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BRS - U&R > Genitourinary System > Flashcards

Genitourinary System Flashcards

1
Q

Name the main parts of the kidneys.

A 
→ renal artery
→ renal vein
→ cortex
→ medulla
→ major + minor calyx
→ ureter
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2
Q

What are the 5 main functions of the kidneys?

A

→ Excretion of metabolic products (e.g. urea, uric acid, creatinine)
→ Excretion of foreign substances (e.g. drugs)
→ Regulation of body fluids, electrolytes & acid-base balance
→ Control of blood pressure
→ Secretes hormones (e.g., erythropoietin, renin)

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3
Q

What is the organisation of vessels from the renal artery to renal vein?

A 
→ renal artery
→ segmental artery
→ interlobar artery
→ arcuate artery
→ interlobular artery
→ afferent arteriole
→ glomerular capillaries
→ efferent arteriole
→ peritubular capillaries
→ interlobular vein
→ arcuate vein
→ interlobar vein
→ renal vein
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4
Q

What is the purpose of the detrusor muscle + where is it found?

A

Contracts to build pressure in the urinary bladder to support urination - surrounds the bladder

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5
Q

What is the purpose of the trigone + where is it found?

A

Stretching of this triangular region to its limit signals the
brain about the need for urination - at the bottom near internal sphincter, has the ureteric openings

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6
Q

What is the purpose of the bulbourethral gland + where is it found?

A

Produces thick lubricant which is added to watery semen to promote sperm survival - found only in men

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7
Q

What is the purpose of the internal scphincter + where is it found?

A

Involuntary control to prevent urination - at the bottom of the bladder after the trigone

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8
Q

What is the purpose of the external scphincter + where is it found?

A

Voluntary control to prevent urination - external to the urethra

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9
Q

What is the nephron?

A

structural + functional unit of the kidneys - kidneys are made up of millions + millions of these filtering units

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10
Q

What is the glomerulus?

A

network of blood capillaries that act as microscopic filter to constantly filter blood

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11
Q

What is the Bowman’s capsule?

A

sac that contains glomerulus + starts filtration into PCT

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12
Q

What is the proximal convoluted tube (PCT)?

A

tube of nephron between Bowman’s capsule + loop of Henle, functions by reabsorbing solutes + Na + Cl ions + H2O from glomerular filtrate

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13
Q

What is the Loop of Henle?

A

long U-shaped portion of tubule that conducts urine within nephron, involved in hormonal control and reabsorption of H2O + Na+ and K+ excretion + acid/base balance through H+ secretion

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14
Q

What is the distal convoluted tubule?

A

between loop of Henle + collecting tubule, partially responsible for regulation of K+ Na+ Ca+ Cl- and pH balance

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15
Q

What is the collecting duct?

A

passages that connects to multiple nephrons to collect tubular fluid, which then undergoes changes in the collecting ducts

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16
Q

What parts of the nephron are RICH in mitochondria?

A
  • PCT
  • thin descending Loop of Henle
  • DCT
  • intercalated cells of the Collecting Duct
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17
Q

What parts of the nephron are LOW in mitochondria?

A
  • thin ascending Loop of Henle

* principal cells in the Collecting Ducts

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18
Q

What are the two types of nephron?

A
  • superficial

* juxtamedullary

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19
Q

What is the ration for the two types of nephrons?

A

10 : 1

superficial : juxtamedullary

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20
Q

What is a juxtaglomerular apparatus?

A
  • GFR regulation through tubulo-glomerular feedback mechanism
  • renin secretion for regulating blood pressure
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21
Q

What are the 3 constituents of the juxtaglomerular apparatus?

A
  • macula densa (DCT) (GFR regulation)
  • extraglomerular mesangial cells
  • juxtaglomerular cells (afferent arteriole) (renin secretion)
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22
Q

What processes occur after glomerular filtration?

A
  • reabsorption
  • secretion
  • excretion
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23
Q

What kind of process is glomerular filtration?

A

passive process - fluid is driven through semi-permeable glomerular capillaries into Bowman’s capsule by hydrostatic pressure of heart

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24
Q

How permeable is the filtration barrier?

A

size + charge dependent:
• highly permeable to fluids + small solutes
• impermeable to cells + proteins

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25
Q

What features of the filtration barrier determine its permeability?

A
  • fenestrae - gaps of 70,, diameter, allows passage of water + ions + small proteins
  • slit diaphragm - thin + porous, allows passage of water + small solutes
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26
Q

What are the 2 participating pressures in glomerular filtration?

A
  • hydrostatic pressure (pushing)

* oncotic pressure (pulling)

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27
Q

What is hydrostatic pressure?

