Week 5 - Study Guide Flashcards

Urinary

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1
Q

Hormones that regulate blood pressure & Na+/K+ balance

A

Renin-angiotensin → aldosterone
ADH

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2
Q

Blood cell production

A

Erythropoietin

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3
Q

Basic processes of urinary system

A

Filter
Secrete
Reabsorb

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4
Q

Toxicity in order of highest to lowest of Nitrogenous waste.

A

Ammonia
Urea
Uric Acid

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5
Q

Energy cost in order of highest to lowest of nitrogenous waste

A

Uric acid = 3 ATP
Urea = 1.5 ATP
Ammonia = NA

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6
Q

Water required for nitrogenous waste highest to lowest

A
  1. Ammonia (500 ml/g). (lot of h20)
  2. Urea (50 ml/g). (if trying to conserve h2o)
  3. Uric Acid (10 ml/g) (body under h20 constriction)
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7
Q

Solubility in highest to lowest for nitrogenous waste

A
  1. ammonia
  2. urea
  3. uric acid
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8
Q

Urine Formation - 4 basic steps

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Water conservation
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9
Q

Where kidneys are located

A

retroperitoneal (behind peritoneal cavity)

T-12 → L3

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10
Q

What holds the kidney in place

A

Perirenal fat capsule

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11
Q

Indent for ureter, blood & lymph vessels, nerves

A

Hilus

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12
Q

Protection of kidney (damage & Infection)

A

Protection (fibrous) capsule

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13
Q

Anchors kidney to abdominal wall

A

Renal Fascia

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14
Q

From fibrous capsule to medulla

A

cortex

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15
Q

Organized into renal pyramids, separated by renal columns, papilla

A

Medulla

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16
Q

Tip of pyramid releases urine to minor calyx

A

papilla

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17
Q

Contains branching extensions called calyces & is continuous with ureter (major calyces divide to minor calyces)

A

Pelvis

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18
Q

How much blood is reabsorbed at eth kidney

A

22% total Cardiac Output of Blood

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19
Q

Arteries blood supply for kidneys

A
  1. Aorta
  2. Renal Artery
  3. Segmental Artery
  4. Interlobar artery
  5. Arcuate Artery
  6. Cortical radiate artery
  7. Afferent arteriole
  8. Glomerulus (capillaries)
  9. Efferent arteriole
  10. (Peritubular capillaries and vasa recta)
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20
Q

Blood supply - veins back to heart

A
  1. Efferent arteriole
  2. Peritubular capillaries and vasa recta
  3. Cortical radiate vein
  4. Arcuate vein
  5. Interlobar vein
  6. Renal vein
  7. Inferior Vena Cava
  8. Right atrium
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21
Q

Bowman’s capsule & Glomerulus

A

Renal corpuscle

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22
Q

What projects into the medulla?

A

Loop of Henle

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23
Q

Nephrons have a portal = 2 capillary beds

A
  1. glomerulus
  2. peritubular capillaries or vasa recta
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24
Q

Juxtaglomerular apparatus = JGA contains

A

DCT joins with afferent arteriole

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25
Q

Where is Juxtaglomerular cells located, what does it monitor and secrete?

A

Afferent arteriole

Monitors Blood pressure - when BP is low it secretes Renin

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26
Q

What has chemoreceptors in DCT and measures solutes

A

Macula Densa cells

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27
Q

Where are Macula Densa Cells located, what do they secrete, what do they measure?

A

DCT

Measures solutes

releases Renin if solutes are low

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28
Q

Name for urination

A

micturition

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29
Q

Which sphincter has voluntary control

A

external

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30
Q

What sphincter is under control of CNS

A

Internal sphincter

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31
Q

Glomerulus is porous and is wrapped in what kind of cells?

A

Podocytes (endfeet)

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32
Q

What surrounds the glomerulus and captures filtrate

A

Bowman’s capsule

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33
Q

The component that attaches the kidneys to the abdominal wall is the ____ ?

A

renal fascia

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34
Q

The two components of the renal corpuscle are —?

A

Glomerulus & Bowman’s capsule

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35
Q

If bood pressure increased, in theory, what should this do to the rate of glomerular filtration?

A

⬆BP
⬆NGF. (more particles get through)

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36
Q

HPg = BP - what is the normal rate?

A

55 mmHg

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37
Q

HPc =

A

hydrostatic pressure in capsule
fluid pressure as it filters to capsule

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38
Q

OPg =

A

osmotic pressure on glomerulus
albumin & solutes in blood

water to move back via osmosis

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39
Q

Average NFP =

A

10 mmHg

NFP = HPg - (OPg + HPc)
10 mmHg = 55-(30+45)

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40
Q

Average GFR

A

120 ml/min

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41
Q

How much filtrate a day

A

180 L filtrate/day

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42
Q

What are the impacts of kidney disease on NFP & GFR?

A

Elevates NFP & GFR

low BV and low BP

more fluid going through

glomerulus becomes permeable to protein (albumin) decreasing OPg

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43
Q

What are the impacts of Hemorrhage on NFP & GFR?

