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Physiology II > Chapter 14 - Urinary System > Flashcards

Chapter 14 - Urinary System Flashcards

1
Q

Main kidney functions

A

-maintain stability of ECF volume
-electrocute composition
-osmolarity

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2
Q

Ureters

A

Transport and store
-exists each kidney at the medial border
-carry urine to bladder

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3
Q

Urinary bladder

A

-stores urine
-empties via urethra

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4
Q

urethra

A

Transports urine out of the body
-shorter in females

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5
Q

Nephron

A

Functional unity of kidney
-vascular/tubular

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6
Q

Two distinct regions in nephron

A

Outer and inner

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7
Q

Outer region

A

Renal cortex

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8
Q

Inner region

A

Renal medulla, renal pyramids

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9
Q

Afferent arteriole

A

Carries blood to the glomerulus

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10
Q

Glomerulus

A

Capillaries that filter a protein free plasma into tubular component

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11
Q

Efferent arteriole

A

Carries blood from glomerulus

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12
Q

Peritubular capillaries

A

Supplies renal tissue
-exchanges with the fluid in tubular lumen

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13
Q

Bowman’s capsule

A

Collects glomerular filtrate

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14
Q

Proximal tubule

A

Uncontrolled reabsorption and secretion of selected substances

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15
Q

Loop Henle of long looped nephrons

A

-osmotic gradient in renal medulla
-produces urine of varying concentration

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16
Q

Distal tubule and collecting duct

A

-reabsorbs Na+ and H2O
-secretes K+ and H+
-fluid leaving is urine

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17
Q

Juxtaglomerular apparatus

A

Produces substances involved in the control of kidney function

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18
Q

A comes before

A

E

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19
Q

Vascular component of nephron

A

-dominant part is glomerulus

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20
Q

Tubular component of nephron

A

Hollow, fluid filled tube formed by a single layer

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21
Q

Draw out the direction of kidney function

A
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22
Q

All nephrons originate in the

A

Cortex

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23
Q

Glomeruli of cortical nephrons life in

A

The outer layer of cortex

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24
Q

Glomeruli of juxtamedullary nephrons lie in

A

The inner layer of the cortex

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25
Q

Most abundant type of nephron

A

Cortical

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26
Q

Long looping vasa recta

A

Juxtamedullary nephrons

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27
Q

Peritubular capillaries

A

Cortical nephrons

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28
Q

Three basic processes

A

-glomerular filtration
-tubular reabsorption
-tubular secretion

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29
Q

Glomerular filtration

A

Non discriminate filtration of protein free plasma
-glomerulus into bowman’s capsule

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30
Q

Tubular reabsorption

A

Selective movement of filtered substances
-tubular lumen into Peritubular capillaries

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31
Q

Tubular secretion

A

Selective movement of non filtered substances
-Peritubular capillaries into tubular lumen

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32
Q

Amount of glomerular filtration

A

180 L/day

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33
Q

Tubular reabsorption amount

A

178.5 L/day

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34
Q

Kidneys receive ___% of cardiac output

A

20 to 25

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35
Q

Total blood flow through the kidneys is

A

> 1L/min

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36
Q

80 percent of plasma that entered the glomerulus is ___ ____ and leaves through the efferent arteriole

A

Not filtered

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37
Q

Filtered fluid from glomerulus into bowman’s capsule passes through ___ layers of glomerular membrane

A

Three

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38
Q

Type of glomerular capillary wall

A

Fenestrated capillary
-large gaps
-more permeable

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39
Q

Cell body of podocyte is

A

Outside of capillary

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40
Q

Podocytes

A

Terminate in foot processes
-surround the basement membrane of the glomerulus

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41
Q

Clefts between the foot processes are called

A

Filtration slit
-where filtrate enters the bowman’s capsule

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42
Q

Glomerular filtration is a __ process in which

A

-passive process
-hydrostatic pressures force the fluids and solute through a membrane

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43
Q

How are glomeruli efficient filters

A
  1. The filtration membrane is a large SA and very permeable to water and solutes
  2. Glomerular pressure is higher vs other capillaries
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44
Q

Three physical forces involved

A

-glomerular capillary bp
-plasma colloid osmotic
-bowman capsule hydrostatic pressure

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45
Q

Glomerular capillary blood pressure

A

Out of capillary

-55 mmHg
-aff vs eff
-along entire capillary length

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46
Q

Plasma colloid osmotic

A

Into capillary
-30 mmHG
-high because of more water filtered

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47
Q

Bowman’s capsule hydrostatic pressure

A

Into outside of capillary
-balance
-15 mmHg

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48
Q

Calculation of pressures in glomerular filtration

A

55 - (30 + 15)

55 - 45

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49
Q

Favours filtration

A

Glomerular capillary blood pressure
-55 mmhg going OUT

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50
Q

Opposes filtration (two)

