FINALS: URINARY SYSTEM Flashcards by Sunwoo's Berry

pH above 7.45

ALKALOSIS

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pH below 7.35

ACIDOSIS

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arterial pH between 7.35 & 7.0

PHYSIOLOGICAL ACIDOSIS

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 Systems of 1 or 2 molecules that act to
prevent dramatic changes in H+
concentrations when acids/bases are added
 Bind to H+ when pH drops
 Release H+ when pH rises
 1st line of defense in resisting pH changes

BLOOD BUFFERS

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3 MAJOR CHEMICAL BUFFER SYSTEMS:

 Bicarbonate buffer system
 Phosphate buffer system
 Protein buffer system

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Mixture of carbonic acid (H2CO3) & sodium
bicarbonate (NaHCO3)
Bicarbonate ions (HCO3‾) react with strong acids to
change them to weak acids
Carbonic acid dissociates in the presence of a strong
base to form a weak base and water

BICARBONATE BUFFER SYSTEM

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prevents excessive water loss in urine

ADH

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regulates Na+ content
of ECF

ALDOSTERONE

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ALDOSTERONE IS TRIGGERED BY THE?

renin-angiotensin
mechanism

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 Regulate aspects of homeostasis: water
balance, electrolytes, acid-base balance in
blood, BP (renin) , RBC production (EPO),
activation of vitamin D
 Excretes wastes in urine
 Lie against the DORSAL body wall in a retroperitoneal position in the superior
lumbar region
 Right kidney is slightly lower than the left
 Attached to ureters, renal blood vessels, &
nerves at renal hilum
 Atop each is an adrenal gland
 Adult: 12 cm (5in)long, 6 cm (2.5in) wide, & 3 cm (1in) thick

KIDNEYS

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 Transport urine from kidneys to urinary
bladder

URETERS

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 Stores urine & expels it into urethra

URINARY BLADDER

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Discharges urine from body

URETHRA

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KIDNEY COVERINGS:
- Smooth, transparent sheet of dense
irregular connective tissue that is
continuous with the outer coat of the
ureter
 Barrier against trauma & helps MAINTAIN THE SHAPE OF KIDNEY

FIBROUS CAPSULE

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KIDNEY COVERINGS:
-  Mass of fatty tissue surrounding the
fibrous capsule
 Protects the kidney from trauma &
holds it firmly in place within the
abdominal cavity

PERIRENAL FAT CAPSULE

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KIDNEY COVERINGS:
-  Thin layer of dense irregular connective
tissue
 ANCHORS the kidney to the surrounding structures & to the abdominal wall

RENAL FASCIA

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RENAL MEDULLA:
Triangular regions with a striped appearance

Renal/medullary pyramids

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RENAL MEDULLA:
portions of the renal
cortex that extend between renal
pyramids

Renal columns

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RENAL PELVIS: inner collecting tube
- cup-shaped structures that funnel urine towards the renal pelvis

Calyces

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 The structural and functional units of the
kidneys
 Responsible for forming urine

NEPHRONS

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TYPES OF NEPHRONS:
 Located entirely in the cortex
 Includes most nephrons

CORTICAL NEPHRONS

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TYPES OF NEPHRONS:
 Found at the boundary of the cortex & medulla

JUXTAMEDULLARY NEPHRONS

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CAPILLARY BEDS ASSOCIATED WITH
NEPHRONS:
 Feeder vessel: afferent arteriole
 Receives blood that has passed through
glomerulus: efferent arteriole

GLOMERULUS

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CAPILLARY BEDS ASSOCIATED WITH
NEPHRONS:
 Arise from efferent arteriole of the glomerulus
 Normal, low-pressure capillaries
 Attached to a venule
 Cling close to the renal tubule
 Reabsorb (reclaim) some substances from
collecting tubes

PERITUBULAR CAPILLARIES

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Glomerular Filtration Rate (GFR):

125 mL/min

GLOMERULAR FILTRATION: Filtration occurs through a structure of three parts:

- The FENESTRATIONS OF THE CAPILLARY endothelium, which blocks blood cells and platelets - The THICK, COMBINED BASAL LAMINA, or GBM, which restricts large proteins and some organic anions - The FILTRATION SLIT diaphragms between pedicels, which restrict some small proteins and organic anions.

 1st FUNCTION to be AFFECTED IN RENAL DISEASE  Begins as soon as the filtrate enters PCT  The peritubular capillaries reabsorb several materials: some water, glucose, amino acids, ions  Some reabsorption is passive, most is active

TUBULAR REABSORPTION

MATERIALS NOT REABSORBED:

- Nitrogenous waste products - Urea - Uric acid - Creatinine - Excess water

 Tubular reabsorption in reverse  Some materials (H+, K+, creatinine, drugs) move from the peritubular capillaries into the renal tubules  Materials left in the renal tubule move toward the ureter & make their way into the urine.

