chapter 25 Flashcards

1
Q

Functions of The Urinary System

A

Filter blood
Regulate volume and composition of the blood
Gluconeogenesis during fasting
Produce hormones
Renin (helps regulate blood pressure)
Erythropoietin (stimulates RBC production)
Metabolizes vitamin D from inactive form to active

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2
Q

Kidney Anatomy

A
Retroperitoneal
Bean shaped
Right slightly lower than left
About the size of a large bar of soap
Renal hilum
Concave vertical cleft
Leads to internal renal sinus
Ureter, renal blood vessels, lymphatics and nerves enter here
Adrenal glands sit on top
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3
Q

renal fascia
Perirenal fat capsule
fibrous capsule

A
Renal fascia
Dense fibrous connective tissue
Anchors kidney and adrenal gland
Perirenal fat capsule
Surrounds the kidney and cushions it
Fibrous capsule
Transparent, prevents infections from spreading to the kidney
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4
Q

Nephrons

A
The structural and functional units of the kidneys
Over 1 million in each kidney
Form the urine
Empty into the collecting tubules
Parts
glomerulus
A ball of capillaries
 renal tubule 
glomerular capsule (Bowman’s capsule)
Cup shaped end of the renal tubule
Has fenestrated endothelium
renal corpuscle
Glomerulus + Bowman’s capsule
Filtrate
Solute rich fluid from the blood (no protein)
Urine made from this
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5
Q

Bowman’s Capsule Structure

A

Parietal layer
Simple squamous epithelium
Not involved in forming filtrate
Visceral layer
Clings to the glomerular capillaries
Podicytes
Highly branched modified epithelial cells
Foot processes intertwine and cling to the basement membrane of the glomerulus
Filtrations slits
Spaces between the foot processes
Allow filtrate to enter the capsular space

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6
Q

The rest of the renal tubule…

A
3 cm long
Single layer of polar epithelial cells with basement membrane
Three parts
Proximal convoluted tubule (PCT)
Loop of Henle
U-shaped
Descending 
Ascending
Distal convoluted tubule
Empty into the collecting ducts
Run through the medullary pyramids and make them look striped
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7
Q

cortical nephrons

juxtamedullary nephrons

A
Cortical nephrons
85%
Almost entirely in the cortex
Part of loop of Henle dips into the outer medulla
Juxtamedullary nephrons
Concentrate urine
Entire loop of Henle is in the medulla
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8
Q

Nephron Capillary Beds

A

Two capillary beds
Glomerulus
Specialized for filtration
Afferent arteriole and efferent arteriole

Peritubular
Arise from the efferent arteiole
Specialized for reabsorption
Vasa recta for juxtamedullary nephrons

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9
Q

Juxtamedullary Apparatus

A
Most distal part of the loop of Henle lies along the afferent arteriole (sometimes efferent too)
Two important cells types in the JMA
Granular cells
Aka juxtamedullary cells
Sense blood pressure and secrete renin
In the arteriole
Macula densa
Chemoreceptors that sense NaCl in the filtrate
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10
Q

Urine Production

A

Three steps

glomerular filtration
tubular reabsorption
tubular secretion

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11
Q

Glomerular Filtration

A
Passive 
Due to hydrostatic pressure
Fluids and small solutes forced out of the glomerulus
Amazing filtration membrane
Filtration rate=120-125 ml/min
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12
Q

Glomerular Filtrate

A
Water
Ions
Sodium, potassium, chloride
Nitrogenous waste
Urea, uric acid, creatine
Organic molecules
Glucose, amino acids
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13
Q

Tubular Reabsorption

Two reabsorption pathways

A

Most of the filtrate is quickly reabsorpted
Must cross the barrier formed by the tubular cells
Two reabsorption pathways
Transcellular (through cells)
Through the luminal and basolateral membranes
Most solutes are reabsorped through this pathway by diffusion or active transport
Paracellular (between cells)
Through tight junctions
Water and some ions use both

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14
Q

Blood Pressure is the driving force of glomerular filtration…what drives reabsorption?

Osmolarity of interstitium is

A

Blood Pressure is the driving force of glomerular filtration…what drives reabsorption?
Water reabsorption
Osmolarity of interstitium is increased
How-transport sodium into the interstitium
Sodium enables the reabsorption of most everything else
Osmomolarity is total concentration of all solute particles in a solution
Water moves from higher water concentration to lower water concentration

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15
Q

Counter current mechanisms maintain osmotic gradient

Ascending and descending limbs of Loop of Henle interact to maintain
Needed for

Ascending limb Creates the conditions need for the
Actively transports
Highest solute concentration near
Impermeable to

A

Ascending and descending limbs of Loop of Henle interact to maintain interstitial osmolarity gradient
Needed for urine concentration
Ascending limb
Creates the conditions need for the descending to function
Actively transports NaCl into interstitium
Highest solute concentration near the bottom
Impermeable to water

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16
Q

Tubular secretetion

A
Reabsorption in reverse
Disposes of substances
Certain drugs
Eliminates undesirable end products that were reabsorped passively
i.e. urea
Rids excess K+
Controls blood pH
17
Q

Counter current cont’d
Descending limb Concentrates
Filtrate concentrates to

A

Descending limb
Concentrates NaCl for ascending limb
Filtrate concentrates to 4X normal body fluid

18
Q

Vasa Recta

How does the kidney retain the solutes?

