Chapter 11 Flashcards

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1
Q

Urinary systems roles

A
  • the urinary system plays a vital role in maintaining homeostasis
  • balancing pH levels in the blood
  • regulation of blood pressure
  • 85% of erythropoietin (EPO) produced to stimulate RBC produced is produced in the kidneys
  • Vitamin D production
    ETC! (Electron Transport Chain)
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2
Q

Excretion

A

Processes that remove wastes and excess materials from the body

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3
Q

Different systems excretions

A

Digestive system: excretes food residue and wastes produced by the liver
Respiratory system: excretes carbon dioxide
Integumentary system: (skin) excretes water and salt
Urinary system: (kidneys) excretes nitrogenous wastes, excess solutes, and water
Urea: waste product of amino acid metabolism
Creatinine: waster product that results from the breakdown of Creatine phosphate
Uric acid: formed from the metabolic processing of nucleotides (Gout)

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4
Q

The kidney regulate nitrogenous wastes and other solutes

A
  • protein metabolism produces nitrogenous wastes
  • initially, NH3 (ammonia) is produced during breakdown of amino acids
  • liver detoxifies NH3, producing urea
  • urea is transported from the liver to kidneys for disposal
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5
Q

Other added solutes regulated by the kidneys

A

Sodium
Chloride
Potassium
Calcium
Hydrogen ions
Creatinine

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6
Q

Maintenance of water levels

A

To maintain homeostasis, water input = water output

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7
Q

Kidneys adjust to water output as necessary

A

Water input: food, drink, metabolism
Water output: lungs, skin, feces, kidneys

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8
Q

Kidneys modify output based on intake and loss

A

Output varies from 1/2 liter/day to 1 liter/hour

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9
Q

Water from food

A
  • water from food usually occurs for 20-25% of recommended total fluid intake
  • fruits and vegetables contain a high amount of water
  • butter, oils, dried meats, chocolate, cookies, and other sweets that have a low water content
    - lettuce, raw strawberries, cucumbers, watercress, Swiss chard, boiled squash, green peppers, bean sprouts, watermelon, cantaloupe, celery, and raw peaches
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10
Q

Water from liquids

A
  • on average an individual consumes 41 ounces of water daily
  • physical activity and thermals tress can increase fluid needs by 5-6 times.
  • In the U.S., majority of water intake is not from plain water ,but from a variety of foods and beverages.
    - other beverages: 43.6% of total water intake
    - water: 31.4% of total water intake
  • during activities, increased sweating and temperature can contribute to greater water loss (drink more water)
  • young children, pregnant and lactating women, the elderly, and people with certain illnesses require increased fluid intake
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11
Q

Alcohol is what

A

A diuretic

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12
Q

Metabolic water

A
  • breakdown of macronutrient molecules in energy metabolism form carbon dioxide and water
  • metabolic water provides about 14% of daily water requirements for a sedentary person
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13
Q

The principal organ of the urinary system

A

Kidney: Lima bean like structures
- located on either side of the vertebral column and extend from the level of the las thoracic vertebra to just above the third lumbar vertebra
- between the T12 and L3

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14
Q

Primary functions of the kidney

A

Process blood and form urine as a waste product

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15
Q

Micturition

A

Urination or voiding of the bladder and waste products

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16
Q

The three primary structures of the kidney

A

Cortex: outer portion of the kidney
Medulla: inner region of the kidney
Renal pelvis: hollow space in center of kidney where urine collects

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17
Q

Ureters

A

Muscular tubes that transport urine from kidneys to the bladder

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18
Q

Urinary bladder

A

Three layers of smooth muscle, lined with epithelial cells
Stores urine (600-1,000ml)

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19
Q

Urethra

A

Carries urine from bladder to outside of the body
Two sphincters control urination

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20
Q

Detrusor muscle

A

Made mostly of smooth muscle
Network of crisscrossing bundles of muscle fibers
- circular
- oblique
- lengthwise

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21
Q

Nephrons

A

Functional units of the kidney
- 1 million nephrons per kidney

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22
Q

Two main part of nephrons:

A

Renal corpuscle: glomerulus (capillaries); bowman capsule (glomerular capsule)
Renal tubule: proximal consulates tubule; henle loop (nephron loop); distal convoluted tubule

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23
Q

Special blood vessels supply the tubules

A
  • renal arteries supply the kidneys
  • blood vessels associated with tubules
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24
Q

Arterioles

A

Efferent: leave the glomerular capsule
Afferent: enters the glomerular capsule

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25
Q

Capillaries

A

Glomerular: network within the glomerular capsule
Peritubular: surround proximal and distal tubule
Vasa recta: parallels the loop of henle

