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a & p II exam 3 > chapter 26: urinary system > Flashcards

chapter 26: urinary system Flashcards

1
Q

the kidney can assist the liver during starvation by performing what, the creation of glucose from non-carbohydrate molecules?

A

gluconeogenesis

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2
Q

what is the layer of collagen that functions to keep the kidney anchored to the body wall?

A

renal fascia

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3
Q

the renal medulla consists of many what?

A

renal pyramids

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4
Q

most of the renal sinus is taken up by what, which funnels urine into the ureters?

A

renal pelvis

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5
Q

inflammation of the kidney from an untreated UTI is called what?

A

pyelonephritis

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6
Q

cortical nephrons have a shorter what than juxtamedullary nephrons?

A

nephron loop

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7
Q

the glomerulus is covered with what visceral epithelium cells are called that intertwine to create filtration slits?

A

podocytes

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8
Q

the part of the renal tubule that is composed of cuboidal epithelium with microvilli is what?

A

proximal convoluted tubule (PCT)

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9
Q

what does secretion mean in the context of the distal convoluted tubule?

A

removal of wastes from the peritubular capillaries into the filtrate

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10
Q

The juxtaglomerular apparatus consists of what endocrine cells of the DCT & juxtaglomerular cells from the afferent arteriole?

A

macula densa

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11
Q

the JGA produces two regulatory substances: renin and what else?

A

erythropoietin

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12
Q

what molecule supplies the normal yellow color of the urine?

A

urobilin

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13
Q

of the total filtrate produced by the glomeruli, what percent is reabsorbed by the
renal tubule before urine exits the papillary ducts?

A

99%

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14
Q

as blood pressure declines, what happens to the GFR?

A

GFR declines

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15
Q

what is the main function of the nephron loop?

A

water reabsorption, ability to concentrate the urine

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16
Q

when aldosterone is present how will the DCT respond?

A

return sodium to the blood & discard potassium into the filtrate

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17
Q

how can the DCT assist in regulating blood pH?

A

optimal removal of H+ to reduce acidity

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18
Q

what triggers the insertion of aquaporin proteins into the cells of the DCT?

A

ADH

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19
Q

how can alcohol consumption lead to dehydration?

A

alcohol inhibits ADH, ADH allows for concentration of filtrate to reduce loss of water

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20
Q

what epithelium lines the ureters & urniary bladder?

A

transitional

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21
Q

the three layers of smooth muscle in the wall of the urinary bladder are
collectively what muscle?

A

detrusor

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22
Q

what’s the outermost layer of the urinary bladder which
anchors it to the pelvic floor?

A

adventitia

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23
Q

what’s reflex controls the timing of urination?

A

micturition

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24
Q

what is the inability to voluntarily control urine excretion?

A

incontinence

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25
Q

urinary retention in men is a result of what?

A

enlarged prostate

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26
Q

urinary system components/ urinary tract

A

-kidneys
-ureters
-urinary bladder
-urethra

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27
Q

excretions (function of the urinary system)

A

kidney
-removes organic wastes from blood

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28
Q

elimination (function of the urinary system)

A

urinary tract
-discharge wastes to enviroment

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29
Q

regulation of plasma volume & solute concentration (function of the urinary system)

A

kidney
-blood volume
-conc. of ions
-stabilize blood pH
-conserve nutrients
-assist liver: deamination, detoxification

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30
Q

what are other kidney functions?

A

a. gluconeogenesis during starvation
b. produce renin (regulate BP)
c. produce erythropoietin (RBC production)
d. convert VitD to calcitrol (Ca++ absorption in GI)

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31
Q

kidney

A

1% of body weight
-retroperitoneal, posterior abdominal wall
-adrenal gland anchored superior
-3 layers of CT anchoring: renal & adipose capsule, renal fascia
-has 2 layers: cortex & medulla

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32
Q

renal capsule(kidneys)

A

collagen fibers covering organ

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33
Q

adipose capsule(kidneys)

A

adipose cushion around renal capsule

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34
Q

renal fascia (kidneys)

A

collagen fiber fused to renal capsule and deep fascia of body wall & peritoneum

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35
Q

renal ptosis

A

floating kidney
-starvation or injury, kidney loose from body wall, could twist blood vessels or ureters

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36
Q

hilum of the kidney

A

-where renal arteries, renal veins, ureters enter/exit
-opens to renal sinus

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37
Q

renal sinus

A

lined with renal capsules, contiguous with outside

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38
Q

cortex (kidney)

A

superficial, contact renal capsule, houses filtration structure (nephrons)

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39
Q

medulla (kidney)

A

6-18 renal pyramids, parallel bundles of collection tubules

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40
Q

papilla (kidney)

