Flash Cards from online work - Urinary
Which of the following describes the location of the kidneys?
Retroperitoneal at the level of T12 to L3
How do the kidneys regulate blood volume and blood?
By regulating water output
The process of separating wastes from the body fluids and eliminating them is called __________.
excretion
What is the order of urine-collecting structures found within the kidney?
Minor calyx, major calyx, renal pelvis, ureter
Which blood vessel carries blood into a glomerulus?
afferent arteriole
When there is a drop in blood pressure, the juxtaglomerular cells respond by secreting which of the following?
renin. Renin triggers chain reaction
That creates hormone angiotensin
That signals adrenal glands to release aldosterone
Your uncle has been diagnosed with renal insufficiency and placed on dialysis. He asks you why he has to take EPO now as well. What do you tell him?
Diseased kidneys no longer produce enough EPO, which can lead to anemia.
Erythropoietin - stimulates red bone marrow to make RBC’s
What is tubular secretion?
The movement of water and solutes from the blood into the tubular fluid. Transfer of materials from peritubular capillaries to the renal tubule. Opposite process of reabsorption. Secretion mainly caused by active transport and passive diffusion
If a patient presents with aStreptococcus viridansinfection, his doctor may prescribe oral penicillin taken four times daily.Why does he have to take the penicillin so often?
The renal tubules extract penicillin from the blood and secrete it into the urine. To keep enough in body so do job need to take reguraly
The primary function of the nephron loop is to generate a medullary ECF osmotic gradient that allows for what?
Elf is extra cellular fluid
The concentration of urine
A friend confides in you that she’s recently started taking a calcium supplement but then started having very painful urination. You suggest she go to a doctor to get checked for which of the following?
Renal calculi
In the kidney, tubular reabsorption refers to the movement of fluid and solutes where?
From the tubular fluid into the blood
Ie. The blood is reabsorbing the fluid hence reabsorption
Nephrons are the functional units of the kidneys, responsible for the processes of
removing wastes and excess h20 from blood
The process of glomerular filtration occurs within the
renal corpuscles of kidney nephrons.
This pressure-driven process moves materials from
the glomerulus into the capsular space across a thin, negatively charged filtration membrane.
The filtration membrane is composed of the
fenestrated endothelium of the glomerulus, the filtration slits of the podocytes found within the visceral glomerular capsule, and the porous basement membrane found between these two cell layers.
This membrane is size selective. It is permeable to smaller substances such as
ions, water, and glucose and impermeable to larger materials such as formed elements and most proteins.
systemic blood pressure drives the movement of what
movement of blood from the afferent arterioles into the glomerulus.
Changes in system blood pressure impact the blood flow into glomerulus, how do the arterioloes compensate for this
altering their diameter so that glomerular blood pressure will be maintained
as systemic blood pressure increases how does the arteriole react
decreases its diameter
Contraction resists The increased pressure
Thereby keeping blood flow consistent
as systemic blood pressure decreases how does the arteriole react
increases its diameter
By increasing in diameter compensates For reduced body in systemic system and maintains consistent flow to glomerular
the capsular space is the region where this collects
filtrate
what are the five substances that can cross the filtration membrane
urea; small protein; h20; ions; glucose; erythrocytes
Glomerular filtration is highly regulated because of its influence on
the amount of substances reabsorbed into the blood and the amount excreted in the urine.
The glomerular hydrostatic pressure (HPg) is responsible for
forcing materials through the filtration membrane from the blood into the capsular space.
Two smaller forces, the blood colloid osmotic pressure (OPg) and the capsular hydrostatic pressure (HPc), work together to
oppose HPg.
Colloid osmotic pressure - induced by proteins in blood that causes A pull on fluid back into the capillary
Capsular hydrostatic pressure - is aback pressure that opposes filtration
Cumulatively, the difference between these pressures determines
the net filtration pressure (NFP), which must be greater than zero for filtration to occur.
By being able to control the glomerular filtration, the kidney is able to control
urine production based on physiological conditions such as hydration
in order for filtration to occur the overall pressure moving outward from the glomerulus to the capsular space muse be
greater than the combined inward pressures
If both the glomerular ( HPg) and capsular hydrostatic (HPc) pressures remain unchanged, an increase in the blood colloid osmotic pressure (OPc) results in __________the net filtration pressure.
a decrease in
Which of the following forces oppose glomerular filtration?
capsular hydrostatic pressure (HPc) and blood colloid osmotic pressure (OPg)Correct
Glomerulosclerosis results in a __________ of the basement membrane.
thickening
Proteinuria occurs when the filtration membrane becomes leaky, allowing proteins to cross. This impacts the blood colloid osmotic pressure by __________ the osmolarity gradient between the blood and filtrate, thereby __________ the strength of this pressure.
decreasing; reducing results in net increase in filtration
glycosylation
plasma glucose levels become elevated, and this excess glucose can attach to proteins, as a result basement membranes of a majority of capillaries around the body are thickened and hardened by deposits of glycosylated proteins.
glomerulosclerosis
general name for hardening or scarring of the glomeruli within the kidneys is
diabetic glomerulosclerosis, not only is there thickening of the basement membranes that form one of the layers of the filtration membrane, but there is also
proliferation and expansion of the intraglomerular mesangial cells and associated matrix.
Most proteins cannot normally cross the filtration membrane due to
their large size and the negative charge of the basement membrane.
During glomerulosclerosis, however, the filtration membrane becomes a less effective barrier, allowing
proteins to enter into the filtrate. Thus, this is one of several conditions that leads to proteinuria
proteinuria
a condition in which proteins leak from blood into the urine.
The net filtration pressure (NFP) is the driving force of the
glomerular filtration process. It is responsible for pushing the filtrate into the capsular space
The glomerular filtration rate (GFR) is the measurement of
filtrate volume per unit time, normally recorded as ml/min, and is influenced by the rate of blood flow into the glomerulus.
