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Embryology of the Renal System

Embryology of the Renal System

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Published by: Std Dlshsi on Dec 11, 2010
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11/23/2012

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P a g e
 
------------------------------------------------
------------------------------------------------
 
Recap: What is…..?
 
BELLINI – collecting ducts (of Bellini)
o
 
Ductules inside the renal pyramids
 
BERTIN – renal columns (of Bertin)
o
 
Parenchyma of the kidney from the cortexthat extends into the medulla between tworenal pyramids
 
MALPHIGI/MALPHIGIAN – corpuscles
o
 
Renal pyramids themselves
 
GEROTA’S – fascia
o
 
Outside the
peri 
renal fat/fascia(ANTERIORLY)
 
ZUCKERKANDL’S – fascia
o
 
Homologue of Gerota’s but POSTERIORLY 
 
TOLDT’S – fascia
o
 
Anterior perpendicular membrane of thekidney
o
 
Accdg to the web, it is continuous with theLIG. OF TREITZ
o
 
Treitz
Toldt’s
splenorenal lig. (differentnames but only one membrane)
 
WAGR Syndrome
o
 
Wilm’s Tumor
o
 
Aniridia (congenital absence of, orincomplete formation of iris)
o
 
Genital anomalies
 
big clitoris
 
small penis
 
widely - spaced scrotum (likelabia)
 
nonrugal formation of thescrotum (very shiny scrotum –sign of prematurity) diba boys?(normally the scrotum has rugalfolds
DARTO’S FASCIA)
o
 
Renal failure (but could also be mentalretardation[mild to moderate])
o
 
Most of the time, WAGR patients areobese, hence WAGRO SYNDRYOME(wherein the O stands for OBESE).
 
That’s why you have to changeyour diagnosis - of an initiallyWAGR patient that becomesobese – to WAGRO
 
VACTERL-H+H
o
 
Vertebral anomalies
o
 
Anal atresia
o
 
Cardiac anomalies
o
 
Tracheoesophageal fistula
o
 
Radial or Renal defect
o
 
Limb defect (either radius or
o
 
thumb)
o
 
Hydrocephaly/-us
o
 
Hypothyroidism
 
DENYS – DRASH SYNDROME
o
 
Renal failure (problem with mesangium)
o
 
Wilm’s tumor
o
 
Pseudohermaphrodism (FALSE)
 
Female pseudohermaphrodism
 
Presence of both externalgenitalia with ovaries
 
i.e. both penis andclitoris and uponultrasonography, pair of ovaries!
 
TRUE HERMAPHRODITE – bothpairs of the gonads are present(both testes and ovaries) andboth external genitalia. (GUIDE isthe INTERNAL GENITALIA)
 
TOWNES-BROCK SYNDROME
o
 
Branchio-oto-renal syndrome
 
Ear problem (oto/otic)
 
Renal - kidney problem
 
Branchio – facies (face) problem(branchial cleft)
o
 
Anal cap imperforation
o
 
i.e. polycystic kidney disease +anotia/microtia + imperforate anus +polydactyly
o
 
2° to GDNF and SALL1 gene mutation(due to close proximity of these genes)
 
EAGLE-BARRET-FRÖLICH-OBRINSKY SYNDROME
o
 
Second longest named syndrome in theworld.
o
 
Also termed as the PRUNE BELLY syndrome
o
 
Triad:
 
Absence of rectus abdominis
 
Dilatation of the urinary tract
 
Undescended testis------------------------------------------------
------------------------------------------------
 UROGENITAL SYSTEM
 
Functionally, can be divided into:
 
o
 
Urinary System
 
o
 
Genital or Reproductive System
 
 
Anatomically and embryologically, these two areintimately interwoven.
 
o
 
Both develop from the same mesoderm,the INTERMEDIATE MESODERM.
 
Mesoderm between the somatic(will become the parietalperitoneum) and the somitic (ispart of paraxial [somitomeric{backbone, ribs, all the musclesof the back} and the somatic])
 
Mesoderm between the futureparietal peritoneum and themuscles of the back = kidney ispositioned RETROPERITONEALLY 
 
o
 
Both of their excretory ducts drain into thecloaca.
URINARY SYSTEM
o
 
21
st
and 25
th
day embryo, all colored whiteis extraembryonic cavity
 
SUBJECT:
 
EMBRYOLOGY 
 TOPIC:
RENAL SYSTEM DEVELOPMENT
LECTURER:
DR. JOSE ANTONIO AMISTAD
DATE:
NOVEMBER 18, 2010
 
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P a g e
 
o
 
Intraembryonic cavity, remember thatthere is incorporation of the yolk sacinside to become the gut
 
 
This will be closed ventrally toform the abdominal cavity. Sothat somatic will become theparietal.
 
o
 
On the lateral sides of the notochord willbecome the muscles and bones of theback (somites), hence called SOMITIC.
 
o
 
Between the somitic and somatic is theintermediate mesoderm, hence, back of the parietal
 
o
 
Lateral view of the 21
st
and 25
th
dayembryo
 
 
There is the presence of the threekidney systems:
 
On the cervical region isthe PRONEPHROS.
 
 
On the upper thoracic tothe lower thoracic is theMESONEPHROS.
 
 
Adult type located on thepelvic region is theMETANEPHROS.
 
