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Unformatted text preview: Pathology II Kidneys are retroperitoneal at around the level of T 12. Right is a little lower; Kidney has a capsule (containing nociceptors) around it. It is painful when it becomes distended if the kidney is inflamed. Dorsal lumbar pain, it consists of the (parenchyma) cortex and the medulla (pyramids). The cortex has the glomeruli. The kidney is a structurally complex organ that has evolved to serve a number of important functions: Excretion of the waste products of metabolism Regulation of the body's concentration of water and salt Maintenance of appropriate acid balance of plasma Secretion of some hormones: rennin - regulation of blood pressure in body, erythropoietin - to promote formation and production of red blood cell, and prostaglandins - formation of various hormones and neurotransmitters, mediators of inflammation The kidney may be divided into four compartments: in the parenchyma Glomeruli, in cortex, filtration of blood (juxtaglomeruli cell) control of BP -> rennin Channels- collecting system- tubules (pyramids of the medulla) Interstitial tissues (stroma) Vessels of the kidney 1. Usually kidney disorders start in one compartment (primary) and then it develops into all the compartments <glomeruli> (immunologically mediated). 2. The compartments are vulnerable to different causes of injury. Glomeruli problem is usually immunopathological. Pathology of the tubules and interstitial tissues is due to bacterial infection by toxins. Glomerulonephritis ( kidney inflammation )- pathology of the glomeruli (immunologically mediated). Inside the glomeruluss are arterioles. The arteriole that enters the glomerulus is the afferent arteriole and the blood leaves via the efferent arteriole. Blood flows into Bowman's capsule then into the tubules. From inside to outside the arterioles are lined with endothelial cells. They have holes called pseudo fenestration. The membrane is the glomerular basement membrane (GBM) and it is on top of the endothelial and on top are visceral epithelial cells (AKA: podocytes), and is the most innermost layer. Once in the Bowman's capsule, the cells that line them are called parietal epithelial cells. Juxtaglomerular cells are located near the (at the beginning) afferent arteriole and they control the BP in the arterioles and GFR Because blood will only diffuse out at optimum BP. If BP drops, it leads to the secretion of Renin, which raises BP. Pathogenic Mechanisms of Glomerulonephritis: Immune complex deposition - classic type III hypersensitivity reaction- it takes place only in the circulation, 1 outside the kidney. There is an appearance of antigens in the bloodoutside the kidney....
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This note was uploaded on 11/23/2011 for the course PATH 2542 taught by Professor Markamos during the Winter '11 term at Life Chiropractic College West.
- Winter '11