A
  • fluid exerted pressure

* solutes + fluid molecules shoved out

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28
Q

What is oncotic pressure?

A
  • solute exerted pressure

* fluid molecules drawn in across semipermeable membrane

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29
Q

What is net ultrafiltration pressure?

A

Puf, represents the interaction between hydrostatic + osmotic pressure

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30
Q

What is HPgc?

A

hydrostatic pressure in glomerular capillaries

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31
Q

What is HPbw?

A

hydrostatic pressure in Bowman’s capsule

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32
Q

What is πgc ?

A

oncotic pressure of plasma proteins in glomerular capillaries

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33
Q

What is the equation for Puf?

A

Puf = HPgc - (HPbw + πgc)

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34
Q

What is GFR (glomerular filtration rate) ?

A

amount of fluid filtered into the Bowman’s Capsule per unit time (mL/min) - sum of filtration rate of all functioning nephrons

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35
Q

What is the equation for GFR?

A

GFR = Puf x Kf

where Kf is an ultrafiltration coefficient - membrane permeability + surface area available for filtration

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36
Q

What would cause GFR imbalances?

A

changes in filtration forces + Kf

37
Q

What is a fall in GFR an indication of?

A

cardinal feature of renal disease

38
Q

What is the healthy range for male GFR?

A

90-140 mL/min

39
Q

What is the healthy range for female GFR?

A

80-125 mL/min

40
Q

What two mechanisms are used to regulate GFR?

A
  • myogenic mechanism

* tubulo-glomerular feedback mechanism

41
Q

What is the myogenic mechanism?

A
  • arterial pressure increase
  • afferent arteriole stretches
  • arteriole contracts
  • vessel resistance rises
  • blood flow reduces
  • GFR stays the same
42
Q

What is the tubulo-glomerular feedback mechanism?

A
  • increase/decrease in GFR
  • increased/decreased NaCl in Loop of Henle
  • change detected by macula densa (their osmolarity changes)
  • increased/decreased ATP & adenosine discharged, leads to production of renin
  • afferent arteriole constricts / dilates, retaining water
  • GFR stabilises
43
Q

What is renal clearance (C)?

A

the no. of litres of plasma that are completely cleared of the substance

44
Q

How can the value of renal clearance (C) be used?

A
  • calculating GFR
  • calculating RPF (renal plasma flow)
  • understand the excretory route of a substance
45
Q

What is the equation for renal clearance?

A

C = (U X V) / P (mL/min)
• U = concentration of substance in urine
• V = rate of urine production
• P = concentration of substance in plasma

46
Q

What happens when a molecule is freely filtered and neither reabsorbed nor secreted?

A
  • amount filtered = amount excreted

* GFR = renal clearance

47
Q

What is the ideal molecule for measuring GFR?

A

inulin

48
Q

Why is inulin the ideal molecule for practical determination of GFR?

A
  • Plant polysaccharide
  • Freely filtered and neither reabsorbed nor secreted
  • Not toxic
  • Measurable in urine and plasma
49
Q

Why is inulin not used very often?

A

not found in mammals so needs to be infused

50
Q

What is commonly used in renal clearance tests instead of inulin?

A

creatinine

51
Q

What is creatinine?

A

waste product from creatine in muscle metabolism

52
Q

What is the advantage of using creatinine?

A

amount of creatinine released is fairly constant

53
Q

Why is creatinine not the ideal molecule?

A

freely filtered + not

reabsorbed BUT small amount is secreted into the nephron - therefore not perfect

54
Q

What does low creatine clearance or high plasma creatine mean?

A

indicates renal failure

55
Q

How do we overcome the shortcomings of creatinine?

A

accounted for when estimating creatinine in blood + urine to allow for GFR calculations

56
Q

What is renal plasma flow?

A

volume of plasma that reaches the kidneys per unit of time

57
Q

When does renal clearance = renal plasma flow?

A

total amount of substance entering kidney = amount excreted

58
Q

What is PAH?

A

para-aminohippuric

59
Q

Why is PAH used?

A

completely removed from the plasma passing through filtration + secretion

60
Q

What is the filtration fraction (FF)?

A

ratio of the amount of plasma which is filtered, and which arrives via the afferent arteriole

61
Q

What is the equation for FF?

A

FF = Quf / Qp
• Quf = ultrafiltrate flow rate
• Qp = plasma flow rate

62
Q

What is the normal range for FF?

A

0.15-0.2 (i.e. 15% to 20% of plasma being filtered)

63
Q

What is the other equation for FF including GFR?

A

FF = GFR / RPF

64
Q

What forms of passive transport do the renal tubules use?