A

-plasma colloid 30
-bowman’s capsule hydrostatic 15

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51
Q

Net filtration pressure
-the difference between opposing and favouring

A

Favour the filtration
-10 mmHg

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52
Q

Blood pressure of glomerular capillary depends on

A

Resistance to blood flow by aff and eff arteriole s

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53
Q

Glomerular capillary blood pressure definition

A

-fluid pressure exerted by blood in glomerular capillaries
-major force producing glomerular filtration

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54
Q

Plasma colloid osmotic pressure is caused by

A

Unequal distribution of plasma proteins across glomerular membrane
-opposes filtration

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55
Q

Bowman’s capsule hydrostatic pressure def

A

-pressure entered by fluid in initial part of tubule
-push fluid out of bowman’s capsule

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56
Q

Glomerular filtration rate depends on

A

Net filtration pressure

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57
Q

Pathological influences on plasma colloid osmotic pressure

A

-severely burned patient has a greater GFR

-dehydrating diarrhea lower GFR

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58
Q

Pathological influences on bowman’s capsule hydrostatic pressure

A

Obstructions lower GFR
-kidney stones

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59
Q

What can be controlled to adjust GFR to suit the body’s needs

A

Glomerular capillary blood pressure

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60
Q

What are constant pressures of the body

A

Plasma colloid osmotic pressure and bowman’s capsule hydrostatic pressure

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61
Q

Two major control mechanisms on glomerular capillary blood pressure to alter GFR

A

-autoregulation
-extrinsic sympathetic control

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62
Q

Autoregulation

A

Aimed at preventing spontaneous changes

-myogenic
-tubuloglomerular feedback

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63
Q

Extrinsic sympathetic control

A

Aimed at long term regulation of arterial blood pressure

-sympathetic ns input to aff arteriols
-barreceptor reflexc

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64
Q

Spontaneous changes in GFR are prevented by

A

Intrinsic regulatory mechanisms
-autoregulation

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65
Q

Increase of BP

A

Increase of GFR

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66
Q

Decrease of BP

A

Decrease of GFR

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67
Q

Autoregulation works by changing the

A

Diameter for afferent arteriole
-then changing bp

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68
Q

Vasoconstriction of aff arteriole

A

Dec glomerular capillary bp and net filtration

Dec GFR

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69
Q

Vasodilation of aff arteriole

A

Inc glomerular capillary bp, net filtration pressure

In GFR

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70
Q

Myogenic mechanism

A

Vascular smooth muscle
-stretch and contract

Less stretch, causes relaxation

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71
Q

Tubuloglomerular feedback

A

Involves juxtaglomerular apparatus
-salt delivery to macula dense regulates ATP release
-degrades to adenosine
-adenosine constricted aff arteriole

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72
Q

Autoregulation by tubuloglomerular feedback

A

Increase in salt increases ATP
-aff constriction
-dec blood flow

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73
Q

Inc salt is due to

A

Increased GFR

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74
Q

Dec blood flow

A

Dec GFR

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75
Q

Autoregulation s prevents

A

Unintentional shifts in GFR

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76
Q

Increase in BP does what to GFR

A

Does not increase GFR

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77
Q

Low BP does not result in

A

Excess waste products

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78
Q

Extrinsic sympathetic control aimed at

A

Aimed at long term regulation of arterial blood pressure

79
Q

Extrinsic control is a

A

Deliberate change mediated by sympathetic ns input to aff arteriole

80
Q

Decrease in arterial blood pressure is detected by

A

Aortic arch and carotid sinus baroreceptors

81
Q

What are the short term adjustments that can be made in response to low arterial blood pressure

A

Inc of cardiac output and TPR

82
Q

Long term adjustment for Dec arterial blood pressure

A

Lowered GFR, urine volume, conservation of fluid and salt

83
Q

Where does filtration take place

A

Glomerulus

84
Q

Where does reabsorption take place

A

-proximal tubule
-loop of henle
-distal tubule
-collection duct

85
Q

Where does secretion take place

A

-proximal tubule
-loop of henle
-distal tubule
-collecting duct

86
Q

Lumen to blood

A

Reabsorption

87
Q

Blood to lumen

A

Secretion

88
Q

Tubular reabsorption

A

-transfer of substances from tubular lumen into Peritubular capillaries

-selective and variable

-transepithelial transport (five barriers)

89
Q

The order of tubular reabsorption

A

-Tubular fluid into luminal membrane
-pass through cytosol
-cross basolateral membrane
-through interstitial fluid and capillary wall