The body quickly adjusts to changes in systemic blood pressure within a narrow range by modifying
the rate of blood flow to the glomerulus from the afferent arterioles via vasodilation and vasoconstriction – this is referred to as
the rate of blood flow to the glomerulus from the afferent arterioles via vasodilation and vasoconstriction – this is referred to as
intrinsic regulation
Extrinsic regulatory pathways include the
nervous and endocrine systems, produce their effects through neurotransmitters and hormones, and have longer lasting effects.
An increase in the NFP would result in __________the GFR
AN INCREASE IN
Renin is released in response to __________ stimulation.
SYMPATHETIC
NFP AND GFR HAVE WHAT TYPE OF RELATIONSHIP
POSITIVE CORRELATION; WHEN NFP INCREASES, GFR INCREASES
EXTRINSIC CONTROLS INFLUENCING GFR INCLUDE
NEURAL AND HORMONAL REGULATION
SYMPATHETIC NERVOUS STIMULATION CAN REDUCE GFR IN TWO WAYS _ ask hormonal is extrinsic-regulation while arterioles
Vasodilation vasoconstriction are intrinsic controls
STIMULATING VASOCONSTRICTION OF ARTERIOLES; OR STIMULALTING RELEASE OF RENIN
WHAT CELLS RELEASE RENIN
JUXTAGLOMERULAR APPARATUS
WHAT DOES RENIN CAUSE TO BE RELEASED
ANGIOTENSIN II - RESULTS IN AN OVERALL DECREASE IN THE FILTRATION SURFACE
THE HEART RELEASES THE HORMONE ATRIAL NATRIURETIC PEPTIDE (ANP) IN RESPONSE TO
INCREASES IN BLOOD VOLUME OR BLOOD PRESSURE.
ANP RESULTS IN AN INCREASE IN GFR IN THREE PATHWAYS
INHIBITION OF RENIN; DILATION OF ARTERIOLOES; INCREASE IN FILTRATION SURFACE
WHAT CAUSES FILTRATION SURFACE TO INCREASE
RELAXATION OF MESANGIAL CELLS - and causes this relaxation - relaxes basement membrane thereby increasing surface area of basement membrane and, this increases glomerular filtration rate
Renin is released from the
juxtaglomerular apparatus (JGA) cells in response to reduced renal arterial pressure, sympathetic neural stimulation, or increased sodium concentration at the distal renal tubule.
The release of renin is regulated by
sympathetic nervous system stimuli.
Renin converts the plasma protein angiotensinogen into
angiotensin I, which is then converted to angiotensin II in the lungs by angiotensin-converting enzyme (ACE).
Angiotensin II stimulates a number of pathways, including the
synthesis of the hormone aldosterone by the adrenal cortex which results in increased sodium and water retention, thus increasing blood pressure. Other effects within the kidney include 1) efferent arteriole vasoconstriction, and 2) the contraction of intraglomerular mesangial cells.
Both angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARB) decrease the
angiotensin mechanism.
ACE inhibitors directly reduce
the amount of angiotensin II being formed, while ARBs depress the effects of angiotensin II by preventing it from binding to its effector cells.
ACE inhibitors lower blood pressure mainly by
decreasing peripheral vascular resistance.
Patients with chronic kidney disease are often prescribed ACE inhibitors because
they stabilize renal function and diminish proteinuria.
Angiotensin II triggers the __________ of the intraglomerular mesangial cells, which results in a(an) __________ of the filtration surface area.
contraction; decreaseCorrect
ACE inhibitors are prescribed to control blood pressure. These drugs work by reducing __________.
the conversion of angiotensin I to angiontensin IICorrect
After blood is filtered in the renal corpuscle, the filtrate passes into
the renal tubule,
the renal tubule CONSISTS OF
which consists of three fairly distinct regions of cells specialized to promote molecular exchange between the renal tubule and the interstitial fluid.
The primary goal of the renal tubule is to
reabsorb substances into the blood that the body needs to help maintain homeostasisand to eliminate substances the body does not need or that might be toxic to the body.
In addition to urine formation, the kidneys help regulate
blood pressure by balancing the levels of water and sodium that are reabsorbed versus excreted. This is a prime example of the integrative nature of body systems.
The renal tubule consists of the
proximal convoluted tubule (PCT), nephron loop (Loop of Henle), and distal convoluted tubule (DCT).
As the filtrate moves through the renal tubules, its composition is selectively altered through the processes of
tubular reabsorption and secretion.
Materials that are reabsorbed move out of the tubular filtrate by crossing both
the luminal and basolateral membranes of the tubular cells, entering the interstitial fluid, and moving into the peritubular capillaries.
Materials that are secreted move in the opposite direction, from
the blood in the peritubular capillary to the tubular filtrate.
Both reabsorption and secretion occur where
throughout the renal tubule;
the majority of reabsorption occurs within
the proximal convoluted tubule.
Tubular reabsorption and tubular secretion differ in that __________.
tubular secretion adds materials to the tubular filtrate while tubular reabsorption removes materials from the tubular filtrate
Which of the following substances utilizes paracellular transport in order to cross the basolateral membrane of the tubule cell during the process of reabsorption?
potassium
filtrate formed at the renal corpuscle enters the
renal tubule at the pct where it is now referred to as tubular fluid
what is path of filtrate tubular flow
renal corpuscle to p.c.t.to nephron loop to d.c.t to collecting duct
reabsorption occurs as
materials are selectively moved out of the tubular fluid and return to the blood at the peritubular capillary
secretion occurs as
materials are moved out of the pertibular capillary into the tubular fluid
materials that are reabsorbed ultimately remain where
the blood supply
what eventually happens to the materials that are secreted
become components of urine
paracellular transport
crossing between the epithelial cells; such as potassium
transceullar transport
entering tubular cells at the luminal membrane and exiting cells at the basolateral membrane; such as sodium, glucose, water
Materials are selectively reabsorbed through either
passive or active transport processes.
