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The Renal System > Gross structure and function of the renal system > Flashcards

Gross structure and function of the renal system Flashcards

1
Q

What structures make up the renal system

A

two kidneys
two ureters
one urethra
bladder

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2
Q

What are the key functions of the renal system

A

excretion
elimination
homeostatic regulation

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3
Q

What are the homeostatic functions of the kidney

A

Regulating blood volume and blood pressure
Regulating plasma ion concentrations
Stabilising blood pH
Conserving valuable nutrients and excreting waste products
Detoxify poisons

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4
Q

What does each nephron consist of

A 
Renal corpuscle (consisting of the glomerulus and the Bowman's capsule and the 
renal tubule)
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5
Q

What is the renal tubule divided into

A

Proximal convoluted tubule
loop of Henle
Distal convoluted tubule

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6
Q

What processes does the nephron undertake in the formation of urine

A

Filtration
Reabsorption
Secretion

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7
Q

What does the Bowman’s capsule of epithelial cells act as

A

A filter of the blood entering through the afferent arteriole

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8
Q

What is the juxtaglomerular apparatus situated in the renal corpuscle important for

A

Regulation of fluid and electrolyte balance

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9
Q

What does the proximal convoluted tubule consist of

A

fused cuboidal epithelial cells

mitochondria

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10
Q

What happens in the PCT

A

all the nutrients (glucose and amino acids) and most of the electrolytes (sodium, chloride and bicarbonate) are reabsorbed here with water

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11
Q

What are the cells of the descending limb like

A

thin and permeable

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12
Q

What does the LOH create through the medulla

A

An osmotic gradient

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13
Q

What does the thick section of the ascending loop of Henle do

A

Moves sodium from the filtrate into the interstitial fluid by active transport using ATP

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14
Q

What hormone increases the permeability of the collecting duct

A

ADH

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15
Q

What system regulates the amount of ions reabsorbed from the distal tubule

A

The RAAS

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16
Q

What does aldosterone do

A

stimulates the reabsorption of sodium into the interstitial fluid and secretion of potassium into the tubular filtrate

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17
Q

what do intercalated cells in the distal convoluted tubule do

A

reabsorb the bicarbonate remaining in the filtrate after the reabsorption in the proximal tubule. this leads to excretion of acid urine.

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18
Q

Where does the filtrate move through

A

the collecting ducts via the calyces into the pelvis of the kidney and then ureter

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19
Q

what three processes form urine

A

filtration, selective reabsorption and secretion

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20
Q

what does glomerular filtrate consist of

A

water, sodium, glucose and waste products

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21
Q

what is the GFR

A

the rate at which the filtrate is formed (ml/minute)

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22
Q

What substances do you examine in excretion of urine to determine GFR

A

Insulin or creatinine clearance

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23
Q

What does the filtrate consist of

A

electrolytes (sodium and potassium), urea, uric acid and creatinine but not protein or cells

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24
Q

What is selective reabsorption

A

The movement of fluid and solutes from the tubular system into the peritubular capillaries

