Chapter 26 Flashcards
Which is not a major function of the kidney?
a) regulation of blood ionic composition
b) regulation of blood cell size
c) regulation of blood volume
d) regulation of blood pressure
e) regulation of blood pH
b) regulation of blood cell size
This is the formation of a new glucose molecule.
a) glycolysis
b) gluconeogenesis
c) glucosamine
d) glucose
e) calcitriol
b) gluconeogenesis
Which of the following is a waste product normally excreted by the kidneys?
a) urea
b) glucose
c) insulin
d) cholesterol
e) carbon dioxide
a) urea
This is smooth dense irregular connective tissue that is continuous with the outer coat of the ureter.
a) adipose capsule
b) renal capsule
c) renal hilus
d) renal cortex
e) renal medulla
b) renal capsule
The portion of the kidney that extends between the renal pyramids is called the
a) renal columns
b) renal medulla
c) renal pelvis
d) calyces
e) renal papilla
a) renal columns
Which is the correct order of blood flow through the kidneys?
a) renal artery > segmental artery > interlobular artery > peritubular capillaries > afferent arterioles
b) interlobar arteries > arcuate arteries > glomerular capillaries > arcuate veins
c) arcuate veins > arcuate arteries > glomerular capillaries > renal vein
d) renal vein > segmental arteries > interlobar arteries > efferent arterioles
e) interlobar veins > afferent arterioles > efferent arterioles > glomerular capillaries
b) interlobar arteries > arcuate arteries > glomerular capillaries > arcuate veins
Which is the correct order of filtrate flow?
a) glomerular capsule, proximal convoluted tubule (PCT), nephron loop, distal convoluted tubule (DCT), collecting duct
b) nephron loop, glomerular capsule, PCT, DCT, collecting duct
c) ascending limb of loop, PCT, DCT, collecting duct
d) collecting duct, DCT, PCT, collecting duct, glomerular capsule
e) PCT, glomerular capsule, DCT, collecting duct, nephron loop
a) glomerular capsule, proximal convoluted tubule (PCT), nephron loop, distal convoluted tubule (DCT), collecting duct
Which structure of the nephron reabsorbs the most substances?
a) glomerular capsule
b) nephron loop
c) ascending limb
d) collecting duct
e) proximal convoluted tubule
e) proximal convoluted tubule
This is the structure of the nephron that filters blood.
a) glomerular capsule
b) nephron loop
c) ascending limb
d) collecting duct
e) renal tubule
a) glomerular capsule
This term means the return of substances into the blood stream from the filtrate.
a) reabsorption
b) filtration
c) secretion
d) excretion
e) none of these choices
a) reabsorption
This is a nephron process that results in a substance in blood entering the already formed filtrate.
a) reabsorption
b) filtration
c) secretion
d) excretion
e) none of these choices
c) secretion
This layer of filtration membrane is composed of collagen fibers and proteoglycans in a glycoprotein matrix.
a) glomerular endothelial cells
b) basal lamina
c) pedicels
d) filtration slits
e) slit membrane
b) basal lamina
This occurs when stretching triggers contraction of smooth muscle walls in afferent arterioles.
a) glomerular filtration rate
b) tubulomerular feedback
c) myogenic mechanism
d) renal autoregulation
e) capsular hydrostatic pressure
c) myogenic mechanism
This occurs when a substance passes from the fluid in the tubular lumen through the apical membrane, across the cytosol, and then into the interstitial fluid.
a) paracellular reabsoprtion
b) transcellular reabsoprtion
c) apical reasborption
d) basolateral reabsorption
e) active transport
b) transcellular reabsoprtion
The proximal convoluted tubules reabsorb which percentage of filtered water?
a) 25%
b) 50%
c) 65%
d) 80%
e) 99%
c) 65%
Which of the following is NOT a way angiotensin II affects the kidneys?
a) It increases GFR
b) It can decrease GFR
c) It enhances reabsorption of certain ions
d) It stimulates the release of aldosterone
e) None of these choices
a) It increases GFR
Urea recycling can cause a buildup of urea in the
a) renal capsule
b) nephron loop
c) ascending tubule
d) renal medulla
e) renal pelvis
d) renal medulla
Increased secretion of hydrogen ions would result in a(n) ______________ of blood ____________?