the majority of sodium reabsorption occurs where
at the p.c.t.
approximately 65% of the cumulative h20 reabsorption happens where
at the p.c.t.
obligatory h20 reabsorption
approximately 65% of the cumulative h20 reabsorption happens where
glucose enters the tubular cells through ________ which allows glucose to move against its concentration gradient
sodium-glucose symport channels found at the luminal membrane
The majority of sodium reabsorption occurs at the proximal convoluted tubule. During this process, sodium enters the tubule cells at the __________ and exits the tubule cells at the __________.
luminal membrane by facilitated diffusion; basolateral membrane through the sodium potassium pumpCorrect
Glucose that is reabsorbed into tubular cells travels __________ its concentration gradient through sodium-glucose symport channels at the luminal membrane. Glucose in tubular cells exits the basolateral membrane into interstitial fluid through the process of __________.
against; facilitated diffusion
Materials are selectively reabsorbed through either
passive or active transport processes.
Uric acid is a nitrogenous waste produced by
peroxisomes as a result of nucleic acid metabolism.
Uric acid levels increase with
increased tissue breakdown and a high purine diet.
Uric acid is produced in
the liver, transported in the blood, and excreted by the kidneys.
Uric acid has limited solubility and high levels can result in
crystallization within the joints. This is termed goutand is considered a type of inflammatory arthritis.
Essentially all of the uric acid within the blood crosses
the filtration membrane and becomes part of the tubular filtrate.
Uric acid is almost entirely reabsorbed at the
proximal convoluted tubule through anion-exchange.
Approximately 10% of this reabsorbed uric acid gets secreted back into
the filtrate at the distal convoluted tubuleand is excreted in the urine.
At normal levels, uric acid partially acts as an
anti-oxidant in the body.
Hyperuricemia,
or high blood uric acid levels, may occur if the levels of uric acid rise (ex. when tissue breakdown is accelerated) or if the kidneys fail.
Many medications can affect both the reabsorption and secretion of uric acid within the renal tubule. is one such drug used to treat chronic gout by inhibiting the reabsorption of uric acid.
Probenecid®
Under normal conditions, the majority of uric acid reabsorption occurs at the __________.
proximal convoluted tubuleCorrect
Treatment with Probenecid®results in __________ levels of uric acid in the urine and __________ levels of uric acid in the blood.
increased; decreasedCorrect
The tubular filtrate in the nephron loop and blood within the vasa recta run parallelbut in
opposite directions.
This arrangement is referred to as the
countercurrent exchange system.
countercurrent exchange system. This design system together with urea recylcing is repsonsible for
establishing the interstitial fluid concentration gradient within the medulla.
The descending and ascending limbs of the nephron loop vary in
permeability.
The descending thin limb is
highly permeable to water and impermeable to salts
while the thick ascending limb is
impermeable to water and highly permeable to sodium.
Water moves out of tubular filtrate at the
descending limb due to osmotic pressure differences between the tubular filtrate and interstitial fluid. This causes the tubular filtrate to become more and more concentrated as it descends.
In contrast, the thick ascending limb is impermeable to
water but actively pumps salt out of the tubular filtrate. This causes the tubular filtrate to become more and more dilute as it ascends.
At the beginning of the nephron loop, the tubular filtrate is essentially
isotonic to the interstitial fluid in the cortex.
The countercurrent multiplier allows for
the tubular filtrate to become much more concentrated (hypertonic) as it descends deeper into the medullawhereas the tubular filtrate becomes hypotonic to the cortex as it ascends and exits the nephron loop.
the area of the medullary is an area of increasing ??
osmolarity
blood flow in the vasa recta runs how
opposite to the flow of the tubular fluid; rsulting in countercurrent exchange of materials between these two regions
the opposing flow encourages what
the movement of h20 out of the tubular fluid and into the blood in the descending limb while enhancing movement of h20 out of blood and into interstial fluid in ascending limb
the higher concentration of solutes in the medulla is largely influenced by
the high conentration of urea in the region
where does urea enter the tubular fluid
at the permeable thin segment of the ascending limb
where does urea leave the tubular fluid
reenters interstitial fluid at collecting ducts
The interstitial fluid within the medulla has a __________ osmolarity than the interstitial fluid within the cortex.
higher
The vasa recta is a specialized capillary that branches from the __________ arteriole. The blood flow in the vasa recta runs __________ to the flow of tubular filtrate within the nephron loop.
efferent; parallel but in the opposite direction
Hypertension affects approximately ____of the adult population in the U.S. and is classified into ‘primary hypertension’ and ‘secondary hypertension.’
20%
Primary hypertension
has no specific, single identifiable factor and is the most common cause of hypertension.
Secondary hypertension
can be attributed to a specific cause, such as chronic volume overload. For patients in which modified diet and exercise plans do not significantly improve hypertensive symptoms, diuretics may be prescribed.
Diuretics increase
urine output and decrease fluid volume by reversibly inhibiting Na+ reabsorption at specific sites of the nephronand increasing the excretion of both Na+ and water. This results in decreased blood volume and blood pressure, improving hypertension.
Diuretics work at
different sites on the nephron.
Loop diuretics
(ex. Furosemide, Bumetanide, and Torsemide) act at specific sites along the nephron loopand specifically inhibit the Na+/K+/2Cl- symport (NKCC2) found at the luminal membrane of the thick ascending loop, thereby preventing the reabsorption of sodium, chloride, and potassium.
Thiazides
(ex. Chlorothiazide and hydrochlorothiazide) act on the Na+/Cl- cotransporter at the distal convoluted tubule (DCT) and inhibit Na+ and water reabsorption in this region.
