HISTOLOGY

5.01 URINARY SYSTEM

REGINETTE F. VILORIA, MD | FEBRUARY 11, 2020

OUTLINE  Lining of the urinary system originate from endoderm

I. Development of Urinary B. Proximal Convoluted Tubule
System C. Loop of Henle
A. Collecting System D. Distal Convoluted Tubule
B. Excretory System and Juxtaglomerular
II. Histology of the Urinary System Apparatus
III. Blood Circulation E. Collecting Ducts
IV. Renal Function V. Ureters, Bladder, Urethra
A. Renal Corpuscle and Blood VI. Congenital Anomalies
Filtration VII. References
LEGEND
Remember Lecturer Book Previous Presentation
Trans

OBJECTIVES:
At the end of the lecture, the student should be able to:
 Enumerate the function of urinary system  FATE OF UROGENITAL SINUS – in contact with the allantois
 Discuss the histology of the kidney and the excretory passages; ureter,  Upper part – forms the urinary bladder, urachus (thick fibrous
bladder and urethra cord)
 Understand the development of the urinary system  Pelvic part – forms the prostatic and membranous urethra,
 Correlate common clinical conditions of the urinary system female urethra
 Phallic part forms the spongy part of the urethra, urethral
I. DEVELOPMENT OF URINARY SYSTEM vestibule and urethral glands (Littre’s), female urethra
 KIDNEY SYSTEMS – 3 overlapping kidney systems are formed in a
cranio-caudal sequence during intra uterine life; PRONEPHROS,
MESONEPHROS, and METANEPHROS.
 Develop at 4th week of embryonic life.
 Germ layer of origin intermediate mesoderm
 As it matures, it stops at the lumbar area

 PRONEPHROS (very 1st KIDNEY ) – Rudimentary and non-

functional
 Formed at beginning of 4th week, represented by 7-10 cell groups
in the cervical region. Atrophies at 5th week.
 These cell groups form vestigial excretory units,
nephrotomes. By the end of the fourth week all indications of the
pronephric system have disappeared.

 MESONEPHROS (2nd KIDNEY ) – May function for a short time

during the early period. Develops at 4th week
 and mesonephric ducts are derived from intermediate
mesoderm from upper thoracic to upper lumbar (L3)
segments.
 During the regression of the pronephric system early in the fourth
week, the first excretory tubules of the mesonephros appear.
 They lengthen rapidly, form an S-shaped loop, and acquire a tuft
of capillaries that will form a glomerulus at the medial extremity.
 Around the tubules form Bowman’s capsule, and together these
structures constitute a renal corpuscle.
 Laterally, the tubule enters the longitudinal collecting duct known
as the mesonephric or wolffian duct which is a part of genital
system.
 Middle of the second month, the mesonephros forms a large
ovoid organ on each side of the midline.
 The ridge formed by both organs is known as the urogenital
ridge.

 METANEPHROS (THE DEFINITIVE KIDNEY) – forms the permanent

kidney
 The third urinary organ, the metanephros or permanent kidney
appears in the 5th week.
 Excretory units develop from metanephric mesoderm same
manner as in the mesonephric system. The development of the
duct system differs from that of the other kidney system.

A. COLLECTING SYSTEM
 Collecting ducts of the permanent kidney develop from the ureteric bud,
an outgrowth of the mesonephric duct close to is entrance to the cloaca.

