KIDNEY GROSS ANATOMY

General

1. Location –

2. Size –

3. Shape –

External anatomy

1. Protective layers –

-a. Renal capsule –

-b. Adipose capsule –

-c. Renal fascia –

2. Hilus –

3. Renal sinus –

Internal anatomy

1. Renal cortex –

2. Renal medulla –

-a. Renal columns –

-b. Renal pyramids –

-c. Papilla –

-d. Collecting tubules –

-e. Lobe –

2. Pelvis –

-a. Major calyces –

-b. Minor calyces –

-c. Smooth muscle –

Blood supply

1. Arterial supply -

-a. Renal arteries –

-b. Segmental arteries –

-c. Lobar arteries –

-d. Interlobar arteries –

-e. Arcuate arteries –

-f. Interlobular arteries –

2. Venous drainage –

-a. Renal vein –

Nerve supply

1. Renal plexus –

THE NEPHRON

Nephron

1. Glomerulus –

-a. Afferent arteriole –

-b. Efferent arteriole –

2. Glomerular (Bowman’s) capsule –

-a. Visceral layer –

-b. Parietal layer –

-c. Glomerular space –

3. Renal corpuscle –

4. Filtrate –

5. Renal tubule –

-a. Proximal convoluted tubule –

-b. Loop of Henle –

-c. Distal convoluted tubule –

6. Collecting duct –

Nephron histology

1. Glomerulus –

2. Visceral layer –

-a. Podocytes –

-b. Pedicels –

-c. Filtration slits –

3. Parietal layer –

4. Proximal convoluted tubule –

-a. Microvilli –

5. Loop of Henle –

-a. Descending limb –

-b. Ascending limb –

-a. Thin segment –

-b. Thick segment –

Types of nephrons

1. Cortical nephrons –

2. Juxtamedullary nephron –

-a. Concentrated urine –

Microvasculature

1. Afferent arteriole –

2. Efferent arteriole –

3. Peritubular capillaries –

4. Vasa recta –

Juxtaglomerular apparatus

1. Juxtaglomerular apparatus –

2. Juxtaglomerular cells –

-a. Mechanoreceptors –

-b. Renin –

3. Macula densa –

4. Function –

Filtration membrane

1. Glomerular endothelium –

2. Basement membrane –

3. Visceral layer –

KIDNEY PHYSIOLOGY: URINE FORMATION

Processes of urine formation

1. Glomerular filtration –

2. Tubular reabsorption –

3. Tubular secretion -

4. Urine concentration –

Glomerular filtration: net filtration pressure

1. GBHP –

2. CHP –

3. BCOP –

4. BOP –

5. NFP –

Glomerular filtration: glomerular filtration rate

1. GFR –

2. Total surface area –

3. NFR –

a. High blood pressure –

b. Dehydration –

GFR regulation: tubuloglomerular mechanism (autoregulation)

1. Macula densa –

-a. High GFR –

-b. Low GFR –

2. JG cells –

-b. Macula densa –

-d. Renin –

GFR regulation: myogenic control (autoregulation)

1. Systemic blood pressure –

-a. Increases –

-b. Decreases –

GFR regulation: sympathetic control

1. Stress –

2. Afferent arteriole –

3. Redirects blood –

GFR regulation: renin-angiotensin mechanism

1. JG cells –

2. Renin –

3. Angiotensin II –

-a. Vasoconstriction –

-b. Efferent arterioles –

-c. Aldosterone –

-d. Thirst –

Proximal convoluted tubules: tubular reabsorption

1. Tubular reabsorption –

2. Peritubular capillaries –

3. Solvent drag –

4. Transcellular route –

5. Paracellular route –

6. Sodium –

7. Glucose –

8. Amino acids –

9. Water –

-a. obligatory water reabsorption –

10. Electrolytes –

11. Proteins –

12. Nitrogenous waste –

-a. Urea –

-b. Uric acid –

-c. Creatinine –

Proximal convoluted tubule: tubular secretion

1. Waste removal –

2. Acid-base balance –

Loop of Henle

1. Electrolyte reabsorption –

2. Water –

3. Thick segment –

4. Urine concentration –

Distal convoluted tubule and collecting duct

1. Aldosterone –

-a. Direct stimulation –

-b. Indirectly –

-c. Principle cells –

-d. Sodium –

-e. Potassium –

-f. Urine –

2. Atrial natriuretic factor –

-a. High BP –

-b. Sodium channels –

Collecting duct

1. Cortex –

2. Urine concentration –

Control of concentration

1. Collecting duct –

-a. Extracellular fluid –

-b. Medullary portion –

2. Dehydration –

-a. GFR –

-b. ADH –

3. Counter current multiplier –

-a. Descending limb –

-b. Thick segment –

-c. Inner medulla –

-d. Urea –

4. Counter current exchanger –mb

-a. Descending –

-b. Ascending –

Formation of dilute urine

1. ADH –

2. Principal cells –

Formation of concentrated urine

1. ADH –

2. Principal cells –

Renal clearance

1. Renal clearance –

2. Inulin –

3. Reabsorbed substances –

4. Secreted substances –

Urine: physical characteristics

1. Color –

-a. Urochrome –

-b. Color –

-c. Infection –

2. Odor –

3. pH –

-a. Diet –

4. Specific gravity –

Urine: chemical composition

1. Nitrogenous waste –

2. Normal constituents –

3. Minor constituents –

4. Diagnosis –

-a. Glucosuria –

-b. Proteinuria (albuminuria) –

-c. Ketonuria –

-d. Hematuria –

-e. Pyuria –

OTHER URINARY TRACT ORGANS

Ureters

1. Renal pelvis –

2. Retroperitoneal –

3. Posterior bladder wall –

4. Histology –

-a. Mucosa –

-b. Muscularis –

-c. Adventitia –

5. Peristalsis –

-a. Neural control –

-b. Smooth muscle stretch –

6. Renal calculi –

-a. Predisposition –

-b. Treatment –

Urinary bladder

1. Retroperitoneal –

2. Trigone –

3. Histology –

-a. Mucosa –

-b. Detrusor muscle –

-c. Adventitia –

4. Rugae –

5. Bladder capacity –

Urethra

1. Urethra –

2. Mucosa –

3. Internal urethral sphincter –

4. External urethral sphincter –

5. Female –

6. Male –

-a. prostatic urethra –

-b. Membranous urethra –

-c. Spongy (penile) urethra –

7. External urethral orifice –

Micturition (voiding or urination)

1. Stretch receptors –

2. Visceral reflex arc –

-a. Afferent fibers –

-b. Pelvic splanchic –

3. Voluntary control –

4. Incontinence –