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Urinary (Semester 3) > Intro To Urinary + anatomy > Flashcards

Intro To Urinary + anatomy Flashcards

1
Q

What happens when the ECF ____ is uncontrolled?

a) Volume
b) Osmolarity

A

a) Changes the BP

b) Shrinks or swells the cell

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2
Q

Why do the kidneys affect the ECF directly and the ICF indirectly?

A

The kidneys can only affect the ECF by altering water and ion reabsorption, and the ECF affects the ICF

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3
Q

What happens when the ECF is hypertonic or hypotonic? What state does the kidney want to maintain?

A

Hypertonic ECF: cell shrinks
Hypotonic: fluid flows into cell, cell grows
Want to maintain an isotonic state

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4
Q

What is the ultrafiltrate?

A

The amount of water and ions that gets filtered (180/L), most is recovered

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5
Q

How much blood flow does the kidney require at rest?

A

25%

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6
Q

What is the anatomical location of the kidneys?

A

Retroperitoneal, behind the peritoneum at T11/T12

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7
Q

What nephron structures lie in the Cortex? What’s in the medulla?

Where does the medulla feed into?

A

Cortex: PCT and DCT
Medulla: Loop of Henle and Collecting duct

The minor-major calyx, hilum, renal pelvis, ureter

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8
Q

What’s the GFR per min and per day?

A

125 mL/min, 180L/day

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9
Q

What should be absorbed in the PCT?
Why does the filtrate remain isotonic?

Where does reabsorbed material filter through?

A

100% glucose and amino acids
80-90% K+
60-70% Na+ and water

Remains isotonic because the solute: water ratio remains the same though the volumes of each differ

Peritubular capillaries take reabsorbed material

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10
Q

What makes epithelial cells polarised (in the PCT)?

Discuss the role of the sodium pumps and how it is electrical and osmotic

A

The luminal membrane (facing the filtrate) has differing properties to the basolateral membrane faces the capillaries

  1. Na+ enters the cell via ENaC channels across the luminal membrane passively down its concentration gradient
  2. Energy from Na+ movement drives reabsorption of other substances like glucose and amino acids
  3. Na/K ATPase continuously pumps Na+ into the ECF so the intracellular Na+ stays low and Na+ can continuously leave the filtrate passively!

Electrical: as the positive Na+ movement attracts Cl- and osmotic because water follows and the PCT wall is permeable to water

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11
Q

What is the main function of the Loop of Henle

A

To concentrate urine:
Water moves out of LOH as the medullary interstitium is highly concentrated and the descending limb is impermeable to water

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12
Q

What is reabsorbed and secreted in the DCT?

A

Variable reabsorption of electrolytes and water, H+ is secreted

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13
Q

Which kidney is lower and why?

A

The right kidney due to the liver

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14
Q

What structure is directly behind the kidneys? Name 3 organs your likely to find immediately anterior to the kidneys?

A

Diaphragm is posterior
Anterior:
1. Stomach: anterior to the superior left kidney
2. Liver: anterior to the superior right kidney
3. Small intestine anterior to the inferior right kidney
4. Jejunum: anterior to the inferior left kidney

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15
Q

What muscles lie directly behind the kidney going from medial-lateral, what separates these muscles?

A

Psoas major, Quadratus laborum, transverse abdominis. Separated by thoracolumbar fascia

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16
Q

What structure insulates and protects the kidneys? What structure directly envelopes this?

A

Perinephric fat, enveloped by renal fascia

17
Q

What is the pathway of the ureters?

A
  1. Superiorly continuous with renal pelvis
  2. Descend down medial part of psoas major
  3. Crosses the common/external iliac arteries into pelvis at the ‘pelvic brim’
  4. Enters bladder obliquely
18
Q

What is hydronephrosis?

A

Swelling of the kidney due to buildup of urine - causing a backflow which can damage the calyces and papilla

19
Q

What are the 3 constriction points along the ureter?

What can occur within these restriction points and what causes these?

A
  1. Ureteropelvic Junction: leaving the renal pelvis
  2. Pelvic inlet: crossing the external iliac artery
  3. Entrance to bladder

Kidney stones, caused by insoluble substances, can become stuck at any of these points

20
Q

What causes Nutcracker syndrome?

A

Since the L renal vein is longer and passes under the superior mesenteric artery it can become entrapped between the SMA and the abdominal aorta

This increases the renal vein pressure which causes inadequate venous drainage

21
Q

What’s the pathway for renal arteries?

What’s the pathway for the renal veins?

A

Branch off the abdominal aorta and travel to the cortex: give off renal artery - segmental artery - interlobular artery - arcuate artery (and cortical radiate artery) –> afferent

Renal veins: branch off the aorta and arise inferiorly to SMA draining into the IVC

22
Q

How does blood travel from afferent - efferent arteriole?

What is a key difference between the glomerular capillaries and the peritubular capillaries?

A

Afferent arteriole- glomerulus - efferent arteriole- peritubular capillaries - venous system

Glomerular: specialized for filtration, has an increased pressure
Peritubular: specialized for absorption, decreased pressure

23
Q

What is the trigone?

A

A triangular region between the 3 openings of the bladder

24
Q

What is unique to the male pelvis?

A

Has a connection between the urinary and reproductive tract:

Vas deferens carry sperm from the testicles to simple tubular glands posteroinferior to the blader that store and produce components of sperm (semen)

The ejaculatory ducts carry the semen through the prostate gland and into the urethra - comes out the penis :)

25
Q

What are the 3 parts of the male urethra?

A
  1. Prostatic
  2. Membranous
  3. Spongy
26
Q

What are the consequences of an enlarged prostate?

What could be the cause of this and how would you investigate?

A

Puts pressure on the urethra which can cause difficulty urinating

Can occur normally in the central region for middle-aged men, or could be cancer. Undergo a rectal exam: Hard lumps can indicate cancer, soft lumps can indicate infection

27
Q

When would you undergo male catheterization? What’s the basic mechanism to insert one?

A
  1. Man can’t pee
  2. Bladder stops working during surgery

Pass catheter up the penile urethra, sphincter, and bladder. Push saline to inflate the balloon and stop catheter from falling out - deflate when removing the catheter

28
Q

Where do prostate cancers tend to spread to, why?

A

Vertebra: since the prostatic venous plexus communicates with the vertebral venous plexus

29
Q

Which arteries supply the female ureter, bladder and urethra?

A

Ureter: branches off renal, gonadal and inferior vesicular/uterine + directly from the aorta

Bladder: superior/inferior vesicular arteries from internal iliac arteries

Urethra: Branches off inferior vesicular, middle rectal and internal pudendal arteries

30
Q

What major vein drains the female ureter, bladder and urethra

A

Internal iliac vein

31
Q

What does the internal and external urinary sphincter control?

A

Internal: controls movement of urine from bladder - proximal urethra

External: Voiding of urine out the urethra (becomes voluntary)

32
Q

How does nervous control work for the bladder

A

Stretch receptors in the urinary wall send afferent signals to the micturition centre in the pons

Efferent signals pass down and can…
1. Synapse with parasympathetic ganglia outside the bladder - causing contraction of the detrusor muscle expelling urine

  1. Somatic: Nerves supplying the external sphincter are in the sacral region, motor fibres passing through the pudendal nerve relax this sphincter to expel urine
33
Q

Try to name 7 issues that would require imaging of the urinary tract

A
  1. Urine blockage and/or incontinence
  2. frequent, urgent urination
  3. abdominal mass
  4. Pain in the groin or lower back
  5. haematuria
  6. hypertension
  7. Kidney failure

Urinary (Semester 3) (14 decks)

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