TRANS Manaig, Pelayo,, Torres HEAD EDITOR Tengco LO Solas 1 of 10

5.01 Urinary System LE 5 TRANS 01
 The bud penetrates the metanephric tissue, which is molded over its
distal end as a cap.
 Subsequently, the bud dilates, forming the primitive renal pelvis, and
splits into cranial and caudal portions, the future major calyces.
 Each calyx forms two new buds while penetrating the metanephric
tissue. Continue to subdivide until 12 or more generations of tubules
have formed.
 At the periphery, more tubules form until the end of the 5th month. The
tubules of the second order enlarge and absorb those of the and fourth
generations, forming the minor calyces.
 Further development, collecting tubules of the fifth and successive
generations elongate considerably and converge on the minor calyx,
forming the renal pyramid.
 The ureteric bud gives rise to:
 Ureter
 Renal pelvis
 Major and Minor calyces
 1-3 million collecting tubules.
B. EXCRETORY SYSTEM
 Each newly formed collecting tubules is covered at its distal end by a
metanephric tissue cap.
 Cells of the tissue cap form small vesicles, renal vesicles, which in turn
give rise to small S-shaped tubules.
 Capillaries grow into the pocket at one end of the S and differentiate into
glomeruli. The tubules, together with their glomeruli, form nephrons or  KIDNEYS
excretory units.  Approximately 12-cm long, 6cm wide, and 2.5cm thick. Has
 The proximal end of each nephron forms Bowman’s capsule, which is concave medial border
deeply indented by a glomerulus.  Renal hilum – where nerves enter, the ureter exits, and blood
 Continuous lengthening of the excretory tubule results in formation of and lymph vessels enter and exit.
the proximal convoluted tubule, loop of Henle, and distal  Outer renal cortex - a darker stained region with many round
convoluted tubule. corpuscles and tubule cross sections
 Upper urinary system – collecting duct, calices, renal pelvis & ureter  Inner medulla – consisting mostly with mostly of aligned linear
arise from ureter anlage (ureteric bud). tubules and ducts. Consist of 8-15 conical structures called renal
 Lower urinary system – bladder and urethra formed from the pyramids, their bases meet with the cortex at the
endoderm of the posterior intestine. corticomedullary junction.
 Renal lobe – pyramid plus the cortical tissue at its base and
 Why does potty training start at 3 years old? Because that is the only extending along at its side. Ducts and tubules extending from the
time that the kidney assumes its adult function medulla comprises the medullary rays, plus their associated
tissue are considered renal lobules.
 Hence, the kidney develops from 2 sources:  Renal papilla – tip of each pyramid, projects into minor calyx that
 1. Metanephric mesoderm (metanephric blastema) – which collect urine formed by tubules in one renal lobe.
provides excretory units  Each kidney contains 1-4 million functional unit called nephrons.
 2. Ureteric bud (metanephric diverticulum) – which gives rise to  Major divisions of each nephron:
the collecting system (ureter, renal pelvis, major and minor calyces).  Renal corpuscle – site of blood filtration, always located in the
cortex
 Urine production begins early in gestation, soon after differentiation of  Proximal tubule – located in the cortex, with a shorter straight
the glomerular capillaries, which start to form by the 10th week. (extra part that enters the medulla.
info)  Loop of Henley (or nephron loop) – in the medulla, with a thin
descending and thick ascending limb.
II. HISTOLOGY OF THE URINARY SYSTEM  Distal tubule – thick straight part ascending from the LOH back
 FUNCTIONS: into the cortex. Convoluted part completely in the cortex.
Balance between water and electrolytes  Connecting tubule – short minor part linking the nephron to
 Acid-base balance collecting ducts.
 Excretion of metabolic waste
 Excretion of bioactive substances III. BLOOD CIRCULATION
 Secretion of renin and EPO  Blood supply of the kidney: Renal artery > segmental artery >
 Activation of vitamin D interlobar artery > arcuate artery > interlobular artery > afferent
 Gluconeogenesis during starvation or prolonged fasting arteriole > glomerulus (tuft of capillaries) > efferent arterioles >
Peritubular capillaries (in the cortex)/Vasa Recta (in the medulla) >
Venules > Interlobular vein > Arcuate vein > Interlobar vein >
Segmental vein > Renal vein

