Download MBBS Anatomy PPT 3 Embryo Urinary System Notes

Intermediate Mesoderm Forms Much

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of the Urogenital System

Mesoderm in the Chick Embryo

Lateral Rotation

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Hindgut with allantois

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Hind Gut-Cloaca

Urorectal Septum

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Urorectal Septum

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Urorectal Septum

Urorectal Septal Defects and

Imperforate Anus

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Kidney Systems

Pronephric Kidney

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Collecting System Forms from the

Ureteric Bud

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The Ureteric Bud Induces the Metanephric

Blastema to Form Filtration Units

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MCQ

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When does the metanephros become
functional?
(A) At week 3 of development
(B) At week 4 of development
(C) At week 10 of development

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(D) Just before birth
(E) Just after birth

Molecular Regulation of Kidney

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Development


Renal Tumors and Defects

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? Wilms' tumor is a cancer of the kidneys that

usually affects children by 5 years of age but may

also occur in the fetus.

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? Wilms' tumor is due to mutations in the WT1

gene on 11p13, and it may be associated with

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other abnormalities and syndromes.

? For example, WAGR syndrome is characterized by

aniridia, Genitourinary abnormalities, and Wilms'

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tumor and mental retardation

? Denys-Drash syndrome consists of renal failure,

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pseudohermaphrodism, and Wilms' tumor.

Renal dysplasias and agenesis

? Multicystic dysplastic kidney in which

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numerous ducts are surrounded by

undifferentiated cells.

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? Nephrons fail to develop
? ureteric bud fails to branch,
? the collecting ducts never form.
In some cases, these defects cause involution of

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the kidneys and renal agenesis

Position of the Kidney

? The kidney, initially in the pelvic region, later shifts to a

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more cranial position in the abdomen.

This ascent of the kidney is caused by
? diminution of body curvature

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? by growth of the body in the lumbar and sacral regions
In the pelvis, the metanephros receives its arterial

supply from a pelvic branch of the aorta. During its ascent

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to the abdominal level, it is vascularized by arteries that

originate from the aorta at continuously higher levels.

The lower vessels usually degenerate, but some may

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remain.

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Kidneys Develop in the Pelvic Region

Ascent of the Kidneys

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Rotation Of Kidney


Developmental anomalies of the kidney

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A. Renal agenesis :
? Failure of one or both kidneys to develop
? Bilateral: rare, associated with other

congenital anomalies, incompatible with life

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? Unilateral: common (one in 4,000 infants,

more boys than girls) , asymptomatic;

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? Other kidney enlarges to compensate#Absent

ipsilateral renal artery

Pelvic and Horseshoe Kidneys

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Developmental Anamoly-

Fused Kidneys

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Developmental Anamoly- Disc Kidney


In congenital polycystic kidney disease

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? It may be inherited as an autosomal recessive or autosomal

dominant disorder or may be caused by other factors.

Autosomal recessive polycystic kidney disease

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? which occurs in 1/5,000 births, is a progressive disorder in

which cysts form from collecting ducts. The kidneys

become very large, and renal failure occurs in infancy or

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childhood.

In autosomal dominant polycystic kidney disease,

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cysts form from all segments of the nephron and usually do

not cause renal failure until adulthood. The autosomal

dominant disease is more common (1/500 to 1/1,000 births)

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but less progressive than the autosomal recessive disease.

Polycystic Kidney

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Recessive form: 1:5000; cysts from collecting tubules; renal failure in infancy

Dominant form: 1:500-1000: cysts from anywhere; renal failure in adulthood

Duplications of the Ureters

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Kidneys With Double Ureter


Duplication of the ureter

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? results from early splitting of the ureteric bud
? Splitting may be partial or complete, and metanephric

tissue may be divided into two parts, each with its own

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renal pelvis and ureter. More frequently, however, the two

parts have a number of lobes in common as a result of

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intermingling of collecting tubules.

? In rare cases, one ureter opens into the bladder, and the

other is ectopic, entering the vagina, urethra, or vestibule .

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This abnormality results from development of two ureteric

buds. One of the buds usually has a normal position,

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whereas the abnormal bud moves down together with the

mesonephric duct. Thus it has a low, abnormal entrance in

the bladder, urethra, vagina, or epididymal region.

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Possible Positions for Ectopic Ureters

MCQ

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During surgery for a benign cyst on the kidney, the

surgeon notes that the patient's right kidney has two

ureters and two renal pelves. This malformation is

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? (A) an abnormal division of the pronephros
? (B) an abnormal division of the

mesonephros
? (C) formation of an extra mass of intermediate

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mesoderm
? (D) a premature division of the metanephric

blastema

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? (E) a premature division of the ureteric bud
MCQ

? The transitional epithelium lining the urinary
bladder is derived from

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? (A) ectoderm
? (B) endoderm
? (C) mesoderm
? (D) endoderm and mesoderm
? (E) neural crest cells

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MCQ

The transitional epithelium lining the ureter is

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derived from
? (A) ectoderm
? (B) endoderm
? (C) mesoderm
? (D) endoderm and mesoderm

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? (E) neural crest cells

MCQ

The podocytes of Bowman's capsule are derived

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from
? (A) ectoderm
? (B) endoderm
? (C) mesoderm

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? (D) endoderm and mesoderm
? (E) neural crest cells

MCQ

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The proximal convoluted tubules of the

definitive adult kidney are derived from the
? (A) ureteric bud
? (B) metanephric vesicle

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? (C) mesonephric duct
? (D) mesonephric tubules
? (E) pronephric tubules

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Floating kidney- Dietl's Crisis

Bladder Development

Final Position of the Ureters and

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Mesonephric Duct (Vas Deferens)


Bladder Development: Incorporation

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of the Mesonephric Duct

Urachal Abnormalities

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MCQ

The trigone on the posterior wall of the urinary

bladder is formed by the

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? (A) incorporation of the lower end of the

mesonephric ducts
? (B) incorporation of the lower end of the

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pronephric ducts
? (C) incorporation of the metanephric

blastema
? (D) incorporation of the mesonephric tubules

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? (E) incorporation of the pronephric tubules


Ectopic Vesicae

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MCQ

Immediately after birth of a boy, a moist, red

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protrusion of tissue is noted just superior to his

pubic symphysis. After observation, urine drainage

is noted from the upper lateral corners of this tissue

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mass. What is the diagnosis?
? (A) Pelvic kidney
? (B) Horseshoe kidney
? (C) Polycystic disease of the kidney

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? (D) Urachal cyst
? (E) Exstrophy of the bladder

MCQ

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A urachal cyst is a remnant of the
? (A) urogenital sinus
? (B) urogenital ridge
? (C) cloaca
? (D) allantois

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? (E) mesonephric duc