Individuals with Bartter syndrome have a defective gene coding for Na+/K+/2Cl- symport (NKCC2) that disables it from functioning. These individuals are expected to have __________ than normal blood potassium levels. This response is the __________ what is expected from individuals taking prescribed loop diuretics.
lower; same asCorrect
The nephron loop is responsible for approximately 25% of the reabsorption of sodium. Loop diuretics cause an overall __________ in the reabsorption of sodium in this region resulting in a(n) __________ in the osmolarity of the tubular filtrate.
decrease; increase
Decreased Na+ and water reaborption due to the use of loop diuretics and thiazides __________ the concentration gradient of the interstitial fluid, thereby __________ the osmotic force at the collecting tubule and duct.
lowers; reducing
The peritubular capillaries are separated from the nephron by
the interstitial fluid, thus movement of substances between the nephron and blood is always through the interstitial fluid.
The processes of reabsorption and secretion occur at the
distal convoluted tubule, collecting tubule, and collecting ductand regulate the composition of both blood and urine.
the distal convoluted tubule, collecting tubule and collecting duct regions of the nephron in particular are susceptible to
hormonal regulation of ion and water transport.
Hormones that regulate both sodium and water include
aldosterone and antidiuretic hormone (ADH).
Aldosterone enhances sodium reabsorption by
upregulating sodium transport proteins and the sodium-potassium pump.
Sodium transport proteins are located at the
luminal membrane facing the tubular filtrate;
the sodium-potassium pump is located at
the basolateral membrane associated with the interstitial fluid.
The increase in the presence of both of these membrane proteins
increases the reabsorption of sodium.
The resulting increase in osmolarity
enhances water reabsorption.
Antidiuretic hormone (ADH) also enhances water reabsorptionbut by a different mechanism. This hormone stimulates the upregulation of
aquaporin proteins on both the luminal and basolateral membranes.
This upregulation
increases water reabsorption back into the interstitial fluidand ultimately the blood.
Aldosterone enhances the reabsorption of sodium through the upregulation of the sodium-potassium pump found at the __________.
basolateral membrane
In addition to enhancing the reabsorption of sodium, aldosterone also enhances the __________ of potassium.
secretion
Antidiuretic hormone enhances water __________ by __________ the number of aquaporins at the tubular cell membrane.
reabsorption; increasingCorrect
water follows the movement of potassium by
osmosis; therefore aldosterone inderectly enhances h20 reabsorption
how does ADH increase h20 reabsorption
by increasing the number of aquaporins present
If the counterion is sodium, what is responsible for maintaining its concentration gradient?
th esodium potassium pump
Within the limits of this animation, what is the ultimate source of energy for cotransport or countertransport?
atp
Which pair of terms is correctly matched to move substances in the same direction?
Cotransport; symport
Small molecules, such as sugars and amino acids, can be transported
up a concentration gradient.
The sugar moves via a
membrane transport protein from outside the cell where the sugar concentration is low to the inside of the cell where the sugar concentration is high
the transport of the sugar through a coupled transport protein is driven by the movement of
counter ions such as sodium ions or protons that are moving down their concentration gradients from a region of high concentration to a region of low concentration
moving down a concentration gradient is which direction
area of high concentration to an area of low concentration
sodium ions and sugar or amino acid simultaneously bind to
the same transmember protein on the outside of the cell called a symport
when the counter ion is sodium, the low concentration of the sodium on the inside of the cell required to transport the sugar is maintained by the
sodium potassium pump which is powered by atp
what powers the sodium potassum pump
atp
counter transport
the inward movement of sodium ions is coupled with the outer movement of another substance such as calcium ions
contransport
the sodium ions and the other substance bind to the same transport protein called the antiport but bind to opposite sides of the membrane and are moved in opposite directions
antiport
??
synmport
a cotransporter in the kidney which has the function of reabsorbing sodium and chloride ions from the tubular fluid into the cells of the distal convoluted tubule of the nephron…
low internal sodium ion concentration is maintained by
the sodium potassium pump
transmember protein
??
During cotransport…
The counterion and transport substance bind to the same side of the symport.
The rate of diffusion is affected by
Temperature, size of molecules, and the incline of the concentration gradient
Molecules dissolved in a solution are in constant random motion due
to their kinetic energy.
One result of this motion is
that dissolved molecules become evenly distributed throughout the solution.
example of diffusion.
This tendency of molecules to spread out
ions constantly move from the area where they are common
to the area where they are scarce.
diffusion.
when molecules move from areas of their higher concentration to areas of their lower concentration
Diffusion continues until
all the molecules become evenly disbursed or equilibrium is achieved
The rate of diffusion is affected by
temperature, size of molecules and the steepness of the concentration gradient
facilitated diffusion
a special carrier protein (ONLY BINED WITH SPECIFIC MOLECULES FOR EX SUGAR OR AMINO ACID) with a central channel acts as a selective corridor which helps molecules move across the membrane
HOW DOES THE PROTEIN CARRIER AID IN FACILITATED DIFFUSION
CHANGING SHAPE AND MOVING THE MOLECULE DOWN ITS CONCENTRATION GRADIENT AND THE THE MEMBRANE INTO THE CELL WHERE IT IS RELEASED
HOW IS FACILITATED DIFFUSION SIMILAR TO SIMPLE DIFFUSION
BOTH INVOLVE MOVEMENT OF MOLECULES DOWN THEIR CONCENTRATION GRADIENT AND THIS MOVEMENT IS CARRIED OUT WITHOUT THE INPUT OF ENERGY
UNLIKE SIMPLE DIFFUSION, IN FACILITATED DIFFUSION, THE MOVEMENT OF MOLECULES WILL ONLY TAKE PLACE IF
IT IS FACILITATED OR HELPED BY A SPECIAL PROTEIN CARRIER IN THE MEMBRANE
WHAT DIRECTION CAN FACILITATED DIFFUSION OCCUR IN
EITHER DIRECTION DEPENDING ON THE CONCENTRATION GRADIENT. IF THERE IS A HIGHER CONCENTRATION OF THE MOLECULE INSIDE THE CELL, THE SAME CARRIER PROTEIN WOULD THEN TRANSPORT THE MOLECULE OUT OF THE CELL
SPECIAL CARRIER MOLECULES ARE COMPOSED OF
PROTEIN
Facilitated diffusion is similar to simple diffusion in that both processes
Involve the movement of substances down their concentration gradients
WHAT IS THE LOCATION OF THE KIDNEYS
BEAN SHAPED ORGANS LOCATED IN A RETROPERITONEAL POSITION ON THE POSTERIOR ABDOMINAL WALL ON EITHER SIDE OF THE VERTERBRAL COLUMN
THE HILUM IS LOCATED WHERE
ON THE CONCAVE MEDIAL BORDER WHERE BLOOD VESSELS AND NERVES ENTER AND EXIT THE KIDNEY
THE HILUM ALSO SERVES AS A POINT OF EXIT FOR
THE RENAL VEIN AND THE RENAL PELVIS; WHICH TRANSPORTS URING TO THE URETER
RENAL PELVIS
TRANSPORTS URINE TO THE URETER
THE HILUM IS CONTINUOUS WITH AN EXPANDED AREA WITHIN THE KIDNEY KNOWN AS
THE RENAL SINUS
RENAL SINUS
??