HISTOLOGY
5.01 Urinary System
IV. RENAL FUNCTION: Filtration, Secretion, & Reabsorption
1. Filtration – water and solutes in the blood leave the vascular space and
enter the lumen of the nephron
2. Secretion – substances move from epithelial cells of the tubules into the
lumens, usually after uptake from the surrounding interstitium and
capillaries
3. Reabsorption – substances move from the tubular lumen across the
epithelium into the interstitium and surrounding capillaries
A. Renal Corpuscle & Blood Filtration
 At the beginning of each nephron is a renal corpuscle
 containing a tuft of glomerular capillaries, surrounded by a double-
walled epithelial capsule called the glomerular (Bowman) capsule
 Internal or Visceral Layer- closely envelops the glomerular
capillaries, which are finely fenestrated; consists of unusual
stellate epithelial cells called podocytes, which cover each
capillary, forming slit-like spaces between interdigitating
processes called pedicels. The pedicels cover much of the
capillary surface, in direct contact with the basal lamina.
 Parietal Layer- forms the surface of the capsule; consists of a
simple squamous epithelium supported by a basal lamina
 Capsular or Urinary Space- space between the two
capsular layers, which receives the fluid filtered through the
capillary wall and visceral layer
 has a vascular pole where the afferent arteriole enters and the
efferent arteriole leaves,
 has a tubular pole, where the proximal convoluted tubule (PCT)
begins; the epithelium here changes to simple cuboidal
 Between the interdigitating pedicels are elongated spaces, or
filtration slit pores
 Polyanionic GAGs in the glomerular membrane are abundant and
their negative charges, like those of the slit diaphragms, tend to
restrict filtration of organic anions.
 Filtrate is produced in the corpuscle when blood plasma is forced
under pressure through the capillary fenestrations, across the filtration
membrane or GBM surrounding the capillary, and through the filtration
slit diaphragms located between the podocyte pedicels.
 Filtration, therefore, occurs through a structure with three parts:
 The fenestrations of the capillary endothelium, which blocks
blood cells and platelets
 The thick, combined basal laminae, or GBM, which restricts large
proteins and some organic anions
 The filtration slit diaphragms between pedicels, which restrict
some small proteins and organic anions
 Mesangial cells, most of which resemble vascular pericytes in having
contractile properties and producing components of an external lamina
From 2022B
Glomerular Filtration Barrier
Components:
1. Fenestrated capillary endothelium – blocks the
entry of blood cells; erythrocytes, leukocytes, and
platelets.
2. Glomerular Basement Membrane – blocks the
entry of most large proteins and some organic anions
3. Filtration slit diaphragms between Pedicels –
HISTOLOGY
LE 5 TRANS 01
Podocytes gives rise to pedicels. Slits can be found in
between the pedicels
Glomerular Filtration Rate - 125 ml/min
 Which are not filtered? Leukocytes, Platelets,
Erythrocytes,Large and Small proteins
 Which are filtered? Water, electrolytes, amino
acids, glucose
B. Proximal Convoluted Tubule
 PCT cells are specialized for both reabsorption and secretion
 Lined by simple cuboidal epithelium with brush borders and
microvilli, which facilitates reabsorption
 cells of the proximal tubules have central nuclei and very acidophilic
cytoplasm because of the abundant mitochondria.
 Reabsorption of all organic nutrients, all proteins, most water and
electrolytes; secretion of organic anions and cations, H+, and NH4+
 Transcellular reabsorption involves both active and passive
mechanisms
 Water and certain solutes can also move passively between the cells
along osmotic gradients through leaky apical tight junctions
 Proximal tubular cells also have many long basal membrane
invaginations and lateral interdigitations with neighboring cells.
 Both the brush border and the basolateral folds contain the many
types of transmembrane proteins that mediate tubular reabsorption
and secretion
 perform hydroxylation of vitamin D and release to the capillaries.
 fibroblastic interstitial cells in cortical areas near the proximal tubules
produce erythropoietin, the growth factor secreted in response to a
prolonged decrease in local oxygen concentration
 C. Loop of Henle
 This is a U-shaped structure with a thin descending limb and a thin
ascending limb, lined by simple squamous epithelia
 The thin ascending limb of the loop becomes the thick ascending
limb (TAL), with simple cuboidal epithelium and many mitochondria
again
 involved in further adjusting the salt content of the filtrate
 Thin descending limb of the loop of henle- permeable to water
 Thin ascending limb of the loop of henle- permeable to solutes;
reabsorb sodium chloride (NaCl) but are impermeable to water.
 The countercurrent flow of the filtrate (descending, then immediately
ascending) in the two parallel thin limbs establishes a gradient of
osmolarity in the interstitium of the renal pyramids, an effect that is
“multiplied” at deeper levels in the medulla.
 Countercurrent blood flow in the descending and ascending loops of
the vasa recta helps maintain the hyperosmotic interstitium.
 interstitial osmolarity at the pyramid tips is about four times that of the
blood
D. Distal Convoluted Tubule & Juxtaglomerular Apparatus
 Juxtaglomerular Complex is composed of:
 Macula Densa
 In the distal tubule near the convoluted part
 Juxtaglomerular cells
 Modified smooth muscle cell
5.01 Urinary System LE 5 TRANS 01
 Mesangial Cells
 Extraglomerular cells/lacis

