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Anatomy and Physiology > A & P - Urinary System > Flashcards

A & P - Urinary System Flashcards

1
Q

what does the urinary system consist of?

A

kidneys
bladder
ureter
urethra

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2
Q

what is the function of the bladder?

A

storing urine

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3
Q

what are the layers of the bladder?

A

serous
muscular
inner mucous coat

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4
Q

how much urine can the bladder hold?

A

250-300ml normally but up to 500ml

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5
Q

what is the function of the urethra?

A

to pass urine from bladder to exterior

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6
Q

how does the urethra differ in men and women?

A

women - shorter (4cm), only serves urinary system

men - longer (18-20cm), serve urinary and repro. systems

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7
Q

what is the function of the ureter?

A

to carry urine from kidney to bladder

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8
Q

what is the structure of the ureter?

A

25-30cm long, thick walled tube ~3mm thick

uses peristalsis contractions 4-5 times a min

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9
Q

what are the functions of the kidneys?

A 
reg. body fluid / volume / osmolality
maintains electrolyte balance
formation of urine
excretion of metabolic waste
acid base balance
production of hormones / enzymes
activation of vit D
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10
Q

what is osmolality?

A

concentration of solutes in body fluid

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11
Q

what is the normal osmolality of the body?

A

280-300mOsm Kg

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12
Q

what % of the body is fluid?

A

70% (32-40l)

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13
Q

describe the distribution of fluid in the body

A

intracellular - 25l
interstitial - 11l
plasma - 3-5l

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14
Q

what is the functional part of the kidney called and what are they made of?

A 
function part - parenchyma
made of - cortex and renal pyramids
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15
Q

what di the renal pyramids consist of?

A

straight tubules

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16
Q

how many nephron does each parenchyma have?

A

~ 1 million

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17
Q

describe the path of blood flow through the kidney

A 
renal artery
interlobar arteries
arcuate arteries
interlobular arteries
interlobular veins
arculate veins
interlobar veins
renal veins
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18
Q

name two types of nephron

A

juxtamedullary nephron

cortical nephron

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19
Q

name 4 functions of the nephron

A
  1. glomerular filtration
  2. tubule reabsorption
  3. tubule secretion
  4. water conservation
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20
Q

what is the endothelial-capsular membrane?

A

3 layers that act as a filter - lets some material from blood pass and restricts others

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21
Q

what is the usual glomerulus filtration rate?

A

women - 115ml/min = 160l plasma p/day

men - 125ml/min = 180l plasma p /day

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22
Q

what is a usual daily urine output and what does it consist of?

A

1-2l per/day - most water and solutes reabsorbed

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23
Q

what is the standard measure of glomerulus filtration?

A

check creatinine

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24
Q

describe the structure and function of the proximal convoluted tubule (PCT)

A

long length and microvilli increase surface area
mitochondria - for active transport
reabsorbs chemicals

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25
Q

name 4 chemicals reabsorbed in the proximal convoluted tubule, by which method are they absorbed and how much

A

sodium - 65% (active transport)
glucose - 100% (secondary active transport)
amino acids - 100% (secondary active transport)
water - 65% (osmosis)

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26
Q

what happens when the transport proteins used in active transport are saturated?

A

glucose (>220mg/dl) remains in the urine (glycosuria)

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27
Q

what is reabsorbed in the loop of henle and in what amounts?

A

sodium 25% (AT)

water 25% (osmosis)

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28
Q

what is reabsorbed in the distal tubule and collecting duct and in what amounts?

A

sodium 8-10% (AT)

water 8-10% (osmosis)

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29
Q

what controls the sodium and water balance in the nephron? and what is its purpose?

A

hormones control sodium and water balance which regulates blood pressure

30
Q

which hormones are involved in the regulation of sodium and water balance?

A

aldosterone
atrial natriuretic peptide (ANP)
anti-diuretic hormone (ADH)

31
Q

what function does aldosterone serve?

A

stimulates sodium reabsorption

increases blood volume

32
Q

what function does atrial natriuretic peptide (ANP) serve?

A

increase sodium excretion

decreases blood volume

33
Q

what function does atrial anti-diuretic hormone (ADH)serve?

A

more - increases water reabsorption

less - decreases water reasborption

34
Q

which part of the nephron do hormones work to control sodium and water balance?

A

distal tubule and collecting duct

35
Q

what is blood pH?

A

measurement of concentration of H+

36
Q

what is a usually blood pH?

A

atrial pH - 7.45
venous pH 7.35
(acceptable range 6.8-8.0)

37
Q

what is acidosis and what are the symptoms?

A

pH be 7.35

depression of CNS, disorientation, coma

38
Q

what is alkalosis and what are the symptoms?

A

pH above 7.45

convulsions, respiratory spasm

39
Q

what are the metabolic causes of H+ in blood?

A
  1. carbonic acid formation
  2. catabolism of organic nutrients, meats, proteins (form sulphuric and phosphoric acid)
  3. organic acids from intermeditate metabolism of fatty acids during meat metabolism and lactic acid from excercise
40
Q

how is acid base balance maintained?

