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Physiology - Guyton & Hall > Chapter 26 - Urinary System > Flashcards

Chapter 26 - Urinary System Flashcards

1
Q

Kidney Functions

A
  • Excretion of metabolic wastes and foreign chemicals
  • Regulation of water and electrolyte balances
  • Regulation of body fluid osmolality and electrolyte concentrations
  • Regulation of arterial pressure
  • Regulation of acid-base balance
  • Regulation of erythrocyte production
  • Secretion, metabolism, and excretion of hormones
  • Gluconeogenesis
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2
Q

Metabolic waste products secreted by the kidney

A

(1) urea - from metabolism of amino acids
(2) creatinine - from muscle
(3) uric acid - from metabolism of nucleic acids
(4) end products of bilirubin breakdown
(5) metabolites of various hormones

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3
Q

Foreign chemicals secreted by the kidney

A

toxins, pesticides, drugs, and food aditives

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4
Q

Substance in the body increase if (1) exceeds (2)

Substance in the body decreases if (3) is less than (4)

A

(1) intake
(2) excretion

(3) intake
(4) excretion

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5
Q

Sodium intake can increase up to (1) and decrease down to (2) - thanks to the kidney’s ability to adjust to maintain homeostasis

A

(1) 1500 mEq/day
(2) 10 mEq/day

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6
Q

Kidneys are the only means of eliminating what types of acids

A

sulfuric acid and phosphoric acid

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7
Q

Stimulus for erythropoietin secretion of the kidneys

A

hypoxia

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8
Q

Kidneys produce the active form of what vitamin

A

vitamin D as 1,25-dihydroxy vitamin D3 (calcitriol)

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9
Q

Calcitriol function

A

normal calcium deposit in bone
calcium reabsorption by GI

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10
Q

(True/False)

The kidney can perform gluconeogenesis

A

True

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11
Q

Weight of the human kidney

A

150 grams

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12
Q

(True/False)

The hilum carries the ureter which carries the final urine from the kidney to the bladder where it is excreted as urine. The hilum does NOT carry the renal artery, vein lymphatics, and nerve supply

A

False

The hilum carries the renal artery and vein, lymphatics, nerve supply, and ureter

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13
Q

2 regions of the kidney

A

(1) outer cortex
(2) inner medulla

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14
Q

Renal pyramids can be found in the

A

medulla

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15
Q

The (1) of the renal pyramid is at the border between the cortex and the medulla while the (2) projects into the renal pelvis

A

(1) renal pyramid - base
(2) renal pyramid - papilla

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16
Q

Blood flow to the 2 kidneys

A

22% of cardiac output
1100 ml/min

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17
Q

Renal circulation pathway

A

Renal artery >
interlobar arteries >
arcuate arteries >
interlobular >
afferent arterioles >
Glomerular capillaries >
efferent arterioles >
peritubular capillaries >
(…vein equivalent interlobular to renal vein)

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18
Q

High hydrostatic pressure of glomerular capillaries

A

60 mmHg
cause rapid fluid filtration

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19
Q

Low hydrostatic pressure in peritubular capillaries

A

13 mmHg
causes fluid reabsorption

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20
Q

Amount of nephrons per kidney

A

800, 000 to 1, 000, 000

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21
Q

(True/False)

The kidney regenerates new nephrons

A

False

The kidney CANNOT regenerate new nephrons

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22
Q

Each nephron is composed of

A

(1) glomerulus
(2) tubules

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23
Q

Which parts of the renal tubules are in the medulla of the kidney

A
  • Loop of Henle (thin descending limb & the thick ascending limb)
  • medullary collecting duct
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24
Q

Where is the macula densa located

A

a segment at the end of the thick ascending limb where wall is composed of SPECIALIZED EPITHELIAL CELLS

25
Q

Which parts of the renal tubules are in the cortex of the kidney

A
  • Bowman’s capsule
  • proximal covoluted tubule
  • distal convoluted tubule
  • cortical collecting tubule
  • cortical collecting duct
26
Q

(1) cortical collecting ducts join to form a single larger collecting duct in the medulla called (2)

A

(1) 8 to 10
(2) medullary collecting duct

27
Q

In each kidney, there are (1) very large collecting ducts where each collects urine from (2) nephrons