THE KIDNEY TISSUE IS DIVIDED INTO
AN OUTER RENAL CORTEX AND AND INNER RENAL MEDULLA
RENAL COLUMNS
EXTENSIONS OF THE CORTEX THAT PROJECT INTO THE MEDULLA BETWEEN RENAL PYRAMIDS
RENAL PAPILLA
BASE OF EACH MEDULLA PYRAMID; LOCATED AT THE JUNCTION OF THE CORTEX AND THE MEDULLA
THE CORTICOMEDULLARY JUNCTION
WHERE THE CORTEX AND MEDULLA MEET - THEIR JUNCTION
APEX OF PYRAMID IS KNOWN AS
THE RENAL PAPILLA
THE RENAL PAPILLA PROJECTS INTO A FUNNEL SHAPED STRUCTURE IN THE RENAL SINUS CALLED
A MINOR CALYX
SEVERAL MINOR CALYCES MERGER TO FORM LARGER STRUCTURES CALLED
MAJOR CALYCES
HOW MANY MAJOR CALYCES DOES THE AVG KIDNEY HAVE
‘2-3
MAJOR CALYCES MERGE TO FORM
A SINGLE FUNNEL SHAPED RENAL PELVIS
HOW MANY LOBES DOES AN AVG KIDNEY HAVE
8-15
WHAT DOES EACH LOBE CONSIST OF
A RENAL PYRAMID WITH A RENAL COLUMN ON EACH SIDE AND THE CORTEX EXTERNAL TO THE PYRAMID BASE
BLOOD IS CARRIED TO EACHBKIDNEY FOR FILTRATIO THROUGH THE
RENAL ARTERY
THE RENAL ARTERY BRANCHES IN THE RENAL SINUS TO FORM
SEGMENTED ARTERIES
SEGMENTED ARTERIES BRANCH TO FORM
INTERLOBAR ARTERIES
INTERLOBAR ARTERIIES PASS THROUGH
THE RENAL COLUMNS TO THE CORTICOMEDULLARY JUNCTION
AT THE CORTICOMEDULLARY JUNCTION, INTERLOBAR ARTERIES BRANCH TO
ARCUATE ARTERIES
ARCUATE ARTERIES PROJECT ALONG
THE BASE OF RENAL PYRAMIDS TO GIVE OFF INTERLOBULAR ARTERIES THAT ENTER THE RENAL CORTEX
INTERLOBULAR ARTERIES
IN THE RENAL CORTEX; FROM THE ARCUATE ARTERIES BRANCHING AT THE BASE OF THE RENAL PYRAMID
REMEMBER BASE OF RENAL PYRAMID IS LOCATED WHERE
NEAR THE CORTEX, APEX IS NEAR THE HILUM
INTERLOBULAR ARTERIES BRANCH TO FORM A SERIES OF
AFFERENT ARTERIOLES
AFFERENT ARTERIOLES FEED A CAPILLARY NETWORK CALLED A
GLOMERULUS
THE GLOMERULUS FORMS WHAT
THE VASCULAR CORE OF THE RENAL CORPUSCLE
THE GLOMERULUS IS THE INITIAL ____________ COMPONENT OF THE KIDNEY
FILTERING
THE RENAL CORPUSCLE AND ITS ASSOCIATED DUCTS FORM THE
FUNCTIONAL FILTRATION UNIT OF THE KIDNEY KNOWN AS THE NEPHRON
Nephrons
are the functional units of the kidneys,
WHAT IS THE ARTERIOLE THAT LEAVES THE GLOMERULUS
EFFERENT ARTERIOLE
WHERE DOES THE EFFERENT ARTERIOLE GO
ENTERS A SECOND CAPILLARY NETWORK
A PERITUBULAR CAPILLARY NETWORK FORMS AROUND
THE PROXIMAL AND DISTAL CONVOLUTED TUBULES
WHERE DOES BLOOD GO FROM THE PERTIBULAR CAPILLARY NETWORK
BLOOD LEAVES THE CORTEX BY FLOWING INTO THE INTERLOBULAR VEINS
WHERE DO THE INTERLOBULAR VEINS DRAIN INTO
THE ARCUATE AND INTERLOBAR VEINS AND FINALLY THE RENAL VEIN
THE EFFERENT ARTERIOLES ASSOCIATED WITH THE NEPHRONS AT THE CORTICOMEDULLARY JUNCTION GO WHERE
ENTER A SECOND CAPILLARY NETWORK ALONG THE NEPHRON LOOP OR LOOP OF HENLE
VASA RECTA
CAPILLARIES THAT RUN PARALLEL TO LOOP OF HENLE BUT FLOW IN THE OPPOSITE DIRECTION
FROM THE VASCA RECTA BLOOD FLOWS TO
INTERLOBULAR VEINS TO ARCUATE VEIN TO INTERLOBAR VEIN TO RENAL VEIN
What is the correct branching sequence of arteries in the kidney?
