MindMap Gallery kidney(3)
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kidney
Location
Located on both sides of the renal column, in the retroperitoneal space, it is an extraperitoneal organ
Left kidney: between the lower edge of the 11th thoracic vertebra and the 2nd-3rd lumbar intervertebral disc
Right kidney: between the upper edge of the 12th vertebral body and the upper edge of the 3rd lumbar vertebral body
Renal hilum: approximately at the level of the first lumbar vertebra
Renal area: The body surface projection of the renal hilum is located at the angle between the lateral edge of the erector spinae muscle and the 12th rib.
form
Substantial star: one on the left and one on the posterior abdominal wall, in the form of broad beans
inner edge
Renal hilum: The place where the blood vessels, nerves, lymphatic vessels and renal pelvis of the kidney enter and leave.
outer edge
Front: raised
Back: relatively flat, close to the posterior abdominal wall
Upper end: wide and thin
Lower end: narrow and thick
structure
renal parenchyma
nephron
renal corpuscle
glomerulus
glomerular filtration
Glomerular filtration: When blood flows through the glomerular capillaries, Except for protein, all other components in plasma can be filtered Enters the renal cyst cavity to generate ultrafiltrate
Glomerular filtration rate: two kidneys per unit time (per minute) The amount of ultrafiltrate produced
Filtration fraction: the ratio of glomerular filtration rate to renal plasma flow
Glomerular effective rate overpressure: forces and countermeasures to promote ultrafiltration The difference between the resistance of ultrafiltration
Determining factors
Glomerular capillary hydrostatic pressure promotes Intracapsular pressure of the kidney against Plasma colloid osmotic pressure in glomerular capillaries antagonism Colloidal osmotic pressure of intrarenal capsule fluid promotes
Factors affecting glomerular filtration
glomerular capillary filtration coefficient
Effective filtration pressure
glomerular capillary pressure intracystic pressure blood colloid osmotic pressure
renal plasma flow
renal capsule
renal tubules
divided into
proximal tubule
proximal tubule
proximal straight tubule
Thin section: The tube diameter is thin and the tube lumen is small, which is conducive to the passage of water and ions.
distal tubule
distal tubule
distal straight tubule
Substance transport function of glomerulus and collecting duct
Passive transport: diffusion, osmosis, facilitated diffusion, and solvent drag
active transport
Primary: proton pump, sodium pump, calcium pump
Secondary: including syn-post-retrograde transport
reabsorption secretion
Na
Proximal tubule/front half (active transport) \Second half (passive transfer)
Medullary loop/ascending limb segment-passive dissimilation and diffusion \Thick segment of ascending branch-Na, K, 2Cl-symporter active reabsorption
Distal tubule-Na-Cl-symporter
Cl: In the thick ascending branch of the medullary loop, it is actively reabsorbed by Na, K, 2CI-symporters, and other parts are passively reabsorbed.
water (osmotic pressure)
proximal tubule-isotonic reabsorption Distal tubule and collecting duct - non-isotonic, regulated by antidiuretic hormone
HCO3-: reabsorbed as CO2 in the proximal ostium
Secretion of H: proximal tubules, distal tubules, and collecting ducts can all secrete
K: 65%~70% is reabsorbed in the proximal tubule, 25%~30% is reabsorbed in the medullary loop
Ca: 70% in the proximal tubule, 20% in the medullary loop, 9% in the distal tubule and collecting duct, less than 1% is excreted
Glucose and amino acids
Proximal tubule: 100% glucose reabsorption, secondary active transport
renal glucose threshold
The maximum capacity of the proximal tubule to absorb glucose
Normal value: 180mg/100ml Maximum transfer rate: 300mg/100ml
Urea
The proximal tubule can absorb 40% to 50% of the urinary toxins filtered by the glomerulus
The influence of small blood vessels on urea osmotic gradient
Influencing factors
Concentration of solute in tubular fluid
glomerular-collecting duct balance
collecting tube
arcuate collecting tube
Straight collecting duct: The diameter of the tube changes from thin to thick, and the epithelium of the tube wall gradually changes from a single layer of cuboidal epithelium to a single layer of columnar epithelium, until the papillary duct becomes a tall columnar epithelium.
nipple duct
renal interstitium
Fibroblasts in the medulla, also called lipid-laden interstitial cells, can synthesize fibers and matrix in the interstitium and produce prostaglandins.
parabulbar complex
Location: Vascular Pole
composition
Juxtaglomerular cells: eh, eh, transformation of carnosacral arteriole cells, large cells, cuboidal round nuclei, weakly basophilic cytoplasm, secretory granules containing renin
Macula densa: epithelial transformed cells in the distal tubule are tightly arranged in columns, the basement membrane is incomplete, and Na changes are felt.
Extrabulbar mesangium
filter membrane
The inner layer is capillary endothelial cells. There are many small holes with a diameter of 70~90nm on the cells, called fenestrae.
The middle becomes the capillary basement membrane, containing components such as type IV collagen, laminin and proteoglycan, and is negatively charged.
The outer layer is the renal capsule epithelial cells with foot processes, also known as podocytes
adjacent to
left kidney
Anterior upper part: adjacent to the back of the fundus of the stomach
Anterior middle part: in contact with the pancreatic tail and splenic vessels
Anterior lower part: adjacent to the jejunum and left curve of the colon
right kidney
Anterior and upper part: adjacent to the liver
Anterior and lower part: in contact with the right flexure of the colon
Inner edge side: adjacent to the descending part of the duodenum
behind both kidneys
Upper 1/3: adjacent to the diaphragm
Lower part: from inside to outside: adjacent to the psoas major, quadratus lumborum and transversus abdominis muscles
Kidney capsule (dense connective tissue)
fibrous capsule
fat sac
renal fascia
Characteristics and characteristics of renal blood flow
Renal blood flow: the blood flow flowing through both kidneys in normal adults under resting conditions
Regulation of renal flow
Autoregulation: Without the influence of external nerves and body fluids, when arterial blood pressure is at a constant The phenomenon that renal blood flow can remain constant when it changes within a certain range
Nervous and humoral regulation
Adjustment by other factors
Renal segmental arteries and renal segments
Renal artery: divides into two branches at the renal hilum, namely the anterior branch and the posterior branch
Segmental renal arteries: The five branches of the renal arteries are distributed segmentally in the kidney.
Renal segment: Each renal segment artery distributes to a certain area of renal parenchyma.
Other functions of the kidneys
Can synthesize prostaglandins, erythropoietin, and has the renin-angiotensin system
Medullary loop (single flat)