Chapter 25 Urinary Flashcards

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1
Q

What are the kidneys?

What are the urinary system structures in the body?

A

They are the main processing center of the excretory system.

Includes pair of kidneys, pair of ureters that drain the kidneys to the bladder, the bladder and the urethra which drains the bladder

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2
Q

What are the kidneys?

What are the urinary system structures in the body?

A

They are the main processing center of the excretory system.

Includes pair of kidneys, pair of urethra that drain the kidneys to the bladder, the bladder and the urethra which drains the bladder

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3
Q

What is the main functions of the kidneys

What is it called when the kidneys fail and toxins build up in the urea?
what is bilirubin? (all part of the first function of kidneys mentioned)

A
  1. waste elimination- excretes nitrogenous waste = urea and ammonia, carbon dioxide, bacterial toxins, and inorganic cells.
    - toxin build up is called uremia
    - bilirubin is formed by break down of hemoglobin
  2. regulates blood composition- composition of certain ions in the blood such as sodium, chloride, potassium, calcium and phosphate. selective reabsorption and secretion
  3. regulates blood volume- eliminates or retains water, this regulates the volume of interstitial fluid
  4. regulates blood pressure- secretes enzyme renin which activates a pathway to increase volume and pressure
  5. regulates blood pH - long term- eliminates excess H+ ions and reabsorbs bicarbonate ions.
  6. metabolism: Gluconeogenesis- during fasting and starvation- glucose breakdown from lactid acid and other non-carbohydrate molecules (fats and proteins)
  7. hormone release- Erythroproietin (RBC production) and calcitriol (calcium uptake)
  8. maintains blood osmolarity- regulates water volume and composition of solutes in blood.
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4
Q

What is the main functions of the kidneys

What is it called when the kidneys fail and toxins build up in the urea?
what is bilirubin? (all part of the first function of kidneys mentioned)

A
  1. waste elimination- excretes nitrogenous waste = urea and ammonia, carbon dioxide, bacterial toxins, and inorganic cells.
    - toxin build up is called uremia
    - bilirubin is formed by break down of hemoglobin
  2. regulates blood composition- composition of certain ions in the blood such as sodium, chloride, potassium, calcium and phosphate. selective reabsorption and secretion
  3. regulates blood volume- eliminates or retains water, this regulates the volume of interstitial fluid
  4. regulates blood pressure- secretes enzyme renin which activates a pathway to increase volume and pressure
  5. regulates blood pH - long term- eliminates excess H+ ions and reabsorbs bicarbonate ions.
  6. metabolism: Gluconeogenesis- during fasting and starvation- glucose breakdown from lactid acid and other non-carbohydrate molecules (fats and proteins)
  7. hormone release- Erythroproietin (RBC production) and calcitriol (calcium uptake)
  8. maintains blood osmolarity- regulates water volume and composition of solutes in blood.
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5
Q

what is the hilum on the kidneys?

A

opening for renal vein and artery

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6
Q

what is the internal anatomy of the kidneys as well as detail about the renal pelvis.

A

renal cortex- outer layer
renal medulla- inner layer, consists renal pyramid
renal pelvis- continuos with ureter that leaves the hilum
renal pelvis has calyx/ calyces (minor and major). minor calyx collects urine from renal pyramid and drains into 2 or 3 major calyces which then empties into renal pelvis and out the ureter

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7
Q

what is the nephron and what does the nephron consist of?

A

nephron is the functioning unit of the kidneys
it contains a renal corpuscle = glomerulus and bowman’s capsule. it has proximal convoluted tubule connected to the loop of henle then the distal convoluted tubule

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8
Q

what is the nephron and what does the nephron consist of?

A

nephron is the functioning unit of the kidneys
it contains a renal corpuscle = glomerulus and bowman’s capsule. it has proximal convoluted tubule connected to the loop of henle then the distal convoluted tubule

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9
Q

what are the three main process of the nephron

A
  1. filter: filters the blood in the renal corpuscle
  2. secretion: selective addition of substances to the filtrate from the interstitial fluid surrounding the nephron. this occurs in the distal and proximal convoluted tubules.
  3. reabsorption: selective removal of fluids from the filtrate to the interstitial fluid. occurs in the convoluted tubules, loop of henle and collecting ducts.
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10
Q

what are the three main process of the nephron

A
  1. filter: filters the blood in the renal corpuscle
  2. secretion: selective addition of substances to the filtrate from the interstitial fluid surrounding the nephron. this occurs in the distal and proximal convoluted tubules.
  3. reabsorption: selective removal of fluids from the filtrate to the interstitial fluid. occurs in the convoluted tubules, loop of henle and collecting ducts.
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11
Q

what are the two types of nephrons in the kidneys

A
  1. cortical nephrons which are in the outer cortex. they have short loops of henle and are the majority of nephrons.
  2. juxtamedullary nephrons are deep in the cortex, they have long loops of henle and make up on 15-20% of nephrons. they are involved in regulating urine concentration
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12
Q

what are the two types of nephrons in the kidneys

A
  1. cortical nephrons which are in the outer cortex. they have short loops of henle and are the majority of nephrons.
  2. juxtamedullary nephrons are deep in the cortex, they have long loops of henle and make up on 15-20% of nephrons. they are involved in regulating urine concentration
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13
Q