Renal artery, segmental arteries, interlobar arteries
The junction of the renal medulla and renal cortex is called the
Corticomedullary junction
The major calices merge to form a single, funnel-shaped
RENAL PELVIS
Blood vessels, nerves and the renal pelvis enter/exit the kidney at the
HILUM
EACH KIDNEY CONTAINS HOW MANY NEPHRONS
ABOUT 1.3 MILLION
EACH NEPHRON CONSISTS OF
A RENAL CORPUSCLE AND A RENAL TUBULE
THE RENAL CORPUSLCE CONTAINS WHAT TWO STRUCTURES
GLOMERULUS AND GLOMERULAR CAPSULE
WHAT IS ANOTHER NAME FOR GLOMERULAR CAPSULE
BOWMANS CAPSULE
BLOOD VESSELS ENTER AND EXIT THE RENAL CORPUSCLE WHERE
AT ITS VASCULAR POLE, THE TUBULAR POLE IS CONTINUOUS WITH THE RENAL TUBULE
GLOMERULAR CAPSULE HAS TWO LAYERS
VISCERAL LAYER; PARIETAL LAYER
VISCERAL LAYER
ENVELOPES CAPILLARIES OF GLOMERULUS; EPITHELIAL CELLS CALLED PODOCYTES
PODOCYTES
HAVE MULTIPLE INTERDIGITATING FOOT LIKE PROCESSED CALLED PEDICELS
PEDICELS
??
INTERDIGITATING
??
PARIETAL LAYER
SIMPLE SQUAMOUS EPITHELIUM; FORMS A CAPSULE AROUND THE GLOMERULUS
WHERE IS THE CAPSULAR SPACE IN THE GLOMERULAR
BETWEEN THE PARIETAL LAYER AND THE VISCERAL LAYER
FILTRATION MEMBRANE OF GLOMERULUS IS FORMED BY THREE COMPONENTS
FENESTRATIONS; BASEMENT MEMBRANE; FILTRATION SLITS
FENESTRATIONS
SMALL PORES IN THE CAPILLARY ENDOTHELIUM
WHERE IS THE BASEMENT MEMBRANE LOCATED
BETWEEN THE ENDOTHELIUM AND THE PODOCYTES
WHERE ARE THE FILTRATION SLITS
BETWEEN THE PEDICELS
RENAL TUBULE IS COMPOSED OF
P.C.T. A NEPHRON LOOP. D.C.T.
WHERE DOES THE P.C.T. ORIGINATE FROM
AT THE TUBULAR POLE OF THE RENAL CORPUSCLE AND IS CONTINOUS WITH THE NEPHRON LOOP
THE NEPHRON LOOP IS DIVIDED INTO WHAT KIND OF SEGMENTS
THICK AND THIN
THE THICK SEGMENT IS LINED WITH
SIMPLE CUBOIDAL EPITHELIUM
THIN SEGMENTS ARE LINED WITH
SIMPLE SQUAMOUS EPITHELIUM
AS FLUID MOVES THROUGH THE RENAL TUBULE, USEFUL SOLUTES MOVE
OUT OF THE TUBULAR FLUID AND RETURN TO THE BLOOD AND WASTE PRODUCTS IN THE BLOOD MOVE INTO THE RENAL TUBULAR FLUID ULTIMATELY TO BE EXRETED AS URINE
TWO TYPES OF NEPHRONS CAN BE IDENTIFIED BASED ON THEIR LOCATION WITHIN THE RENAL CORTEX
CORTICAL NEPHRONS; JUXTAMEDULLARY NEPHRONS
CORTICOL NEPHRONS
85% OF NEPHRONS; HAVE GLOMERULUS NEAR THE PERIPHERY OF THE CORTEX AND NEPHRON LOOPS IN THE MEDULLA
JUXTAMEDULLARY NEPHRONS
GLOMERULUS IS LOCATED AT THE CORTICOMEDULLARY JUNCTION; HAVE RELATIVELY LONG NEPHRON LOOPS; AND EXTEND DEEP INTO THE MEDULLA
JUXTAGLO0MERULAR APPARTUS IS LOCATED WHERE
WHERE AFFERENT AND EFFERENT ARTERIES MEET
3 PARTS OF JUXTAGLOMERULAR APPARATUS
MACULA DENSA; JUXTAGLOMERULAR CELLS; EXTRAGLOMERULAR MESANGIAL CELLS
MACULA DENSA;
COMPOSED OF SPECIALIZED CELLS OF THE DISTAL CONVOLUTED TUBULE
JUXTAGLOMERULAR CELLS
MODIFIED SMOOTH MUSCLE CELLS
; EXTRAGLOMERULAR MESANGIAL CELLS
??
JUXTAGLO0MERULAR APPARTUS MONITORS
BLOOD SODIUM CONCENTRATION AND ADJUSTS GLOMERULAR FILTRATE VOLUME THROUGH HORMONAL FEEDBACK MECHANISMS
THE EFFERENT ARTERIOLES A EACH GLOMERULUS ENTERS A SECOND
CAPILLARY NETWORK CALLED THE PERTIBULAR CAPILLARY NETWORK
THE EFFERENT ARTIOLES OF JUXTAMEDULLARY NEPHRONS ENTER
CAPILLARIES KNOWN AS THE VESA RECTA
WHAT DOES THE VESA RECTA SURROUND
THE DESCENDING AND ASCENDING LIMBS OF THE NEPHRON LOOP
WHERE DOES BLOOD FLOW FROM THE VESA RECTA
INTO THE INTERLOBULAR VEINS
The micturition reflex involves impulses TO WHAT REGION
traveling from the urinary bladder to the sacral region of the spinal cord
MICTURATION REFLEX IS COORDINATED BY
NEURONS IN THE SPINAL CORD AND CAN BE INFLUENCED BY SIGNALS FROM THE BRAIN
When a urinary bladder becomes stretched there is
an increase in the frequency of action potentials carried from the bladder wall to the sacral region of the spinal cord.