A

Decreases NFP and GFR

less fluid going through

reduces HPg (BP)

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44
Q

What are the impacts of nervous control on NFP & GFR?

A

Decreases NFP & GFR

sympathetic NS constricts afferent & efferent arteriole

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45
Q

What is NFP = 0

A

renal suppression
No net drive/movement

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46
Q

Smooth membrane, tightly adherent to the kidney surface

A

fibrous capsule

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47
Q

Portion of the kidney containing mostly collecting ducts

A

medulla

48
Q

portion of the kidney containing the bulk of the nephron structures

A

cortex

49
Q

Superficial region of kidney tissue

A

cortex

50
Q

basinlike area of the kidney, continuous with the ureter

A

renal pelvis

51
Q

a cup-shaped extension of the pelvis that encircles the apex of a pyramid

A

minor calyx

52
Q

area of cortical tissue running between the medullary pyramids

A

renal column

53
Q

Tonicity drives

A

osmosis

54
Q

Where does most of the reabsorption happen in the tubulars?

A

PCT = 65%
DCT

55
Q

What is the maximum reabsorption capacity of tubes, excess goes to urine (diabetes & glucose)

A

Tubular Maximum

56
Q

If reabsorption declines, which of the following occur?

a. more urine produced
b. loss of potentially valuable resources
c. decline in filtration
d. inability to rid body of appropriate toxins and waste
e. both a & b
f. a, c, & d are all true
g. all of the above

A

e. both a & b

Solutes first followed by water

57
Q

What are the commonly secreted items?

A

K+
NH4- (ammonium)
H+
foreign substanes

NH4- & H+ are pH issue

58
Q

Hypotonic urine =

A

well hydrated

low solutes - high volume

got rid of solutes
produced more urine volume

59
Q

Hypertonic urine =

A

Dehydrated

high solutes - low volume

holding onto urine

ADH - Aldosterone

60
Q

cortical nephrons =

A

peritubular capillaries

61
Q

Which capillaries are about filtering?

A

peritubular capillaries
cortical nephrons

filtering - not concentrated urine

62
Q

Which capillaries are about concentrated urine?

A

Vasa Recta
juxtamedullary nephron

Creates concentrated urine

63
Q

Countercurrent exchange

A

Vasa Recta

64
Q

Countercurrent multiplier

A

Loop of Henle

65
Q

What cells secrete renin if BP falls and where are they located?

A

Juxtaglomerular cells in the afferent arteriole

66
Q

What cells secrete renin if solutes fall and where are they located?

A

Macula densa cells - chemoreceptors in the DCT

67
Q

What are the concentration levels in the cortex vs the medulla in a juxtamedullar nephron?

A

300 mOsm in the cortex
1200 mOsm in the medulla

68
Q

Define counter-current flow

A

opposite directions in 2 tubes
More efficient

69
Q

Counter-current multiplier refers to what structure within the kidney?

A

Loop of Henle of the Juxtamedullary nephrons

70
Q

Counter-current exchanger refers to what structure within the kidney?

A

Vasa Recta of the juxtamedullary nephrons

71
Q

What happens to the solute concentration within the interstitial space as you move from the cortex to the medulla?

A

Increases - 300-1200 mOsm

72
Q

If the descending limb of the vasa recta vessels suddenly became more permeable to H2O, what impact could this have on the function of the kidney?

A

Job of exchanger - create a concentration gradient

73
Q

During respiratory acidosis, the kidneys should?

A

Reabsorb HCO3- (blood) and retain H+ & NH4+

Get rid of bicarb - making pH too high

Remember - Reabsorption of flitered HCO3- is coupled to H+ secretion

Inverse relationship

74
Q

If the levels of aldosterone increased in the body which of the following would occur?

a. [sodium] in the urine rises
b. urine volume increases
c. [sodium] in the blood rises
d. urine volume decreases
e. [potassium] in the blood decreases

A

c. [sodium] in the blood rises
d. urine volume decreases
e. [potassium] in the blood decreases

75
Q

If ADH is produced, which of these processes occur?

a. decreased H2O reabsorption
b. increased plasma solute concentration
c. increased sodium reabsorption
d. decreased urine production
e. decreased urine concentration

A

d. decreased urine production

76
Q

What is the specific action of ADH on the nephrons?

A

Aquaporins in the collecting ducts allow water to leave the collecting ducts via osmosis.

WATER FOLLOWS NA+ into interstitial fluid

water moves into vasa recta and back into general circulation

77
Q

Diabetes Insipidus does not make what hormone?

A

ADH

Urine volume up due to lack of ADH.

Nothing to stop the urine

Excess sugar - glucose

78
Q

SIADH does what?

A

Syndrome of inappropriate ADH

When hydrated - retaining H2O when not needed.
Dilutes concentration

79
Q

Temperature effects urine -

If you want to decrease the frequency of urination would it better to crank heat up to 90° or turn the heat off.

