Ch 85 Physiology And Pharmacology Of Renal Pelvis And Ureter Flashcards
With increasing urine flow rates (such as during diuresis), the following most accurately describes the response of the ureter
A. The initial response of the ureter is to increase peristaltic frequency. After the maximal frequency is achieved, further increases in urine transport occur by means of increases in bolus volume
B. Initially, urine bolus volume increases. After a maximum volume is achieved, the contraction rate increases
C. The initial response of the ureter is to increase in ureteral caliber and decrease ureteral tension. After the maximal caliber is achieved, ureteral pressure slowly increases
D. The ureteral response is consistent and set by the ureteral pacemaker in the upper tracts. Hypercalcemia and hypokalemia decrease ureteral pacemaker activity, urine flow rate changes ureteral action minimally
A. The initial response of the ureter is to increase peristaltic frequency. After the maximal frequency is achieved, further increases in urine transport occur by means of increases in bolus volume
B. Initially, urine bolus volume increases. After a maximum volume is achieved, the contraction rate increases
C. The initial response of the ureter is to increase in ureteral caliber and decrease ureteral tension. After the maximal caliber is achieved, ureteral pressure slowly increases
D. The ureteral response is
consistent and set by the ureteral pacemaker in the upper tracts. Hypercalcemia and hypokalemia decrease ureteral pacemaker activity, urine flow rate changes ureteral action minimally
In species with a multicalyceal system, such as the pig, sheep, and human, the “pacemaker cells” for ureteral peristalsis are located
A. Near the pelvicalyceal border
B. Near the corticomedullary junction
C. In the juxtaglomerular apparatus
D. Within the renin-angiotensin complex
A. Near the pelvicalyceal border
B. Near the corticomedullary junction
C. In the juxtaglomerular apparatus
D. Within the renin-angiotensin complex
The following is a secondary effect of PDE5 inhibitors in the ureter
A. relaxant effect on the ureter due to an increase in cGMP
B. relaxant effect on the ureter due to an increase in 5-HT
C. Peristaltic effect on the ureter due to an increase in 5-HT
D. peristaltic effect on the ureter due to an increase in cGMP
A. relaxant effect on the ureter due to an increase in cGMP
B. relaxant effect on the ureter due to an increase in 5-HT
C. Peristaltic effect on the ureter due to an increase in 5-HT
D. peristaltic effect on the ureter due to an increase in cGMP
Baseline, or resting, ureteral pressure is at:
A. 0-5 cm H20
B. 5-10 cm H20
C. 10-15 cm H20
D. 15-25 cm H20
A. 0-5 cm H20
B. 5-10 cm H20
C. 10-15 cm H20
D. 15-25 cm H20
A normal ureter is re-implanted into a normal bladder without tunneling. This new system:
A. May or may not reflux
B. Will reflux 100% of the time, a submucosal tunnel determines reflux
C. Will not reflux 100% of the time, ureteral pacemaker peristaltic activity determines reflux
A. May or may not reflux
B. Will reflux 100% of the time, a submucosal tunnel determines reflux
C. Will not reflux 100% of the time, ureteral pacemaker peristaltic activity determines reflux
The relationship between the length and diameter of the intravesical distal ureteral segment is important in preventing vesicoureteral reflux (VUR), the following best describes the ratio in normal ureters, and in pathologic refluxing ureters. (ratio as length:diameter)
A. 5:1 (old studies) 2.23:1 (newer studies) in normal distal ureters; 1.4:1 in children with VUR
B. 4:1 (old studies) 2.23:1 (newer studies) in normal distal ureters; 1:1 in children with VUR
C. 2.23:1 (old studies) 5:1 (newer studies) in normal distal ureters; 1.5:1 in children with VUR
D. 2.23:1 (old studies) 5:1 (newer studies) in normal distal ureters; 1:1 in children with VUR
A. 5:1 (old studies) 2.23:1 (newer studies) in normal distal ureters; 1.4:1 in children with VUR