Figure 1. Kidney Cortex

Figure 1. Juxtaglomerular apparatus. Proximal Tubules (P), Distal Tubules (D) Afferent
 Difference of Distal Convoluted Tubule vs Proximal Tubules arteriole (AA), Macula Densa (MD), Juxtaglomerular granule cells (JG), Efferent arteriole
 Much less tubular reabsorption occurs here (EA)
 Simple cuboidal cells
 Differ in terms of being smaller, having no brush borders, and
more empty lumens.  Macula Densa have apical nuclei, basal Golgi complexes
 More nuclei  The smooth muscle cells in the tunica media of the afferent arteriole are
modifies as Juxtaglomerular granular cells.
 Fewer mitochondria
 Less acidophilic  More rounded nuclei
 More Rough ER
 Sparse Microvilli
 More Golgi complexes and granules with Renin
 pag tinanong ni doc sa lab, what is the lining epithelium? Tapos
sinagot simple cuboidal, tama yun o kaya sinulat mo simple cuboidal  Lacis cells can be seen at the vascular pole
with sparse/little microvilli tama pa rin kung kaya niyo isulat  Extraglomerular mesangial cells
 JGA Functions:
  arterial pressure =  glomerular capillary blood pressure that will
lead to  GFR
 Higher GFR leads to higher luminal concentrations of Na+ and Cl-
increase ion levels of the lumen trigger the release of ATP,
adenosine and others
 Contraction of the afferent arteriole
  glomerular pressure
  GFR
  Arterial pressure will stimulate JGA as a result of baroreceptor function
 Release renin
 Remember RAAS!
 Renin cleaves angiotensinogen into angiotensin I
 Angiotensin-converting enzyme (ACE) clips this further to angiotensin
II
 Potent vasoconstrictor and stimulates the secretion of aldosterone
 Aldosterone promotes Na+ and water reabsorption in the DT and
Connecting tubules
 Raises blood volume that will result to increase blood pressure

Figure 1. Distal (D) and Proximal Tubules (P) FROM 2022A TRANS
 Juxtaglomerular apparatus is constituted by 3 cell types:
 Na absorption is regulated by aldosterone
+
 Macular densa cells of DCT
 Sodium ba kayo? Kase para akong water, where sodium goes, I  Cells that become columnar & closely packed
follow (Viloria, 2020)  Lies adjacent to the vascular pole
 If the initial and straight part of the DT contacts the arterioles at the  Juxtaglomerular cells of afferent arteriole
vascular pole of the renal corpuscle. Its cells become more columnar  Smooth muscle cells of tunica media that become spherical
and closely packed, forming macula densa  Contain renin granules
 Part of the Juxtaglomerular apparatus (JGA)  Intraglomerular mesangial cells
 Utilizes feedback mechanism to regulate glomerular blood flow  Found inside the glomerulus
 Keep the rate of glomerular filtration relatively constant  For support, phagocytosis, and secretion of cytokines
 Extraglomerular mesangial cells
 Found outside the glomerulus
 In between the afferent and efferent arteriole
 Similar to those within glomerulus and surrounded by thick BL
 For support
 Lacis Cells