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26
Q

Renal vein

A

Collects filtered blood from the kidneys

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27
Q

Filtration defined

A

Movement of water and protein-free volutes from plasma in the glomerulus, across the capsular membrane, and into the capsular space

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28
Q

Tubular reabsorption

A

Movement of molecules out of the various segments of the tubule and into the peritubular blood
Tubes -> Blood

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29
Q

Tubular secretion

A

Movement of molecules out of peritubular blood and into the tubule for excretion
Tubes <- Blood

30
Q

Filtration - kidney physiology

A
  • as blood flows through the glomerulus, water and small solutes filter out of the blood into the Bowman’s capsules
  • the only blood constituents that do not have cells and most plasma proteins
31
Q

ow many liters of glomerular filtrate are formed daily

A

180 liters of glomerular filtrate are formed each day
- with about 99% being reabsorbed (spoilers)
- meaning about 1 L being excreted daily
This filtration occurs due to pressure gradients (high blood pressure in glomerular capillaries)

32
Q

The two ways that rate of filtration if regulated

A
  • Resting rate under local control that adjusts diameter of afferent arterioles
  • stress causes sympathetic nervous system to reduce blood flow to the kidneys
33
Q

Percentages of kidney physiology

A
  • 100% of filtered glucose, amino acids, and bicarbonate and 50% or urea are reabsorbed
  • most tubular reabsorption occurs in proximal tubules
  • water reabsorption
    - 65-70% occurs in the proximal tubule
    - 25% occurs in loop of Henle
    - <10% occurs in distal tubule and collecting duct - but this is where water excretion is regulated
34
Q

Brush border is what

A

Brush border of microvilli on proximal tubule cells facilitate reabsorption
- reabsorption process starts in proximal tubule

35
Q

Characteristics of urine

A

Urine composition varies:
Water intake, exercise, environmental temperature, nutrient intake, health and disease, etc.

36
Q

Urinalysis

A

The analysis of urine
- this often provides a number of clues to an individual’s health and/or disease rate

37
Q

Urine volume

A

Urine volume varies daily and typically ranges from 1-2L/day
- the kidneys must produce a minimum urine volume of about 500ml/day to rid the body of waste products

38
Q

Kidney maintain homeostasis in many ways
6 ways

A

-contribute to maintenance of water balance
-contribute to maintenance of salt balance
-secrete an enzyme involved in Cornell of blood volume and blood pressure
-maintain acid-base balance and blood pH
-regulate red blood cell production via erythropoietin
- active an inactive form of vitamin D

39
Q

ADH (antidiuretic hormone) regulates what

A

Water balance

40
Q

ADH regulating water balance involved what

A

Hypothalamus: synthesizes ADH
Posterior pituitary gland: releases ADH
Kidneys: responds to ADH

41
Q

Negative feedback chain regulates what

A

The negative feedback chain regulates solute concentration of the blood
- involves increasing or reducing ADH secretion, which will modify water reabsorption by the kidneys
- Involves increasing or decreasing thirst

42
Q

Blood solute concentration High means?

A

(Low water concentration)
ADH released:
- increase in permeability of collecting ducts to water
- increase in water reabsorbed by kidneys
- decrease in urine production
- increase in thirst

43
Q

Blood solute concentration low means?

A

(High water concentration)
ADH inhibited:
- decrease in permeability of collecting ducts to water
- decrease in water reabsorbed by kidneys
- Increase in urine production
- decrease in thirst

44
Q

Diuresis

A

High urine flow rate

45
Q

Diuretic

A

Any substance that increase the formation and excretion of urine
- lasix (furosemide): medication that reduce blood volume and blood pressure
- used in treatment of congestive heart failure and hypertension
- Caffeine: inhibits sodium reabsorption
- alcohol: inhibits ADH release

46
Q

Aldosterone

A

Adrenal hormone that regulates sodium excretion
- Mechanism: increases Na+ reabsorption from the distal tubule and collecting duct

47
Q

Aldosterone secretion is controlled by?

