Block 3 - Renal/Urinary Flashcards

1
Q

what are the functions of the urinary system

A

filter blood, collect waste as urine, transport urine to the external environment

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2
Q

what is the urinary tract and what is it composed of

A

all connected organs which form urinary system

kidneys, ureters, urinary bladder, urethra

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3
Q

what are the margins of the kidney

A

lateral border, medial border, superior and inferior poles

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4
Q

describe the positioning of the kidney relative to each other

A

right lower than left due to liver

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5
Q

what is the hilum of the kidney and what is there

A

part of medial border where strucutres enter / leave

renal a (segmental a and accessory renal aa)
renal v
renal pelvis
ureter

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6
Q

what is the renal pelvis

A

funnel like dilated portion of ureter where urine is collected from kidneys

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7
Q

what is the renal sinus

A

structures of the hilum pass through renal sinus, space deep to hilum surrounded by tissue of kidney

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8
Q

what are polar arteries

A

accessory arteries which pierce pole of kidney directly

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9
Q

what is the ureter

A

transports urine inferiorly form kidney to bladder

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10
Q

what is kidney parenchyma

A

solid part / tissue where physiological processes take place

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11
Q

what are the two types of tissue in renal parenchyma

A

cortex and medulla

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12
Q

what renal structures are in the cortex

A

cortical arches, renal columns

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13
Q

what renal structures are in the medulla

A

pyramids

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14
Q

what are renal papillae

A

apex of renal pyramid blood converted to filtrate to urine, each pyramid drains during to renal papillae

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15
Q

where does filtrate become urine

A

at renal papillae

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16
Q

what are the main functions of the kidneys

A

maintenance of extracellular volume and osmolarity / maintenance of bicarb buffer system / glucose moderation

endocrine

excretion of catabolic wastes / bioactive substances / produce and excrete uring

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17
Q

what is calcitriol and what does it do

A

hormone, increase Ca2+ in blood

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18
Q

what is erythropoietin and what does it do

A

RBC production, hormone

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19
Q

what is renin and what does it do

A

increase BP

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20
Q

describe the position of the kidney in the abdomen / thoracic cage

A

in paravertebral gutter - space formed btwn spinal column and posterior thoracic cage, in retroperitineal space

L: T11-12
R: T12-13
Hila: L1 on level of transpyloric plane

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21
Q

what is the peritoneum

A

serous membrane which lines abdominopelvic cavity

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22
Q

what are the boundaries of the retroperitoneal space

A

anterior: peritoneum
posterior: posterior abdominal wall

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23
Q

what are the subdivisions of the retroperitoneal space superficial to deep

A

pararenal space, perirenal fascia, perirenal space (enters renal sinus)

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24
Q

how can weight loss influence kidney positioning and what are the consequences of this

A

lose some of the adipose tissue in the retroperitoneal space, cause kidney to slide inferiorly which can kink the ureters