A
  1. lungs
  2. proximal tubules (PCT) cells
  3. type A intercalated cells in collecting ducts
41
Q

how do the proximal tubules (PCT) cells maintain acid base balance?

A

secrete H+ ions
reabsorb HCO3 ions
excrete ammonium ions
generate HCO3

42
Q

how do the type A intercalated cells in collecting ducts maintain acid base balance?

A

secrete H+ ions
reabsorb HCO3 ions
excrete dihydrogen phosphate ions
generate HCO3

43
Q

which hormones are secreted by the kidney and what are their roles?

A

renin - control total body fluids

erythropoietin - stimulates RBC production

44
Q

what does the kidney activate?

A

vitamin D, needed for calcitriol which regulates calcium and phosphorus in blood

45
Q

why is urine yellow?

A

urochrome from breakdown of haemoglobin

46
Q

what gives urine its odour?

A

bacteria degrade urea to ammonia

47
Q

what is the osmolality of urine?

A

50-1200 mOsm/kg

48
Q

what is the pH range of urine?

A

4.5 - 8.2 (usually 6.0)

49
Q

what is the chemical composition of urine?

A

95% water

~ 5% solutes (urea, NaCl, creatinine, uric acid)

50
Q

what controls bladder function?

A

stretch receptors
sensory fibres
interneuron relays
parasympathetic motor fibres

51
Q

what role do the interneuron relays play in bladder function?

A

sends sensation to thalamus, then cerebral cortex - makes you aware you want to wee

52
Q

what role do the parasympathetic motor fibres play in bladder function?

A

relay impulses from pelvis to post-ganglionic neurons - stimulate detrusor muscle to contract, micturition occurs after voluntary relaxation of sphincter

53
Q

what is the cause of kidney disease in diabetic patients?

A

damage to large and small renal blood vessels - leads to lack of blood supply to kidney and cell death

54
Q

why can hypertension cause kidney failure?

A

nephron glomeruli damaged by high pressure so no longer filters blood

55
Q

in both diabetes and hypertension the renal blood vessels become damaged, what effect does this have on the glomeruli?

A

glomeruli become ‘leaky’ allowing albumin to enter urine

56
Q

name two congenital renal abnormalities

A

autosomal dominant polycystic kidney disease (ADPKD) - renal cysts
renal chloride diseases - barters syndrome, gitelmans syndrome, dents syndrome

57
Q

what are kidney stones?

A

calcium compounds - oxalate or phoshate

58
Q

what do the terms nephrolithiasis and urolithiasis mean?

A

nephrolithiasis - stones in kidneys

urolithiasis - stones anywhere in urinary system

59
Q

what are the symptoms of kidney stones?

A 
often none
sharp back pain or in side, abdomen, groin
nausea/vomiting
haematuria (blood in urine)
infection
60
Q

what is glomerulonephritis and what causes it?

A

inflammation of kidney glomeruli - impaired filtering
causes - post infection complications, lupus
symptoms - blood/protein in urine

61
Q

what is acute kidney failure and what are the causes?

A

sudden loss of renal function

causes - ureter or bladder obstruction, extreme low BP, toxic injury, blockage of renal blood supply

62
Q

what is chronic kidney disease (CKD)?

A

gradual loss of renal function, marked by 5 stages

63
Q

list the stages of chronic kidney disease and the glomeruli filtration rate at each stage

A 
stage 1 - GFR >90ml/min
stage2 - 60-89ml/min
stage 3 -  30-59ml/min
stage 4 - 15-29ml/min
stage 5 - <15ml/min
64
Q

what treatment is given for renal failure (end stage renal disease)?

A

dialysis or transplantation

65
Q

what are the early symptoms of chronic kidney disease?

A

high BP
frequent urination
difficult/painful urination
swollen hands/feet

66
Q

how is urinalysis used to detect kidney damage?

A

detects proteinuria (early marker)
detects abundant protein albumin
usually 30mg/day but in proteinuria 300mg/day

67
Q

what risk factors are linked with chronic kidney disease?

A

obesity (itself and increase risk of diabetes/hypertension)
genetic factors
usually due to multiple risk factors

68
Q

what treatments are available for chronic kidney disease?

A

control of blood pressure
weight control
dialysis

69
Q

how can diet be used to control CKD?

A

reduces work of kidneys if the following are reduced:
protein (urea build up)
phosphorus (removes calcium)
sodium (reduce BP)

70
Q

name the two types of dialysis which can be used in end stage CKD

A

haemodialysis

peritoneal dialysis

71
Q

explain how a kidney transplant is performed

A

new kidney - lower abdo.
joined to iliac vein in leg
renal artery joined onto iliac artery
ureter joined to bladder

72
Q

list three problems with kidney transplant

A

requires donor
risk of infection
immunosuppressive drugs - increase risk if cancer and infection

Anatomy and Physiology (15 decks)

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