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IDC Stuff > GU 19.1 > Flashcards

GU 19.1 Flashcards

1
Q

What are the components of the urinary system?

A

two kidneys
two ureters
one urinary bladder
one urethra

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2
Q

After kidneys filter the blood they return most of the water and many solutes where?

A

the bloodstream

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3
Q

What is the scientific study of the anatomy, physiology, and disorders of the kidney?

A

Nephrology

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4
Q

What is the branch of medicine that deals with the male and female urinary system and the male reproductive system?

A

Urology

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5
Q

What are the 5 functions of the kidneys?

A

Regulation of ion levels in the blood
Regulation of blood volume and blood pressure
Regulation of blood pH
Production of hormones
Excretion of wastes

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6
Q

What ions are most importantly regulated by the kidneys?

A

Sodium ions (Na+)
Potassium ions (K+)
Calcium ions (Ca^2+)
Chloride ions (Cl-)
Phosphate ions (HPO4^2)

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7
Q

How do the kidneys adjust blood volume?

A

returning water to the blood or eliminating it in the urine

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8
Q

Blood pressure is regulated by what?

A

Secreation of enzyme renin

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9
Q

Enzyme renin does what?

A

activates the renin-angiotensin-aldosterone pathway by adjusting blood flow into and out of the kidneys, and by adjusting blood volume

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10
Q

How do the kidneys regulate the concentration of H+ in the body?

A

Excreting a variable amount of H+ in the urine

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11
Q

The kidneys conserve what important buffer of H+ to regulate pH?

A

HCO3-

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12
Q

What hormones do the kidneys produce?

A

Calcitriol
Erythropoietin

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12
Q

Calcitriol is the active form of vitamin D and does what?

A

Helps regulate calcium homeostasis

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13
Q

What does erythropoietin do?

A

stimulates production of red blood cells

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14
Q

What wastes or substances do the kidneys excrete?

A

Ammonia and urea
Bilirubin
Creatinine
Uric acid
Drugs and enviromental toxins

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15
Q

Ammonia and urea are from the breakdown of what?

A

Amino acids

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16
Q

Bilirubin is from the breakdown of what?

A

hemoglobin

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17
Q

Creatinine is the breakdown from what?

A

Creatine phospate in muscle fibers

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18
Q

Uric acid is the breakdown from what?

A

nucleic acids

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19
Q

Where do kidneys lie in the body?

A

Either side of the vertebral column between the peritoneum and the back wall of the abdominal cavity

between T-12 and L-3

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20
Q

What provides protection for the superior aspect of the kidneys?

A

11-12th pairs of ribs

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21
Q

What is the indentation near the center of the medial border of the kidney called?

A

Renal hilum

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22
Q

What enters and exits at the renal hilum?

A

Enters/Exit
-blood vessels
-lymphatic vessels
-nerves

Exit
-Ureters

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23
Q

What surrounds each kidney that is smooth, transparent, connective tissue sheath that gives shape and serves as a barrier against trauma?

A

renal capsule

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24
Q

What surrounds the renal capsule and cushions the kidney as well as anchors the kidney to the posterior abdominal wall with dense irregular connective tissue?

A

Adipose tissue

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25
Q

What are the two main regions inside the kidney?

A

Renal cortex
Renal medulla

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26
Q

Which region of the internal kidney is the outer light-red region?

A

Renal cortex

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27
Q

Which region of the internal kidney is the inner, darker red-brown region?

A

Renal medulla

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28
Q

Cone-shaped renal pyramids are within what structures?

A

Renal medulla

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29
Q

What structures fill the spaces between renal pyramids and are extensions of the renal cortex?

A

Renal columns

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30
Q

What cuplike structures does urine that is formed in the kidney pass from papillary ducts into?

A

minor calyces

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31
Q

How many minor calyces are in each kidney?

A

8-12

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32
Q

Urines flows from the minor calyces to what?

A

Major calyces

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33
Q

How many major calyces are in a kidney?

A

2-3

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34
Q

Urine travels from the major calyces to the single large cavity called?

A

renal pelvis

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35
Q

The renal pelvis drains urine into the ureter that transports urine to where? and then where?

A

urinary bladder
urethra

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36
Q

How much of the resting cardiac output flows into the kidneys through the right and left renal arteries?

