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Renal anatomy, Cerebral Cortex and Brain Stem
The external urethral…
Renal anatomy
Histology
Kidney
- Renal corpuscles
- Renal Glomeruli
- Bowman's capsules
- Bowman's space
- Renal tubules
Ureter
- Lumen
- Transitional epithelium
- Lamina propria
- Smooth muscle
- Aventitia
Urinary bladder
- Transitional epithelium
- Lamina propria
- Detrusor muscle
Imaging
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KUB Film
- Imaging kidney, urethra, and bladder at one go (KUB)
- IV Pyelography
- Plain abdominal x-ray
- Inject IV contrast medium
- X ray after 5 min
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To describe the location, relations and blood supply of kidneys.
Kidneys
- One on each side of the midline
- Suprarenal glands superiorly
- Long axis, from superior to inferior
- Positioned just lateral to psoas major
- Para vertebrae gutter on left and right.
- Kidneys are located slightly higher up from here.
- Within the costal margin and mostly covered by rib cage
Surface mapping
- Kidneys are retroperitoneal organs
- Right kidney slightly lower than left, because of liver placement
- Reference to vertebrae (green on notes)
- Two vertical lines 5 and 11cm
- Two horizontal upper part of T12 horizontal and L3
- Kidneys placed within the rectangle.
- Left kidney is from T12 to L2.
- Right kidney is from L1 to L3.
- Purple line in notes is the pleural cavity. Cannot poke into here for extraction
Relations and Coverings (posterior)
- Right side of kidney is the Inferior Vena Cava.
- Medial aspect is the hilum
- Renal capsule surrounds the kidney
- Perinephric fat after the renal capsule. Followed by...
- Paranephric fat (more obese people have this)
- Renal fascia
- Goes underneath the diaphragm
- Kidneys move during inspiration and expiration, so coverings help keep kidneys in position.
- Posteriorly abdominal wall are related to the posterior surface of kidney.
- Iliac fossa is posterior to kidney.
Anterior relations
Right
- Suprarenal gland
- Liver
- Right kidney casts an impression on visceral surface of liver
- Descending part of duodenum on medial side.
- Right colic flexure on lateral side
- Small intestine inferiorly
Left
- Suprarenal gland
- Lesser sac of the stomach
- Spleen
- Body of pancreas
- Left colic flexure on lateral side
- Descending colon
- Jejunum
Sectional Anatomy
- Renal cortex. Projections into the insides are...
- Renal columns. Separated by
- Renal pyramids. End up in conical tips called
- Renal papilla. Opens into receptacle called
- Minor calyx. Merging into a
- Major calyx. Several major calyxes joins and form
- Renal pelvis. Can hold 5ml of urine. Goes into the
- Ureter
- The above is called the collecting system of the kidneys
- The renal sinus is filled with fat
Blood supply
- Supplied by renal arteries
- Branched from abdominal aorta from around L1 and L2
- Emerge almost in right angles
- Arteries go into hilum of kidney
- Renal vein is anterior of renal artery
- Arteries go into upper and lower pole
- Lateral and medial border
- Anterior to Renal pelvis
- Branches to segmental artery within kidney
To correlate the structural features of the nephron with the functional significance of its various segments.
Renal corpuscle
- Part of the Nephron
- Significantly, Bowman's capsule, which leads to proximal convoluted tubule
- Within the Bowman's capsule
- Afferent arteriole breaks up into
- Glomerulus. Its thin lining of epithelial cells is called
- Pedicels
- Podocytes is continuous with the parietal layer. In between the visceral and parietal layer is the
- Capsular space. Receives the filtered blood through the podocyte. This is then exit to proximal convoluted tubule.
Proximal Convoluted Tubule
- Has abundant microvilli and cuboidal cells
- Has mitochondria to provide energy for nephron segment
- Reabsorbing actively. Water and electrolytes
- Located in renal cortex
PCT narrows down to the medullary pyramids and goes into a loop called
- Loop of Henle, which has
- Squamous cells
The ascending limb is thicker, and has...
- Cuboidal cells
- Proceeds on to the Distal Convoluted Tubule
Distal Convoluted Tubule
- Has Cuboidal cells, and no microvilli
Collecting Duct
- Has Principal cells
- Connected to other nephrons
Papilla and minor calyx. Just before the collecting duct ends are the
- Columnar cells, which transit to
- Transitional epithelium
Juxtaglomerular Apparatus (JGA)
- Macular densa cells
- Afferent arteriole modified to perform secretory role. Secretes
- Lacis (mesangial) cells outside the capillary, but between the DCT and arterioles
- Produces concentrated urine
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Cortical Nephron (85%)
- Found in the renal cortex
Juxtamedullary nephron (15%)
- Loops are very long as it dips into the renal pyramid
- Vasa recta are found here, found in their Loop of Henle
Podocytes are found lining the Bowman's capsules in the nephrons of the kidney. The foot processes known as pedicels that extend from the podocytes wrap themselves around the capillaries of the glomerulus to form the filtration slits.
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To describe the location and blood supply of the suprarenal glands, and correlate their parts with their secretions
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Cerebral Cortex and Brain Stem
- The external urethral sphincter though, gives "permission" for urine to be voided. Signal is also from the cerebral cortex
- Upon right time, the cerebral cortex tells the sphincter to relax via spine and the pudendal nerve
- 500ml seems to be max volume.
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