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DEVELOPMENT OF THE KIDNEY-HUMAN EMBRYOLOGY- DR ROSE JOSE — Transcript

by LIFE IN THE WOMB DR ROSE · 2,528 words · 378 segments · language en · Watch on YouTube

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0:09[music]
0:23Let's discuss the development of kidney
0:25uh uh in this session. So in this
0:27session we'll be seeing uh the
0:29development of kidney in detail along
0:31with the anomalies of kidney. So before
0:34coming into the development of kidney uh
0:35in the last session we have already seen
0:37the development of intrambbriionic
0:39misodm. So just we'll have a recap on
0:42the intrambionic misoderm. So the
0:44intrambbriionic misoderm is actually
0:46subdivided into paraxial misodm, the
0:49intermediate misodm and the lateral
0:51plate misodm. The three derivatives of
0:52the intra embriionic misoderm out of
0:55which the intermediate misoderm which is
0:57lying between the paraxial and lateral
0:59plate misodorm is actually developing
1:02into a cord known as nephroenic cord and
1:05it is from the nephroenic cord we have
1:07the development of kidney. So when we
1:09talk about the development of kidney it
1:11is actually uh undergoing three phases
1:14of development according to the
1:15evolution. So when we talk about
1:17evolution uh the fishes the fishes were
1:20having kidney developed from the pronos.
1:26Then the higher vertebbrates including
1:29anamniots were having kidney developed
1:32from mispheros
1:35and the vertebrae including human beings
1:39are developing from metanphos. The
1:41kidney of human beings including the
1:44amniots are developing from the metanu.
1:47So what is happening is all these three
1:49stages are seen in human kidney during
1:53the developmental phases of human
1:55kidney. So first let's see where the
1:57pro- nepheos is seated where the miso is
2:00seated and where the metanros is seated.
2:02So all these three parts are actually uh
2:06derived from the nephroenic cord of the
2:08intra embriionic misodum. The proniferos
2:11is seen actually in the cervical region.
2:14So pronos is seen in the cervical
2:16region. Misoliferose is seen in the
2:18thoracco lumbar region and the metanros
2:22is seen in the sacral region. So these
2:26are the three segments derived from the
2:28nephroenic cord and proliferos is
2:31actually seen during the early period of
2:34development of kidney and as soon as it
2:36is formed it just degenerates. That is
2:39what is going to happen for the
2:40proniferus. So as the pronifer develops
2:43we can see that several duct tules
2:45develop from the proniferus and a major
2:47duct is developed from the proniferose
2:50which is getting connected to a
2:52dilotation known as cloaka. So let's see
2:55what is a cloaka. Clloraca we have
2:58already seen that the distal part of the
3:00gut the dilated end of the distal part
3:03of the gut is known as cloaka. And cloa
3:06is actually uh divided into two parts.
3:09One is the primitive rectum and this is
3:13called the eurogenital sinus. primitive
3:17rectum and the eurogenital sinus. These
3:19are the two parts derived from the
3:21cloaka which is seen at the distal end
3:24of the gut and it is from the
3:26eurogenital sinus we have the
3:28development of the urinary bladder. So
3:30eurogenital sinus is giving rise to
3:32urinary bladder. So as the pronifer
3:35develops during the early stages of
3:37development of kidney it has got many
3:39duct tules and a duct. So the duct of
3:42the pronapros is actually opening into
3:45the eurogenital sinus or the primitive
3:48urinary bladder. So as soon as it is
3:50formed it is actually nonfunctional in
3:53human beings. So as soon as it is formed
3:55it is just degenerating. The duct tules
3:57will degenerate and the duct will
4:00persist. And what is further happening
4:03what then we have the misonic part of
4:06the nephrogenic cord this will give rise
4:08to many duct tules which is which will
4:10be joining with the duct of pronos. So
4:13at this period the pronic duct is
4:16actually called the misonic duct. So
4:20what once with the development of the
4:21misonic tubules the pronic duct will be
4:25renamed as misonic duct. So the misone
4:29duct will be again opening into the
4:31urinary bladder because it is the same
4:33as that of the pronic duct. So we have
4:35the misenffric tubules and the misonic
4:37duct and later towards the final stages
4:41of development of kidney. This misonic
4:44duct tules as well as the misonic duct
4:48will be actually disappearing especially
4:50in females but this will persist in
4:53males to form the ductal system of
4:55testice. So the development of testice
4:57will be dealt in another session. So
4:59actually the misinphric duct as well as
5:02the misonic tubules will be disappearing
5:04in females. Another name for misinphric
5:06duct is called wolfian duct. Wolfian
5:10duct is another name given to the
5:11misinphric duct. And towards the further
5:15stages towards the end stages of the
5:17development of kidney what is happening?