Blood supply- renal artery

what drives the pressure of filter in the glomerulus

details about the efferent arterioles- two types:

A

branches many times before forming afferent arterioles, each form a small knot of capillaries then rejoin and form efferent arterioles

Pressure in afferent arterioles is higher than pressure in efferent which drives the filtration

efferent arterioles form capillary bed around tubules

  • peritubular capillaries- close to adjacent renal tubule for blood reabsorption and secretion
  • vasa recta- long and straight bundles for osmotic regulation and concetration of urine
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14
Q

Blood supply- renal artery

what drives the pressure of filter in the glomerulus

details about the efferent arterioles- two types:

A

branches many times before forming afferent arterioles, each form a small knot of capillaries then rejoin and form efferent arterioles

Pressure in afferent arterioles is higher than pressure in efferent which drives the filtration

efferent arterioles form capillary bed around tubules

  • peritubular capillaries- close to adjacent renal tubule for blood reabsorption and secretion
  • vasa recta- long and straight bundles for osmotic regulation and concentration of urine
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15
Q

Blood supply- renal artery

what drives the pressure of filter in the glomerulus

details about the efferent arterioles- two types:

A

branches many times before forming afferent arterioles, each form a small knot of capillaries then rejoin and form efferent arterioles

Pressure in afferent arterioles is higher than pressure in efferent which drives the filtration

efferent arterioles form capillary bed around tubules

  • peritubular capillaries- close to adjacent renal tubule for blood reabsorption and secretion
  • vasa recta- long and straight bundles for osmotic regulation and concentration of urine
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16
Q

what makes up the renal corpuscle and what is its purpose

A

purpose is to filter blood make up of the glomerulus and the bowmans capsule
Has three layers:
Endothelium of glomerulus: is porous, everything but blood can pass through
Basement membrane of glomerulus: prevents large molecules from passing through
Filtration slips of capsule podocytes: processes wrap around the glomerulus which have slits with membranes. the filtration slits block medium proteins from passing though.
Everything can pass through except: blood cells, and medium and large proteins

17
Q

what is the hilum on the kidneys?

A

opening for the renal vein and artery

18
Q

what are the three main processes of the nephron

A
  1. filter: filters the blood in the renal corpuscle
  2. secretion: selective addition of substances to the filtrate from the interstitial fluid surrounding the nephron. this occurs in the distal and proximal convoluted tubules.
  3. reabsorption: selective removal of fluids from the filtrate to the interstitial fluid. occurs in the convoluted tubules, loop of henle and collecting ducts.
19
Q

what makes up the renal corpuscle and what is its purpose

A

purpose is to filter blood make up of the glomerulus and the bowmans capsule
Has three layers:
Endothelium of glomerulus: is porous, everything but blood can pass through
Basement membrane of glomerulus: prevents large molecules from passing through
Filtration slips of capsule podocytes: processes wrap around the glomerulus which have slits with membranes. the filtration slits block medium proteins from passing though.
Everything can pass through except: blood cells, and medium and large proteins

20
Q

what is the final bit of the ascending loop of henle called and what makes it up/ purpose

A

juxtaglomerular apparatus: contacts the arterioles entering the glomerulus. Where they touch the tubular cells are tall and densely packed making up the macula densa which monitors the salt concentration in the filtrate.

21
Q

what is the final bit of the ascending loop of henle called and what makes it up/ purpose

A

juxtaglomerular apparatus: contacts the arterioles entering the glomerulus. Where they touch the tubular cells are tall and densely packed making up the macula densa which monitors the salt concentration in the filtrate.

22
Q

Glomerulus filtration pressure:
HP gc=
OP gc=
HP cs=

A

HP gc= hydrostatic pressure on glomerulus: pressure exerted by blood on glomerulus arterioles
OP gc= colloid osmostic pressure on glomerulus capillaries: pressure exerted by proteins in blood
HP cs= hydrostatic pressure in capsular space: exerted by filtrate on glomerulus capsule

23
Q

What are the two ways the body regulates the glomerulus filtration rate?

A

intrinsic (renal autoregulation) and extrinsic (nervous and endocrine system maintaining BP)
Renal autoregulation- ability of kidneys to maintain stead GFR despite fluctuations in BP
Two ways:
Myogenic mechanism: constricts or relaxes vascular smooth muscle
Tubuloglomerular feedback mechanism: regulated by the macula densa cells of the juxtaglomerular complex

Extrinsic

24
Q

What are the two ways the body regulates the glomerulus filtration rate?

