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7 UA > 1 > Flashcards

1 Flashcards

1
Q

The urinary system is composed of what 4 components?

A

1) Kidneys
2) Ureters
3) Bladder
4) Urethra

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2
Q

What do the kidneys produce?

A

Urine, which removes liquid waste products from blood

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3
Q

What part of the urinary system keeps a “metabolic balance of the blood?”

A

Kidney

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4
Q

What hormones do the kidneys produce?

A

Erythropeoietin, Calcitriol, and Prostaglandins

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5
Q

What hormone helps with red blood cell production?

A

Erythropoietin

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6
Q

What is the active form of Vitamin D?

A

Calcitriol

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7
Q

What do the ureters do?

A

Carry urine to the bladder

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8
Q

What does the bladder do?

A

Stores the urine produced

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9
Q

What does the urethra do?

A

Delivers the urine for excretion outside the body

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10
Q

Where is the left kidney located?

A

Level of T11 - L2

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11
Q

Where is the right kidney located?

A

Level of T12 - L3

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12
Q

The renal artery, renal vein, and ureter all leave the kidney through what?

A

An indention of the hilum (hilus) of each kidney

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13
Q

What covers the kidney?

A

A capsule

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14
Q

What 4 things consist of the internal kidney?

A

1) Cortex (including renal columns
2) Medulla (pyramids)
3) Minor Calyces, Major Calyces
4) Renal Pelvis

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15
Q

What endocrine gland is associated with the kidney (located on top)?

A

Adrenal gland

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16
Q

What is the main functional unit of the kidney?

A

Nephron

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17
Q

How many nephrons in each kidney?

A

1 million or slightly more

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18
Q

Where are nephrons located?

A

Both the renal cortex and the renal medulla

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19
Q

What does the nephron consist of?

A

Glomerulus, proximal convoluted tubule, loop of Henle, and distal convoluted tubule

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20
Q

Nephrons empty into collecting ducts that run out to the ______

A

Minor and Major calyx, and renal pelvis

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21
Q

What are the 2 nephron types?

A

1) Cortical

2) Juxtamedullary

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22
Q

Where are cortical nephrons located, and what appearance do they have?

A

Located mostly within the cortex, and have short length of the loop of Henle

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23
Q

Where are Juxtamedullary nephrons located and what is their appearance?

A

Extend deep into the medulla and have long loop of Henle

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24
Q

How do various regions of the nephron differ from one another?

A

Anatomically, and they consist of different types of epithelium related to their own functions

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25
Q

What are the 4 stages of Urine Formation?

A

1) Filtration (from blood to kidney)
2) Reabsorption (From kidney back to body)
3) Secretion (from body straight to kidney)
4) Excretion

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26
Q

Where does “Filtration” occur?

A

In Glomerulus

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27
Q

Where does “Secretion” occur?

A

Proximal convoluted tubule, loop of Henle, and Distal convoluted tubule

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28
Q

Where does “Excretion” occur?

A

In collecting duct, minor calyx, major calyx, and renal pelvis

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29
Q

20-25% of the blood leaving the left ventricle of the heart enters _________

A

The kidneys via renal arteries

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30
Q

Blood passes through the kidneys at a rate of ______

A

1200 ml/min, or 600 ml/min/kidney **

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31
Q

___1_____ arterioles carry blood to the ____2___ known as the _____3____

A

1) Afferent
2) Capillary Tuft
3) Glomerulus

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32
Q

___1____ arterioles that contain the remaining blood that was not filtered by the glomerulus form the __2___ in the cortex and ____3___ in the medulla

A

1) Efferent
2) Peritubular capillaries
3) Vasa Recta

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33
Q

Where are the peritubular capillaries?

A

Cortex

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34
Q

Where are the Vasa Recta?

A

Medulla

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35
Q

Where is the glomerulus located?

A

Between 2 arterioles

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36
Q

Each glomerulus is located in _______

A

Bowman’s Capsule

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37
Q

What is the outer layer of the Bowman’s capsule?

A

“Parietal” layer, and it is composed of squamous epithelium (aka parietal epithelial cells)

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38
Q

What is the inner layer of Bowman’s capsule?

