ureteric bud?

the nephrons

When does nephron function begin?

Nephron function begins at approximately 8 weeks.

With fetal growth, the kidneys appear to migrate from their pelvic location to the abdomen. This so-called migration is not complete until when?

5 or 6 years of life

the kidneys in infants and young children are located…

more caudal (inferior)

Kidneys are a bean shaped ______, and endocrine organs

• intraperitoneal

• retroperitoneal

• neither

retroperitoneal

true/false: The upper poles of the kidneys are usually located at the level of the T12 vertebra and the lower poles extend to the level of the L4 vertebra.

true

What is a triangular muscle that lines both sides of the spine from hips to mid back, seen posterior medial to kidney?

Psoas muscle

What is a flat muscle posterior lateral to the psoas and immediately
posterior to the kidney?

Quadratus Lumborum muscle

What is the hilum?

located medially where the renal artery, vein, and nerves enter and leave the concave surface through a notch called the hilum

True/False: Average Adult length 9-12 cm, width 4-6 cm and AP 3-4 cm

true

What is most anterior at the hilum?

• renal vein

• renal pelvis/ureter

• renal artery

• renal pyramids

renal vein

What is most posterior at the hilum?

• renal vein

• renal pelvis/ureter

• renal artery

• renal pyramids

renal pelvis/ureter

What is between the two structures at the hilum?

• renal vein

• renal pelvis/ureter

• renal artery

• renal pyramids

renal artery

What provides support and protection from trauma and infection?

Supportive layers of Kidney

it’s a true capsule which surrounds the kidney and gives kidney a smooth appearance

• fibrous renal capsule

• Glisson’s capsule

• adipose capsule

• renal fascia/ Gerota’s fascia

fibrous renal capsule

Also referred to as perirenal fat. It envelopes both the kidney and adrenal glands.

• fibrous renal capsule

• Glisson’s capsule

• adipose capsule

• renal fascia/ Gerota’s fascia

adipose capsule

It encompasses the kidneys, adrenals, and perirenal fat. This is also
referred to as perirenal space.

• fibrous renal capsule

• Glisson’s capsule

• adipose capsule

• renal fascia/ Gerota’s fascia

renal fascia/ Gerota’s fascia

What are the three supportive muscles of the kidneys?

1. Psoas muscle

2. Quadratus lumborum muscle

3. Transversus abdominus muscle

Which muscle does the following describe?

– Major groin muscle
– Primary flexor of the hip joint
– Lies posterior to the inferior pole of each kidney

Psoas muscle

Which muscle does the following describe?

– Muscle of the posterior abdominal wall
– Lies posterior and medial to each kidney

Quadratus lumborum muscle

Which muscle does the following describe?

– Deepest layer of flat muscles of the anterolateral wall
– Lies lateral to each kidney

Transversus abdominus muscle

The kidney is composed of two types of tissue:

renal parenchyma and renal sinus

What is the point at which the distal convoluted tubule comes in contact with the afferent arterioles and secretes rennin?

Juxtaglomerular Apparatus

what is an enzyme important for regulating sodium and water retention; regulates blood pressure?

rennin

What is the capsule that surrounds the kidney?

true capsule/renal capsule

What is the sonographic appearance of the cortex?

Cortex is isoechoic or hypoechoic to liver

what extends from the capsule to the base of the pyramids and performs blood filtration?

the cortex

What consists of the cortex and the medulla?

renal parenchyma

What contains the renal corpuscles and the proximal and distal convoluted tubules of the nephron?

the cortex

The medulla contains ___________ renal pyramids. Pyramids are anechoic.

8 to 18

What are triangular structures with the wide portion (base) facing the renal cortex and the narrow tip (apex) converging toward the renal sinus?

Pyramids

What contains the loop of Henle and collecting duct?

Medulla

What separates the medulla from the cortex?

Arcuate arteries

Where does reabsorption occur?

Medulla

What is the inner hyperechoic portion of the kidney?

