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Physiology > Ch 25: Urinary Part 3 > Flashcards

Ch 25: Urinary Part 3 Flashcards

1
Q

What is osmolality?

A

Number of solute particles in 1 kg of H2O that reflects ability to cause osmosis

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2
Q

How is osmolality regulated by the kidneys?

A

Countercurrent mechanism by regulating urine concentration and volume

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3
Q

What is the mOsm of kidneys?

A

300

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4
Q

What is the countercurrent mechanism?

A

Occurs when fluid flows in opposite directions in 2 adjacent segments of same tube with hair pin turn

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5
Q

What is countercurrent multiplier?

A

The interaction of filtrate in ascending/descending limbs of nephron loops of juxtamedullary nephrons

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6
Q

What is the countercurrent exchanger?

A

Blood flow in ascending/descending limbs of vasa recta

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7
Q

What is the role of countercurrent mechanisms?

A
  1. Establish and maintain osmotic gradient from renal cortex through medulla
  2. Allow kidneys to vary urine concentration
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8
Q

Describe the countercurrent multiplier of the descending limb of the nephron loop

A
  1. Freely permeable to H2O
  2. H2O passes out of filtrate into hyperosmotic medullary interstitial fluid
  3. Filtrate osmolality increases to 1200mOsm
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9
Q

Describe the countercurrent multiplier of the ascending limb of the nephron loop

A
  1. Impermeable to H2O
  2. Na+ and Cl– actively reabsorbed in thick segment; some passively reabsorbed in thin segment
  3. Filtrate osmolality decreases to 100mOsm
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10
Q

Describe the route of the nephron loop

A
  1. Filtrate entering the loop is isosmotic to both plasma and cortical interstitial fluid
  2. Water moves out of the filtrate in the descending limb down its osmotic gradient concentrating the filtrate
  3. Filtrate reaches its highest concentration at the bend of the loop
  4. Na+ and Cl- are pumped out of the filtrate increasing the interstitial fluid osmolality
  5. Filtrate is most dilute as it leaves nephron
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11
Q

Describe the countercurrent exchanger in vasa recta

A
  1. Preserves medullary gradient
  2. Prevent rapid removal of salt from interstitial space
  3. Remove reabsorbed water
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12
Q

What happens to urine during overhydration?

A
  1. Decrease osmolality
  2. ADH decreases
  3. Aldosterone removes additional ions
  4. Decrease in aquaporins
  5. Less H2O reabsorption
  6. Large volume of dilute urine
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13
Q

What happens to urine during dehydration?

A
  1. Increase osmolality
  2. Maximal ADH released
  3. Increased aquaporins
  4. Increase H2O reabsorption
  5. Small volume concentrated urine
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14
Q

How is urea recycled?

A
  1. Enters filtrate in ascending thin limb of nephron loop
  2. Cortical collecting duct reabsorbs water; leaves urea
  3. In deep medullary region now highly concentrated urea → interstitial fluid of medulla → back to ascending thin limb → high osmolality in medulla
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15
Q

What is a diuretic?

A

Chemicals that enhance urinary output

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16
Q

What are examples of diuretics?

A
  1. ADH inhibitors: alcohols
  2. Na+ reabsorption inhibitors: caffeine, hypertension drugs, edema
  3. Loop diuretics inhibit medullary gradient formation
  4. Osmotic diuretics: substance not reabsorbed so water remains in urine
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17
Q

What is required for assessing renal function?

A

Blood and urine examination

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18
Q

What is renal clearance?

A

Volume of plasma kidneys clear of particular substance in given time

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19
Q

What is the purpose of renal clearance tests?

A
  1. Determine GFR
  2. Detects glomerular damage
  3. Follows progress of renal disease
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20
Q

What factors are proportional to renal clearance?

A
  1. Concentration of substance in urine
  2. Flow rate of urine formation
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21
Q

What factors are inverse to renal clearance?

A

Concentration of same substance in plasma

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22
Q

What is the standard use of inulin in regards to renal clearance?