A

apex of medulla points toward renal sinus

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41
Q

renal lobe

A

-divides kidney into sections
-renal pyramid + surrounding cortex or renal columns
-lobe is complete site of urine production

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42
Q

urine production:

A

nephron (cortex) -> collecting ducts (medulla) -> papilla -> minor calyx -> major calyx -> renal pelvis

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43
Q

renal pelvis

A

fill majority of renal sinus. funnels urine into ureter

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44
Q

pyelonephritis

A

inflammation of kidney, infection usually enters from ureter & spreads up through ducts to nephron

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45
Q

blood supply & innervation to kidney:

A

-receives 20-25% cardiac output
-highly vascularized, many capillaries (nephrons)
-innervation from renal plexus controlled by ANS

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46
Q

when is innervation of the kidney sympathetic?

A
  1. adjust rate of urine formation (change BP & flow at nephron)
  2. stimulate release of renin (restricts water & Na+ loss at nephron)
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47
Q

nephron

A

-smallest functional unit of kidney
-more than 1 million per kidney
-two important capillary beds: glomerulus & pertitubular
-two major parts: renal corpuscle & tubule

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47
Q

renal corpuscle (nephron -> kidney)

A

glomerular capsule + glomerulus

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48
Q

renal tubule (nephron -> kidney)

A

proximal convoluted tubule (PCT) + nephron loop + distal convoluted tubule (DCT)

49
Q

glomerulus (nephron -> kidney

A

capillary bed associated with nephron
-filtration
-connected to arterioles: afferent -> capillary -> efferent

50
Q

peritubular capillaries (nephron-> kidney)

A

capillary bed associated with nephron
-reclaim filtrate, concentrate urine
-connected to arterioles: afferent -> capillary -> efferent

51
Q

cortical nephron

A

majority nephron, in cortex, short nephron loops

52
Q

juxtamedullary nephron

A

15% of nephrons, at cortex/medulla interface, long nephron loops, important for water conservation & concentrated urine

53
Q

renal corpuscle (nephron -> kidney)

A

-site of filtration
-2 parts: glomerular capsule & glomerulus

54
Q

glomerular capsule (renal corpuscle -> nephron -> kidney)

A

thin parietal epithelium forms capsule around glomerulus

55
Q

glomerulus (renal corpuscle -> nephron -> kidney)

A

fenestrated capillaries covered by podocytes

56
Q

podocytes (glomerulus -> renal corpuscle -> nephron -> kidney)

A

visceral epithelium, intertwine to create filtration slits on surface of capillaries, slits smaller than fenestrations in glomerular capillaries to restrict filtration of large molecules

57
Q

glomerulonephritis

A

inflammation of glomeruli prevents filtration, can be result of antigen/Ab complexes trapped in filtration slits following allergy or blood infection

58
Q

renal tubule(nephron -> kidney)

A

-reabsorption to process raw filtrate into urine
-3 parts: PCT, nephron loop & DCT

59
Q

proximal convoluted tubule (PCT) (renal tubule -> nephron -> kidney)

A

simple cuboidal epithelium with microvilli, reabsorbs organic nutrients, ions, water & salt plasma proteins from filtrate exiting glomerular capsule

60
Q

nephron loop (renal tubule -> nephron -> kidney)

A

simple squamous epithelium, reabsorbs Na+, Cl- & H2O from filtrate, important to regulate volume & solute conc. of urine, has descending & ascending limbs

61
Q

distal convoluted tubule (DCT) (renal tubule -> nephron -> kidney)

A

simple cuboidal epithelium, flat surface, has four important functions

62
Q

functions of DCT (renal tubule -> nephron -> kidney)

A
  1. secretion: removal of wastes from peritubular capillaries into filtrate
  2. reabsorb Na+ & Ca2+ from filtrate
  3. optional H2O reabsorption from filtrate under hormonal control
  4. formation of juxtaglomerular apparutus
63
Q

juxtaglomerular apparutus (JGA)

A

-consists of two cells
1. endocrine cells of DCT = macula dense
2. granular cells of afferent arteriole = juxtaglomerular cells

64
Q

renin

A

-monitored & produced by JGA cells
-enzyme, restricts Na+ & H2O at nephron

65
Q

erythropoietin

A

-monitored & produced by JGA cells
-hormone stimulates RBC production

66
Q

collecting system of urine:

A

-collecting ducts + papillary ducts nephrons -> 1 collecting duct (renal pyramid) many collecting ducts -> papillary duct

67
Q

final osmotic concentration of filtrate adjusted by collecting duct, after urine is complete & exits kidney:

A

papillary duct (renal papilla) -> minor calyx -> major calyx -> renal pelvis -> ureter

68
Q

polycystic kidney disease

A

genetic, cysts form that cause swelling of kidney tubules; compression reduces function

69
Q

renal physiology

A

urinary system functions to regulate blood volume and conc. removes wastes & produce urine

70
Q

filtrate

A

everything in blood plasma except large proteins & cells

71
Q

urine

A

metabolic waste, 1% filtrate

72
Q

urea (common waste in urine)

A

from catabolism of amino acids

73
Q

creatinine (common waste in urine)

A

from catabolism or damage of skeletal muscle tissue (creatine phosphate is energy storage of muscle)

74
Q

uric acid (common waste in urine)

A

from recycling of RNA

75
Q

urobilin (common waste in urine)

A

from breakdown of hemoglobin (yellow color)

76
Q

dialysis

A

blood filtering machine, used for patients with kidney failure

77
Q

glomerular filtration (urine formation)

A

blood hydrostatic pressure forces water & solutes through glomerular wall

78
Q

tubular reabsorption (urine formation)

A

selective uptake of water & solutes from filtrate

79
Q

tubular secretion (urine formation)

A

transport of wastes from capillaries to tubules

80
Q

glomerular filtration process:

A

-occurs through filtration membrane
-filtration is passive but all small solutes escape (glucose)
1. fenestrated endothelium of glomerular capillaries (restrict cells)
2. podocytes restrict solutes protein sized & larger
3. fused basal laminate for both

81
Q

glomerular filtration depends on:

A
  1. large surface area
  2. high glomerular BP
  3. good permeability
82
Q

glomerular filtration rate (GFR)

A

amount of filtrate kidneys produce/minute
~125ml/min -> 180L/day
-99% reabsorbed, 1% lost as urine
-drop in BP = ↓ GFR (↓ 15% BP = 0 GFR)

83
Q

autoregulation (regulation of GFR)

A

functions to maintain constant GFR with abnormal BP fluctuation in systemic arteriole

84
Q

reduce blood flow/BP triggers (autoregulation -> regulation of GFR):

A

-dilation of afferent arteriole
-dilation of glomerular capillaries
-constriction of efferent arteriole
all functions to ↑ pressure at glomerulus to ↑ GFR

85
Q

high blood flow/ BP triggers (autoregulation -> regulation of GFR):

A

-constriction of afferent arteriole
-constriction of glomerular capillaries
-dilation of efferent arteriole
all function to ↓ pressure at the glomerulus to ↓ GFR

86
Q

hormonal regulation (regulation of GFR)

A

extrinsic regulation aimed at maintain systemic blood pressure

87
Q

renin released by JGA in response to (hormonal regulation -> regulation of GFR):

A

-decline in BP at kidney
-decline in osmotic concentration of filtrate
-direct sympathetic stimulation

88
Q

renin activates angiotensin in blood to form angiotensin II, which triggers (hormonal regulation -> regulation of GFR):

A

-arteriole constriction to elevate BP
-secretion of aldosterone from adrenal glands (aldosterone promotes sodium reabsorption in kidney tubules)
-thirst
-release of ADH from pituitary (ADH promotes water uptake in tubules)

89
Q

effect of renin (hormonal regulation -> regulation of GFR):

A

↑ blood volume, ↓ urine production (conservation of water)

90
Q

natriuretic peptides (hormonal regulation -> regulation of GFR):

A

hormones released in response to stretching in heart or aorta (↑ blood volume)

91
Q

natriuretic peptide triggers (hormonal regulation -> regulation of GFR):

A

dilation of afferent arteriole, constriction of efferent arteriole

92
Q

effect of natriuretic peptide (hormonal regulation -> regulation of GFR):

A

↑ GFR, ↑ urine production, ↓ blood volume

93
Q

autonomic nervous system (regulation of GFR):

A

sympathetic causes vasoconstriction = ↓ GFR, ↓ urine production
-prolonged sympathetic stimulation can cause hypoxia of kidneys & water accumulation in blood

94
Q

tubular reabsorption process:

A

-transport proteins in renal tubule cells return substances from filtrate to plasma
-when carrier proteins are saturated by substance they carry (max. velocity) renal threshold for that substance has been reached, additional amounts of substance will be lost in urine

95
Q

glycosuria

A

glucose in urine: glucose levels in blood/filtrate exceed renal threshold

96
Q

PCT reabsorption (tubular reabsorption)

A
  • PCT reabsorbs 60-70% of filtrate
    1. reabsorption of 99% of organic nutrients by facilitated diffusion & cotransport
    2. passive reabsorption of ions by diffusion
    3. selective reabsorption of ions by active transport (ion pumps controlled by hormones)
    4. reabsorption of water by osmosis
97
Q

nephron loop reabsorption (tubular reabsorption)