Renal sinus

What is the collecting system of the kidney and is the central portion of
the kidney, and it contains the collecting system (major and minor calyces), arteries and veins, lymphatics, fat, fibrous tissues, and part of the renal pelvis.

Renal sinus

What drains each of the medullary pyramids?

Minor calyces

True/False: There are 2-3 major calyces and each connects to several minor calyces

true

What combines to form the renal pelvis?

Major calyces

What is the upper expanded portion of the ureter located at the
hilum, posterior to blood vessels?

Renal pelvis

What is funnel-shaped transition from the major calyces to the ureter?

Renal pelvis

What is the functional unit of Kidney consisting of the renal corpuscle, proximal convoluted tubule, descending and ascending limbs of Henle’s loop, distal convoluted tubule and collecting tubules?

Nephron

What consists of glomerulus and glomerular capsule (Bowman’s capsule)?

Renal corpuscle(Malpighian body)

What surrounds the glomerulus?

Bowman’s Capsule

What consist of a the cluster of capillaries?

Glomerulus

What has an ascending and descending limb, these loops along with
their blood vessels and collecting tubes for the pyramids in the medulla?

Loop of Henle

What is farthest from the glomerulus; helps regular potassium excretion?

Distal Convoluted Tubule

What collects the filtrate?

collecting duct

What originates from the lateral aorta and is Immediately inferior to
the superior mesenteric artery (SMA)?

Main renal artery(s)

True/False: It is uncommon for individuals to have more than one renal artery arising from the aorta. Variants include more than one unilaterally or bilaterally.

false, because It is common for individuals to have more than one renal artery arising from the aorta. Variants include more than one unilaterally or bilaterally.

What enters the kidney hilum anterior to the ureter and posterior to
the renal vein?

renal artery

What is longer as it needs to pass posterior to the IVC?

right renal artery

After entering the renal hilum, the renal artery divides into five ___________ within the renal pelvis

segmental arteries

The segmental arteries branch into the __________ that course along side of the renal pyramids

interlobar arteries

The interlobar arteries arch over the base of the pyramids to form the
_____________

arcuate arteries

Branching from the arcuate arteries are the __________. These will give rise to the afferent arterioles to enter the renal glomeruli which is a component of the nephron

interlobular arteries

What is the correct order of the arteries?

• Renal artery to
• Segmental artery to
• Interlobar to
• Arcuate artery to
• Interlobular artery to
• Afferent arterioles to
• Glomerulus to
• Efferent arterioles

After passing through the glomerulus, blood exits through the
efferent arterioles to drain into the __________

interlobular veins

Paralleling the arcuate arteries, the ________ course along the base of the medullary pyramids

arcuate veins

Converging of the arcuate veins, the __________ are formed and run in between the medullar-y pyramids

interlobar veins

What is formed by the convergence of the interlobar veins, these veins will converge to form the main renal vein?

Segmental veins

What does this describe?: The renal vein exits the kidney hilum anterior to the renal artery and ureter. The left renal vein is longer passing between the abdominal aorta and the SMA on its way to confluence with the IVC.

Main renal vein

What supplies the kidneys, adrenals, and ureters?

Renal artery

What courses posterior to the IVC and anterior to the right psoas
muscle?

Right renal artery

What courses anterior to the left psoas muscle?

Left renal artery

Both renal arteries course posterior to the _______

renal veins

Renal Arteries have normal…..

Low resistance flow with low resistive index (RI)

What does increased RI >0.7 indicate?

renal dysfunction and ischemia

What an cause increased resistance in the parenchyma?

Renal dysfunction, renal arterial stenosis, renal vein thrombosis

What drains the kidneys, ureters, and adrenals?

renal veins

What courses anterior to the RRA to enter the IVC?

RRV

What originates at the renal hilum anterior to the LRA and courses between the aorta and superior mesenteric artery (SMA), then anterior to the proximal RRA to reach the IVC?

LRV

What can cause the kidney to enlarge and renal function to decrease?

Thrombosis of the renal vein

What are the functions of the kidneys?