A

“Visceral” layer, and it is composed of specialized cells known as podocytes (aka visceral epithelial cells)

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39
Q

The epithelial layers of the glomerulus rest on what?

A

A thin basal lamina

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40
Q

What is “Bowman’s Space?”

A

The space between the outer portion of the capsule and visceral portion of the capsule

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41
Q

Where does the filtrate of the blood pool?

A

Bowman’s space

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42
Q

What does the glomerulus consist of?

A

Bowman’s Capsule, Glomerular Tuft, and Juxtaglomerular Apparatus

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43
Q

What are the 3 major components of glomerular capillary wall (They help account for the glomerular filtration)?

A

1) Endothelial cells with fenestra
2) Glomerular Basement Membrane (GBM)
3) Visceral Epithelial cells, aka podocytes

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44
Q

Approximately 90-120 ml/min, or 1/5th of the renal plasma, is filtered through the glomeruli forming _______

A

The Ultrafiltrate *

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45
Q

Ultrafiltrate has the same composition as to blood plasma and includes:

A

Water, Electrolytes, Glucose, Amino Acids, Urea, Uric Acid, Creatinine, and Ammonia

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46
Q

What is a key indicator of kidney function and is used to check how well the kidneys are working, or monitor kidney disease progression?

A

Glomerular Filtration Rate (GFR)

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47
Q

What does GFR specifically estimate?

A

How much blood passes through glomeruli each minute

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48
Q

What is the normal result of GFR range?

A

90-120 ml/min

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49
Q

What is GFR proportional to?

A

Body size and varies with age and sex

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50
Q

Older people have __1___ normal GFR levels, because GFR ___2__ with age

A

1) Lower

2) Decreases

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51
Q

GFR test aka:

A

Clearance Test *

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52
Q

What does the GFR test (glomerular filtration rate) aka clearance test measure?

A

How well the kidneys are filtering creatinine * which is a waste product of creatine phosphate breakdown in muscles

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53
Q

For the Glomerular Filtration Rate test (GFR), what is required?

A

1) A 24 hour urine sample

2) Blood sample

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54
Q

When the kidneys aren’t working as well as they should _______ builds up in the blood

A

Creatinine

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55
Q

What are “Threshold substances?”

A

Those substances which are almost completely reabsorbed by the renal tubules when their concentration in the plasma is within normal limits

56
Q

In regards to tubular function, when the normal plasma level is exceeded, what happens?

A

The substance is no longer totally reabsorbed and it appears in the urine

57
Q

Glucose is a high threshold substance, T/F?

A

TRUE

58
Q

When does glucose appear in the urine?

A

When plasma concentration exceeds about 160 to 180 mg/dl *

59
Q

What are some of the other threshold substances in tubular function?

A

amino acids, creatine, potassium, and sodium chloride

60
Q

Tubular function of the proximal tubules reabsorbs what?

A

1) 100% of amino acids, proteins and glucose
2) HCO3
3) K+, NaCl, Ca
4) H20

* NO REABSORPTION OF CREATININE ***

61
Q

What does the proximal tubule secrete?

A

1) Uric Acid
2) Organic acids (antibiotics)
3) Creatinine
4) Hydrogen Ion

62
Q

What is reabsorbed in the Loop of Henle?

A

1) H20
2) NaCl
3) Ca, Mg

63
Q

What is secreted from the Loop of Henle?

A

Hydrogen ion and Ammonia

64
Q

What is the key feature of the Descending loop of Henle?

A

PERMEABLE to water *

  • Reabsorption of solutes does NOT occur in this part of the loop
65
Q

What limb of the Loop of Henle is Nearly impermeable to water?

A

Ascending limb

66
Q

Which limb of the loop of Henle has hydrogen ion and ammonia secreted?

A

Ascending Limb

67
Q

What is the key function of the Ascending Loop of Henle?

A

Active Resorption of Solute** without water

sodium chloride, calcium, and magnesium

68
Q

Fluid leaving the loop of Henle has a ___1____ osmolality than plasma because of lost ___2____

A

1) Lower

2) Sodium Chloride

69
Q

What do the distal tubules reabsorb?

A

1) NaCl
2) H20
3) Ca

Not much reabsorption is happening

70
Q

What do the distal tubules secrete?