90
Q

Tubular fluid is the same concentration as in plasma except for

A

PROTEINS

91
Q

Waste material remains in

A

Tubule

92
Q

Passive reabsorption

A

-no energy needed
-down electrochemical/osmotic gradients

93
Q

Active reabsorption

A

-requires energy
-against electrochemical gradient

94
Q

Percentage of Na reabsorbed: proximal tubule

A

67

95
Q

Percentage of Na reabsorbed: ascending limb—> loop of henle

A

25

96
Q

Percentage of Na reabsorbed: distal and collecting tubules

A

8

97
Q

Role of Na reabsorption: proximal tubule

A

Reabsorbs: glucose, amino acids, H2O, Cl and urea

98
Q

Role of Na reabsorption: ascending limb of the loop of henle

A

Kidneys ability to produce urine of varying concentrations

99
Q

Role of Na reabsorption: distal and collecting tubules

A

-hormonal control
-regulates ECF volume

100
Q

What is found on basolateral membrane and is essential for Na reabsorption

A

Na and K, ATPase pump

101
Q

What happens to water when sodium is reabsorbded by osmosis

A

Water follows direction of sodium

102
Q

Sodium reabsorption effects

A

-blood volume
-blood pressure

103
Q

Why is Na reabsorption so important

A

Volume and pressure

104
Q

If you control Na (and Cl) you control..

A

ECF and water volume

105
Q

If you control ECF water volume you control…

A

Blood volume

106
Q

If you control blood volume you control…

A

BP control

107
Q

What increases blood volume

A

-passive bulk flow of fluid from IF into plasma
-salt and water retention

108
Q

___ is the most abundant cation in the filtrate

A

Na

109
Q

___ reabsorption is almost always active transport

A

Na

110
Q

Function of Na pump

A

Generates and electrochemical gradient that couples to passive entrance of other substances

-glucose, amino acids

111
Q

Fine tuning of Na reabsorption takes place in

A

Distal tubule

112
Q

If there is too much Na then..

A

Less reabsorbed
-excreted in urine

113
Q

If too little Na

A

Then more is reabsorbed

114
Q

Na load reflects ___ volume

A

ECF

115
Q

ECF volume changes

A

Affect BP

116
Q

RAAS

A

Renin angiostensin aldosterone system

117
Q

Renin angiostensin aldosterone system

A

Important for Na regulation
-renin release
-control volume ECF

118
Q

Liver releases

A

Angiotensinogen

119
Q

Kidney releases

A

Renin

120
Q

What two hormones combine to activate angiotensin 1

A

Renin and angiotensinogen

121
Q

Angiotensin activates

A

Angiotensin 2

122
Q

Angiotensin II activates

A

Aldosterone

123
Q

Aldosterone

A

Stimulates kidney to increase Na reabsorption

124
Q

Function of RAAS

A

Inc Na absorption, promotes water retention
-stimulate thirst
-stimulate vasopressin secretion

125
Q

Aldosterone

A

Acts on last portion of distal convoluted tubules and collecting ducts
-Na channels
-more Na/K ATPase pumps

126
Q

Low ECF volume and low BP causes

A

More renin released

127
Q

More renin released causes

A

More aldosterone

128
Q

More Aldosterone causes

A

More Na reabsorption

129
Q

More Na reabsorption causes

A

Greater volume in ECF

130
Q

High ECF volume causes

A

Less renin released

131
Q

Less renin released causes

A

Less aldosterone

132
Q

Less aldosterone causes

A

Less Na reabsorption

133
Q

Less Na reabsorption causes

A

More body volume in urine

134
Q

ANP- atrial natriuretic peptide

A

Inhibits Na reabsorption
-secreted by atria

135
Q

Inhibiting Na reabsorption opposes

A

Aldosterone effects

136
Q

ANP is secreted by atria in response to

A

-stretching due to Na retention
-expansion of ECF volume
-inc in arterial pressure

137
Q

How are glucose and amino acids reabsorbed

A

By sodium dependent
-secondary active transport

138
Q

How is electrolytes such as Ca reabsorbed

A

Cl follows passively

139
Q

80 percent of water reabsorbed is

A

Uncontrolled

140
Q

What places in the urinary system is water reabsorbed

A

-proximal tubule 65
-loop of henle 15
-distal portion of nephron

141
Q

20 percent of water reabsorbed is

A

Controlled

142
Q

Where is water reabsorption controlled

A

When in control of hormone vasopressin
-distal portion

143
Q

Water follows

A

Na

144
Q

When water is reabsorpted in the proximal tubule and loop of henle it is what?