a) increase, pressure
b) decrease, volume
c) increase, sodium levels
d) decrease, pH
e) increase, urea
d) decrease, pH
Increased secretion of aldosterone would result in a(n) ______________ of blood ____________?
a) increase, potassium
b) decrease, volume
c) increase, calcium levels
d) decrease, pH
e) increase, sodium
e) increase, sodium
An analysis of the physical, chemical, and microscopic properties of urine is called
a) urinalysis
b) filtration study
c) concentration study
d) diuretic
e) osmolarity
a) urinalysis
Water accounts for which percentage of the total volume of urine?
a) 25%
b) 50%
c) 75%
d) 80%
e) 95%
e) 95%
This is a test to measure kidney function.
a) Plasma creatinine
b) Renal study
c) Kidney assay
d) Dialysis
e) Hilus study
a) Plasma creatinine
This transports urine from the kidney to the bladder.
a) Urethra
b) Ureter
c) Descending nephron loop
d) Renal hilus
e) None of these choices
b) Ureter
This layer of the ureter is composed of connective tissue, collagen and elastic fibers.
a) Mucosa
b) Transitional epithelium
c) Lamina propria
d) Adventitia
e) Lamina elastica
c) Lamina propria
This lies in the anterior corner of the trigone of the bladder.
a) Urethral sphincter
b) Adventitia bundle
c) Ureter
d) Internal urethral orifice
e) Muscularis bundle
d) Internal urethral orifice
This is composed of dense irregular tissue that runs continuous with the ureter.
a) A
b) B
c) C
c) C
This layer’s main function is to protect the kidney from trauma and hold it in place within the abdominal cavity.
a) A
b) B
c) C
b) B
This layer runs deep to the peritoneum on the anterior surface of the kidneys.
a) A
b) B
c) C
a) A
This can be divided into the cortical zone and the juxtamedullary zone.
a) A
b) D
c) E
d) F
e) G
a) A
Each kidney can have anywhere from 8 to 18 of these.
a) I
b) J
c) K
d) L
e) H
c) K
This structure is the apex of a renal pyramid.
a) E
b) D
c) G
d) K
e) L
a) E
Urine formed by the nephrons first drains into these.
a) H
b) I
c) J
d) K
e) L
d) K
What two structures comprise the renal corpuscle?
a) A and B
b) C and D
c) E and F
d) K and L
e) N and O
a) A and B
Where is the distal convoluted tubule?
a) D
b) E
c) J
d) K
e) L
a) D
Where is the arcuate vein?
a) E
b) F
c) G
d) H
e) I
d) H
Where is the ascending limb of the nephron loop?
a) C
b) D
c) J
d) K
e) L
e) L
Where is the corticomedullary junction?
a) G
b) J
c) M
d) N
e) O
b) J
Where is the papillary duct?
a) C
b) F
c) H
d) N
e) O
d) N
What does line “M” point to?
a) Arcuate artery
b) Arcuate vein
c) Collecting duct
d) Descending loop
e) Efferent arteriole
c) Collecting duct
What is line “C” pointing to?
a) Distal convoluted tubule
b) Interlobular artery
c) Efferent arteriole
d) Arcuate artery
e) Corticomedullary junction
c) Efferent arteriole
What is line “A” pointing to?
a) Fenestration
b) Pedicel
c) Filtration slit
d) Basal lamina
e) Lumen of the glomerulus
a) Fenestration
What is line “B” pointing to?
a) Fenestration
b) Pedicel
c) Filtration slit
d) Basal lamina
e) Lumen of the glomerulus
b) Pedicel
What is line “C” pointing to?
a) Fenestration
b) Pedicel
c) Filtration slit
d) Basal lamina
e) Lumen of the glomerulus
c) Filtration slit
What is line “D” pointing to?
a) Fenestration
b) Pedicel
c) Filtration slit
d) Basal lamina
e) Lumen of the glomerulus
d) Basal lamina
Describe the flow of blood through the kidneys.