TUBULAR SECRETION

major site for removal of nonfiltered substances

Proximal Convoluted Tubule

TUBULAR SECRETION 2 MAJOR FUNCTIONS:

1. REGULATION OF THE ACID-BASE BALANCE in the body through the secretion of hydrogen ions. 2. ELIMINATION OF WASTE PRODUCTS not filtered by the glomerulus

24 HOURS:  Kidneys filters ________of blood plasma

150-180 L

24 HOURS: Only about ___of urine are produced

1-18 L

 2 slender attaching the kidney to the bladder  25-30 cm (10-12 in) long & 6 mm (1/4 in) in diameter  Peristalsis (contraction of smooth muscle layers in their walls) aids gravity in urine transport  Small valvelike folds of bladder mucosa: prevents urine from flowing back into the ureter

URETERS

 Smooth, collapsible, muscular sac  Temporarily stores urine  TRIGONE (3 openings) - 2 ureters openings (ureteral orifices) - Single opening of urethra (internal urethral ORIFICE: drains the bladder  Males: prostate gland surrounds the neck of the bladder  3 layers of smooth muscle (detrusor muscle)  Mucosa made of TRANSITIONAL EPITHELIUM  Walls are thick & folded in an empty bladder  Bladder can expand significantly W/OUT INCREASING INTERNAL PRESSURE

URINARY BLADDER

 Thin-walled tube that carries urine by peristalsis from the bladder to the outside of the body  Release of urine is controlled by 2 sphincters: - INTERNAL URETHRAL SPHINCTER (involuntary): smooth muscle - EXTERNAL URETHRAL SPHINCTER (voluntary): skeletal muscle

URETHRA

 Act of emptying the bladder

MICTURITION (VOIDING)

Volume of urine in the bladder exceeds

200-400 mL

2 sphincters control the flow of urine from the bladder, both must open to allow voiding: - relaxed after stretching of the bladder

INTERNAL URETHRAL SPHINCTER

2 sphincters control the flow of urine from the bladder, both must open to allow voiding: must be voluntarily relaxed

EXTERNAL URETHRAL SPHINCTER

 Falling/floating kidney, is an inferior displacement/dropping of the kidney  Cause: Kidney is not securely held in place by adjacent organs/its covering of fat  Dangerous because the ureter may kink & block urine flow---exerts pressure on kidney tissue (hydronephrosis)

NEPHROPTOSIS

Abnormally low urinary output (100-400 mL/day)  Indicates that glomerular BP is too low to cause filtration  Other causes: transfusion reactions & acute inflammation/from crush injuries of the kidneys

OLIGURIA

less than 100 mL

ANURIA

 Formed by the occasional precipitation & solidification of the crystals of salts present in urine  Commonly contain crystals of calcium oxalate, uric acid or calcium phosphate

RENAL CALCULI (KIDNEY STONES)

 Decrease/cessation of glomerular filtration  Kidneys abruptly stop working entirely  Main feature: suppression of urine flow (oliguria/anuria)

ACUTE RENAL FAILURE

 Infection of a part of the urinary system/presence - Symptoms: DYSURIA (painful urination), urinary urgency & frequency, fever

URINARY TRACT INFECTION (UTI)

inflammation of urethra

URETHRITIS

inflammation of urinary bladder

CYSTITIS

kidney inflammation

PYELONEPHRITIS/PYELITIS

 Unable to voluntarily control the external sphincter  Normal in infants & children 2-3 years old  TYPES: - Stress incontinence - Urge incontinence - Overflow incontinence - Functional incontinence

INCONTINENCE

 Bladder is unable to expel its contained urine  Causes: - After surgery in which anesthesia has been given - Hyperplasia (enlargement) of prostate gland

URINARY RETENTION

 ADH is not released, huge amounts of very dilute urine (25 L/day) flush from the body day after day  Can lead to severe dehydration & electrolyte imbalances  Always thirsty & have to drink fluids almost continuously to maintain normal fluid balance

DIABETES INSIPIDUS

 Hypoaldosteronism  Have polyuria (excrete large volumes of urine) & lose tremendous amounts of salt & water to urine

ADDISON’S DISEASE

 Degenerative condition, 1 or both kidneys enlarge & have many blisterlike sacs (cysts) containing urine

ACUTE POLYCYSTIC KIDNEY DISEASE

 Condition found in male babies only  Urethral orifice is located on the ventral surface of the penis

HYPOSPADIAS

 Inflammation of the kidney that involves the glomeruli  Common cause: allergic reaction to the toxins produced by streptococcal bacteria that have recently

GLOMERULONEPHRITIS

 The thickening and loss of function in the GBM produced as part of the systemic microvascular sclerosis in diabetes mellitus  Is the leading cause of (irreversible) endstage kidney disease in the United States, treatment requires either a kidney transplant or regular artificial hemodialysis

DIABETIC GLOMERULOSCLEROSIS

 One of the most common problems caused by sickle cell disease  Occurs when the affected erythrocytes sickle in the vasa recta, because of the low oxygen tension there.  The nephropathy results from renal infarcts, usually within the renal papillae or pyramids

SICKLE CELL NEPHROPATHY

can cause an unstable urothelium, with benign urothelial changes involving hyperplasia or metaplasia

Chronic cystitis

is usually some form of transitional cell carcinoma arising from unstable urothelium.

Bladder cancer