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IPAP > A&P 2: Renal > Flashcards

A&P 2: Renal Flashcards

1
Q

What are the 8 functions of the kidneys?

A 
Ionic composition
Blood pH
Blood volume
BP
Blood osmolarity
Hormones
Blood glucose
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2
Q

What ions does the kidney help regulate?

A 
Na
K
Ca2
Cl
HPO42
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3
Q

Kidney’s regulate blood pH by excreting __ ions and saving __ ions

A

Excrete- H

Saves- HCO3

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4
Q

Kidney’s maintain a relatively constant osmolarity close to ____

A

300 mOsm/L

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5
Q

What are three hormones the kidney excretes and their function?

A

Renin- inc Bp
Calcitriol- inactive Vit D
Erythropoietin- stims RBC production

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6
Q

What can the kidney use, similar to the liver, to help maintain blood glucose levels?

A

AA glutamine for gluconeogenesis

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7
Q

What are the 4 wastes the kidney excretes and where do the waste products come from?

A

Ammonia/urea- deamination of aa
Bilirubin- Hgb catabolism
Creatinine- breakdown of creatinine in muscles
uric acid- nucleic acid catabolism

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8
Q

Where are kidneys located within the body?

A

Retroperitoneal space
Between T12-L3
Protected by 11 and 12 rib

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9
Q

What are the 3 external layers of the kidney and what are their functions?

A

Renal fascia- dense CT that anchors in place
Adipose capsule- protects and holds in place, surrounds capsule
Renal capsule- protective smooth transparent CT, continuous w/ ureters, maintains kidney shape

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10
Q

What does the term Cortex encompass?

A

Contains all glomeruli and convoluted tubules of nephrons

Makes columns between pyramids

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11
Q

What does the term Medulla encompass ?

A

Contains LoH and collecting ducts

Collection of ALL renal pyramids

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12
Q

Pyramids belong to what part of the kidney?

How many are in each kidney?

A

Portion of medulla

8-18/kidney

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13
Q

What does the term Papilla encompass?

A

Narrow apex of pyramid

Contains papillary duct leading to minor calyx

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14
Q

What does the term Columns encompass?

A

Space between renal pyramids

Portion of renal cortex

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15
Q

Function of Lobe?

What structures make up a “lobe”?

A

Functional region of the kidney

Pyramid medulla + cortex + 1/2 of adjacent column (cortex)

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16
Q

Function of Minor Calyx?

How many are in each kidney?

A

Small urine collection chambers from papilla

8-18/kidney

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17
Q

Function of Major Calyx?

How many per kidney?

A

Larger chamber for collecting urine from minor calyces

2-3/kidney

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18
Q

Major Calyx are extensions of what structure?

A

Ureters

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19
Q

Function of Renal Pelvis?

A

Collection point from major calyces
Mixes all urine from entire kidney
Connects to ureter outside of kidney

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20
Q

What is the Renal Sinus?

A

Spaces of adipose tissue w/ blood and nerves

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21
Q

What structure meet the kidney at the Renal Hilum?

A

Ureter emerges
Blood/lymph vessels
Nerves

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22
Q

Renal blood flow is ______mL/min

A

1200

600mL/kidney

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23
Q

What is the total amount of blood in adults?

A

4500-5500mL

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24
Q

What is the specialized capillary inside of the kidneys and what is it’s function?

A

Glomerulus, tufted

Allow filtration, no reabsorption

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25
Q

What is the sequence of blood flow from Aorta->kidney-> heart?

A 
Aorta
Renal Artery
Segmental Artery
Interlobar artery
Arcuate Artery
Interlobular arter 
Afferent Arteriole
Glomerulus
Vasa Recta (jux nephrons only)
Interlobular Vein
Arcuate Vein
Interlobar Vein
Renal Vein
Inferior Vena Cava
ARS IAI AGE PVI AIR I
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26
Q

Interlobular arteries are AKA ?

Interlobular veins are AKA ?

A

Radial arteries

Radial veins

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27
Q

How does blood enter and exit the kidney to be filtered?