B. 4:1 (old studies) 2.23:1 (newer studies) in normal distal ureters; 1:1 in children with VUR
C. 2.23:1 (old studies) 5:1 (newer studies) in normal distal ureters; 1.5:1 in children with VUR
D. 2.23:1 (old studies) 5:1 (newer studies) in normal distal ureters; 1:1 in children with VUR
Losartan has the following effect on ureteral activity
A. Decreases amplitude and frequency of spontaneous ureteral contractions
B. Decreases baseline ureteral pressure
C. Increases velocity of urinary bolus
D. Increases length of urinary bolus
A. Decreases amplitude and frequency of spontaneous ureteral contractions
B. Decreases baseline ureteral pressure
C. Increases velocity of urinary bolus
D. Increases length of urinary bolus
The ureter contracts at this rate
A. 2-6 times per minute
B. 6-10 times per minute
D. 10-15 times per minute
E. 1-2 times per minute
**A. 2-6 times per minute **
B. 6-10 times per minute
D. 10-15 times per minute
E. 1-2 times per minute
These cells that resemble interstitial cells of Cajal in the intestine (ICC-like cells) in the upper urinary tract serve as preferential conduction routes of electrical signals from pacemaker cells to typical smooth muscle cells of the renal pelvis and ureter. They are also generally called:
A. Telocytes
B. Podocytes
C. Gliocytes
D. Urokinocytes
A. Telocytes
B. Podocytes
C. Gliocytes
D. Urokinocytes
Visualizing the speed of the ureteral persitaltic wave is critical for intraoperative monitoring. If the heart’s Purkinje fibers conduct potentials at 1.5-2meters/sec, the ureteral pacemakers conduct at the following velocity:
A. 2-6 cm / sec antegradely
B. 2-6 m / sec retrogradely
C. 1-2 cm / sec retrogradely
D. 1-2 m / sec antegradely
A. 2-6 cm / sec antegradely
B. 2-6 m / sec retrogradely
C. 1-2 cm / sec retrogradely
D. 1-2 m / sec antegradely
In vivo experiments in animals show the following responses of peristalsis to a ureteral calculus
A. increase in amplitude of contractions, decrease in rate of contractions, decrease in baseline ureteral pressure, persisted for a period even after spontaneous passage of the calculus
B. increase in amplitude of contractions, increase in rate of contractions, decrease in baseline ureteral pressure, persisted for a period even after spontaneous passage of the calculus
C. increase in amplitude of contractions, increase in rate of contractions, decrease in baseline ureteral pressure, resolved after spontaneous passage of the calculus
D. increase in amplitude of contractions, increase in rate of contractions, increase in baseline ureteral pressure, resolved after spontaneous passage of the calculus
E. increase in amplitude of contractions, decrease in rate of contractions, increase in baseline ureteral pressure, resolved after spontaneous passage of the calculus
A. increase in amplitude of contractions, decrease in rate of contractions, decrease in baseline ureteral pressure, persisted for a period even after spontaneous passage of the calculus
B. increase in amplitude of contractions, increase in rate of contractions, decrease in baseline ureteral pressure, persisted for a period even after spontaneous passage of the calculus
C. increase in amplitude of contractions, increase in rate of contractions, decrease in baseline ureteral pressure, resolved after spontaneous passage of the calculus
D. increase in amplitude of contractions, increase in rate of contractions, increase in baseline ureteral pressure, resolved after spontaneous passage of the calculus
E. increase in amplitude of contractions, decrease in rate of contractions, increase in baseline ureteral pressure, resolved after spontaneous passage of the calculus
The pressure within the bladder during the storage phase is paramount in determining the efficacy of urine transport across the UVJ. The ureter has been shown to decompensate when sustained intravesical pressure approaches at least:
A. 40 cm H2O
B. 20 cm H2O
C. 60 cm H2O
D. 80 cm H2O
A. 40 cm H2O
B. 20 cm H2O
C. 60 cm H2O
D. 80 cm H2O