5:19It is the metanros which is developing
5:22towards the final stages of development
5:24of kidney. And this is actually giving
5:26rise to the human kidney proper. So what
5:29are the features happening at this
5:31level? We can see that there is a bud
5:34arising from the misonafric duct. This
5:37bud is called uratoric bud. So the bud
5:41which is derived from the misonafric
5:43duct is called uratoric bud. And the
5:46metanros
5:48from which the human kidney is
5:50developing the kidney proper is
5:51developing this is called metanric
5:55blast. Metanfic blasema. So till now we
6:00have mentioned pronos and mison but they
6:03are not actually contributing to the
6:05formation of the uh adult kidney but you
6:08have the ureic bud which is derived from
6:10the misonic duct and you have the
6:12metanic blasta which is actually derived
6:16from the metanros. Now let's see what is
6:19happening how kidney is further
6:21developing. So let's have a look at this
6:23site here. So metanros is actually
6:27forming a vesicle. This is called the
6:29metanric vesicle. And we can see that
6:32this is a ureriic bud. And this ureic
6:35bud is actually having a distal dilated
6:39portion. This distal dilated portion is
6:42called ampula. So you have a vesicle and
6:46you have an ampula. So when we uh
6:48discuss about the development of kidney,
6:50we can discuss it under two main
6:52headings. the excretory portion of the
6:54kidney which includes the nephrons and
6:57the collecting portion of the kidney
6:59which includes the collecting tubules
7:01the calluses the major and minor
7:03calluses and the renal pelvis. So these
7:06are the two portions um with which the
7:08kidney is made up of. So we can see that
7:11ureitric as it enters the metanic blast
7:14it is further divided into major
7:17calluses and minor calluses and again it
7:21redivides so that the distal end will be
7:24dilated. So this is the distal dilated
7:27portion of the uric bud which is known
7:29as the ampula and nearer to that we have
7:32a vicle which is derived from the
7:34metaniferus. This is called the metanic
7:36vicle. So in the beginning stage the
7:38metanic vesicle is circular or somewhat
7:41spherical in shape. Later it becomes a
7:45pear-shaped vesicle and this pear-shaped
7:48vicle will actually join with the
7:51dilated end of the uritric bud that is
7:53the ampula. Then what happens further
7:56this pear-shaped vicle is actually
7:58getting transformed into an S-shaped
8:01vicle or uh now we can call it as an
8:04S-shaped tube. Now further the S-shaped
8:07tube uh further develops into what is
8:11known as the nephron and we can see that
8:13the distal end of the nephron we have
8:15the capillaries invaginating into the
8:18distal end. This is the future
8:20glomeulus. So this portion is called the
8:24nephron which is otherwise called the
8:27excretory portion of kidney. So the
8:30excretory portion of kidney is actually
8:33derived from the vicle which is again
8:36developed from the metanophric blast. So
8:38the excretory portion the nephron is
8:40derived from the vicle which is actually
8:42derived from the metanophric blast. Then
8:45we can see the uritric bud which is
8:48actually dividing and forming the
8:50collecting tubules and the collecting
8:52duct. So this is called the collecting
8:54portion of kidney. So the collecting
8:56portion of kidney is actually derived
8:59from the uratoric bud which is bing off
9:01from the misinphric duct. So these are
9:04the two major components of kidney. Now
9:08we have to say something about the
9:09ascent of kidney because we have already
9:12mentioned that the proifpheros is seen
9:14in the cervical region which
9:15degenerates. Misoliferose is seen in the
9:17tora lumbar region again which will be
9:19degenerating and it is the metanros
9:21which is seen in the sacral region uh
9:24which will be giving rise to the human
9:26kidney. So this is actually seated in
9:29the sacral region. But now we know that
9:31the adult kidney is not seen in the
9:33sacral region but in the lumbar region.
9:35So shifting of the position of the
9:37kidney from the metanic region into the
9:40lumbar region is called the ascent of
9:43kidney. So this is actually along with
9:46the development of the uh body as the
9:49body elongates the kidney will be
9:51actually shifted from its uh previous
9:54sacral position into the lumbar
9:56position. So when it was in the sacral
9:57region it was supplied by the lateral
10:00sacral vessels but as it ascends into
10:03the lumbar region it will be getting its
10:06final blood supply from the realal
10:08vessels which are arising from the
10:10abdominal iota. So that is what is
10:12happening when it shifts from the sacral
10:14region to the lumbar region which is the
10:16normal position of kidney in human
10:18beings. And one more thing which I would
10:21like to stress is as we all know kidney
10:24is shaped like a bean and we can see we
10:27can we already know that this region is
10:29called the hilm of kidney which is
10:31actually facing medially but during
10:34development this hilum will be facing
10:36anteriorly and it is actually by
10:39rotation that the anteriorly faced hilum
10:41will be facing medially. So this is
10:44actually the hilum of kidney. Now uh
10:47when you are asked to write about the
10:49development of kidney, you should also
10:51add some points regarding the
10:53developmental anomalies. So let's see
10:55one by one what are the developmental
10:57anomalies which you expect when you uh
11:00discuss about the development of kidney.
11:01So the first one is aenesis. Aenesis as
11:04we all know the kidneys may not develop.