A

Enters corpuscle, filtered in glomerulus, exits corpuscle into capillary system

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28
Q

When blood is in the ______ capillaries, it still has the same properties as blood in any other body location

A

Pertibular capillaries/vasa recta

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29
Q

The pressures in the pertibular capillaries/vasa recta allows for what mechanism?

A

Secondary filter

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30
Q

Where is filtrate first found?

Where does it flow to after?

A 
Glomerular capsule (Bowmans's capsule)
Tubule->collecting ducts
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31
Q

Filtrate is not called urine until it leaves what structure?

A

Collecting ducts

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32
Q

What has a larger diameter, Afferent or Efferent arteriole?

A

Afferent- larger

Efferent- smaller, forms back pressure

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33
Q

What is the functional unit of the kidney?

A

Nephron

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34
Q

What are the two parts of a nephron?

A

Renal Corpuscle

Renal Tubule

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35
Q

What are the two parts of the Renal Corpuscle?

A

Glomerulus

Glomerular Capsule

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36
Q

What are the three parts of the Renal Tubule?

A

PCT- attached to capsule
LoH- middle
DCT- distant from capsule, empties into collecting ducts

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37
Q

Corpuscle and both convoluted tubules reside in the ______

A

Cortex

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38
Q

Only the ____ extends into the renal medulla

A

LoH

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39
Q

What are the two types of nephrons?

A

Cortical nephron

Juxtamedullary nephron

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40
Q

What type of nephron is the majority?

A

Cortical- 85%

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41
Q

What are the subcomponents of the Cortical Nephron?

A

Renal corpuscles lie in outer portion of renal cortex
Short LoH, barely dips into medulla before returning to renal medulla
Peritubular capillaries only

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42
Q

What are the subcomponents of Juxtamedullary nephrons?

A

Renal corpuscles that lie deep in cortex
Long LoH
Peritubular capillaries that give rise to Vasa Recta

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43
Q

Justamedullary nephrons make up __% of total nephrons?

A

15%

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44
Q

What is the Vasa Recta of the Jux. Nephrons?

A

Capillary bed that extends into medulla surrounding the LoH

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45
Q

How do Cortical peritubular capillaries return back to systemic circulation?

A

After proximal/convoluted tubules, flow into interlobular veins, then to systemic circ.

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46
Q

What part of the kidney causes dilute or concentrated urine?

A

Juxtamedullary nephron long LoH

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47
Q

How do Juxtamedullary peritubular capillaries return to systemic circulation?

A

Vasa Recta- goes deep into renal medulla along LoH

Allows flow out of capillaries into filtrate and out of filtrate into capillaries

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48
Q

What kidney structure is extremely important for keeping a constant osmotic pressure gradient?

A

Juxtamedullary Vasa Recta

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49
Q

What are the characteristics of the Afferent Arteriole?

A

Arteriole into corpuscle/glomerulus

Wider lumen, thicker walls w/ greater capability to constrict/dilate

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50
Q

What are podocytes?

A

Modified simple squamous epitherlial cells w/ projections (pedicels) that wrap around glomerular capillaries

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51
Q

What is the ball of twine-like capillary structure that buds off an afferent arteriole?

A

Glomerulus

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52
Q

What are the characteristics of the Efferent Arteriole?

A

Arteriole leaving corpuscle/glomerulus
Brings blood w/ larger solutes into peritubular capillaries and back into systemic circulation

Have a smaller lumen and thinner walls which aids in back-pressure needed for filtration

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53
Q

A single layer of epithelial cells forms the entire wall of what three things?

A

Glomerular Capsule
Renal Tubule
Ducts

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54
Q

What is the histology of the PCT?

A

Sinple cuboidal w/ microvili on the apical surface (facing the lumen)

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55
Q

What is the histology of the LoH?

A

Think descending and ascending made of simple squamous

Thick ascending- simple cuboidal to columnar

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56
Q

Histology of the DCT?

