General Kidney/Urinary Bladder

Question 1

What are the functions of the renal system?

Answer 1

EXCRETION, water/electrolyte balance, pH regulation, control of circulating volume, hormone secretion, gluconeogenesis

Question 2

What is the typical daily fluid intake?

Answer 2

2300 mL/day (ingestion of food/fluid + carb oxidation)

Question 3

How do we lose body water?

Answer 3

Breathing, through our skin, sweating, feces, excretion by kidneys

Question 4

What is the most common electrolyte disorder?

Answer 4

Hyponatremia

Question 5

What is hyponatremia?

Answer 5

Low plasma sodium via dehydration or overhydration

Question 6

What things could cause hyponatremia due to dehydration?

Answer 6

Diarrhea, vomiting, overuse of diuretics (overall loss of sodium chloride)

Question 7

What could cause hyponatremia due to overhydration?

Answer 7

Abnormally high secretion of ADH

Question 8

What serious conditions can result from hyponatremia?

Answer 8

Edema, brain swelling, brain damage, death

Question 9

Why is it important to not induce rapid correction of hyponatremia?

Answer 9

Gradual correction is necessary to avoid further damage

Question 10

What is hypernatremia?

Answer 10

High plasma sodium due to dehydration or overhydration

Question 11

What are things that can cause hypernatremia due to dehydration?

Answer 11

Excessive sweating, lack of ADH production/sensitivity

Question 12

How can hypernatremia be caused by overhydration?

Answer 12

Abnormally high secretion of aldosterone

Question 13

In which scenario do effects tend to be more severe: hypo- or hypernatremia?

Answer 13

Hyponatremia

Question 14

Why are the effects of hypernatremia less severe than hyponatremia?

Answer 14

Cells resist damage from shrinkage

Question 15

Hyponatremia, metabolic depression, and lack of adequate nutrition can cause what kind of edema?

Answer 15

Intracellular edema

Question 16

Fluid leakage and lymphedema (lymphatic failure) can can what kind of edema?

Answer 16

Extracellular edema

Question 17

A person who is sweating profusely is at risk for: hypo- or hypernatremia?

Answer 17

Hypernatremia

Question 18

Does someone with hyponatremia have very high or low levels of sodium in their blood plasma?

Answer 18

Low

Question 19

When standing, the kidneys are located around what vertebral levels?

Answer 19

L1-L4 (in the retroperitoneal space)

Question 20

Where is the base of the medulla located?

Answer 20

Cortical-medullary border

Question 21

What is the tip of the medulla called?

Answer 21

Papilla

Question 22

What structures contract to propel urine to the bladder?

Answer 22

Calyces, renal pelvis, and ureter

Question 23

The kidneys make up about how much of cardiac output?

Answer 23

22%

Question 24

What makes the renal blood flow so unique?

Answer 24

2 capillary beds separated by efferent arterioles (glomerular and peritubular capillaries)

Question 25

Which set of renal capillaries has high hydrostatic pressure? Low?

Answer 25

High - Glomerular capillaries | Low - Peritubular capillaries

Question 26

Which set of renal capillaries causes rapid fluid filtration? Which allows for rapid fluid reabsorption?

Answer 26

Fluid filtration - glomerular capillaries | Fluid reabsorption - peritubular capillaries

Question 27

What is the functional unit of the kidney?

Answer 27

Nephron

Question 28

What are the two different nephron structures/areas?

Answer 28

Cortical nephron, juxtamedullary nephron

Question 29

Which nephron structure has a significantly longer Loop or Henle and penetrates deeper into the medulla?

Answer 29

Juxtamedullary nephron

Question 30

Are new nephrons able to be regenerated by the kidneys?

Answer 30

No

Question 31

After what age do we see a decrease in the number of functional nephrons?

Answer 31

40 (then 10% decrease every 10 years)

Question 32

Where are glomerular capillaries encased?

Answer 32

In the Bowman's capsule

Question 33

What is the pathway of fluid being filtered from the glomerular capillaries?

Answer 33

Bowman's capsule --> proximal tubule --> loop of Henle --> distal tubule --> connecting tubule --> collecting duct --> renal pelvis

Question 34

Which structural type of nephron has a short loop of Henle and barely penetrates into the medulla?

Answer 34

Cortical nephron

Question 35

Which are more common (70-80% of nephrons): cortical or juxtamedullary nephrons?

Answer 35

Cortical nephrons

Question 36

What surrounds cortical nephrons?

Answer 36

Peritubular capillaries

Question 37

What surrounds juxtamedullary nephrons?

Answer 37

Specialized peritubular capillaries called vasa recta

Question 38

What kind of muscle makes up the urinary bladder?

Answer 38

Smooth muscle

Question 39

What part of the bladder is where urine is collected?

Answer 39

Body

Question 40

What part of the bladder attaches to the urethra and passes inferior and anterior from the body?

Answer 40

Neck

Question 41

What is the name of the smooth muscle involved in emptying the bladder?

Answer 41

Detrusor muscle

Question 42

Where is the trigone of the bladder located?

Answer 42

Posterior wall of the bladder

Question 43

Where do the ureters enter the bladder?

Answer 43

At the upper trigone obliquely through the detrusor muscle

Question 44

What is the difference between the surface of the trigone and the rest of the bladder walls?

Answer 44

``` Trigone = smooth mucosa Rest = folded rugae ```

Question 45

What is the purpose of the tone of the detrusor muscle shutting down the ureters during micturition?

Answer 45

Prevents blackflow of urine

Question 46

What muscle is located at the neck of the bladder?

Answer 46

Internal sphincter

Question 47

What is the function of the internal sphincter?

Answer 47

Prevents emptying of the bladder until the pressure rises above the critical threshold

Question 48

What is the internal sphincter composed of?

Answer 48

Detrusor muscle and elastic tissue

Question 49

Which urethral sphincter is under voluntary control and made of smooth muscle?

Answer 49

External sphincter

Question 50

What is the innervation of the urinary bladder?

Answer 50

Pelvic nerves through sacral plexus (S2-S3)

Question 51

What kinds of fibers innervate the detrusor muscle?

Answer 51

Parasympathetic motor fibers

Question 52

What kinds of fibers detect the stretch of the bladder wall?

Answer 52

Sensory fibers

Question 53

What nerve innervates the external bladder sphincter?

Answer 53

Pudendal nerve (somatic nerve fibers)

Question 54

What makes up the sympathetic innervation of the urinary bladder and what does it stimulate?

Answer 54

Hypogastric nerves (L2); stimulate blood supply to bladder