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01

FOR LABORATORY
 Cell Pointed: Macula Densa
Figure 1. Fluid transport in the urinary system
 Structure pointed: Distal Tubule
 Approaching the apex of each renal pyramid, several medullary
 Lining Epithelium: Simple Cuboidal
collecting ducts merge again to form papillary duct (Duct of Bellini)
 Identify: Juxtaglomerular apparatus
 Deliver urine directly into the minor calyx
 Collecting ducts lie in the area with very high interstitial osmolarity
E. Collecting Ducts  Parallel with the descending and ascending limbs of LH and vasa
 You won’t see this in the renal cortex recta
 Carries the filtrate into a collecting system that transports it to a minor  Composed of pale staining Principal cells
calyx and in which more water is reabsorbed if needed  abundant in medullary rays and medulla, cuboidal/columnar pale
 Connecting tubules will join together in the cortical medullary rays staining cells
forming the collecting ducts  Few organelles
 Simple cuboidal (Junquera)  Sparse microvilli
 Sometimes simple columnar, sometimes simple cuboidal  Unusually distinct cell boundaries
 40m  Rich in aquaporins
 Collecting ducts will merge further in the medulla, forming larger and  Sequestered in membranous cytoplasmic vesicles
straighter collecting ducts with increasingly columnar cells  Collecting ducts are the final site of water reabsorption from the
 200m filtrate.
 Antidiuretic Hormone (ADH) will be released from the posterior pituitary
gland as the body becomes dehydrated.
 Makes collecting ducts more permeable to water
 Increases the rate at which water molecules are pulled osmotically
 ADH receptors on the basolateral cell surface stimulate the
movement and insertion of vesicles with aquaporins into the apical
membranes
 High osmolarity of the interstitium draws water passively from
collecting ducts, concentrating the filtrate (Always remember water
moves from a lower osmolarity to a higher osmolarity!)
 Scattered among the principal cells are variably darker Intercalated cell
 More abundant in medullary rays
 More abundant mitochondria and projecting apical folds
 Maintain acid-base balance by secreting:
 Type A or  intercalated cells: H+
 Type B or  intercalated cells: HCO3-
Figure 1. Collecting Ducts (CD), Thick ascending limb (A), Thin descending and ascending
limbs (T), Capillaries (C), Interstitium (I)  Medullary Ray of Ferein
 Extension of the collecting system
 Found between the renal corpuscle, proximal and distal convoluted
tubules
 Composed of tubules oriented in the same direction, traveling a
straight course to or from the medulla
IV. URETERS, BLADDER, & URETHRA
 Urine is transported by the ureters from the renal pelvis to the urinary
bladder where it is stored until emptying by micturition via the urethra.
 Walls, mucosal, muscular (different with GIT; Inner longitudinal and
outer circular ) and adventitial layers of ureters are similar to calyces
and renal pelvis
 Becoming gradually thicker closer to the bladder
 Stratified urothelium or Transitional Epithelium (3 layers)
 Single layer of small basal cells resting on a very thin basement
membrane
 One to several layers of cuboidal or low columnar cells in the
intermediate region
 Large bulbous or elliptical umbrella cells in the superficial layer

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01

B. Urinary Bladder

Figure 1. Urethelium

A. Ureters
 Ureters moves urine via peristaltic contractions
 Have prominent mucosal folds when empty

FROM 2022A TRANS Figure 1. Urinary Bladder

 Tunica mucosa
 Lined by 5-6 layers of transitional epithelium that rests on lamina  Bladder have a well developed umbrella cells
propria  Greatest contact with urine
 Tunica muscularis  Apical surface consists mainly of asymmetric unit membranes
 Has inner and outer longitudinal and middle layer of smooth  Composed of lipid rafts containing uroplakins
muscles (distal end)  Uroplakins assemble into paracrystalline arrays of stiffened plaques
 Tunica serosa/adventitia  Serve as an osmotic barrier because of abundant membranous
plaques and tight junctions
 Mucosa fold extensively and individual umbrella cells decrease their
apical surface area when the bladder is empty. Has a bulbous
umbrella cells

Figure 1. Ureters. Mucosa (M), Muscularis (MU), Adventitia (A)

Figure 1. Empty Urinary Bladder

 Vesicles rejoin the apical membrane and the cells become less bulbous
as the bladder fills again