A

20-25%
1200 mL of blood per min

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37
Q

What smaller vessels do renal artery divide into? (all)

A

segmental
interlobar
arcuate
Cortical radiate

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38
Q

Vessels that branch from the renal artery ultimately deliver blood to what structure?

A

afferent arterioles

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39
Q

afferent arteriole divide into a tangled capillary network called the?

A

glomerulus

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40
Q

The capillaries of the glomerulus reunite to form what structure?

A

Efferent arteriole

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41
Q

What capillaries do efferent arterioles divide into?

A

peritubular capillaries

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42
Q

Where do the veins from the peritubular capillaries ultimately drain into after leaving the glomerulus?

A

Renal vein

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43
Q

What is the functional unit of the kidney?

A

Nephron

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44
Q

How many nephrons are in each kidney?

A

About a million

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45
Q

What are the two parts of the nephron?

A

Renal corpuscle
Renal tubule

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46
Q

Where is blood plasma filtered in the nephron?

A

Renal corpuscle

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47
Q

Filtered fluid, called glomerular filtrate passes through what structure of the nephron?

A

Renal tubule

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48
Q

What is added to fluid as it moves through the renal tubles?

A

Waste
excessive substances

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49
Q

What are the two parts that make up a renal corpuscle?

A

glomerulus
glomerular capsule (Bowman’s)

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50
Q

Glomerular filtrate enters the glomerular capsule and then pass into the?

A

renal tubule

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51
Q

What are the three main sections of the renal tubule?

A

proximal convoluted tubule
loop of Henle
distal convoluted tubule

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52
Q

What lies within the renal cortex?

A

Renal corpuscle
Convoluted tubules

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53
Q

What structure of the renal tubule extends into the renal medulla?

A

loop of Henle

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54
Q

What does a papillary duct lead into?

A

minor calyx
major calyx
renal pelvis
ureter

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55
Q

What are the basic functions performed by a nephron?

A

Glomerular filtration
tubular reabsorption
tubular secretion

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56
Q

What is the first step of urine production?

A

Glomerular filtration

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57
Q

What forces water and blood plasma solutes across the glomerular capillaries?

A

Blood pressure

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58
Q

How much of the filtered water and useful solutes to the blood during tubular reabsorption?

A

99%

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59
Q

The filtered fluid is called urine after tubular reabsorption and secretion and it enters what structures?

A

minor and major calyx

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60
Q

Nephrons perform glomerular filtration, tubular reabsorption and tubular secretion to maintain what?

A

Homeostasis of blood volume and composition

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61
Q

What two layers of cells compose the capsule that surrounds the glomerular capillaries?

A

podocytes
simple squamous epithelial cells

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62
Q

Why do blood cells and most plasma proteins remain in the blood during filtration?

A

Too large to pass through membrane

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63
Q

What are two pressures that oppose glomerular filtration?

A

Blood colloid osmotic pressure
Glomerular capsule pressure

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64
Q

When osmotic or capsule pressure increases what happens to glomerular filtration?

A

decreases

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65
Q

What is the normal net filtration pressure when blood pressure is greater than osmotic and capsule pressures?

A

10 mm Hg

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66
Q

How much volume does net filtration pressure force into the capsular space for men and women?

A

M- 180 L
F- 150 L

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67
Q

What is the formula for net filtration pressure?

A

Blood colloid osmotic pressure + Glomerular capsular pressure
minus
Glomerular capillary blood pressure
equals
Net Filtration pressure

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68
Q

Which arteriole assists with raising blood pressure and has a smaller diameter?

A

Efferent

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69
Q

The amount of filtrate that travels through the kidneys every minute is called?

A

Glomerular filtration rate

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70
Q

What is the GFR for men and women?

A

M- 125mL/min
F- 105mL/min

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71
Q

What happens to substances if the GFR is too high?

A

pass out of the body in urine due to inability to reabsorb

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72
Q

What would cause all filtrate being reabsorbed and waste not be excreted in the urine?

A

Low GFR

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73
Q

What hormone promotes loss of sodium ions and water in urine partly due to increase glomerular filtration rate and involves the stretching of the atria?

A

Atrial Natriuretic Peptide (ANP)

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74
Q

ANP acts on what organ to increase loss of sodium ions and water in urine to reduce blood volume?

A

Kidneys

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75
Q

What would be seen when vessels are constricted, i.e. exercise or hemorrhage, in the kidneys?