A

NOT subject to regulation

145
Q

Aquaporins

A

How water is reabsorbed

146
Q

Bulk flow in water reabsorption is enhanced by …

A

Is enhanced by inc plasma colloid osmotic pressure in the peritubular capillaries

147
Q

Waste products become more ___ as water is reabsorbed

A

Concentrated as water is reabsorbed

148
Q

Urea

A

Waste product from the breakdown of protein

149
Q

Tubular secretion

A

Moving from peritubular capillaries into the tubular lumen
-kidney tubules selectively add

150
Q

H+ secretory system

A

Important in regulating acid base balance

151
Q

Where is H+ secreted

A

Proximal, distal and collecting tubules

152
Q

K+ secretory system

A

Keeps plasma K concentration at appropriate level

-to maintain normal membrane excitability in muscles and nerves

All filtered K is reabsorbed

153
Q

Where does K+ tubular secretion take place

A

Distal and collecting tubules
-control of aldosterone

154
Q

Organic irons secretory system

A

Efficient elimination of foreign organic compounds from the body

155
Q

where are organic ions secreted

A

Only in proximal tubules

156
Q

Na K pump

A

-moves Na out of the cell into lateral space

-transports K from lateral space into tubular cells

157
Q

Control of K secretion

A

Aldosterone
-if there is an inc of K, then Aldosterone will inc to promote secretion of excess K

158
Q

Aldosterone can be stimulated by

A

Two separate pathways

159
Q

Inc aldosterone leads to

A

Promotes Na reabsorption and K secretion

160
Q

K+ secretion in basolateral membrane vs luminal membrane

A

-basolateral membrane: K+ is recycled

-luminal membrane: K+ secretion

161
Q

Basolateral membrane is located

A

Proximal tubule and loop of henle

162
Q

Luminal membrane is found

A

Distal portions

163
Q

If aldosterone pathway activated by decreased Na+ could cause

A

Deficiency in K+

164
Q

Two organic ion secretion proximal tubule (2)

A

-anionic transporter
-cationic transporter

165
Q

Endogenous compounds

A

-NE, histamine, prostaglandins

166
Q

Exogenous compounds

A

-drugs, chemicals
-converted by liver enzymes to anionic form

167
Q

Depending on the body’s state of hydrations the kidneys

A

Secrete urine of varying concentrations

168
Q

Vertical osmotic gradient

A

Formed by accumulation of solutes, primarily NaCl and urea
-allows water reabsorption and concentrated urine production

169
Q

Too much water (<300) in the ECF establishes

A

A hypotonic ECF

170
Q

A water deficient ECF (>300) establishes

A

A hypertonic ECF

171
Q

Medullary vertical osmotic gradient is established by

A

Countercurrent multiplication

172
Q

Concentration of urine ___ as you go down the descending limb

A

-increases
-as water leaves

173
Q

Concentration of urine ___ as you go up the ascending limb

A

Decreases
-NaCl reabsorption only (leaving)

174
Q

Water moves in the distal convoluted tubule only if

A

There is vasopressin available

175
Q

Descending limb is

A

Highly permeable to water but not sodium

176
Q

Ascending limb

A

Actively transports NaCl out of the tubular lumen into the surrounding interstitial fluid

-impermeable to water

177
Q

Secretion of vasopressin increases

A

Permeability of tubule cells to water

178
Q

Vasopressin action

A

-activates cyclic AMP
-inc permeability to H2O by inserting water channels

179
Q

Vasopressin is produced in

A

The hypothalamus
-released from the post pituitary

180
Q

Dehydration and concentration levels

A

Concentration may be up to 1200 mOsm/L as it leaves collecting tubule

-since H2O is conserved for body

181
Q

Water excess and concentration

A

Large volume of dilute urine, no collecting tubule H2O is reabsorbed in distal portion of nephron
-excess H2O is eliminated

182
Q

Vasopressin increases during

A

A water deficit
-less urine produced

183
Q

Vasopressin decreases during

A

An excess of water
-more urine is produced

184
Q

Osmotic diuresis

A

Large volume of urine
-inc excretion of water and solute

185
Q

Diabetes mellitus

A

High filtered load of glucose, that exceeds reabsorption capacity

-glucose in urine

186
Q

Water diuresis

A

Inc urine with no or little increased solute

187
Q

Excretion of large quantities of Na+ is always accompanied by

A

Excretion of large amounts of water

188
Q

Excretion of large amounts of water does not

A

Always mean excretion of Na+

189
Q

Proximal tubule

A

-Na reabsorption uncontrolled
-H2O is passive
-reabsorption of glucose, amino acids, Cl, H2O, urea

190
Q

Loop of henle

A

-Na+ reabsorption is uncontrolled (establishes the medullary interstitial vertical osmotic gradient)
-H2O reabsorption is passive

191
Q

Distal and collecting tubules

A

-Na reabsorption variable and subjective to aldosterone control (important in regulating ECF volume and bp)
-H2O reabsorption not linked to solute reabsorption

192
Q

Control of Na reabsorption is important for

A

Regulating ECF volume and long term control of blood pressure

193
Q

Internal urethral sphincter

A

Smooth muscle
-relaxed bladder causes closure

194
Q

External urethral sphincter

A

Skeletal muscle
-under voluntary control

Physiology II (12 decks)

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