A

1) K+
2) H+
3) Urea

71
Q

What do the collecting ducts reabsorb?

A

1) Urea
2) NaCl
3) H20

Not much reabsorption is happening here either

72
Q

What do the collecting ducts excrete?

A

1) H20
2) NaCl
3) K+
4) HCO3
5) CREATININE **

73
Q

About 90% of the glomerular filtrate is reabsorbed by the time it reaches ______

A

The distal tubule

74
Q

Where is urea absorbed?

A

In the Collecting Duct

75
Q

Is there any reabsorption of creatinine in the “Tubular Reabsorption?”

A

NO

76
Q

T/F, some reabsorption is passive and some requires energy for active transport across the cells?

A

TRUE

77
Q

What does Tubular Secretion involve?

A

Sending molecules from the blood into the tubular filtrate

78
Q

What does the tubular secretion account for?

A

Removal of unneeded foreign waste substances that are not filtered by the glomerulus including various toxins and medications (such as penicillin)

79
Q

What type of ions are secreted during “tubular secretion?”

A

Removal of hydrogen ions and other ions to help regulate acid-base and electrolyte balance

80
Q

What are the actual ions being being secreted?

A

ammonium, sodium, potassium, bicarbonate, and uric acid

81
Q

Within the human body, the blood pH must be maintained within the narrow range of _____

A

7.35 - 7.45

82
Q

Maintaining pH within the limits is regulated by proper functions of _______

A

lungs and kidneys

83
Q

pH outside the range of 7.35 - 7.45 becomes incompatible with life. What happens during the process?

A

Proteins of the body are denatured and cells are destroyed enzymes lose their ability to function, and death is possible

84
Q

What are hydrogen ions produced as?

A

Waste from metabolism and are generally secreted

85
Q

What happens to bicarbonates in regards to the “Kidney’s role in Ion secretion and acid-base balance?”

A

Bicarbonates can be secreted but they are more often reabsorbed, usually up to 100% to help maintain the proper blood pH

86
Q

What plays a major role in the metabolic acid-base balance?

A

The kidneys, and they also help with compensation of respiratory acidosis or alkalosis

87
Q

What are the 3 main functions of the distal and collecting tubules?

A

1) Adjustment of the pH, osmolality, and electrolytes
2) Secretion of potassium, ammonia, and hydrogen ions
3) Reabsorption of sodium and bicarbonate

88
Q

What is a region of tissue found in each nephron in the kidney that is important in regulating blood pressure and body fluid and electrolytes?

A

Juxtaglomerular Apparatus (JGA)

89
Q

What is a microscopic structure in the kidney that regulates the function of each nephron?

A

Juxtaglomerular Apparatus (JGA)

90
Q

What are the 3 cellular components of the JGA?

A

1) Macula Densa of the distal convoluted tubule
2) Juxtaglomerular cells
3) Mesangial cells

91
Q

Smooth muscle cells of the afferent arteriole are also known as what?

A

Juxtaglomerular cells

92
Q

What do juxtaglomerular cells produce and secrete?

A

Renin

93
Q

Mesangial cells secrete what?

A

Erythropoietin

94
Q

What is Renin?

A

An ENZYME produced by the juxtaglomerular cells, it is secreted and reacts with the precursor angiotensin in the blood to convert into angiotensin 1

95
Q

Angiotensin 1 passes through the lungs where the enzyme ________

A

Angiotensin Converting Enzyme (ACE) changes it to the active angiotensin II

96
Q

Angiotensin II results in:

A

Systemic vasoconstriction including the afferent and efferent arterioles

97
Q

Angiotensin II results in systemic vasoconstriction by triggering the release of what hormone?

A

Aldosterone (from the adrenal glands), which increases sodium reabsorption

98
Q

Besides Angiotensin II triggering the release of Aldosterone, what other hormone does it trigger the release of?

A

Antidiuretic hormone aka VASOPRESIN, from the posterior pituitary gland

99
Q

What is aldosterone secreted by?

A

Adrenal cortex (zona glomerulosa)

100
Q

What is the most precise thing that aldosterone does?

A

Increases blood sodium reabsorption in the distal tubules of the nephron, which in turn increases blood volume as water follows salt, raising blood pressure (could contribute to hypertension)

101
Q

What does aldosterone enhance?