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25
what does the perirenal fascia surround
suprarenal glands, kidneys, upper ureters
26
what is in the perirenal space
suprarenal glands, kidneys, proximal ureters, adipose
27
what is the difference between a simple and a radical nephrectomy
simple: removal of kidney radical: removal of all contents of perirenal space
28
trace the path of urine conduction from nephrons to ureter
collecting ducts of nephrons, renal papillae, minor calices, major calices, renal pelvis and ureter
29
what are the 5 renal segments
apical, anterior superior, anterior inferior, inferior, posterior
30
why is a partial nephrectomy possible
renal arteries are end arteries and do not anastomose with each other. intrarenal veins do but its not a big deal
31
what is a renal lobe
pyramid and surrounding cortex
32
what is a renal lobule
cortical arch surrounding a single medullary ray
33
describe the branching pattern of renal arterial supply
renal a, segmental a, interlobular a, arcuate a, cortical radiate aa
34
what is the renal portal system
glomeruli, efferent arterioles, peritubular capillaries capillary bed feeding into another capillary bed via intermediate aa
35
trace the renal venous drainage system
vasa recta, peritubular venules, cortical radiate vv, arcuate v, interlobular v, renal v
36
what is the difference between hilar and polar ateries
hilar enter in hilum polar enter in a pole
37
what does the L renal v receive drainage from
L suprarenal v, L inferior phrenic v, L gonadal v
38
explain L renal entrapment syndrome
L renal vein is between superior mesenteric a and aorta. if dilation / aneurysm of either occurs the L renal v would be compressed. prevents drainage from the L kidney and feeder vv. can cause pain and hematuria
39
what is more significant for renal function, intrinsic or extrinsic control
intrinsic
40
where does intrinsic renal control come from
auto regulation within the nephron
41
where does extrinsic renal control come from
hormones and renal plexus
42
what is antidiuretic hormone and where is it from
from pituitary, vasosurpressant, decreases urine output
43
what is parathyroid hormone and where is it from
from parathyroid gland, increases calcium absorption in nephron
44
does vasoconstriction increase or decrease filtration and urine production
decrease
45
what does juxtaglomerular apparatus stimulation do
renin secretion, increase BP
46
does the renal plexus receive sympathetic or parasympathetic input
both
47
what nerve does the renal plexus receive sympathetic input from
splanchnic nn
48
where do sympathetic renal fibers travel / synapse
preganglionic fibers that synapse in aorticorenal ganglia, postganglionic travel in renal plexus to kidney
49
what nerve does the renal plexus receive parasympathetic input from
vagus nn
50
where do parasympathetic renal fibers travel / synapse
preganglionic fibers pass through anticorenal ganglion w/o synapsing and travel in renal plexus to kidney, synapse directly in wall of kidney
51
what is the renal corpuscle
glomerulus and glomerular capsule combined
52
what is the glomerular capsule
sac that collects filtrate produced by glomerulus and funnels into renal tubule
53
what are the renal tubules
transport filtrate through nephron for additional reabsorption / secretion
54
what is the afferent arteriole
carries blood into glomerulus to be filtered in nephron
55
what is the efferent arteriole
carries filtered blood out of glomerulus and into peritubular capillary
56
what is the glomerulus
primary site of filtration in kidney / nephron
57
what is the peritubular capillary
surrounds renal tubule so that material may be exchanged between filtrate and blood after primary filtration
58
what is tubular secretion and reabsorption
secretion: 2nd chance for filtering of blood in peritubular capillary reabsorption: materials pulled out of renal tubule and back into blood (water)
59
what are the parts of the renal tubule
proximal convoluted tubule (convoluted and straight part) which reveives filtrate from renal corpuscle nephron loop which dips into medulla distal convoluted tubule which empties filtrate into collecting duct
60
where do renal tubules drain
into collecting duct which drains into renal papillae
61
what are the two types of nephrons
cortical and juxtamedullary
62
what are the differences between cortical and juxtamedullary nephrons
cortical: sit high in cortex, short nephron loops juxta: less common, low in cortex, longer nephron loops. vasa recta flow with, create more concentrated urine (longer loop is more water reabsorbed)
63
what is the glomerular filtration rate
speed at which glomerulus can transform blood to filtrate, adjustable, proportional to BP
64
what are mesangial cells and what do they do
specialized glomerulus cells, smooth muscle between podocytes that affect distance between podocytes through contraction and relaxation and help with intrinsic control of GFR
65
what is included in the visceral layer of the filtration membrane in the glomerulus
podocytes: specialized cells / slits between cells that allow for passing of specific materials filter: active filter
66
what is the vasa recta
vasculature following the nephron loop to secrete and reabsorb
66
where does primary reabsorption of water occur in nephron loop and what force drive that
in descending limb by hypertonic medulla
67
how does the H2O reabsorption process continue in the nephron loop
hypertonic medulla pulls water out of loop, vasa recta pulls water out of medulla to maintain hypertonicity
68
where does primary secretion of Na+ from the loop happen
in ascending limb
69
what do intercalated cells in the distal convoluted tubule do
maintain pH homeostasis
70
what are principle cells in the distal convolutes tubule and describe their process
help with reabsorption. aldosterone stimulates cells which allows for reabsorption of Na, water follows Na, vasopressin release simulates H2O reabsorption, increased blood volume = increased BP
71
what does parathyroid hormone stimulate in the distal convoluted tubule
reabsorption of Ca2+
72
what is the juxtaglomerular apparatus and what does it regulate
mucula densa plus afferent arteriole, renal blood flow and GFR
73
what are macula densa
cluster of cells adjacent to renal corpsule that sense Na Cl and K in filtrate (information about GFR)
74
how does the afferent arteriole change GFR
receives information from macula densa and smooth muscle increases or decreases diameter of arteriole which changes GFR
75
how do diuretics work to increase urinary production
increase tubular secretion of water or decrease tubular reabsorption of water
76
what aa supply the superior urinary bladder
superior vesical aa from umbilical a
76
what are the three parts of the ureters
abdominal, pelvic (begins at bifurcation of common iliac a), intramural (within posterior bladder wall)
76
what are rugae
bumpy appearance of inner wall of bladder that are present only when the bladder is empty
77
what aa supply the inferior urinary bladder
inferior vesical a
78
what is the detrusor muscle
makes up bladder wall
79
what aa supply the detrusor muscle
superior and inferior vesicle aa
80
what is the innervation of the detrusor muscle
vesicle plexus
81
what is the fundus and what are the important parts
where ureters descend into blasser posteroinferior part and ureteric orifices
82
where is the ureteric crest
between ureteric orifices
83
what is the trigone of bladder
triangle made of ureteric orifices and crest and internal urethral orifice
84
which urethral sphincter has autonomic control? somatic?
internal: auto external: somatic
85
what nerve is responsible for parasympathetic input of the organs of the pelvic cavity
pelvic splanchnic nn
86
what nerve is responsible for sympathetic input of the organs of the pelvic cavity
sacral splanchnic nn
87
what plexus is the primary bladder innervation
vesical plexus
88
explain the process of the micturition reflex
sensors detect amount of urine in bladder, parasympathetic innervation causes detrusor m contraction, sympathetic innervation causes internal urethral sphinctor to relax, voluntary control relaxation of the extrenal urethral sphincter
89
what plexus is the innervation of the organs of the pelvic cavity
inferior hypogastric plexus