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25
what three processes does reabsorption occur via
osmosis, diffusion and active transport
26
What is secretion
The removal of waste products and substances not required by the body that are extracted from the blood, passed into the convoluted tubules and collecting ducts and excreted from the body in urine
27
What substances are secreted
waste products of metabolism (urea, creatinine, ammonium ions), foreign materials such as drugs, H+ ions or bicarbonate ions
28
What % of substances make up urine
95% water | 5% dissolved liquids and gases
29
What is the pH of urine
4.5-8.0 (average 6.0)
30
What is the normal composition of urine
Water, urea, uric acid, creatinine, ammonia, sodium, potassium, chloride, bicarbonate, calcium, magnesium and phosphate
31
What should urine not normally contain
Protein, glucose, blood, ketones, white blood cells and casts
32
what do the ureters do
collect urine from the calyces of the kidneys and drain it into the bladder by peristalsis
33
When does Vesicoureteral reflux occur and what can it cause and why
When the oblique entry of the ureter into the bladder is straightened and back flow of urine from the bladder into the ureter occurs. Can cause infection because it enables bacteria to ascend from bladder to kidneys.
34
What is the area at which the ureters enter the bladder
The trigone
35
What initiates the need to micturate
The stretching of receptors in the trigone of the bladder
36
What is the main muscle of the bladder
The detrusor
37
What is the bladder lining formed of
Transitional epithelium
38
When empty, what do the bladder walls fold into
Rugae
39
What volume of urine can be held in the bladder and at what point does micturition occur
600-800ml | 150-300ml
40
what is the role of the urethra
carries urine from the bladder to the external urinary meatus to remove excess fluid from the body
41
How long is the female urethra
4.8-5.1cm
42
Where does the female urethra exit the body
through the external meatus of striated voluntary muscle between clitoris and vagina
43
What are the 3 layers of the urethra
Muscular, erectile and mucosal
44
Which nerves control the external urethral sphincter
The pudendal nerves
45
How long is the male urethra
15-29cm
46
What are the 4 parts of the urethra in males
pre-prostatic prostatic membranous spongy (or penile)
47
What higher brain centres are responsible for the voluntary control of the micturition reflex
The pons of the hindbrain and the cerebrum
48
What happens during the storage stage of bladder activity
Distension of the bladder occurs as urine collects and when 150ml has collected, stretching provides stimulus to the sympathetic nervous supply to the bladder. This inhibits contraction of the detrusor and constricts the internal urethral sphincter around the neck of the urethra, preventing micturition. When urine volume reaches 400ml, desire to pass urine occurs and is prevented by voluntary contraction of the external urethral sphincter through the pudendal nerves.
49
What happens during the voiding stage of bladder activity
Neurons in the micturition centre send maximum impulses to the sacral centre and the parasympathetic fibres stimulate contraction of the bladder and relaxation of the internal urethral sphincter. The external urethral sphincter is consciously relaxed enabling micturition to occur.
50
What is urinary incontinence
a condition in which involuntary loss of urine is a social or hygienic problem
51
What are the different types of incontinence
``` stress UI urge UI Mixed UI Overflow UI Reflex UI Enuresis (involuntary loss of urine) nocturnal enuresis Functional UI ```
52
What cells are inside the epithelium of the nephron
Podocytes (filtration slits)
53
What are the three types of cells in the juxtaglomerular region of the nephron
macula dense extraglomerular mesangial juxtaglomerular cells
54
What do the macula densa cells do
sense when levels of sodium and chloride are low e.g. hypovolemia and hypotension
55
what do the extraglomerular mesangial cells do
help with signalling between macular densa and juxtaglomerular cells
56
what do juxtaglomerular cells do
recieve signals from the macula densa cells and sense low blood pressure. secrete renin that increases sodium reabsorption - raises blood volume and increases constriction of blood vessels, which raises BP.
57
What forces water and small solutes across the glomerulus membrane
The hydrostatic pressure
58
Why does the osmotic concentration in the fluid around the descending limb increase
the descending limb is permeable to water and relatively impermeable to solutes
59
What is stress incontinence
Incontinence due to coughing/sneezing/laughing
60
what is urge incontinence
Abrupt and intense urge to urinate
61
What is overflow incontinence
overflow of urine due to blockage of urethra causing overfilling
62
what is functional incontinence
due to impaired functioning of the nervous system
63
what does ADH (antidiuretic) control
blood volume | controls volume of urine produced by controlling the amount of water present within urine
64
what does the RAAS control
blood pressure
65
what structure produces ADH
the pituitary gland
66
What is the pathway of activity when the hypothalamus detects too little water in blood
pituitary gland releases ADH ADH acts on the kidneys to reabsorb water back into the blood less water is lost in urine (urine more concentrated) blood water level returns to normal
67
describe the pathway of the RAAS when blood pressure or fluid volume drops
renin released from kidney angiotensin released from liver renin acts on angiotensinogen to form angiotensin 1 ACE released from lungs and acts on angiotensin 1 to form angiotensin 2 angiotensin 2 acts on blood vessels stimulating vasoconstriction and decreasing GFR angiotensin 2 acts on adrenal gland to stimulate release of aldosterone aldosterone acts on kidneys to stimulate reabsorption of salt and water
68
why would you carry out urinalysis
screening diagnosis management and planning
69
what should not be present in urine
``` proteinuria red blood cells white blood cells microorganisms glucose ketones ```
70
what would proteinuria indicate
breakdown of basement membrane in Bowman's capsule due to injury, high blood pressure, toxins or pre-eclampsia
71
what would red blood cells in urine indicate
injury, infection, kidney stones
72
what would white blood cells or microorganisms in the urine indicate
infection or inflammation
73
what could glucose in the urine indicate
diabetes mellitus or pregnancy
74
what would ketones in the urine indicate
excessive fat breakdown e.g., starvation, uncontrolled type 1 diabetes, diabetic ketoacidosis
75
why are UTI's more common in females
they have a shorter urethra so more bacteria can enter and less distance for them to travel
76
what is the main bacteria that causes UTI's
E-coli
77
what 3 structures does the kidney develop from fetally
pronephros, mesonephros, metanephros (functional kidney)
78
how are waste products cleared from the blood during pregnancy
through the placenta
79
what happens to nephrons with maturation
the number does not grow but they do grow in weight and function
80
before what age should bladder control be accomplished
5
81
which area of the spinal column controls bowel and bladder
sacral area
82
what is cystitis
infection of the bladder
83
what is pyelonephritis or glomerulonephritis
infection of the kidney (inflammation of the glomerulus or nephron)
84
symptoms of kidney infection
fever, shivery, sick, pain in back or side, symptoms of UTI
85
what is renal agenesis
when a baby is born without kidneys
86
what is vesicoureteral reflux and what does it cause
abnormal development of the ureteric and bladder junction causes backflow of urine up the ureter meaning the bladder does not empty properly
87
what is hypospadias
a condition where the urethral meatus is located on the under surface of the penis
88
what is epispadias
a condition where the urethral opening is located on the upper surface of the penis

The Renal System (2 decks)

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