A

Most- simple cuboidal

Last part- Principal cells: receptors for ADH and aldosterone; Intercalated cells- role in blood pH

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57
Q

What is the histology of the Collecting Duct?

A

Simple cuboidal w/ principal and intercalated cells

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58
Q

What two places are Principal and Intercalated cells located?

A

Last part of DCT

Collecting Duct

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59
Q

What are the 3 functions nephrons and collecting ducts perform?

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

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60
Q

Define Glomerular Filtration

A

Water and solutes in blood moves across glomerulus wall into Bowmans capsule and into tubules

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61
Q

Define Tubular Reabsorption

A

Water and solutes in tubule system can be reabsorbed

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62
Q

How much of filtrate is reabsorbed and where does it happen?

A

99% in tubular reabsorption

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63
Q

Define Tubular Secretion?

A

Peritubular capillaries and vasa recta give final chance for wastes to be transferred into filtrate

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64
Q

Adults make ___ L of filtrate per day compared to a normal urine output of ___ L

A

150-180L/day of filtrate

1-2L of urine

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65
Q

What form the leaky barrier in the capsule?

What is it’s function?

A

Glomerular capillaries and podocytes
Allows water/solutes to pass into capsular space
Prevents- proteins, RBCs, platelets from getting into capsular space

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66
Q

What are the 3 layers of the filtration membrane?

A

Fenestrations of endothelial cells- prevents blood from passing
Basement membrane/Basal lamina- prevents large proteins from passing
Slit membranes between pedicels- prevents filtration of most other proteins

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67
Q

What are Mesangial Cells and what are their function?

A

Glomerular capillaries
Regulate surface area for filtration
Relaxed= max SA
Contracted= reduced SA

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68
Q

Define GBHP

A

Glomerular blood hydrostatic pressure- pressure in glomerulus pushing outward into capsular space

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69
Q

Define CHP

A

Capsular hydrostatic pressure- pressure by fluid in capsular space pushing inward on visceral glomerular membrane, “back pressure”

Opposing filtration pressure

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70
Q

Define BCOP

A

Blood colloid osmotic pressure- pressure due to proteins (albumin) in blood plasma
Pulls on fluid to keep them in glomerulus
Opposes filtration

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71
Q

Define NFP and the equation

A 
Net Filtration Pressure
NFP= GBHP-CHP-BCOP
NFP pressure is supposed to promote filtration
\+ = filtration
- = no filtration
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72
Q

Normal NFP is the pressure that causes a normal amount of ____ to filter from ____->______

A

blood plasma
glomerulus
capsular space

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73
Q

What is the average GFR for an adult?
What happens if it’s too fast?
Too slow?

A

125mL/min
amount of blood filtered by kidney’s glomeruli into capsular space per time
Fast= filtrate passes too quickly, substances not reabsorbed
Slow= all filtrate reabsorbed and wastes no excreted efficiently

74
Q

How is GFR calculated?

A

Estimation

Serum creatinine levels plus age, race, weight, gender

75
Q

How is a creatinine clearance test conducted?

What if it’s low?

A

With 24 hour urine collection sample

Low urine level= kidney’s not filtering creatinine correctly, kidney damage

76
Q

What patient population has a higher serum creatinine level?

A

Afro-Caribbean due to increased muscle mass and higher rates of muscle breakdown
21% higher than normal level for non-black PTs

77
Q

GFR is directly related to what?

A

Pressures that determine net filtration pressure

78
Q

If GBHP drops by even 10mmHg, what happens to filtration?

A

Filtration in glomerulus stops

79
Q

What are mechanisms that regulate GFR?

A

Renal auto regulation- innate w/in kidney
Neural regulation- SNS input/lack of
Hormonal- Angiotensin II, ANP

80
Q

Kidneys help regulate their own GFR through what two mechanisms?