A

The renin-angiotensin system

48
Q

Atrial natriuretic hormone protects against blood volume excess

A
  • another controller of renal sodium excretion
  • high blood volume stretched atria of the heart
  • atria secretes ANH(atrial natriuretic hormone) and collecting ducts
  • Na+ excretion increases
  • water follow the Na+
  • effect of ANH is opposite to that of aldosterone
49
Q

Erythropoietin stimulate production of red blood cells

A
  • decrease in amount of oxygen is detected by certain cells throughout the kidney
  • O2 sensitive cells in kidney secrete hormones, erythropoietin, in response to a decrease in oxygen
  • erythropoietin triggers increase in red blood cell production in the bone marrow
50
Q

Kidneys activate Vitamin D

A

-exposure of skin to sunlight causes production of an inactive form of vitamin D from a precursor found in the skin
- inactive forms of vitamin D is transported to liver, where it is modified
- inactive form of vitamin D is then converted to active forms by kidneys
- conversion to active vitamin D in kidneys is influenced by activity of PTH (parathyroid hormone)

51
Q

Kidneys help maintain acid-base balance and blood pH

A

-blood pH must try between 7.35 and 7.45
-pH regulated by kidneys, buffers, lungs
-Role of kidneys in pH maintenance
- reabsorption of filtered bicarbonate
- excretion of acid as ammonium (NH4+)

52
Q

PH balance

A

-acids and bases continually enter the blood as a result of absorbed food and the metabolism of nutrients at the cellular level
- therefore, a mechanism for neutralizing or eliminating these substances is necessary if blood pH is to remain constant

53
Q

Sources of pH-influencing chemicals -> metabolism

A

Carbonic acid - aerobic glucose catabolism
Lactic acid - anaerobic glucose catabolism
Ketone bodies - incomplete breakdown of fats
Sulfuric acid - oxidation of sulfur containing amino acids
Phosphoric acid - hydrolysis of nucleic acids and phosphoproteins

54
Q

Sources of pH-influencing chemicals -> foodstuffs

A

Acid forming minerals:
- chlorine, sulfur, phosphorus
- meat, fish poultry, and eggs (high protein)
- some grains (wheat, corn, oats)
Basic-forming minerals:
- potassium, calcium, sodium, and magnesium
- fruits and vegetables

55
Q

PH control mechanisms

A

Chemical buffer
- 1st line of defense
- rapid-acting
-immediately combines with any added acid or alkali that enters the body fluids (preventing drastic changed in hydrogen ion concentration and pH)

Physiological buffer
- 2nd line of defense
- slower
- involve removing hydrogen ions from the body (respiration. Excretion (micturition)

56
Q

Buffers

A

A substance tat prevents marked changes in pH of a solution when an acid or a base is added to it

57
Q

Metabolic acidosis

A

Occurs when blood is acidic due to too little bicarbonate
- most common cause is excessive ketones in the blood

58
Q

Metabolic alkalosis

A

Occurs when blood is too alkaline due to too much bicarbonate
- most common cause is following the ingestion of excessive amount of bicarbonate, citrate or antacids.

59
Q

Acidosis

A

PH drop - increased H+
- caused by accumulation of acids or loos of bases

60
Q

Alkalosis

A

PH rise - decreased H+
-caused by loss of acids or accumulation of bases

61
Q

Chemical buffer

A
  • 1st line of defense
  • rapid - acting
  • immediately combines with any added acid or alkali that enters the body fluids
    • preventing drastic changes in hydrogen ion concentration and pH
62
Q

Physiological buffer

A
  • 2nd line defense
  • slower
    -involves removing hydrogen ions from the body
    • respiration
    • excretion (micturition)
63
Q

Respiratory acidosis

A

Occurs when the blood is overly acidic due to an excess of carbonic acid, resulting from too much CO2 in the blood
- common causes include anything that interfere with respiration

64
Q

Respiratory alkalosis

A

Occurs when the blood is overly alkaline due to deficiency in carbonic acid and CO2 levels in the blood
- occurs when too much CO2 is being exhaled from the lunges
- hyperventilation

65
Q

Kidney stones

A

Crystallized minerals
Block urine flow

66
Q

Urinary tract infections

A
  • usually caused by bacteria
  • more common in women than men because of a shorter urethra
  • if untreated, bladder infections may ascend to involve the kidneys
67
Q

Acute renal failure

A
  • short-term impairment, may be reversible
  • potential causes: sustained very low blood pressure, large kidney stones within renal Elvis, infections, transfusion reactions, severe injury, toxin exposure, drug reactions
68
Q

chronic renal failure

A
  • also known as end stage renal disease (ESRD)
  • ESRD: long-term, irreversible damage leading to >60% reduction in functioning nephrons
  • patients may have <10% normal filtering capacity
    Results when:
    - renal tubular cells do not receive the nutrients they need
    - glomerular filtration is blocked for too long
  • diabetes may lead to diabetic nephropathy, which often progresses to ESRD
69
Q

Polyuria

A

Excessive urine production
>2.5 L/day

70
Q

Oliguria

A

Decreased urine production
300-500 ml/day

71
Q

Anuria

A

Virtual absence of urine production
<50 ml/day

72
Q

What is ADH

A

Antidiuretic hormone
Increase or decrease of thirst
Influence water reabsorption in kidneys