• Kidneys remove wastes from blood and produce about 150ml of urine a day; 95% water, 5% waste
• It helps to regulate fluid levels, pH and electrolytes
• The kidneys maintain blood homeostasis. It helps to control blood concentration and volume by removing selected amounts of water and solutes

What describes the following?

– Secreted by the posterior pituitary, increases the water permeability of the collecting tubule segments (facultative reabsorption)
– Responsible for maintaining the body’s fluid balance,
– ADH secretion increases in the event of increased water loss (sweating or diarrhea) or reduced blood volume or blood pressure (hemorrhage).

Antidiuretic hormone (ADH)

What is secreted by the adrenal cortex, increases the rate of tubular resorption of sodium and produces a concurrent loss of potassium?

Aldosterone

What is secreted by the JGA, increases in response to decreased blood pressure in the afferent arteriole secondary to sodium depletion or to a change from the supine to the upright position?

Renin

What acts as a catalyst on certain plasma proteins to produce angiotensin I, which is converted to angiotensin II by proteolytic enzymes?

Renin

What increases systemic blood pressure by acting as a potent vasoconstrictor?

Angiotensin II

What is it called when fluid is forced across a membrane into the nephron; increases with increased blood pressure; decreased with kidney disease

• Glomerular Filtration

• Tubular Resorption

• Tubular Secretion

Glomerular Filtration

What is it called: while the fluid is within the renal tubules, it can be resorbed according to the body's needs; electrolytes and components of the fluid are selectively resorbed to allow for excretion of intended waste products

• Glomerular Filtration

• Tubular Resorption

• Tubular Secretion

Tubular Resorption

What is the name of the selective process of disposing of the waste products and pH regulation

• Glomerular Filtration

• Tubular Resorption

• Tubular Secretion

Tubular Secretion

What is the order of urine formation?

• Glomerular Filtration

• Tubular Resorption

• Tubular Secretion

What increases with renal failure?

• Uric Acid

• White Blood Cell Count

• Aldosterone

• Lactate Dehydrogenase

Uric Acid

What is increased with infection and decreased with chemotherapy or radiation therapy?

• Uric Acid

• White Blood Cell Count

• Aldosterone

• Lactate Dehydrogenase

White Blood Cell Count

What increases with decreased urinary output?

• Uric Acid

• White Blood Cell Count

• Aldosterone

• Lactate Dehydrogenase

Aldosterone

What increases with chronic renal disease and renal infarction?

• Uric Acid

• White Blood Cell Count

• Aldosterone

• Lactate Dehydrogenase

Lactate Dehydrogenase

What is more specific in determining renal dysfunction?

• creatinine

• blood urea nitrogen (BUN)

• hematuria

• proteinuria

creatinine

What describes the following?:

– Normal 0.6 to 1.2 mg/dL.
– A waste product produced from meat protein and normal wear and tear on the muscles in the body.
– More specific in determining renal dysfunction than BUN levels.
– Elevated in renal failure, chronic nephritis or urinary obstruction.
– Decreases in debilitation, muscle weakness or dystrophy, starvation, hyperthyroidism

creatinine

What describes the following?:

– Normal 11 to 23 mg/dL.
– Produced from the breakdown of food proteins.
– Elevated in urinary obstruction, renal dysfunction, or dehydration.
– Decreased levels associated with over hydration, pregnancy, liver failure, decrease in protein intake, and smoking.

blood urea nitrogen (BUN)

What describes the following?:

– Visible or microscopic red blood cells in the urine.
– Associated with early renal disease.

hematuria

What describes the following?:

– Abnormal amount of proteins in the urine.
– Associated with nephritis, nephrolithiasis, carcinoma, polycystic disease, hypertension, and diabetes mellitus.
– Increases risk of developing progressive renal dysfunction.

proteinuria

What is the adult kidney size?

9 to 12-cm long, 4 to 6-cm wide, and 3 to 4-cm thick

What is paired bean-shaped structures lying in a sagittal oblique plane in the retroperitoneal cavity?

kidneys