A

Myogenic mechanism- increased BP causes afferent stretching, smooth muscle contraction of afferent arteriole, reduced renal blood flow, reduced GFR (inc BP=myogenic constriction=compensating vasodilation)

Tubuloglomerular feedback- Juxtaglomerular apparatus. GFR inc=rate through tubules increased
Reduced Na, Cl and water
Macula densa sense increased levels of ions in filtrate, inhibits release of NO, afferent arterioles constrict, lowers GFR, lowers GFR rate through tubules

81
Q

What kidney regulation process helps preserve nephron integrity from a sudden/abrupt increase of BP?

A

Myogenic mechanism

82
Q

Define Juxtaglomerular Apparatus

What does it contain?

A

Ability to affect systemic BP through auto regulation of tubuloglomerular feedback
Contains: one JGA per nephron in walls of afferent arteriole
Macula densa cells- walls of DCT
Lacis cells, located between a/efferent arterioles and DCT

83
Q

Define Lacis cells

A

Modified mesangial cells

84
Q

What are the two functions of the JGA?

A

Detect low BP (lack of stretch in afferent wall)

Synthesize, store and secrete renin

85
Q

Where are macula densa cells located?

A

DCT

86
Q

What are the two functions of macula densa?

A

Detect increase in NaCl in FILTRATE

Release ATP, adenosine that contract afferent arteriole, reduces GFR

87
Q

What are the 3 components of the Justaglomerular apparatus?

These components together make up what concept?

A

Macula Densa
Juxtaglomerular cells
Lacis cells

Tubuloglomerular feedback

88
Q

What does tubuloglomerular feedback regulate?

A

BP within kidneys and eventually, systemic BP

89
Q

Kidney blood vessels are only supplied by what NS?

A

Sympathetic
At rest- low
Exercise/fight: Constriction of afferent, decreased flow to glomerulus, decreased GFR

90
Q

What two processes protect the nephrons from sudden BP increases?

A

Myogenic mechanism

GFR neural regulation

91
Q

What are the two hormones that control regulation of GFR?

A

Angiotensin II- reduces GFR

ANP- increases GFR

92
Q

How does Angiotensin II create its effect on GFR?

A

Potent vasoconstrictor
Acts on efferent arteriole
Reduces renal flow

93
Q

How does ANP create its effect on GFR?

A

Secreted by atria in response to increased volume

Vasodilates afferent and efferent, increases GFR

94
Q

When does passive movement occur?

A

Pressure gradients allow flow from high->low w/out ATP (glomerular filtration)

95
Q

When does active movement occur?

A

Moving solutes against a gradient w/ help of ATP expenditure (Na/K pump)

96
Q

What three structures can reabsorb filtrate?

Where does the majority occur?

A

Renal Tubule
Renal Ducts
PCT- reabsorbs the most

97
Q

What are solutes that are actively and passively reabsorbed?

A 
Glucose
AA
Urea
Na
K
Ca
Cl
Ma
Bicarb
Phosphates
98
Q

What distal structures “fine tune” the reabsorption process?

A

LoH
DCT
Collecting duct

99
Q

If small protein and peptides are passed through the glomerular filter, how are they usually reabsorbed?

A

Pinocytosis

100
Q

Tubular reabsorption occurs through what two processes?

A

Paracellular- PASSIVE movement between adjacent tubule cells, 50% of reabsorption

Transcellular- PASSIVE and ACTIVE movement through the tubule cell itself

101
Q

Define Apical Membrane

A

Lumen side of the cell

102
Q

Define Basolateral Membrane?

A

Interstitial side of the cell

103
Q

Define Obligatory Water Reabsorption and where does it occur?

A

90% of water reabsorption by kidneys occurs through the reabsorption of Na, Cl and glucose

Occurs in PCT and descending LoH

104
Q

What drives obligatory water reabsorption?

A

Solute reabsorption via osmosis

105
Q

What areas of the kidney are ALWAYS permeable to water?

A

PCT

Descending LoH

106
Q

Obligatory water reabsorption accounts for 90% of reabsorbed fluid, what happens to the other 10%?

A

Facultative water reabsorption

107
Q

What regulates Facultative Water Reabsorption and where does it occur?