Kidneys receive 20 to 25% of the resting cardiac output via the renal arteries. The renal arteries branch to form segmental arteries, which branch to form interlobar arteries (through renal columns) to arcuate arteries (over bases of pyramids) to interlobular arteries. The interlobular arteries branch to form afferent arterioles to each nephron. Afferent arterioles branch to form glomerular capillaries where filtration occurs. Glomerular capillaries merge to form efferent arterioles, which then branch to form peritubular capillaries. Juxtamedullary nephrons also have vasa recta capillaries around them. Peritubular capillaries merge to form peritubular veins and with the vasa recta to form interlobular veins to arcuate veins to interlobar veins. Blood exits the kidney via renal veins.
Trace the flow of a water molecule through the nephrons from the afferent arteriole to the minor calyx.
The water would flow from the afferent arteriole into the glomerulus, where it would be filtered into the Bowman’s capsule. From the Bowman’s capsule, it would enter the proximal convoluted tubule (PCT). Most of its companion water molecules would be reabsorbed into the blood from the PCT. The next part of the trip would take the water molecule through the descending of the nephron loop, where more of its companion water molecules would be reabsorbed. From there, the water molecule would climb the ascending nephron loop and move into the distal convoluted tubule (DCT). Toward the end of the DCT and most of the collecting duct, there are principal cells that respond to ADH and can reabsorb more water molecules. If not reabsorbed in the DCT or the collecting duct, the water molecule would move into the papillary duct that drains into the minor calyx.
Describe the structural features of the renal corpuscle that enhance its blood filtering capacity.
Endothelial cells of the glomerular capillaries are fenestrated. Their basement membranes are part of the filtering mechanism. Podocytes with filtration slits between pedicels wrap the glomerular capillaries. The large surface area also contributes to filtering ability, as does the high glomerular hydrostatic pressure created by the arrangement of the afferent and efferent arterioles, in which the diameter of the efferent arteriole is smaller than that of the afferent arteriole.
Describe in detail how the renin angiotensin negative feedback loop helps regulate blood pressure and glomerular filtration rate in response to dehydration.
Dehydration causes a decrease in blood volume and pressure, which then decreases glomerular filtration rate (GFR). The juxtaglomerular( JG) cells of the juxtaglomerular apparatus sense decreased stretch and macula densa cells sense decreased water. The JG cells secrete renin, which converts angiotensinogen in blood to angiotensin I. The latter is converted to angiotensin II by angiotensin converting enzymes in the lungs. Angiotensin II causes constriction of efferent arterioles, increased thirst, greater ADH secretion from the posterior pituitary, and increased secretion of aldosterone from the adrenal cortex. Blood volume is increased, which increases venous return, stroke volume, cardiac output, and blood pressure. GFR is also increased.
Discuss the importance of countercurrent flow to the functioning of the nephron.
Countercurrent flow refers to the flow of fluid in opposite directions in parallel tubing (tubules and blood vessels). The arrangement allows gradients to develop between tubular fluid, blood, and interstitial fluid. Gradients allow for reabsorption of large amounts of water and ions from the tubular fluid.
Fluid flowing from point N in the figure will go to which structure next?
a) G
b) H
c) C
d) B
e) K
a) G
Fluid flowing from point G in the figure will go to which structure next?
a) N
b) H
c) I
d) M
e) K
c) I
Fluid flowing from point H in the figure will go to which structure next?
a) L
b) B
c) I
d) G
e) N
b) B
Fluid flowing from point B in the figure will go to which of the following structures?
a) J
b) M
c) I
d) G
e) H
a) J
Which vessel in the diagram is the afferent arteriole?
a) C
b) D
c) E
d) F
e) L
a) C
Which vessel in the diagram is the interlobular vein?
a) C
b) D
c) E
d) F
e) L
c) E
Which vessel(s) in the diagram are the vasa recta?
a) C
b) D
c) E
d) M
e) L
e) L
Which vessel in the diagram is the interlobular artery?
a) D
b) E
c) F
d) L
a) D
Which vessel in the diagram is the arcuate artery?