A

Crank the heat up to 90°

80
Q

Diuretics -

A

increase urine volume by decreasing reabsorption of water or solutes

81
Q

What inhibits ADH

A

Alcohol - no ADH more fluid out

82
Q

What inhibits Na+ reabsorption

A

caffeine

83
Q

Increases urine

A

Increase in BP = increases filtration

increase in [na+ solute] = excessive sodium intake = more urine

Decreased blood [plasma protein]
liver damage - liver disease – not producing Albumin in - not enough osmosis pressure in glomerulus to pull fluid back = more urine

84
Q

Renal clearance

RC=UV/P

A

volume of blood plasma from which a substance is completely removed in one minute

U= urine concentrtion
V= flow rate of urine formation
P = concentration of substance in plasma

Three options only:
Fliter
Reabsorb
Secrete

85
Q

What does a urinalysis reveal?

A

Kidney disease
gall bladder problems
heart disease
pregnancy

86
Q

What damage does albuminuria indicate?

abnormal constituents of albumin

A

Damage
chemical toxicity
High BP

all at the kidney

87
Q

What damage does glycosuria indicate?

A

glucose > tubular maximum

cortisol stress
pregnancy
diabetes
excess carbs

not making insulin - mobilizing sugar into the bloodstream

88
Q

What damage does hematuria indicate?

A

erythrocytes - RBCs in urine

indicates inflammation of glomerulus or serious damage

89
Q

What damage does pyuria indicate?

A

Leukocytes - milky - WBCs should not be there

indicates UTI

90
Q

What damage does acetonuria indicate?

A

Ketone bodies

Not always bad - burning fat you will see ketones

indicates starvation or depressed CHO intake

91
Q

Different colors of urine:

red-brown =

A

presence of blood

92
Q

Different colors of urine:

red-amber =

A

urobilinogen (cirrhosis of the liver)

fecal waste is why it is brown

93
Q

Different colors of urine:

brown-green =

A

bile pigments - gall bladder

94
Q

Different colors of urine:

milky =

A

bacteria
WBCs or urate
infection

95
Q

Specific gravity of urine density/water density

A

1.010-1.020

don’t go below or don’t go over

96
Q

Urinary Disorders:

Inflammation of urinary bladder.

Caused by bacterial infection OR chemical OR

A

Cystitis

97
Q

Urinary Disorders:

Inflammation of kidney tissue

A

Nephritis

98
Q

Urinary Disorders:

Inflammation of nephron

A

Glomerulonephritis

Associated with streptococcal infections due to toxins filtered from blood

Gold, lead, & mercury can also damage glomerulus

99
Q

Urinary Disorders:

Inflammation of renal pelvis & calyces

A

Pyelitus

100
Q

Urinary Disorders:

Inflammation of renal pelvis, calyces, & renal tubules

A

Pyelonephritis

101
Q

Another name for kidney stones

A

renal calculi

insoluble salts of various metabolic products.

  1. Obstruct urinary pathway
  2. Exact formation process unkown
  3. Predisposing factors
102
Q

What are some predisposing factors of kidney stones?

A
  1. milk consumption (and a lot of tea)
  2. low water consumption
  3. extensive bed reset with little urine output
  4. some infections
103
Q

What is it called - passing kidney stones?

A

renal colic

104
Q

Renal Failure =

A

abnormally low urine production

low bp = does not allow filtration
extensive blood loss = low cardiac output

105
Q

Artificial filtration of blood in patients with urinary disease or loss

A

Hemodialysis

106
Q

Net filtration pressure is calculated by:

equation

A

NFP = (HPg) - (OPg +HPc)

This balance tells you how much fluid will be filtered based upon glomerular blood pressure, [solute] in glomerulus, and the fluid pressure of the filtrate itself.

107
Q

NFP tells us about filtration dynamics..

A

which will be regulated in part by the function of the podocytes regulating the degree of permeability at the glomerulus

If you look at the NFP value over time - you can determine GFR

108
Q

CounterCurrent mechanism =

A

juxtamedullary nephron

109
Q

Countercurrent Multiplier =

A

Vasa Recta

110
Q

Important in filtrating blood, but do NOT produce concentrated urine, and HAVE peritubular capillaries

A

Cortical Nephrons

111
Q

Produce concentrated urine by descending deep into the medulla where solute concentration is very high (1200 mOsm)

A

Juxtamedullary nephrons

112
Q

Three filtration membranes of the glomerulus

A
  1. Fenestrated Epithelia
  2. Basement Membrane. (negatively charged) (connective tissue that is filled with collagen)
  3. Podocytes
113
Q

Glomerulus filtration rate is higher means -

A

get rid of more stuff

114
Q

Glomerulus filtration rate is lower means -

A

hold on to more stuff

115
Q

How to influence GFR - in the afferent arteriole

A

making diameter smaller (vasoconstrict)
- less blood going to the glomerulus

Pressure in glomerulus ⬇
Less filtration. ⬇

116
Q

How to influence GFR - in the efferent arteriole

A

Make diameter smaller (vasoconstrict)

Pressure in glomerulus ⬆
More filtration ⬆