A

blood flow to glomerular capillaries is decreased
NFP drops
GFR drops

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76
Q

What is the second basic function of nephrons and collecting ducts?

A

Tubular reabsorption

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77
Q

What percentage of water in glomerular filtrate leaves the body in urine?

A

1%

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78
Q

Where does the 1% of the water in filtrate leave the kidney?

A

Renal pelvis

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79
Q

What makes up the largest contribution to reabsorption?

A

Proximal convoluted tubules

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80
Q

What does the PCT reabsorb?

A

65% of filtered water
100% of filtered glucose and amino acids
large quants of ions (Na+, K+, Cl-, HCO3-, Ca^2+ & Mg^2+)

81
Q

Water moves by what into peritubular capillaries?

A

osmosis

82
Q

What is the third function of the nephrons?

A

tubular secretion

83
Q

What is tubular secretion?

A

the transfer of materials from the blood through tubule cells into tubular fluid

84
Q

Tubular absorptions occurs via what?

A

passive diffusion
active transport processes

85
Q

What secreted substances are seen in the tubular secretion phase?

A

Hydrogen ions (H+)
Potassium (K+)
ammonia (NH3)
urea
creatinine
drugs (PCN)

86
Q

What basic function of the nephrons helps eliminate substances from the body?

A

Tubular secretion

87
Q

Urea and ammonia are secreted in sweat but mostly where?

A

Urine

88
Q

What does tubular secretion help control?

A

blood pH

89
Q

Urine is typically acidic due to what ion being secreted?

A

H+

90
Q

What is the pH of urine?

A

Below 7

91
Q

What are the most important hormonal regulators of ion reabsorption in the nephrons?

A

angiotensin II
aldosterone

92
Q

Angiotensin II enhances what to take place in the PCT?

A

Na+ and Cl- reabsorption

93
Q

Angiotensin II stimulates what to release aldosterone?

A

adrenal cortex

94
Q

Aldosterone stimulates the DCT to do what?

A

Reabsorb more Na+ and Cl-
Secrete K+

95
Q

What occurs when more Na+ and Cl- are absorbed?

A

More water is retained by osmosis

96
Q

What is the major regulator of K+ in the blood?

A

Aldosterone-stimulated secretion

97
Q

What plays a small role in the inhibition of Na+ and Cl- reabsorption and increases glomerular filtration rate?

A

ANP

98
Q

What is the major hormone that regulates water reabsorption?

A

Antidiuretic hormone (ADH)

99
Q

ADH operates via what?

A

Negative feedback

100
Q

What stimulates ADH to be released from the posterior pituitary?

A

Water concentration in blood decreases by 1%
Hemorrhage
Severe dehydration

101
Q

In the absence of ADH, renal tubes have what?

A

very low permeability

102
Q

Water permeability of tubules is achieved when ADH causes what?

A

insertion of proteins to form channels in the plasma membrane

103
Q

Low levels of Ca^2+ in the blood stimulates the parathyroid gland to release what?

A

Parathyroid hormone (PTH)

104
Q

What part of the tubules does PTH act on to reabsorb more Ca^2+?

A

DCT

105
Q

PTH also inhibits what ion reabsorption in the PCT promoting it’s excretion?

A

HPO4^2- or phosphate

106
Q

What is the normal volume of urine eliminated per day in a normal adult?

A

1-2 L

107
Q

Water accounts for what percentage of total volume of urine?

A

95%

108
Q

What solutes are typically present in urine? (long list…11 things)

A

urea
creatinine
potassium
ammonia
uric acid
sodium
chloride
magnesium
sulfate
phosphate
calcium`

109
Q

What structures transport, store and eliminate urine?

A

Ureters
Urinary Bladder
Urethra

110
Q

Ureters transport urine from what structure to the bladder?

A

Renal pelvis

111
Q

What compresses the ureters to prevent backflow?

A

Bladder

112
Q

What illness may arise if the urinary bladder physiological valve of the ureters is not functioning properly?

A

cystitis to kidney infection

113
Q

The wall of the ureter consists of what layers?

A

Mucosa
Middle layer of smooth
outer layer of areolar connective tissue

114
Q

What does the mucosa contain what allows the ureter to stretch to accommodate variable volume of fluid?

A

transitional epithelium

115
Q

How do ureters transport urine from the renal pelvis to the bladder?

A

peristaltic contractions

116
Q

What layer of the ureter houses the nerves, blood and lymph vessels?