They are slightly overlapping in appearance, meaning before the mesonephros starts to appear, all the cranialones will undergo degeneration. So they are not present atthe same time.
Kidney SystemBasic FunctionalUnitDescriptionPRONEPHROS
NephrotomeNon-functional
MESONEPHROS
Renal corpuscleFunctional,but for avery shorttime
METANEPHROS
Nephron Adult type
PRONEPHROS
 
Composed of 7-10 cell groups in segmentalarrangement on the lateral sides of the neck(cervical).
 
It is very vestigial (rudimentary), sometimes mostanatomists do not appreciate this as an organ.
 
It will begin to appear during the first days of 4
th
 week AOG and all indication of nephrotome willundergo degeneration at the end of 4
th
week.
 
For one week, though it is equipped with twoglomeruli and one nephric tubule, it is still notfunctional.
 
Again, it is composed of two glomeruli that deeplyindent the Bowman’s capsule. It is well-equippedwith two glomeruli (coming from the dorsal aortae)and one nephric tubule but non-functional.* It is only functional among fishes.
MESONEPHROS
 
Extends from the upper thoracic to the lowerlumbar (accdg. to Mosby, T3 – L3).
 
The largest ovoid mass (or organ) on the posteriorabdominal wall during 6
th
to 8
th
week (stillretroperitoneal).
 
It has an excretory tubule which is a S – shapedloop.
 
Renal corpuscle is composed of the S-shapednephric tubule + ONLY ONE glomerulus.------------------------------------------------
------------------------------------------------
 
PHYSIOLOGIC HERNIATIONAside from the hematopoietic function of the liver, theelongation of the jejunum and ileum, and the fact that theabdominal cavity per se cannot contain all the enlarging organs, presence and enlargement of the mesonephros isone of the factors that lead to the physiologic herniationduring the 6
th
– 8
th
week.------------------------------------------------
------------------------------------------------
 
 
At first it is a solid organ, but eventually, during 7
th
 -8
th
week it undergoes segmentation. These S-shaped looped nephric (excretory) tubules iscomposed of Bowman’s capsule (which will beindented with glomerulus) and an S-shaped loop.
 
On the lateral side of the segmented mesonephrosis the MESONEPHRIC DUCT. All the newly producedurine of the mesonephros will be collected bythese ducts.
 
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P a g e
 
 
WOLFFIAN DUCT – other term for mesonephricduct.
 
This is an oblique lateral view of the abdominalpart of the embryo. The gut tube is suspended bythe dorsal mesentery. On the lateral side of thedorsal mesentery is the GONAD). If female: OVARY ::male: TESTIS
 
The mesonephros will begin to appear during the3
rd
day of the 4
th
week and will start to degenerateduring the 8
th
week along with the degeneration of the mesonephric duct.
 
But, among males, the mesonephric duct willbecome the ductuli efferentes (epigenital ductule),epididymis, paradidymis, vas deferens, seminalvesicle and ejaculatory duct [these are termed asthe derivatives of the said duct]. But because of the absecnce of the Y chromosome in genotypicallyfemale embryos, it undergoes degeneration.
 
On the lateral-most part of this genitourinary ridgeis the PARAMESONEPHROS.
 
The paramesonephric duct (MÜLLERIAN DUCT) isnon-functional among males because it willbecome the fallopian tubes, uterus and upper 1/3of the vagina.
 
On the caudal-most part of the mesonephric duct,near the cloaca, is the outgrowth of the URETERICBUD (from mesonephric mesoderm) thatpenetrates the metanephros. The ureteric bud, asits name implies, will become the ureter.
 
During the mid-2
nd
month or the 6
th
week, themesonephros achieves its largest size. And by theend of the 2
nd
month or 8
th
week, it will undergodegeneration. All signs of mesonephros willundergo apoptosis.
METANEPHROS
 
3
rd
or permanent or definitive type of kidney beginsto appear at 5
th
week AOG until adulthood. It justso happened that the metanephros appeared inthe pelvic region.
 
Metanephric tissue is also termed as BLASTEMA
 
The metanephric system is composed of twosystems:
COLLECTING DUCT SYSTEM
 
The collecting duct develops from theureteric bud that outgrows from the distal-most part of the Wolffian, near the cloaca.
 
That ureteric bud penetrates the blastemaand some blastemal tissue will mold overthe distal part of this kidney because thatmetanephric cap will give induction forbranching.
 
The first part is to dilate this distal part.This dilatation will become the RENALPELVIS.
 
Further induction will split this dilatedportion into a cranial and a caudal one,the MAJOR CALYCES.
 
Further induction will split these majorcalyces into another set of collecting ducts,the MINOR CALYCES (3
rd
generation).
 
Will continue up to 12 generations until itforms the Bellini (the smallest ductules of the collecting system).
 
The collection of Bellini’s will form therenal pyramid of Malphigi.
 
Those parts without Bellini are calledBertin. Between two pyramids of Malphigiare the columns of Bertin.
 
The endpoint of Bellini’s formation is therenal cortex. Once the distal-most Bellinireaches the cortex, it will stop branching (Mosby). But accdg. to Langman’s,definitely at the start of 5
th
month AOG, nomore Bellini will be formed.
 
The urerter, renal pelvis, major and minorcalyces + one million to three millioncollecting tubules of Bellini’s anlage is theureteric bud.
EXCRETORY DUCT SYSTEM
o
 
This is the system that forms the functional unit of the metanephros, the nephron (glomerulus +bowman’s capsule + thick and thin ascending anddescending parts).
o
 
Metanephric cap handles the induction of theureteric bud. This cap (mesenchyme) mustundergo epithelialization. So from a mesenchyme,it forms a RENAL VESICLE.

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