A
  • Diffusion
  • Osmosis
  • Electrical Gradient Difference
65
Q

What forms of active transport do the renal tubules use?

A 
• Primary Active Transport e.g. Na+/K+ ATPase pump
• Endocytosis
• Secondary Active/Coupled
Transport e.g. Na+/Glucose
Symporter, Na+/H+ Antiporter
66
Q

What is the paracellular pathway in the tubules?

A

movement between cells, usually water + ions move with water

67
Q

What is the transcellular pathway for H2O?

A

aquaporins allow movement of water across cells

68
Q

What is the mechanism for transcellular Na+ reabsorption?

A
  • Na+/K+ pump on basolateral cell membrane creates Na+ gradient
  • Na+ moves in from tubular fluid
69
Q

What gets reabsorbed in the early PCT?

A
  • 100% Glucose
  • 100% amino acids
  • 90% HCO3-
  • 67% Na+
  • 67% Cl-
  • 67% Water
  • 50% urea
70
Q

How is Na+ reabsorption in the PCT regulated?

A

angiotensin II by increasing Na+/H+ antiporters

71
Q

What substances are secreted by the early PCT?

A
  • Drugs
  • Ammonia
  • Bile salts
  • Prostaglandins
  • Vitamins (folate & ascorbate)
72
Q

What is the mechanism of Na+ and HCO3- reabsorption in the early PCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • CO2 enters cell through diffusion + combines w/ H2O = H+ + HCO3-
  • Na+ H+ antiporters transport Na+ into cell + H+ out of cell
  • Na+ HCO3- symporters pump Na+ + HCO3- out of cell into blood
73
Q

What is the mechanism of glucose reabsorption in the early PCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • Na+ glucose symporter pumps Na+ + glucose into cell
  • GLUT2 transports glucose out of cell into blood
74
Q

What substances are reabsorbed into Henle’s Loop?

A
  • 25% Na+
  • 25% Cl-
  • 15% H2O
75
Q

What is the thin descending limb permeable and impermeable to?

A
  • H2O (passive) permeable

* Na+ and Cl- impermeable

76
Q

What is the thin ascending limb permeable and impermeable to?

A
  • Na+ and Cl- (passive) permeable

* H2O impermeable

77
Q

What is the thick ascending limb permeable and impermeable to?

A

Na+ and Cl- actively pumped out

78
Q

What is the mechanism of Na+ and Cl- reabsorption in the early PCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • Na+ K+ and 2 Cl- symporter pumps into cell
  • K+ Cl- symporter transports glucose out of cell into blood
  • K+ and Cl- are passively transported out
79
Q

What is the mechanism of Na+ and Cl- reabsorption in the early DCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • Na+ Cl- symporter pumps into cell
  • K+ Cl- symporter transports glucose out of cell into blood
  • Cl- are passively transported out
80
Q

What is the mechanism of active Ca2+ reabsorption in the early DCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • Na+ Ca2+ antiporter pumps Na+ into cell + Ca2+ out into blood
  • Ca2+ ATPase pump pumps out into blood
81
Q

How is Na+ reabsorption regulated in the principal cell of the late DCT + collecting duct?

A

Aldosterone - increasing apical Na+ channels & basolateral Na+/K+ ATPase pumps

82
Q

How is H2O reabsorption regulated in the principal cell of the late DCT + collecting duct?

A

ADH - increasing apical aquaporins

83
Q

What is the mechanism of active Na+ K+ and H2O reabsorption in the early DCT?

A
  • Na+/K+ ATPase pump creates low conc. of Na+ in cell
  • K+ passively diffuses out of cell + Na+ moves into cell
  • H2O osmotically moves in + out through aquaporins at membranes
84
Q

What is the function of intercalated cells of the late DCT + collecting duct?

A

maintaining acid-balance

85
Q

What is the function of ⍺-intercalated cells?

A

HCO3- reabsorption & H+ secretion

86
Q

What is the function of β-intercalated cells?

A

HCO3- secretion & H+ reabsorption

87
Q

What is the mechanism of active HCO3- reabsorption & H+ secretion in the early DCT?

A
  • Cl- + HCO3- antiporter pumps Cl into cell and HCO3- out of cell into blood
  • H+ ATPase pump actively pumps H+ ions out of cell
  • Cl- passively moves out of cell into blood
88
Q

What is the mechanism of active HCO3- secretion & H+ reabsorption in the early DCT?

A
  • H+ ATPase pump actively pumps H+ ions out of cell into blood
  • Cl- + HCO3- antiporter pumps Cl into cell and HCO3- out of cell
  • Cl- passively moves out of cell into blood

BRS - U&R (2 decks)

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