11:07So that is called the aenesis. It can be
11:09unilateral or bilateral. You may be
11:11seeing one missing kidney on one side or
11:13both the kidneys will be absent or there
11:16will be hypoplasia.
11:18Then the another thing is duplication of
11:20kidney. So instead of two kidneys on one
11:22side you will get an additional kidney.
11:24So that is called the duplication of
11:26kidney. Now what is what about the shape
11:28of kidney? What are the anomalies you
11:30expect as far as the shape of kidney is
11:33concerned? We know that you will get two
11:35kidneys on either side like this.
11:38Sometimes the lower poles will fuse
11:41together like this so that it will
11:44appear like a horseshoe. This usually
11:47happens at the lower pole. It can even
11:49happen at the upper pole as well. So
11:51this is called horseshoe kidney.
11:53Sometimes both the kidneys will come
11:55close together and it will be just like
11:58a pancake. So that is called pancake
12:01kidney. So these are the anomalies which
12:03can you can expect as far as the shape
12:06is concerned. What about the position of
12:08kidney? Position of kidney we all know
12:11as it develops it will be first seen in
12:13the sacral region because the metanos is
12:15seated in the sacral region. But uh
12:18sometimes it may not ascend. In human
12:21beings in the adult position you may get
12:24kidney still in the sacral region if it
12:27is not ascending. Sometimes it will it
12:29may ascend further high up so that it
12:32may not be seen in the lumbar region but
12:34it will be seen in the thoracic cavity.
12:37In the thoracic region you will be
12:38seeing the kidney. So these are the
12:40anomalies which you can expect as far as
12:42the position of kidney is concerned.
12:44What about the abnormal rotation of
12:46kidney? Abnormal rotation we have
12:48already mentioned that the hilm in the
12:50beginning stages it will be facing
12:51anteriorly. Sometimes it may not rotate
12:53medially. At times it may persist like
12:57uh same in the same way as the anterior
13:00position. So what will happen? The hilum
13:02will be facing anteriorly even in adult
13:04kidney. Sometimes instead of rotating
13:06into the medial position it may rotate
13:08laterally. So what happens instead of a
13:11picture like this you will get a kidney
13:13with the hilum facing laterally. So
13:16these are the options which you have as
13:18far as the abnormal rotation of kidney
13:20is concerned. Another most important
13:23thing is called congenital polycystic
13:26kidney. Congenital polycystic kidney
13:28means this vesicle may remain like this
13:32and it won't join with the ampula. So
13:34when you see the kidney when you take a
13:36section of a kidney you will be seeing
13:38the kidney filled with vesicles which
13:40are actually nonfunctional because if it
13:43is not communicating with the ampula the
13:45entire system won't work. So the there
13:48will be vesicles the kidney will be
13:49studied with vesicles and it is again a
13:51developmental anomaly that is called
13:53congenital polycystic kidney. Some
13:55others even prefer to say that the
13:58collecting tubules may develop as
14:01vesicles or clusters of vesicles. So
14:04there are two theories the vesicles can
14:06be either derived from the excretory
14:09unit or from the collecting unit. In
14:11both ways the kidney will be studied
14:13with vesicles which are nonfunctional
14:16that is called congenital polycystic
14:17kidney. Another one more thing which I
14:20would like to add is lobilated kidney.
14:23So actually in the beginning stages the
14:25fetal kidney is always lobilated but if
14:28it persists in adult that is called
14:31lobilated kidney. So these are the uh
14:34various anomalies which you can expect
14:36as far as the development of kidney is
14:38concerned. So we'll do it in a nutshell.
14:40Once again kidney is developed from the
14:43nephroenic cord which is actually a
14:46derivative of the intra embriionic
14:47misodum. It has got three portions as
14:50far as the evolution is concerned.
14:51Pronos, mison and metanapros. Proneros
14:54and mison part actually nonfunctional
14:57and hence it degenerates and it is from
14:59the metanic part we have the adult
15:01kidney developed. When you discuss about
15:03the adult kidney does got two portions.
15:05One is the collecting part and one and
15:07this other one is excrety portion. The
15:10excretary portion is actually derived
15:11from the metanaphric blast whereas the
15:14collecting part is actually derived from
15:16the uritric bud arising from the
15:18misonophric duct. And we have already
15:21seen the developmental anomalies. There
15:23will be a genenesis. There will be
15:24duplication of kidney. There will be
15:26different shapes for the kidney. There
15:28will be different positions for the
15:30kidney. And um according to the abnormal
15:33rotation you you can have the hilum
15:35facing anteriorly or facing laterally.
15:37And if the if it is filled with just
15:40vesicles which are nonfunctional you
15:41call it as congenital polycystic kidney.
15:44And uh if it is still in the lobilated
15:47phase as we see during development that
15:49is as sometimes the fetal kidney the
15:52lobilated kidney may persist even in
15:54adults that is called lobilated kidney.
15:56Hope you got an idea about the
15:58development of kidney. Thank you.

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