A

Regulated by ADH

Occurs in late DCT and Collecting Ducts

108
Q

Tubular secretion gives the final chance to secrete what substances?

A 
H 
K
Ammonium
Creatinine
Drugs like penicilin
109
Q

If antibiotics/drugs were to be secreted into filtrate, where would the transfer occur?

A

Tubular secretion, from capillaries (peritubular/vasa recta), interstitial and tubule cells to filtrate

110
Q

What happens to most of the ammonia made in the body?

A

Converted to urea in liver

111
Q

What is urea’s beneficial component to the body?

A

Significant in creating/maintaining osmotic gradient in renal medulla

112
Q

Where is the majority of bicarbonate reabsorbed?

A

PCT

113
Q

Since Bicarbonate can’t be reabsorbed in tit’s complete form, what steps have to happen first?

A

H + HCO3= H2CO3 Carbonic Acid
H2CO3 disassociates into CO2 and water
CO2 diffuses into tubule cells and joins with H2O forming H2CO3 in tubule cells where it dissociates into H and HcO3

114
Q

For every H+ secreted into tubular lumen, how many bicarb and Na are reabsorbed?

A

One and One

115
Q

The largest amount of solute and water reabsorption from filtered fluid occurs where?
What are the solute %s that are reabsorbed?

A

PCT
100% of glucose, aa and vitamins
80-90% of Bicarb

65% Na, K and water
50% Cl and urea

116
Q

How is Na moved out of tubules and into interstitial fluids?

A

Actively with Glucose and AA co-transported w/ Na

117
Q

How does urea and Cl ions move from filtrate into interstitial fluid?

A

Passively

118
Q

What happens when Na and Cl move into interstitium?

A

Osmotic imbalance, causing water to be obligated to move out of filtrate into interstitium by osmosis which often brings K and Ca

119
Q

Why are cells in PCT and descending LoH especially permeable to water?

A

Aquaporin 1 channels- protein water channels that increase rates of water movement

120
Q

Define Solvent Drag

A

Osmosis of water bringing K and Ca with it in the PCT

121
Q

What effects does PTH have on the kidneys and reabsorption?

A

Stimulates PCT to secrete phosphate
Stimulates calcitriol (Vit D) to be made in PCT and absorbed in blood
Stimulates cells in DCT to absorb more calcium

122
Q

How does calcitriol exert it’s effect on Ca absorption?

A

Calcitriol circulates in intestines to cause more Ca from digestive system to be absorbed

123
Q

Where is solute and water reabsorption independently regulated?

A

Entire LoH

NOT in PCT

124
Q

Where is filtrate diluted or concentrated?

A

Descending- mostly water reabsorption and solute secretion, concentrates

Ascending- no water absorption, solute absorption, dilutes

125
Q

What happens in the thin portion of the Ascending LoH?

A

Passively permeable to small solutes, impermeable to water

Solutes move out of tubule, water remains causing first dilution of filtrate

126
Q

After the end of the first dilution process in the Ascending LoH, is the filtrate hyper or hypoosmotic?

A

Hypo

127
Q

What happens in the thick portion of the Ascending LoH?

A

Active reabsorption of K, Na, Cl but region is IMPERMEABLE to water
Filtrate moves up ascending limb and dilutes even more

128
Q

What events occur in the late portion of the DCT?

A

90-95% of filtered solutes/water have been reabsorbed and returned to circulation

129
Q

Amount of reabsorption of solutes/water in the DCT is dependent on what?

A

Body feedback
Hormonal
Osmoreceptor

130
Q

How are the DCT and PCT similar in regards to Na reabsorption?
How is the DCT different?

A

Completed by active transport
Cells impermeable so water doesn’t follow Na by osmosis
ADH can cause principal cells in DCT and collecting ducts to become permeable

131
Q

How does ADH trigger Principal cells and Collecting Ducts to reabsorb water?

A

ADH causes cells to generate Aquaporin 2 channels in apical membrane of cells lining the tubule

132
Q

With ADH present, what is the concentration of urine?

