On section note _color_, _blood-content_ and _consistence of
cut-surface_, _relations of cortex and medulla_. The cortex is
normally 0.5-1.0 cm. broad (increased in acute degenerations and
inflammations, diminished in chronic inflammation and atrophy).
Note number, size and color of the _glomeruli_. They appear as
red pin-head points in congestion; in anæmia as small colorless
granules; in the normal kidney as small reddish points against the
lighter color of the labyrinths. In amyloid disease they are enlarged
and glassy. Calcified glomeruli are white and opaque. In venous
congestion the interlobular veins appear as bluish-red stripes;
hæmorrhages appear as red points in the glomeruli and convoluted
tubules, as red stripes in the collecting tubules. The blood-content
is increased in chronic passive congestion and chronic alcoholism. On
the cut-surface anæmic infarcts are usually wedge-shaped, with the
base toward the cortical surface. The color of the kidney-parenchyma
is usually gray; in fatty degeneration and cloudy swelling it
becomes yellow or grayish-yellow. The areas of greatest degeneration
appear as cloudy, opaque, yellowish points and stripes. Slight
degenerations are shown by slight cloudiness of the cortex. The
contrast between the grayish-white cortex and the dark-red medulla is
often very striking in severe parenchymatous nephritis. In uric-acid
infarction of the new-born ochre-yellow or vermilion-red stripes
or lines are seen in the medullary pyramids; white lines indicate
chalk-infarction; golden-yellow lines a bilirubin infarction. In gout
whitish deposits of urates occur in the kidney; they are usually
surrounded by scar-tissue. In purulent pyelonephritis yellow stripes
of pus surrounded by hæmorrhage occur in the pyramids. Tuberculosis
begins usually in the papillæ, destroying the pyramids first and then
the cortex, forming a multilocular sac lined with caseating tissue.
In hydronephrosis due to obstruction of the ureter the kidney becomes
converted into a multilocular sac without ulceration or caseation of
its papillæ. Note size of _pelvis_ and calices, contents, character
of mucosa, concretions, etc. The normal mucosa is grayish-red and
delicate; it is rose-red in inflammation and often shows petechiæ.
In severe inflammations grayish-white sloughs encrusted with urates
are often found. Concretions of urates, phosphates or oxalates may
be present, often associated with decubital ulcers of the mucosa.
Tuberculous ulcers of the pelvic mucosa are common. The _ureters_ are
straight and about 4 mm. thick. Note size, contents, thickness of
wall, changes in the mucosa, obstruction, dilatation, concretions,
etc.
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