A

Potassium/sodium ions in distal tubules of the nephron

102
Q

Andtidiuretic Hormone aka

A

Vasopresin

103
Q

Where is ADH aka Vasopresin synthesized?

A

Hypothalamus

104
Q

Where is ADH/ vasopressin stored?

A

In vesicles released from the posterior pituitary gland (neurohypophysis)

105
Q

What does ADH/vasopresin regulate?

A

Absorption of water in the collecting ducts

106
Q

What makes walls of the collecting ducts permeable?

A

Antidiuretic Hormone/ADH/ Vasopresin

107
Q

Production of ADH depends on the body’s state of _______

A

Hydration

108
Q

Insufficient ADH results in ______

A

Diabetes Insipidus (DI)

109
Q

DI (diabetes insipidus) is a problem of 2 possible things, what are they?

A

1) Decreased production of antidiuretic hormone (Central DI)

2) Abnormal kidney’s response to antidiuretic hormone (nephrogenic DI)

110
Q

What is “Syndrome of Inappropriate ADH (antidiuretic Hormone) Secretion” characterized by?

A

Excessive release of antidiuretic hormone from the posterior pituitary gland or another source

111
Q

Syndrome of Inappropriate ADH Secretion aka

A

SIADH syndrome

112
Q

80% of SIADH syndrome is caused by ______ ?

A

Small cell lung carcinoma (aka oat cell carcinoma)

113
Q

What might SIADH result from?

A

Complication of brain injury, tumor growth, and certain medications

114
Q

What is also characterized by continuous secretion of ADH in spite of plasma hypotonicity and normal or expanded plasma volume?

A

Syndrome of Inappropriate ADH aka SIADH syndrome

115
Q

What are the 5 main things Syndrome of Inappropriate ADH secretion results in?

A

1) High plasma volume
2) Low serum osmolarity
3) Low plasma sodium (hyponatremia)
4) High urine osmolarity
5) Higher than normal urine sodium

116
Q

In general, increased ADH causes water retention _______

A

WITHOUT* extracellular fluid volume expansion and without edema or hypertension

117
Q

When hyponatremia is severe, what symptoms will occur?

A

Cerebral edema become prominent (irritability, confusion, seizures, and coma)

118
Q

Fluids filtered at the glomerulus:

A

90-120 ml/min

119
Q

Final urine volume Excreted as urine:

A

1ml/min on average

120
Q

Dehydration reduces urine production to _____

A

0.3 ml/min

121
Q

Excessive hydration increases urine production to ______

A

15ml/min

122
Q

Average adult urine daily volume of urine:

A

1200-1500ml

123
Q

More urine is produced during _____

A

the day

124
Q

What is the normal total urine range ?

A

600-2000 ml/ 24 hours

125
Q

What is polyuria?

A

Abnormal increase in the volume of urine (2500 ml and > per 24 hours), as in diabetes insidious and diabetes mellitus

126
Q

What is Oliguria?

A

Decrease in urinary volume, such as occurs in shock and acute glomerulonephritis.

127
Q

What is oliguria defined as?

A

Being < 400 ml/24 hr

128
Q

What is Anuria?

A

Designates the complete suppression of urine formation

129
Q

What is Anuria sometimes defined as?

A

Being < 75 ml/24 hours during 2-3 consecutive days, in spite of a high fluid intake

130
Q

In 24 hours the body excretes approximately ___1__ of dissolved material, half of which is ___2___

A

1) 60 g

2) UREA

131
Q

What is in ABNORMAL urine?

A

1) Bilirubin
2) Blood
3) Glucose
4) Ketone Bodies
5) Porphyrins
6) Protein

132
Q

What is in the “sediment” of urine?

A

1) Cells
2) Crystals
3) Casts

Some of these are considered to be normal, while others are seen in various renal and metabolic disorders

133
Q

What is inflammation of the bladder?

A

Cystitis

134
Q

Nephritis can be present with bacterial infection, what is that called?

A

Pyelonephritis

135
Q

Nephritis can be present WITHOUT bacterial infection, what is that called?

A

Glomerulonephritis

7 UA (4 decks)

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