Figure 1. Ureter

Figure 1. Full Urinary Bladder

 Thickness of full bladder urothelium is half that of the empty bladder
 2-3 cell layers vs 5-7 layers (3-6 layers )
 Bladder’s lamina propria and dense irregular connective tissue of the
submucosa are highly vascularized.
 Can hold 400-600 mL of Urine (Adult)
 Urge to empty: 150-200 mL
 Muscularis have 3 poorly delineated layers called detrusor muscle
 Contract to empty the bladder
 Most distinct at neck of the bladder
 Ureters pass through the wall of the bladder obliquely

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01
 Forming a valve that prevents backflow of urine  Lined by stratified columnar and pseudostratified columnar
 All the urinary passages are covered externally by an adventitial layer, epithelium non keratinized with stratified squamous
EXCEPT the upper part of the bladder that is covered by serous epithelium distally
peritoneum

FROM 2022A TRANS

 T. Mucosa
 Lined by up to 14 cell layers of transitional epithelium that rests on
lamina propria of LCT
 T. submucosa
 Highly vascular and rich in elastic fibers
 DICT
 T. muscularis
 As inner and outer longitudinal and middle layer of smooth
muscles (detrusor muscles)
 T. serosa/adventitia
 The longitudinal muscles form sphincters at the:
 Ureterovesicular junction to prevent backflow of urine Figure 1. Penile/Spongy Urethra
 Neck of bladder to regulate urine emptying
 In women, the urethra is exclusively a urinary organ
 3-5cm long tube
 Crescentic lumen
 Lined initially with transitional epithelium which then transitions to
non-keratinized stratified squamous epithelium continuous at the skin
of labia minora

Figure 1. Neck of the bladder. Wall shows 4 layyers: the mucosa with
urothelium (U) and lamina propria (LP); the thin submucosa (S); inner, middle,
and outer layers of smooth muscle (IL, ML, and OL); and the adventitia (A)

C. Urethra Figure 1. Female Urethra

 Carries the urine from the bladder to the exterior
 Mucosa has prominent longitudinal folds
 In Males, two ducts for sperm transport during ejaculation join the
urethra at the prostate gland’ V- shaped
 Middle part of both sexes is surrounded by the external striated
muscle sphincter.
 Females are more prone to UTI because of shorter opening, di tulad sa
male na pwedeng nasa taas ung opening, nasa right, nasa left, medyo
malayo sa opening
 Pag mas madalas nagkakaUTI ang batang lalaki, baka mayroon siyang
congenital problem o pinapaaga ang circumcision.
 Pag nauhaw ka na, you are already dehydrated!

FROM 2022A TRANS

 T. Mucosa
 Transitional epithelium but changes to stratified squamous at
external urethral orifice
 Lacuna of Morgagni
 LP: LCT, Cavernous sinuses, Littre’s glands
 T. submucosa
 Has cavernous tissues spaces that are typical of erectile tissue
 T. muscularis
 Has inner and longitudinal and middle layer of smooth muscles as
in bladder but towards external urethral orifice, it acquires an
external layer of skeletal muscle called straited urethralis
Figure 1. Male Urethra
muscole
 T. serosa/adventitia
 Male urethra is longer and consists of 3 segments
 Prostathic urethra
 3-4 cm long, extends through the prostate gland and is lined by
urothelium.
 Membranous urethra
 Short segment
 Passes through an external sphincter of striated muscle
 Lined by stratified columnar and pseudostratified columnar
epithelium
 Spongy Urethra
 15cm enclosed within erectile tissue of the penis

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01
 no formation of kidneys
 Double and Ectopic Ureter
 Ectopic ureter opens anywhere except into the urinary bladder
 Males: open into the neck of the bladder or in the prostatic part of
urethra but may enter ductus deferens, prostatic utricle, seminal
glands
 Pelvic Kidney
 Failure of the kidney to ascend
 Close to each other
 May form discoid kidney
 Horseshoe Kidney
 Poles of the kidney are fused
Figure 1. Urethra  Large U-shaped kidney usually lies in the hypogastrium anterior
CONGENITAL ANOMALIES to the inferior lumbar vertebrae
 Usually produces no symptoms because its collecting system
develops normally and ureters enter the bladder