A

(1) 250
(2) 4 000

28
Q

2 types of nephrons:
cortical nephron vs. juxtamedullary nephrons

A

Cortical
* abundant
* entire tubular system is surrounded by peritubular capillaries

Juxtamedullary
* deep in the renal cortex near the medulla
* 20-30% of kidney nephrons
* surrounded by specialized capillaries called vasa recta

29
Q

Nervous reflex that empties the bladder - excreting urine

A

micturition reflex

30
Q

2 parts of the bladder

A

(1) body
(2) neck

31
Q

Smooth muscle of the bladder

A

detrusor muscle

32
Q

Contraction of the detrusor muscle increases the bladder pressure to

A

40 to 60 mmHg

33
Q

Small triangular area lying at the posterior wall of the bladder immediately above the bladder neck

A

trigone

34
Q

What enters at the trigone - specifically in:
(1) uppermost angles
(2) lowermost apex

A

(1) ureters
(2) posterior urethra - urethra

35
Q

(True/False)

The mucosa of the trigone is smooth while the rest of the bladder contain folds called rugae

A

True

36
Q

Location of the internal sphincter

A

posterior urethra

37
Q

Location of the external sphincter

A

Urethra - at the level where it passes the urogenital diaphgram

38
Q

(True/False)

The external sphincter is composed of smooth muscle

A

False

(smooth) > skeletal

39
Q

Nerve supply of the bladder

A

(1) pelvic nerves from the sacral plexus (S2 and S3) - as the principal supply

(2) skeletal motor fibers from the pudendal nerve - as somatic nerve fibers

(3) sympathetic innervation from the sympathetic chain of the hypogastric nerves (L2) - for blood vessels

40
Q

Type of nerves carried by the pelvic nerve

A

sensory and motor nerve fibers

41
Q

Detects stretch in the urinary bladder

A

sensory nerve fibers of the pelvic nerves

42
Q

(True/False)

Motor nerve fibers of the pelvic nerves are sympathetic

A

False

(sympathetic) > parasympathetic

43
Q

Movement of urine from the renal pelvis to the ureter is via

A

peristalsis

44
Q

Ureter length

A

25 to 35 cm

45
Q

Parasympathetic and sympathetic effects on urination

A

Parasympathetic - stimulates urination
Sympathetic - inhibits urination

46
Q

Ureter course obliquely for several centimeters through the bladder wall…why?

A

compression of bladder wall as pressure builds up prevents backflow of urine

47
Q

When urine from the bladder flows back to the ureter

A

vesicoureteral reflux

48
Q

Effect that is important for attenuating the flow of fluid into the pelvis of a kidney with a blocked ureter

A

ureterorenal reflex

49
Q
A
  • No urine in the bladder - intravesicular pressure is 0 mmHg
  • a rise in 30 to 50 ml of urine increases pressure by 5 to 10
  • additional urine - 200 to 300 ml can collect with minimal pressure rise with the help of intrinsic tone of bladder wall
  • beyond 300 to 400 ml urine, pressure rises rapidly
  • peaks are micturition waves caused by micturition reflex
  • dashed spikes as micturition contractions
50
Q

Micturition complete cycle

A
  1. progressive and rapid increase of pressure
  2. a period of sustained pressure
  3. return of pressure to the basal tone of the bladder

cycle continues after a few minutes when bladder is not emptied

51
Q

Involuntary voiding occurs when

A

micturition reflex is powerful enough to cause another reflex that passes through the pudendal nerves to the external sphincter - inhibiting it

52
Q

Centers of the brain that can inhibit the autonomic reflex of micturition

A

(1) strong facilitative and inhibitory centers in the brain stem - pons

(2) centers in the cerebral cortex - mainly inhibitory

53
Q

(True/False)

Higher centers normally exert final control of micturition

A

True

54
Q

Urine formation results from

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
55
Q

Urine excretion rate

A

= filtration rate - reabsorption rate + secretion rate

56
Q
A

Substance A: creatinine
Substance B: electrolytes - Na and Cl
Substance C: amino acids, glucose
Substance D: organic acids and bases

57
Q

GFR

A

180 L/day

58
Q

Entire plasma can be filtered () times a day

A

60

59
Q

(True/False)

High GFR allows kidneys to control the volume and composition of the body fluids precisely and rapidly

A

True

Physiology - Guyton & Hall (21 decks)

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