a) C
b) D
c) E
d) F
e) L
d) F
Which vessel(s) in the diagram are the peritubular capillaries?
a) C
b) D
c) E
d) M
e) L
d) M
An increase in permeability of the filtration membrane due to disease, injury, or irritation of kidney cells by substances such as bacterial toxins, ether, or heavy metals indicates which condition?
a) albuminuria
b) lucosuria
c) robilinogenuria
d) ketonuria
e) bilirubinuria
a) albuminuria
Anorexia, starvation, or a diet too low in carbohydrates indicates which condition?
a) albuminuria
b) glucosuria
c) urobilinogenuria
d) ketonuria
e) bilirubinuria
d) ketonuria
Stress, causing excessive amounts of epinephrine secretion which stimulates glycogen breakdown, indicates which condition? This condition can also indicate diabetes mellitus.
a) albuminuria
b) glucosuria
c) urobilinogenuria
d) hematuria
e) bilirubinuria
b) glucosuria
Excessive urine concentration of a normal breakdown product of hemoglobin, caused by pernicious anemia, infectious hepatitis, jaundice or cirrhosis, indicates which condition?
a) albuminuria
b) glucosuria
c) urobilinogenuria
d) hematuria
e) bilirubinuria
c) urobilinogenuria
This substance gives bile its major pigmentation:
a) ketone bodies
b) erythrocytes
c) casts
d) bilirubin
e) glucose
d) bilirubin
These are tiny masses of material, hardened in the lumen of the urinary tubule and are flushed out when filtrate builds up behind them:
a) ketone bodies
b) erythrocytes
c) casts
d) microbes
e) urobilinogen
c) casts
Candida albicans and E. coli are which type of abnormal constituent of urine:
a) ketone bodies
b) erythrocytes
c) casts
d) microbes
e) urobilinogen
d) microbes
Which is the normal pH range of urine in humans?
a) 8.1 – 10.6
b) 4.6 – 8.0
c) 1.0 – 3.0
d) 3.1 – 4.0
e) 10.0 – 12.0
b) 4.6 – 8.0
What is the normal volume of urine produced in humans?
a) 1L / hr
b) 2L / day
c) 2L / hr
d) 3L / week
e) 10L / 24 hours
b) 2L / day
What is the normal specific gravity range of urine in humans?
a) 2.350 – 3.700
b) 0.002 – 1.000
c) 4.6 – 8.0
d) 1.001 – 1.035
e) 1.04 – 2.60
d) 1.001 – 1.035
True/False
Parasympathetic division of ANS regulates kidney functions.
False
This hormone is released when the blood volume increases.
a) Parathyroid Hormone
b) Renin
c) ADH
d) Atrial Natriuretic Peptide
e) Aldosterone
d) Atrial Natriuretic Peptide
Consumption of salty food will cause an increase in this hormone.
a) Aldosterone
b) Renin
c) ANH
d) Angiotensin-II
e) ADH
e) ADH
Absence of angiotensin converting enzyme will lead to
a) decreased blood pressure
b) increased blood pressure
c) will not have any effect on blood pressure
d) All of these choices are correct.
e) None of these choices is correct.
a) decreased blood pressure
In males, both the urinary system and the _________ use the urethra.
a) integument
b) reproductive system
c) respiratory system
d) digestive system
b) reproductive system
The kidneys release _________ to raise blood pressure.
renin
The kidneys convert some of the bilirubin from hemoglobin breakdown to ________, a yellow pigment.
urobilin
Shock wave lithotripsy is often used to treat which condition?
a) renal calculi
b) urinary tract infections
c) glomerulonephritis
d) polycystic kidney disease
e) urinary bladder cancer
a) renal calculi
Excessive calcium ingestion and low water intake can lead to which condition?
a) renal calculi
b) urinary tract infections
c) glomerulonephritis
d) polycystic kidney disease
e) urinary bladder cancer
a) renal calculi
Inflammation of the kidneys is called
a) cystitis
b) nephrotic syndrome
c) pyelonephritis
d) urethritis
c) pyelonephritis