IN RESPONSE TO THESE ACTION POTENTIALS
parasympathetic neurons from the spinal cord to the bladder are activated and this causes the smooth muscle on the bladder wall to contract.
CENTURY SIGNAL ?? CAN ALSO STIMULATE WHAT
The century signal to the sacral region of the spinal card also stimulate ascending pathways to the pons and cerebrum which results in a conscious desire to urinate.
If urination is not convenient at the time, the brain sends impulses down the spinal cord
to inhibit the micturition reflex.
Impulses carried via somatic motor neurons keep
the external urinary sphincter contracted which also prevents urination.
When urination is desired signals
from brain stimulate the micturition reflex.
The brain also decreases action potentials in the somatic motor neurons TO
RELAX EXTERNAL URINARY SPHINCTER
The external urethral sphincter is under ___________ control.
voluntary control
Relaxation of the external urethral sphincter is caused by
SIGNALS FROM THE BRAIN
The micturition reflex involves impulses from the bladder traveling to which region of the spinal cord?
??
What causes an increase in the frequency of action potentials from the bladder to the spinal cord?
??
Diffusion is
the net movement of molecules down a concentration gradient.
DIFFUSION ALLOWS WHAT
SMALL MOLECULES, SUCH AS 02 AND CO2 TO CROSS THE PLASMA MEMBRANE
MOST POLAR MOLECULES, SUCH AS SUGARS AND PROTEINS CANNOT FREELY CROSS THE LIPD MEMBER. TRUE OR FALSE
TRUE
ALTHOUGH WATER MOLECULES ARE POLAR, WHY ARE THEY ABLE TO PASS TRHOUGH THE MEMBRANE
THEY ARE SMALL ENOUGH
OSMOSIS
SPECIAL CASE OF DIFFUSION WHERE WATER MOLECULES, EVEN THOUGH THEY ARE POLAR, ARE ABLE TO PASS THROUGH THE MEMBRANE
If a molecule, such as urea, is added to one side of a membrane, it will not be able to diffuse across the membrane because
IT IS BOTH LARGE AND POLAR
ISOTONIC SOLUTIONS
WHEN THE OSMOTIC CONCENTRATIONS OF TWO SOLUTIONS ARE EQUAL
HYPERTONIC
SOLUTION WITH THE HIGHER CONCENTRATION
HYPOTONIC
SOLUTION WIT THE LOWER CONCENTRATION
The net movement of molecules down a concentration gradient is known as
DIFFUSION
Osmosis deals specifically with the diffusion of
H20 MOLECULES
When the osmotic concentrations of two solutions are equal, the solutions are said to be
??
WHAT IS THE MAIN FUNCTION OF THE FEMAL URETHRA
TO TRANSPORT URINE TO THE OUTSIDE OF THE BODY
WHAT IS THE MAIN FUNCTION OF THE MALE URETHRA
SERVES URINARY AND REPRODUCTIVE FUNCTIONS; ACTS AS A PASSAGEWAY FOR BOTH URINE AND SEMEN
MAJOR FUNCTIONS OF URINARY SYSTEM ARE
REMOVAL OF WASTE PRODUCTS AND REGULATION OF WATER AND ELECTROLYTE BALANCE
ORGANS OF THE URINARY SYSTEM
KIDNEYS URETERS BLADDER AND URETHRA
WHAT ARE URETERS
FIBROMUSCULAR TUBES THAT CONDUCT URINE FROM THE KIDNEYS TO THE BLADDER
EACH URETER BEGINS AS __________ AND EXTENDS DOWNWARD TO
RENAL PELVIS; BLADDER
WHAT DOES THE PRESENCE OF URINE IN THE RENAL PELVIS INTITIATE
A PERISTALIC WAVE IN THE MUSCULAR LAYERS OF THE URETER THAT PROPEL URINE THROUGH THE URETERS AND INTO THE URINARY BLADDER
WHAT IS THE URINARY BLADDER
AN EXPANDABLE MUSCULAR CONTAINER THAT SERVES AS A RESERVOIR FOR URINE
WHERE IS THE URINARY BLADDER LOCATED
BEHIND THE PUBIC SYMPHYSIS
WHERE DO URETERS ENTER THE URINARY BLADDER
THE POSTEROLATERAL WALL THROUGH THE URETERAL OPENINGS
WHAT IS THE BLADDER WALL MADE UP OF WHAT TISSUES
THREE LAYERS OF SMOOTH MUSCLE, COLLECTIVELY CALLED THE DETRUSOR MUSCLE
WHAT DOES THE DETRUSOR MUSCLE DO DURING URINATION/MICTURITION
CONTRACTS TO EXPEL URINE FROM THE BLADDER
THE BLADDER NARROWS TOWARDS IT BASE FORMING A CONSTRICTED NECK THAT IS CONTINOUS WITH
THE URETHRA
THE URETHRA IS
FIBROMUSCULAR TUBES THAT CONDUCT URINE FROM THE KIDNEYS TO THE BLADDER
ARE MALE AND FEMAL URETHRAS THE SAME LENGTH
NO, MALE URETHRA APPROX 4x AS LONG THAN FEMALE
IN BOTH MALES AND FEMALES, THE DETRUSOR MUSCLE THICKENS AT THE NECK OF THE BLADDER NEAR THE URETHRA TO FORM
AN INTERNAL URETHRAL SPHINCTER; SMOOTH MUSCLE, INVOLUNTARY CONTROL
WHERE THE URETHRA PASSES THROUGH THE UROGENITAL DIAPHRAGM IT IS ENCIRCLED BY
AN EXTERNAL URETHRAL SPHINCTER; SKELETAL MUSCLE; VOLUNTARY CONTROL
WHAT HAPPENS DURING URINATION
BOTH URETHRAL SPHINCTERS RELAX, ALLOWING URINE TO EXIT
ETERNAL URETHRAL ORIFICE
ON GUYS, HOLE IN THEIR PENIS, GIRLS IS IT THE VAGINA??