A

outer layer

117
Q

Where does the bladder sit in the pelvic cavity?

A

behind the pubic symphysis
infront of the rectum (male)
infront of the vagina, below uterus (female)

118
Q

The shape of the bladder is determined by what?

A

the amount of urine it contains

119
Q

What is the average capacity of urine held in the bladder?

A

700-800ml

120
Q

What is the muscular layer or the bladder wall called?

A

detrusor muscle

121
Q

What are the layers of the bladder?

A

Mucosa
detrusor muscle
peritoneum

122
Q

Which urethral sphincter is composed of skeletal muscle and is under voluntary control?

A

External urethral sphincter

123
Q

Urination is also known as what?

A

micturition

124
Q

Stretch receptors are activated in the bladder when the pressure exceeds from urine volume above what?

A

200-400 ml

125
Q

Where do bladder stretch receptors transmit nerve impulses to?

A

spinal cord

126
Q

What is the reflux that occurs when the bladder stretch receptors are activated?

A

micturition reflex

127
Q

Parasympathetic impulses from the spinal cord during post micturition reflex causes detrusor muscles and internal urethral sphincter muscle to do what?

A

Detrusor - contract
Internal sphincter - relax

128
Q

What is inhibited to cause relaxation of skeletal muscles in the external urethral spinchter?

A

somatic motor neurons

129
Q

Body fluids make up what percentages of total body mass in a lean adult?

A

55-60%

130
Q

Fluids in the body are present in what two main compartments?

A

inside and outside cells

131
Q

What amount of fluid in the body are found within cells?

A

two-thirds

132
Q

Fluids found in the cells are called what?

A

intracellular fluid or cytosol

133
Q

Fluid outside the cells are called what?

A

Extracellular fluids

134
Q

How much fluid in the body is found outside the cells?

A

one-third

135
Q

What is the breakdown of fluids in extracellular fluid?

A

80% interstitial fluid
20% blood plasma

136
Q

What are other examples of extracellular fluids that are grouped with interstitial fluid?

A

Lymph
Cerebrospinal
Synovial
aqueous humor and vitreous
endolymph and perilymph
pleural, pericardial and peritoneal

137
Q

What are the two barriers that separate intracellular fluid, interstitial fluid and blood plasma?

A

Plasma membrane
Blood vessel walls

138
Q

Which barrier separates intracellular fluid from the surrounding interstitial fluid?

A

plasma membrane

139
Q

Water is the largest single component of the body, making up what percentage of total body mass?

A

45-75%

140
Q

Movement of water between intracellular and interstitial fluid is determined by what?

A

concentration of solutes

141
Q

What is the utmost importance of the kidneys in the maintenance of homeostasis?

A

The ability of the kidneys to excrete dilute urine or concentrated urine

142
Q

What are the two methods body can gain water?

A

Ingestion
Metabolic reactions

143
Q

About how much liquid is from ingested liquids?

A

1600 ml

144
Q

What amount of water is gained by moist food?

A

about 700 ml

145
Q

What is the total amount of water absorbed in the GI tract a day?

A

2300 ml

146
Q

Metabolic water gains is usually what amount?

A

200 ml/day

147
Q

Daily water gain totals what amount?

A

2500ml

148
Q

Excretion values are:
Kidneys-
Evaporation-
Exhale-
Feces-

A

Kidneys- 1500ml
Evaporation- 600ml
Exhale- 300ml
Feces- 100ml

149
Q

What area is known as the thirst center?

A

hypothalamus

150
Q

What amount of fluid must decrease for mild dehydration to exist?

A

2% of fluid loss

151
Q

What are the two main solutes in extracellular fluids?

A

Sodium ions (Na+)
Chloride ions (Cl-)

152
Q

What are the three hormones that regulate the extent of renal Na+ and Cl- reabsorption?

A

Atrial natriuretic peptide
Angiotensin II
Aldosterone

153
Q

What does atrial natriuretic peptide promote?

A

natriuresis (secretion of salt)

154
Q

When blood volume increases renin is released more slowly effecting what hormone?

A

angiotensin II

155
Q

What is the major hormone that regulates water loss?

A

antidiuretic hormone (ADH)

156
Q

When intracellular and interstitial fluids are the same cells do what?

A

neither shrink nor swell

157
Q

Cells shrink slightly when what is occuring?