A

intrinsic (renal autoregulation) and extrinsic (nervous and endocrine system maintaining BP)

Renal autoregulation- ability of kidneys to maintain stead GFR despite fluctuations in BP
Two ways:
Myogenic mechanism: constricts or relaxes vascular smooth muscle
Tubuloglomerular feedback mechanism: regulated by the macula densa cells of the juxtaglomerular complex

Extrinsic controls- neural and hormonal mechanisms
Two mechanisms:
sympathetic NS control- baroreceptors work in short-term fashion to either promote or restrict kidney water loss
renin-angiotensin mechanism- declining blood pressure triggers the release of renin which triggers the release of angiotensin II. Angiotensin II is a potent vasoconstrictor that stimulates aldosterone secretion. aldosterone enhances renal reabsorption and stimulates ADH release.

25
Q

What are the two ways the body regulates the glomerulus filtration rate?

A

intrinsic (renal autoregulation) and extrinsic (nervous and endocrine system maintaining BP)

Renal autoregulation- ability of kidneys to maintain stead GFR despite fluctuations in BP
Two ways:
Myogenic mechanism: constricts or relaxes vascular smooth muscle
Tubuloglomerular feedback mechanism: regulated by the macula densa cells of the juxtaglomerular complex

Extrinsic controls- neural and hormonal mechanisms
Two mechanisms:
sympathetic NS control- baroreceptors work in short-term fashion to either promote or restrict kidney water loss
renin-angiotensin mechanism- declining blood pressure triggers the release of renin which triggers the release of angiotensin II. Angiotensin II is a potent vasoconstrictor that stimulates aldosterone secretion. aldosterone enhances renal reabsorption and stimulates ADH release.

26
Q

Tubular reabsorption: Proximal convoluted tubule, loop of henle, and distal convoluted tubule

A

-tubule reabsorption is the movement of fluids and solutes from filtrate back into blood (peritubule capillaries)
reabsorption across PCT: Na+ actively pumped out tubule and diffuses into capillary, water flows by osmosis, K+ Ca2+ Cl- bicarbonate ion and urea flow by diffusion, and molecules such as glucose, amino acids, and lactid acids move through active transport.

27
Q

Tubular reabsorption: Proximal convoluted tubule, loop of henle, and distal convoluted tubule

A

-tubule reabsorption is the movement of fluids and solutes from filtrate back into blood (peritubule capillaries)
reabsorption across PCT: Na+ actively pumped out tubule and diffuses into capillary, water flows by osmosis, K+ Ca2+ Cl- bicarbonate ion and urea flow by diffusion, and molecules such as glucose, amino acids, and lactid acids move through active transport.
Loop of henle: Descending limb is more permeable to water through osmosis, ascending limb is more permeable to ions such as N+ Cl-, uses secondary active transport and passive diffusion.
distal convoluted tubule: regulated secretion and reabsorption. reabsorbs remaining water (10%) salt and water fine tuning reabsorption in last portion of tubules.

28
Q

what are the hormones that play a role in reabsorption?

A

aldosterone: causes reabsorption of Na+ by principle cells, water follows, the result is increase in blood volume and pressure
adh: principle cells become more permeable, retains more water, the result is urine becomes more concentrated. without ADH urine is very diluted

29
Q

what is the purpose of tubule secretion?

A

controls pH, eliminates substances that were absorbed but not needed, disposes of other wastes

30
Q

what is the purpose of tubule secretion?

A

controls pH, eliminates substances that were absorbed but not needed, disposes of other wastes

31
Q

how is the osmotic gradient established and maintained?

A

through countercurrent mechanism. A) countercurrent multiplier: flow of filtrate in ascending and descending limbs. B) countercurrent exchanger: flow of blood in vasa recta

32
Q

how is the osmotic gradient established and maintained?

A

through countercurrent mechanism. A) countercurrent multiplier: flow of filtrate in ascending and descending limbs. B) countercurrent exchanger: flow of blood in vasa recta

33
Q

how does the countercurrent multiplier work?

A

in the descending look of henle, water leaves filtrate through osmosis due to high salt concentration in interstitial fluid. ascending loop of henle Na+ and Cl- are pumped out so filtrate becomes more dilute as it goes up. Na and Cl cause high salt concentration in interstitial fluid

34
Q

how does the countercurrent exchanger work

A

the vasa recta preserves the gradient. countercurrent exchange preserves osmotic gradient by: preventing rapid removal of salt for medullary interstitial space and by removing reabsorbed water. as a result the blood enter and leaving the cortex via vasa recta has nearly the same solute concentration

35
Q

what is a diuretic and what are some examples:

A

substances that increase urine output.
examples are:
-high glucose in diabetes mellitus = osmotic diuretic which means water leaves with glucose
-alcohol inhibits adh release so urine increases
-Caffeine inhibits Na+ reabsorption and therefor the water that follows.

36
Q

what connects the kidneys to the bladder? what can block this connection and what is the cause?

A

the ureters connect the kidneys to bladder and they can be blocked by kidney stones caused by frequent bladder infections, urine retention, or high concentration of calcium in the blood and alkaline urine.

37
Q

what connects the kidneys to the bladder? what can block this connection and what is the cause?

A

the ureters connect the kidneys to bladder and they can be blocked by kidney stones caused by frequent bladder infections, urine retention, or high concentration of calcium in the blood and alkaline urine.