A

How does the kidney retain the solutes?
They would be absorbed by normal capillaries but are not by the vasa recta, why?
They function as circulatory counter current exchangers
Loops deliver nutrients and oxygen
Then form hairpin loops to go from increasing osmolarity back to decreasing.

19
Q

Urine
Color and transparency
Yellow due to
-Pigment by product of

Pink, brown
Cloudy

A
Color and transparency
Clear, pale to deep yellow
Yellow due to urochrome
Pigment by product of hemoglobin destruction
Pink, brown
may be due to eating certain foods
may be due to presence of bile pigments or blood
Certain meds or vitamins
Cloudy
may indicate urinary tract infection
20
Q

odor

A
Odor
Fresh usually has little smell
Develops an ammonia odor due to bacteria
Some drugs and foods alter odor
i.e. asparagus, brocholi
Some diseases affect odor
i.e. diabetes mellitus fruity smell
21
Q

pH
Acidic
Alkaline-

A
pH
Usually about 6
Health and diet can affect pH 
Range 4.5-8 normal
Acidic- due to high protein diet
Alkaline- due to vegetarian diet
22
Q

urine Compostion

A

95% water
Next is urea
other nitrogenous waste
Uric acid, creatine
Solutes (in order of normal concentration most to least)
Na+, K+, PO43-, SO42-, creatine, uric acid, Ca2+, Mg2+, HCO3-

23
Q

Ureters

A

Slender tubes that carry urine from the kidneys to the urinary bladder

24
Q

Urinary Bladder

A
Collapsible muscular sac
Temporarily stores urine
Retroperitoneal
Trigone
Outlined by the three openings, area where infections “sit”
Ureters enter inferiorly
So a full bladder closes them off, prevents back flow
Urethra exits inferiorly
Detrusor muscle
Rugae
25
Q

How much can a bladder hold???

A

Very distensible!
Holds about 500 ml of urine when moderately full
Can hold about twice that much (800-1000 ml)
Can burst if over extended
Due to blockage, you cannot hold it long enough to burst your bladder, your body won’t let you

26
Q

Urethra

A
Thin walled muscular tube
Drains urine from the bladder
Internal urethral sphincter
At bladder-urethral junction
Involuntary
Prevents leaking when not voiding
Contracts open and relaxes closed (weird right?)
External urethral sphincter
Surrounds the urethra as it passes through the urogenital diaphram
Voluntary
Works with the levator ani
27
Q

Now to gender differences

A
Female
3-4 cm
Bound to anterior vaginal wall
External urethral orifice
Anterior to vaginal opening
Posterior to the clitoris
Male
20 cm
Three regions
Prostatic urethra
2.5 cm
Within the prostate
Membranous urethra
Through urogenital diaphram
2 cm from prostate to the beginning of penis
Spongy urethra
15 cm
Passes through the penis and opens at the external urethral orifice at the penis tip
Carries semen and urine
28
Q
Micturition
3 thing must happen to allow micturition
The detrusor muscle must
The internal urethral sphincter must 
The external urethral sphincter must
A

AKA urination, voiding
The act of emptying the urinary bladder
3 thing must happen to allow micturition
The detrusor muscle must contract (open)
Involuntary
The internal urethral sphincter must open (relax)
Involuntary
The external urethral sphincter must open (relax)
Voluntary
In general low bladder volumes inhibit micturition and high volumes stimulate

29
Q

Where most of the tubular reabsorption occurs so the fluid becomes more concentrated

A

Proximal convoluted tubule

30
Q

Where the filtrate is formed

A

glomerulus

31
Q

Blood vessels that receive the products being reabsorbed in the kidneys

A

pertitubal capillaries

32
Q

Drains the distal convoluted tubule

A

collecting duct

33
Q

Passive movement of water out of the tubule

A

descending limp of Nephron loop

34
Q

Blood vessel that enters the glomerulus

A

afferent arteriole

35
Q

Blood vessel that exits (drains) the glomerulus (unique!)

A

efferent arteriole

36
Q

Establishes the medullary osmotic gradient

A

nephron loop

37
Q

The structural and functional unit of the kidney

A

nephron

38
Q

Bowman’s capsule plus glomerulus

A

renal corpuscle

39
Q

Regulates systemic blood pressure by controlling filtrations rate and producing renin (granular cells) when the blood pressure drops

A

juxtaglomerular complex