The main functions of the urinary system are
Removal of waste and regulation of water and electrolyte balance AND Ph
Blood vessels and the renal calices are located in the
RENAL SINUS
What is the collective name for the layers of muscle in the wall of the urinary bladder?
??
WHERE IS URINE FORMED
IN THE NEPRON
WHAT ARE THE THREE PROCESSES OF URINE FORMATION
GLOMERULAR FILTRATION; TUBULAR REABSORPTION; TUBULAR SECRRETION
glomerular filtration occurs when
BLOOD CIRCULATES THROUGH THE GLOMERULUS; WASTES WITHIN THE GLOMERULAR CAPILLARIES MOVE ACROSS THE FILTRATION MEMBRANE INTO THE CAPSULAR SPACE TO FORM FILTRATE; ONCE FILTRATE ENTERS THE RENAL TUBULE, IT IS CALLED TUBULAR FLUID
WHAT PROCESSES CAN BE USED TO WHEN SOLUTES MOVE ACROSS THE TUBULE WALL IN THE INTERSTITIAL FLUID
DIFFUSION, FACILITATED DIFFUSION, ACTIVE TRANSPORT, COTRANSPORT, OSMOSIS
WHAT PERCENTAGE OF H20 IS REABSORBED FROM THE P.C.T.
65%
WHAT PERCENTAGE OF H20 IS REABSORBED FROM THE NEPHRON LOOP
15%
WHAT PERCENTAGE OF H20 IS REABSORBED FROM THE D.C.T. AND COLLECTING DUCTS
19%
WHAT PERCENTAGE OF GLOMERULAR FILTRATE ULTIMATELY RETURNS TO THE BLOODSTREAM
99%; THE REMAINING 1% WILL BE EXCRETED AS URINE
TUBULAR FLUID THAT ENTERS COLLECTING DUCTS IS CALLED
urine production based on physiological conditions such as hydration
DEPENDING ON THE NEED TO ELIMINATE OR CONSERVE H20, THE COLLECTING DUCTS CAN
REABSORB H20 TO PR0ODUCE DILUTE OR CONCENTRATED URINE
WHEN H20 INTAKE IS HIGH, THE KIDNEYS PRODUCE
LARGE VOLUME OF DILUTE URINE
WHEN H20 INTAKE IS LOW, THE KIDNEYS PRODUCE
THE KIDNEYS CONSERVE H20 BY PRODUCING A SMALL AMOUNT OF COCENTRATED URINE, HENCE PREVENTING DEHYDRATION
WHAT ARE THE TWO KEY FACTORS THAT DETERMINE THE KIDNEYS ABILITY TO CONCENTRATE URINE
MAINTAINING A HIGH CONCENTRATION OF NaCl AND UREA IN RENAL MEDULLA; AND PRESENCE OF ADH
How do the kidneys KEEP A HIGH CONCENTRATION OF NaCl
THE COUNTERCURRENT FUNCTIONS OF THE NEPHRON LOOPS
WHAT DOES ADH DO TO THE COLLECTING DUCTS
MAKES THEM MORE PERMEABLE TO WATER
Urine is formed in the
NEPHRON
What percentage of glomerular filtrate becomes urine?
1%
Most of the water in tubular fluid is resorbed in the
Proximal convoluted tubule
Tubular secretion involves the movement of substances
From capillary blood to tubular fluid
In fact, the body must produce at least
0.5 liters of urine per day to adequately remove waste from the body.
Each kidney filters approximately
1 liter of blood per minute.
The amount of urine produced will vary based on
fluid intake, blood pressure, and temperature, amongst other factors.
Fresh urine is normally
clear and pale yellow.
Darker-color urine indicates the urine may be
more concentrated.
Cloudy urine may indicate the
presence of a urinary tract infection.
Urine pH ranges from
4.5 through 8.0 depending on diet and the body’s needs. A pH of 6.0 is typical.
Normal healthy urine is
sterile and formed from filtered blood. It is mostly water with solutes such as salts (Na+, K+, Cl-, Ca2+, Mg2+, H2PO4-, SO42-, NH4+), nitrogenous wastes (urea, creatinine, uric acid), some hormones, and small quantities of ketones. Some drugs can also be found within urine.
The presence of glucose, blood (erythrocytes), leukocytes, excess protein, or ketones is
abnormal and indicates infection or disease.
Glucose is normally fully absorbed back into the body from
the filtrate. Its presence in urine indicates abnormally high levels of glucose, such as that found in diabetics.
Erythrocytes (red blood cells) are not n
ormally found in urine as they should not be able to pass through the filtration membrane. Their presence indicates disease or infection.
Leukocytes are part of the immune response and
should not be found in urine. The presence of leukocytes indicates infection, such as a kidney or urinary tract infection.
Protein is not usually found in urine as it cannot typically pass into the filtrate. Presence of excess protein, known as proteinuria,
may indicate problems with the kidney.
Ketones are formed during
fatty acid metabolism. A small amount of ketones in urine is normal. However, excessive ketones in urine is a sign of diabetes.
The pads on a urinalysis test strip contain which of the following?
reagents that react with solutes
loudy urine may indicate what
UTI
Why is it important to wait 60 seconds before reading the urine values?
have to allow adquate time for urine to react with each test pad on the urine test strip