A

Freely filtered; neither reabsorbed nor secreted by kidneys

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23
Q

Describe what occurs during the change of renal clearance

A
  1. If C < 125 ml/min, substance reabsorbed
  2. If C = 0, substance completely reabsorbed, or not filtered
  3. If C = 125 ml/min, no net reabsorption or secretion
  4. If C > 125 ml/min, substance secreted (most drug metabolites)
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24
Q

What is GFR of chronic renal disease?

A

Less than 60mL/min for 3 months

25
Q

What is GFR of renal failure?

A

Less than 15mL/min

26
Q

What is uremia?

A

Ionic and hormonal imbalances, metabolic abnormalities, toxic molecule accumulation

27
Q

How is renal failure treated?

A

Hemodialysis

Transplant

28
Q

What is cloudy urine indicate?

A

UTI

29
Q

What does pale deep yellow urine indicate?

A

Urochrome breakdown; more concentrated urine → deeper color

30
Q

What does pink, brown, smoky urine indicate?

A

Food ingestion, bile pigments, blood, drugs

31
Q

What is the specific gravity of urine?

A

1.001 - 1.035

32
Q

Describe the odor of urine

A
  1. Aromatic when fresh
  2. Develops ammonia has bacteria metabolizes
33
Q

What is the pH of urine?

A

4.5-8 depending on diet

34
Q

What is the chemical composition of urine?

A
  1. 95% water
  2. 5% solutes
35
Q

What are nitrogenous wastes of urine?

A
  1. Urea: AA breakdown
  2. Uric acid: Nucleic acid metabolism
  3. Creatinine: metabolite of creatine phosphate
36
Q

What are the ions that leave from urine?

A
  1. Na+
  2. K+
  3. (PO4)3-
  4. (SO2)2-
  5. Ca2+
  6. Mg2+
  7. HCO3-
37
Q

What is the purpose for ureters?

A

Convey urine from kidneys to pladder

38
Q

Describe the location of the ureters

A

Retroperitoneal

39
Q

What is the medical name for kidney stones?

A

Renal calculi

40
Q

What forms kidney stones?

A

Crystallized calcium, magnesium, or uric acid salts that block and increase pressure in ureters

41
Q

What can cause kidney stones?

A
  1. Bacterial infection
    1. Urine retention
    2. Increased Ca2+ in blood
    3. Increased pH of urine
42
Q

How is kidney stones treated?

A

Shock wave lithotripsy

43
Q

What the urinary bladder?

A

Muscular sac for temporary storage

44
Q

Where is the bladder located?

A
  1. Males: prostate inferior to bladder neck
  2. Females: anterior to vagina and ureters
45
Q

What is a trigone?

A

Smooth triangular area outlined by openings for ureters and urethra

Susceptible to infection

46
Q

What is is the muscular layer of the bladder?

A

Detrusor

47
Q

What happens when the bladder empties?

A

It collapses causing rugae to appear

48
Q

How much urine can the bladder hold?

A

500mL, twice as much if necessary

49
Q

What is the urethra?

A

Muscular tube draining urinary bladder

50
Q

What are sphincters of the urethra?

A
  1. Internal urethral
  2. External urethral
51
Q

What is the difference between the internal and external urethral sphincter?

A
  1. I: Involuntary (smooth muscle) that contracts to open at bladder-urethra junction
  2. E: Voluntary (skeletal) that surround urethra
52
Q

What is micturition?

A

Urination or voiding

53
Q

What are the events of micturation?

A
  1. Contraction of detrusor by ANS
  2. Opening of internal urethral sphincter by ANS
  3. Opening of external urethral sphincter by Somatic NS
54
Q

What is reflexive urination?

A

Urination in inflants

55
Q

What is stress incontinence?

A

Increased intra-abdominal pressure forces urine through external sphincter

56
Q

What is overflow incontinence?

A

Urine dribbles when bladder overfills

57
Q

What occurs during urinary retention?

A
  1. Bladder unable to expel urine
  2. Can be due to anesthesia
  3. Hypertrophy of prostate
58
Q

What is the treatment for urinary retention?

A

Catheterization

Physiology (22 decks)

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