Overview Kidney development progresses in a cranial to caudal direction intermediate mesoderm → urogenital ridge → nephrogenic cord → urinary system Pronephros non-functional appears by week 4 degenerates by week 5 Mesonephros development induced by pronephric duct forms mesonephric duct (Wolffian duct) interim kidney for 1st trimester opens into urogenital system and gives rise to male genital system Metanephros develops from mesonephric outgrowth called ureteric bud during week 5 fully canalized and functioning at week 10 nephrogenesis continues through 32 - 36 weeks of gestation derivatives include ureteric bud develops into ureter pelvises calyces and collecting ducts aberrant development may result in congenital malformations of the lower urinary tract metanephric mesenchyme interaction with ureteric bud causes metranephric mesenchyme to differentiate the renal structures from collecting tubules to glomerulus abnormal interaction with ureteric bud may cause malformations Ureteropelvic junction with kidney canalizes last most common site of obstruction in fetus which results in hydronephrosis Adult kidney embryo grows faster caudally causing a change in location of the kidney from S1 - S2 to a final position of T12 - L3 Developmental Abnormalities Renal agenesis failure of ureteric buds to form → no kidney formation Potter's Syndrome bilateral renal agenesis → oligohydramnios → fetal compression resulting in limb deformities clubbed feet facial deformities pulmonary hypoplasia Horseshoe kidney fusion of inferior poles of kidneys ascension of kidney is prevented by the inferior mesenteric artery fused kidneys remain low in abdomen and may cause other renal vascular anomalies. normal kidney function
QUESTIONS 1 of 9 1 2 3 4 5 6 7 8 9 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.EB.14.70) A child is born by routine delivery and quickly develops respiratory distress. He is noted to have epicanthal folds, low-set ears that are pressed against his head, widely set eyes, a broad, flat nose, clubbed fleet, and a receding chin. The mother had one prenatal visit, at which time the routine ultrasound revealed an amniotic fluid index of 3 cm. What is the most likely underlying cause of this patient's condition? QID: 106475 Type & Select Correct Answer 1 An extra 18th chromosome 23% (54/237) 2 Bilateral renal agenesis 57% (134/237) 3 Autosomal recessive polycystic kidney disease (ARPKD) 10% (23/237) 4 Unilateral renal agenesis 5% (12/237) 5 A microdeletion in chromosome 22 4% (10/237) M 1 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (M1.EB.14.26) At a 20-week screening ultrasound of a 31-year-old G1P0 woman, the technician finds bilateral renal aplasia (Figure A). While discussing the findings with the expectant parents, the physician notes that this condition leads to which of the following? QID: 101920 FIGURES: A Type & Select Correct Answer 1 Polyhydramnios 14% (5/37) 2 Intraventricular hemorrhage 0% (0/37) 3 Pulmonary hypoplasia 78% (29/37) 4 Ventricular septal defect 5% (2/37) 5 Malrotation of the midgut 0% (0/37) M 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.EB.12.9) A 28-year-old pregnant female presents for a prenatal check-up at 20 weeks gestation, which includes routine screening ultrasound. Fetal ultrasound demonstrates bilateral multicystic dysplastic kidneys. Her pregnancy has been complicated by persistent oligohydramnios. The child requires significant pulmonary support upon delivery. Which of the following clinical findings is most likely present in this child as a result of these abnormalities? QID: 101903 Type & Select Correct Answer 1 Urachal fistula 12% (37/300) 2 Esophageal atresia 17% (52/300) 3 Spina bifida occulta 3% (10/300) 4 Clubbed feet 61% (183/300) 5 Macrosomia 5% (15/300) M 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (M1.EB.12.40) A 27-year-old female in her 20th week of pregnancy presents for a routine fetal ultrasound screening. An abnormality of the right fetal kidney is detected. It is determined that the right ureteropelvic junction has failed to recanalize. Which of the following findings is most likely to be seen on fetal ultrasound: QID: 101934 Type & Select Correct Answer 1 Bilateral renal agenesis 2% (2/83) 2 Unilateral hydronephrosis 77% (64/83) 3 Renal cysts 6% (5/83) 4 Pelvic kidney 1% (1/83) 5 Duplicated ureter 7% (6/83) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic
All Videos (4) Login to View Community Videos Login to View Community Videos The development of the urinary tract Luigi Bonini Embryology - Kidney Embryology D 4/5/2016 141 views 5.0 (3) Login to View Community Videos Login to View Community Videos Kindey Embryology - Metanephros Keshav Mudgal Embryology - Kidney Embryology D 9/3/2015 65 views 4.8 (4) Login to View Community Videos Login to View Community Videos Kindey Embryology - Mesonephros Keshav Mudgal Embryology - Kidney Embryology D 9/3/2015 54 views 5.0 (1) Embryology | Kidney Embryology Embryology - Kidney Embryology Listen Now 16:19 min 3/30/2021 17 plays 4.0 (1) See More See Less