 Bladder Exstrophy
 Due to failure of abdominal wall to close during fetal
development.
 A-Malrotation  the protrusion of the posterior bladder wall to the lower abdominal
 B-Unilateral agenesis wall.
 C-Duplicated ureter (prone to frequent UTI)  more common in males.
 D-Renal ectopia (displaced)  present with incontinence, repeated UTI, and vesico-ureteric
reflux
 E-Horshoe kidney
 F-Misaligned kidney (nephroptosis)

 Congenital Cystic Kidneys

 Polycystic kidney disease
 Autosomal recessive disorder
 Both kidneys contains many hundred small Cysts, results in renal
insufficiency
 Most common large mass in the abdomen of children

REFERENCES
 Junqueira’s Basic Histology Text & Atlas 15th Edition
 Atlas of Histology with Functional Correlations 13th Edition
 Dr. Viloria’s PPT
 Upper trans 2022A and 2021B

 Renal Agenesis
 Unilateral or bilateral
 Males > females
 Left kidney is usually the one that is absent
 No symptoms because the other kidney usually undergoes
compensatory hypertrophy and performs the function of the
missing kidney

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01
c. Production of EPO
d. All of the above

Answers and Rationale

1. B. Urinary space or bowman’s space is the space between the parietal
layer and visceral layer of the glomerular capsule. It is where the
filtered blood will be going and then it eventually drains to the PCT.
2. A. Both PCT and DCT are lined by simple cuboidal epithelium, but the
PCT has well developed microvilli compared to DCT.
3. A. The thin ascending limbs are permeable to solutes but
impermeable to water. (Lifted directly from Junqs)
4. C. The type A intercalated cells secrete mainly the H + while the type B
intercalated cells will mainly excrete your Bicarbonates.
5. D. 66% of the water is reabsorbed in the PCT. As the water continue
to travel in the nephron it will be reabsorbed, the final tubule that will
reabsorb water is the collecting ducts.
6. D. Penile or the Spongy Urethra is part of the male urethra wherein
the lining epithelium is lined by stratified columnar and
pseudostratified columnar epithelium non keratinized with stratified
squamous epithelium distally. Prostate Urethra is lined by urothelium.
Guide Questions Membranous urethra is lined by stratified columnar and
1. Space between the two capsular layers, which receives the fluid pseudostratified columnar.
filtered through the capillary wall and visceral layer 7. D. Urethra originated from Metanephric mesoderm
a. Renal capsule 8. B. Usually produces no symptoms because its collecting system
b. Urinary space develops normally and ureters enter the bladder
c. Bowman's capsule 9. B. Pronephros is rudimentary and non-functional
d. Nota 10. D. All are functions of the kidney
2. Lined by simple cuboidal epithelium with brush borders and
microvilli, which facilitates reabsorption
a. PCT
b. LH
c. DCT
d. CT
3. Permeable to solutes; reabsorb sodium chloride (NaCl) but are
impermeable to water.
A. Thin ascending loop of henle
B. Thin descending loop of henle
C. Thick ascending loop of henle
D. Thick descending loop of henle
4. It is the main secretory cell of HCO3
a. Principal Cell
b. Type A Intercalated Cell
c. Type B Intercalated Cell
d. Interstitium Cell
5. It is the final site of water reabsorption
a. Proximal Convoluted Tubules
b. Loop of Henle
c. Distal Convoluted Tubule
d. Collecting Ducts
6. It is a part of the male urethra wherein the lining epithelium is lined by
stratified columnar and pseudostratified columnar epithelium non
keratinized with stratified squamous epithelium distally.
a. Membranous Urethra
b. Bulbous Urethra
c. Prostathic Urethra
d. Penile Urethra
7. All originates from ureteric bud EXCEPT:
a. Ureter
b. Renal Pelvis
c. Major and Minor calyces
d. Urethra
8. Which of the following anomalies produces no symptoms
a. Bladder exstrophy
b. Horseshoe kidney
c. Congenital cystic kidneys
9. Which of the following stages is non-functional
a. Metanephros
b. Pronephros
c. Mesonephros
d. None of the above
10. Function of the kidneys
a. Activation of Vit. D
b. Excretion of metabolic waste
APPENDIX

HISTOLOGY
5.01 Urinary System LE 5 TRANS 01

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HISTOLOGY