A

increase osmotic pressure in interstitial fluid

158
Q

A decrease in the osmotic pressure of interstitial fluids causes cells to do what?

A

swell

159
Q

What is the most abundant extracellular ion?

A

Sodium ions (90% of extracellular cations)

160
Q

What is the most prevalent anions in extracellular fluid?

A

Chloride ions

161
Q

What is the most abundant cation in intracellular fluid?

A

Potassium

162
Q

What is exchanged when K+ moves in or out of a cell?

A

H+

163
Q

The level of K+ in blood plasma is controlled by what hormone?

A

Aldosterone

164
Q

98% of calcium is located where in adults?

A

Skeleton and teeth

165
Q

What are the main regulators of Ca^2+ in the blood plasma?

A

Parathyroid hormone (PTH)
calcitriol

166
Q

What are the functions of electrolytes?

A

Control the osmosis of water between fluid compartments
Maintain acid-base balance
Carry electrical current
Serve as cofactors

167
Q

How are ions formed?

A

when electrolytes break apart

168
Q

What is the chief difference between the extracellular fluids?

A

blood plasma contains many protein anions
interstitial fluids has very few

169
Q

What is the major homeostatic challenge to keep pH in range?

A

maintaining appropriate H+ ions

170
Q

North American diets generally do what to blood pH?

A

acidify the blood

171
Q

What are the three major mechanisms to remove H+ from the body?

A

buffer systems
exhalation of CO2
kidney excretion into urine

172
Q

What are the three buffer systems?

A

Protein
Carbonic Acid-Bicarbonate
Phosphate

173
Q

What is the most abundant buffer in intracellular fluid and plasma?

A

Protein buffer system

174
Q

What are the functional groups of the protein buffer system?

A

carboxyl group
amino group

175
Q

Carboxyl groups does what when pH rises?

A

releases H+

176
Q

What group in the protein buffer system combines with H+ when pH fails?

A

Amino

177
Q

The protein buffer system can act on acids or bases?

A

both

178
Q

The carbonic acid-bicarbonate buffer system can act as what?

A

a weak base (bicarb)
a weak acid (carbonic)

179
Q

What are the components of the phosphate buffer system?

A

dihydrogen phosphate
mono-hydrogen phosphate

180
Q

Which component of the phosphate buffer system can act as a weak acid?

A

dihydrogen phosphate ion

181
Q

Which component of the phosphate buffer system can act as a weak base?

A

mono-hydrogen phosphate

182
Q

Phosphate buffer system is an important regulator of pH in what?

A

cytosol

183
Q

An increase in CO2 in body does what to H+ concentration?

A

increases H+

184
Q

An increase in H+ in the blood makes the pH?

A

more acidic

185
Q

A decrease in CO2 in body fluids raises the pH making it what?

A

more alkaline

186
Q

Increased ventilation can cause what to happen IRT blood pH?

A

CO2 decreases
H+ falls
pH rises

187
Q

If ventilation is slower or decreased what happens to blood pH?

A

Falls

188
Q

What can stimulate the inspiratory area in the medulla oblongata?

A

chemoreceptors

189
Q

Where are the chemoreceptors that stimulate the inspiratory area?

A

medulla oblongata
aortic body
carotid body

190
Q

What is the slowest mechanism of removing acids?

A

Kidney excretion of H+

191
Q

Kidneys synthesize and reabsorb what important buffer in the urine that contributes to the acid-base balance?

A

HCO3-

192
Q

What is the condition when arterial blood pH is below 7.35?

A

Acidosis

193
Q

What is the principal physiological effect of acidosis?

A

depression of the CNS, synaptic transmission

194
Q

coma or death may occur if the pH falls below what?

A

7

195
Q

What is the condition where blood pH is higher than 7.45?

A

alkalosis

196
Q

What is the major physiological effect of alkalosis?

A

over-excitability of the CNS and peripheral nerves

197
Q

What is the term for hypo or hyperventilation that can return blood pH to normal?

A

respiratory compensation

198
Q

What is the compensation that occurs if the blood pH change is due to respiratory causes?

A

renal compensation

199
Q

How quickly does respiratory compensation occur and reach its maximum effectiveness?

A

occurs within minutes
maximum effect in hours

200
Q

How quickly does renal compensation occur and reach its maximum effectiveness?

A

occurs within minutes
takes days to reach max effect

IDC Stuff (67 decks)

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