Where does the presence of ADH cause an osmotic imbalance?

A

ADH present, small quantity of highly concentrated urine

DCDuct

133
Q

What cascade occurs when ADH is present and causes an osmotic imbalance?

A

Forces urea reabsorption

Urea assists with increasing high osmolarity in interstitial fluid

134
Q

Where does Urea Recycling occur?

A

Reabsorbed in Distal Collecting Duct

Secreted in descending LoH

135
Q

If ADH is at max secretion levels, how much urine output will there be?

A

400-500mL very concentrated urine

136
Q

When blood pressure/volume stabilizes, what occurs with ADH?

A

Decline, removing Aquaporin-2 molecules from Principal cells

137
Q

What happens to Principal Cells when aldosterone is present?

A

Na reabsorption

K secretion

138
Q

What causes aldosterone to be released?

A

Hyperkalemia

Angiotensin II- low BP

139
Q

Principal cells are responsible for secretion of __ and reabsorption of __?

A

K

Na

140
Q

What stimulates the two different Intercalated cells?

A

Osmoreceptor readings in reference to pH and K levels

141
Q

What are the two types of intercalated discs and what are their functions?

A

Type A:
Secrete H
Reabsorb Bicarb and K

Type B:
Reabsorb of H
Secrete Bicarb
Secrete K

142
Q

Where does ANP have its effect?

How does it carry out this effect?

A

DCT
Collecting Ducts

Inhibits reabsorption of Na and water (inc urine output)
Inhibits RAAS

143
Q

RAAS is activated when low BP/volume is sense where?

A

Afferent arteriole

144
Q

What is the cascade of events when the RAAS is activated?

A

Low pressure sensed at afferent arteriole
Juxtaglomerular cells release renin
Hepatocytes release angiotensiogen
Renin cleaved 10 aa peptides off of angiotensinogen making Angiotensin-1 which goes to lungs
Converted to Angiotensin-2 by ACE and is now ACTIVE

145
Q

Angiotensin II affects renal physiology in what 3 ways?

A

Decreases GFR by constricting afferent arteriole
Enhances Cl, Na and water reabsorption in PCT by Principal cells
Stimulates release of aldosterone from adrenal cortex

146
Q

Regulation of plasma osmolarity and volume are the responsibility of what areas in the kidneys?

A

LoH:
Descending= permeable, concentration of urine, concentrating filtrate
Ascending= diluting urine, impermeable
DCT and Collecting ducts= final dilution/concentration

147
Q

Absence of ADH= _____ urine

Presence of ADH= _____ urine

A 
Absent= diluted
Present= concentrated
148
Q

What is normal color for urine?

A

Yellow or amber

149
Q

What is urine turbidity?

A

Transparent when voided, become cloudy with time

150
Q

What is urine’s odor?

A

Mildly aromatic, become ammonia like with time (bacteria turning urea->ammonia)

151
Q

What is normal urine pH range?

A

4.6-8.0 w/ 6.0 being average

152
Q

What are some dietary factors that can alter urine pH?

A

High protein increases acidity

Vegetarian increases alkalinity

153
Q

What is normal urines specific gravity?

A

1.001-1.035
lower=hydrated
higher the solute, higher the SpecG. value

154
Q

Water accounts for _% of urine
Solutes account for _%
What are the solutes?

A

95%
5%
Urea, creatinine, uric acid, urobionogen
Fatty acids, pigments, enzymes, hormones

155
Q

Where does uric acid and urobilinogen come from to get into urine?

A

Uric acid- break down of nucelic acids

Urobilinogen- breakdown of Hgb

156
Q

What are the two blood tests for testing urine function?

A

Blood Urea Nitrogen- BUN increases when GFR severely reduces

Plasma creatinine- no use for creatinine in f body

157
Q

What are normal levels for BUN and plasma creatinine?

A

BUN= 7-20mg/dL

1.6mg/dL

158
Q

Define Renal Plasma Clearance

A

Volume of plasma in mL that can be completely cleared of a substance per time unit

159
Q

What is a great measure of true GFR?