The following correctly describes the effect of ureteral stents on ureteral activity, EXCEPT:
A. Ureteral dilatation
B. Decrease in ureteral peristaltic activity Correct answer
C. Decrease in tissue inflammation
D. Decrease in expression of GLi1, a transcription factor in ureteral smooth muscle part of the Sonic hedgehog signaling pathway
A. Ureteral dilatation
B. Decrease in ureteral peristaltic activity Correct answer
C. Decrease in tissue inflammation
D. Decrease in expression of GLi1, a transcription factor in ureteral smooth muscle part of the Sonic hedgehog signaling pathway
The sensory neuropathy in diabetics has been shown to affect ureteral activity. The following accurately describe this effect in in vivo animal models, EXCEPT:
A. Decreased length and velocity of movement of urinary bolus
B. Increased contraction amplitude
C. Decreased frequency of contraction
D. Supersensitivity to sensory neurotoxins
A. Decreased length and velocity of movement of urinary bolus
B. Increased contraction amplitude
C. Decreased frequency of contraction
D. Supersensitivity to sensory neurotoxins
The increase in intraluminal baseline ureteral pressure to a peak before declining into a plateau occurs in obstructed ureters in the first few:
A. Hours
B. Days
C. Weeks
D. Minutes
A. Hours
Obstructed and refluxing dilated ureters have the following changes in collagen composition:
A. An increase in type 1 and type 3 collagen, an increase in collagen to smooth muscle ratio
B. An increase in type 1 and type 2 collagen, an increase in collagen to smooth muscle ratio
C. A decrease in smooth muscle, type 1 and type 2 collagen, but an increase in collagen to smooth muscle ratio due to a disparate increase
D. A decrease in smooth muscle, type 1 and type 3 collagen, but an increase in collagen to smooth muscle ratio due to a disparate increase
A. An increase in type 1 and type 3 collagen, an increase in collagen to smooth muscle ratio
B. An increase in type 1 and type 2 collagen, an increase in collagen to smooth muscle ratio
C. A decrease in smooth muscle, type 1 and type 2 collagen, but an increase in collagen to smooth muscle ratio due to a disparate increase
D. A decrease in smooth muscle, type 1 and type 3 collagen, but an increase in collagen to smooth muscle ratio due to a disparate increase
Increases in renal pelvic pressure (stretch) results in the release of this substance, and a subsequent increase in afferent renal nerve activity
A. Substance P
B. Substance K
C. Neurokynin
D. Tachykinin
A. Substance P
B. Substance K
C. Neurokynin
D. Tachykinin
The following changes take place in an obstructed kidney, EXCEPT:
A. An increase in ureteral intraluminal pressure
B. An increase in ureteral length
C. An increase in ureteral diameter
D. A transient initial decrease in peristaltic amplitude
A. An increase in ureteral intraluminal pressure
B. An increase in ureteral length
C. An increase in ureteral diameter
D. A transient initial decrease in peristaltic amplitude
Morphine has the following effect on ureteral activity:
A. Decrease in ureteral tone
B. Increase in ureteral contraction amplitude and frequency
C. Increase in degree of ureteral dilatation
D. Decrease in ureteral pacemaker activity in Beta cells
A. Decrease in ureteral tone
B. Increase in ureteral contraction amplitude and frequency
C. Increase in degree of ureteral dilatation
D. Decrease in ureteral pacemaker activity in Beta cells
Agents that primarily activate Beta adrenergic receptors, such as isoproterenol and orciprenaline tend to:
A. Inhibit ureteral and renal pelvic activity
B. Stimulate ureteral and renal pelvic activity
C. Inhibit ureteral activity and stimulate renal pelvic activity
D. Stimulate ureteral activity and inhibit renal pelvic activity
A. Inhibit ureteral and renal pelvic activity
B. Stimulate ureteral and renal pelvic activity
C. Inhibit ureteral activity and stimulate renal pelvic activity
D. Stimulate ureteral activity and inhibit renal pelvic activity