A

-functions to concentrate filtrate
-reabsorbs half remaining water & 2/3 Na+ & Cl- by countercurrent multiplication: ascending limb pumps ions from filtrate to medulla, high ion conc. then causes water to move by osmosis out of descending limb

98
Q

DCT reabsorption (tubular reabsorption)

A

-aldosterone promotes Na+ uptake & K+ loss via sodium-potassium pump
-parathyroid hormone & calcitriol promote Ca2+ uptake
-ADH stimulates water uptake

99
Q

tubular secretion

A

-selectively removes solutes from blood, delivers them to filtrate
-secretion carried out mostly by DCT, but some also occurs in collecting ducts

100
Q

tubular secretion process:

A
  1. dispose of drugs & wastes that weren’t filtred
  2. eliminate wastes that were reabsorbed
  3. rid body of excess K+
  4. control blood pH: remove H+ CO2 + H2O <-> H2CO3 <-> H+ + HCO3-
    -bicarbonate ions used to buffer blood pH but H+ must be secreted into filtrate
101
Q

control of water volume in urinary system

A

obligatory water reabsorption occurs by osmosis in PCT & descending nephron loop (cannot be prevented)

102
Q

facultative water reabsorption can occur in DCT & collecting ducts (impermeable) (control of water volume in urinary system):

A

ADH causes formation of water channels by triggering insertion of aquaporin

103
Q

aquaporins

A

-proteins in cell membranes of DCT & collecting duct cells
-allow more osmosis to concentrate urine & conserve water

104
Q

diuretics

A

substances that causes water loss

105
Q

osmotic diuretics

A

substances that can’t be reabsorbed and thus take water with them

106
Q

hypertension & edema meds

A

prevent Na+ uptake (water follows salt)

107
Q

alcohol in urinary sytem

A

inhibits ADH, preventing facultative water reabsorption

108
Q

diabetes insipidus

A

not enough ADH, produces large quantities of dilated urine, up to 24 L/day (1.2L normal)

109
Q

anuria

A

low urinary output, less than 150ml/day, usually due to events that block filtration (nephritis, immune reactions, crushing injuries)

110
Q

urine transport, storage & elimination

A

-urine production & modification: renal tubules & collecting system
-once in renal pelvis, urine complete, excreted via ureters, bladder, urethra

111
Q

nephrolithiasis

A

blockage of urinary passage
ex: calculi (kidney stone)

112
Q

calculi (kidney stone)

A

crystallized deposits of calcium, magnesium, or uric acid form in renal pelvis & can become lodged in ureters
-large ones disrupted by lithotripter

113
Q

ureters

A

-connect renal pelvis to urinary bladder
-wall layers:
1. mucosa with transitional epithelium
2. muscularis with 2 layers of smooth muscle
3. adventitia: attaches to posterior body wall
-contractions occur every 30sec to force urine toward bladder

114
Q

urinary bladder

A

-wall folded into rugae when empty (expands)
-wall layers:
1. mucosa with transitional epithelium
2. muscularis with 3 layers of smooth muscle
3. adventitia: fibrous, anchors bladder to pelvic floor

115
Q

detrusor muscle (urinary bladder)

A

-contraction causes expulsion of urine from bladder
-thickened around urethral opening to create the internal urethral sphincter (involuntary control over release of urine)

116
Q

urethra

A

-single tube, connects bladder to environment
-lined with pseudostratified columnar epithelium
-passes through band of skeletal muscle that forms external urethral sphincter under voluntary control, relaxation results in micturition

117
Q

micturition (urination) reflex

A

-when bladder contains ~200ml urine, stretch receptors triggered, signal conscious awareness of pressure & stimulate contraction of detrusor muscle
-voluntary maintenance of contracted external urethral sphincter prevents urination, detrusor will relax
- continued increase in urinary volume will repeatedly trigger reflex

118
Q

what happens when the urinary volume in the bladder exceeds ~500ml?

A

forced relaxation of internal & external urethral sphincters will result in non-voluntary urination/ micturition

119
Q

incontinence

A

inability to voluntarily control urine excretion, due to: loss of muscle tone, damage to sphincters, damage to nerves or control centers in brain

120
Q

age-related changes for urinary system

A
  • ↓ functional nephrons
  • ↓ GFR (damage or ↓ blood flow)
  • ↓ sensitivity to ADH = dilute hormone
  • ↑ incontience
  • ↑ urinary retention (enlarged prostate)

a & p II exam 3 (3 decks)

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