What is a good estimate for GFR?

A

Insulin- plant polysaccharide

Creatinine clearance

160
Q

What is the sequence of urine flow from kidney to elimination?

A 
Collecting ducts
Papilla
Papillary ducts
Minor calyces
Major calyces
Renal pelvis
Ureter
Bladder
Urethra
161
Q

Where do ureters meet with kidneys?

A

Pass obliquely into posterior/inferior aspect of bladder

162
Q

Define anti-reflux mechanism

A

When bladder is full, it pulls down which closes valves to ureters

163
Q

What are the 3 layers of ureters?

A

Adventitia- anchors ureters to tissues and contains blood/lymph vessels and nerves
Muscularis- provides paristalsis
Mucosa- transition epithelium w/ goblet cells to protect mucosa from acidity

164
Q

What is the bladders shape when empty and full?

A

Collapsed

Pear shaped

165
Q

What is the bladders anatomical location?

A 
Posterior pubic symphisis
Anterior rectum (males)
Anterior vagina
Inferior uterus
Held by peritoneal folds
166
Q

What are the 3 layers of the bladder?

A

1: Serosa- visceral peritoneum
2: Adventitia- covers post/inferior surface and continuous w/ ureter
Muscularis- detrusor muscle
3: Mucosa- uroepitheroium, rugae, transitional epitherlium,

167
Q

What are the 3 layers of the detrusor muscle?

A

Inner longitudinal
Middle circular
Outer longitudinal

168
Q

What happens when detrusor muscle is relaxed and contracted?

A 
Relaxed= bladder filling
Contracted= forced emptying
169
Q

What part of the renal system is a huge sight for development of cancer cells?

A

Transitional epithelium of bladder

170
Q

Define trigone

A

Smooth triangular bladder floor w/ ureteral openings in posterior corners and urethral opening in the anterior corner

171
Q

Define the Internal Urethral Sphincter

A

Inferior aspect of the bladder
Extension of detrusor muscle w/ involuntary control by parasymp. NS
Located just above prostate in males

172
Q

Define External Urethral Sphincter

A

Skeletal muscles of deep perineal muscles and pelvic floor
Below prostate in males
Opening of external urethra in females

173
Q

What are the 3 parts of the male urethra?

A

Prostatic
Membranous
Spongy

174
Q

What are the characteristics of the Prostatic urethra?

A

Smooth muscle forming internal urethral sphincter

Contains openings for prostatic fluids and sperm

175
Q

What are the characteristics of the Membranous Urethra?

A

Shortest region
Passes through urogenital diaphragm
Skeletal muscle forms external urethral sphincter

176
Q

What are the characteristics of the Spongy Urethra?

A

Longest region

Contains bulbourethral openings- Cowpers glands, delivers alkaline fluid to neutralize urethra acidity

177
Q

What does the mucosa of the female urethra consist of?

A

Epithelium and lamina propria
Transitional epithelium near bladder
Middler section is pseudo/stratified columnar
External urethra is non-keratinized stratified squamous

178
Q

What initiates the mechanism for urination?

What is the sequence of events?

A

Parasympathetic
Involuntary contraction on detrusor muscle
Internal urethral sphincter opens, urine moves from bladder to urethra
Sensation to urinate is sent/received
Voluntary contraction of external urethra sphincter prevents urination until appropriate time
Voluntary relaxation of external sphincter allows for urination

179
Q

Why do humans wear diapers as babies and geriatrics?

A

Learned control to contract/relax external urethra sphincter and pelvic muscles to over ride weak spinal muscles which are normally contracted
No conscious thought as infant
Weak muscles as a geriatric

180
Q

What effects does nephron deterioration cause with age?

A

Kidney shrinkage

Decreased renal flow/GFR

181
Q

Why does increased incidence of calculi occur with age?

A

Decreased thirst sensation

182
Q

What influences can cause polyuria and nocturia?

A

BPH
Prostate cancer
Hematuria
Dysuria

IPAP (212 decks)

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