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A&P II 2nd Half > Lecture Exam- Urinary System > Flashcards

Lecture Exam- Urinary System Flashcards

1
Q

Urinary System

A

rids the body of waste products
closely associated with the reproductive system
Shared embryonic development and adult anatomical relationship
Collectively called the urogenital (UG) system

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2
Q

kidneys

A

play important roles in blood volume, pressure, and composition

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3
Q

parts of the Urinary System

A
  • consists of six organs: two kidneys, two ureters, urinary bladder, and urethra
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4
Q

Functions of the Urinary System

A

Filter blood and excrete toxic metabolic wastes
Regulate blood volume, pressure, and osmolarity by regulating water output
Regulate electrolyte and acid-base balance of body fluids
Secrete erythropoietin stimulating production of RBcs
Regulate calcium homeostasis and bone metabolism by calcitriol
Clear hormones and drugs form blood limiting action
Detoxify free radicals
In starvation, synthesize glucose from amino acids.

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5
Q

Nitrogenous Wastes

A

are nitrogen containing compounds consist of urea, uric acid, creatine,

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6
Q

what are the three nitrogen wastes and how are they made

A 
Urea formation 50%
Proteins-amino acids-NH2 removed-forms ammonia, Liver converts ammonia to urea 
Uric acid
Product of nucleic acid catabolism
Creatinine
Product of creatine phosphate catabolism
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7
Q

azotemia

A

Blood urea nitrogen (BUN)—level of nitrogenous waste in blood
Azotemia: elevated BUN- May indicate renal insufficiency

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8
Q

uremia

A

Uremia: syndrome of diarrhea, vomiting, dyspnea, and cardiac arrhythmia stemming from the toxicity of nitrogenous waste
Treatment—hemodialysis or organ transplant

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9
Q

four body systems carry out excretion

A

Respiratory system- CO2, water
Integumentary system- water, inorganic salts, lactate, and urea
Digestive system- eliminates food residue, excretes water, salt, CO2, lipids, bile pigments, cholesterole
Urinary system-excretes metabolic wastes, toxins, drugs, hormones, salts, hydrogen ions, and water

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10
Q

Nephrons what are they what are they composed of?

A

Each kidney has about 1.2 million nephrons

Each composed of two principal parts renal corpuscle and renal tubule

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11
Q

Renal corpuscle:

A

simple squamous. Glomerular filtrate collects in capsular space, flows into proximal convoluted tubule. Note the vascular and urinary poles. Note the afferent arteriole is larger than the efferent arteriole. .filters the blood plasma
consists of the glomerulus and a two-layered glomerular capsule that encloses glomerulus

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12
Q

Renal tubule:

A

long, coiled tube that converts the filtrate into urine

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13
Q

Name and describe the three parts of the glomerular capsule

A

Parietal (outer) layer of glomerular capsule is simple squamous epithelium
Visceral (inner) layer of glomerular capsule consists of elaborate cells called podocytes that wrap around the capillaries of the glomerulus
Capsular space separates the two layers of glomerular capsule

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14
Q

Cortical nephrons

A

85% of all nephrons
Short nephron loops
Efferent arterioles branch into peritubular capillaries around PCT and DCT

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15
Q

Juxta medullary nephrons

A

15% of all nephrons
Very long nephron loops, maintain salinity gradient in the medulla and help conserve water
Efferent arterioles branch into vasa recta around long nephron loop

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16
Q

Vascular pole

A

—the side of the corpuscle where the afferent arterial enters the corpuscle and the efferent arteriole leaves

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17
Q

Urinary pole

A

the opposite side of the corpuscle where the renal tubule begins

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18
Q

Renal (uriniferous) tubule

A

—duct leading away from the glomerular capsule and ending at the tip of the medullary pyramid
Divided into four regions
Proximal convoluted tubule, nephron loop, distal convoluted tubule: parts of one nephron

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19
Q

Collecting duct

A

receives fluid from many nephrons.
receives fluid from the DCTs of several nephrons as it passes back into the medulla
Numerous collecting ducts converge toward the tip of the medullary pyramid
. Osmolarity of extracellular fluid 4x as high in lower medulla than cortex, medullary portion is more permeable to water than solutes as it goes down increasingly hypertonic leaving tubule by osmosis while other wastes stay behind

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20
Q

Proximal convoluted tubule (PCT)

A

—arises from glomerular capsule
Longest and most coiled region
Simple cuboidal epithelium with prominent microvilli for majority of absorption

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21
Q

Nephron loop

A

long U-shaped portion of renal tubule. found mostly in medulla begins where PCT straightens and dips toward or into medulla
Descending limb and ascending limb
Thick segments have simple cuboidal epithelium
Initial part of descending limb and part or all of ascending limb
Heavily engaged in the active transport of salts and have many mitochondria
Thin segment has simple squamous epithelium
Forms lower part of descending limb
Cells very permeable to water

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22
Q

Distal convoluted tubule (DCT)—

A

begins shortly after the ascending limb reenters the cortex
Shorter and less coiled than PCT
Cuboidal epithelium without microvilli
DCT is the end of the nephron

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23
Q

Papillary duct:

A

formed by merger of several collecting ducts
30 papillary ducts end in the tip of each papilla end in pores at tip of papilal w/ urine draining into minor calyx that encloses it
Collecting and papillary ducts lined with simple cuboidal epithelium

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24
Q

Filtration Membrane what is it and what passes through what doesn’t and how do these pass through?

A

Filtration Membrane: Almost any molecule smaller than 3 nm can pass freely through the filtration membrane. Water, rest electrolytes, glucose, fatty acids, amino acids, nitrogenous wastes, and vitamins
Some substances of low molecular weight are bound to the plasma proteins and cannot get through the membrane
Most calcium, iron, and thyroid hormone
Unbound fraction passes freely into the filtrate

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25
Q

In what cases would the filtration membrane allow larger molecules?

A

W/ kidney disease presence of proteins, albumin or hematuria (blood in urine) present in blood w/ distance runner and swimmers having temporary reducing perfusion of kidneys deteriorating glomerulus under prolonged hypoxia leaking protein and blood into filtrate.

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26
Q

Glomerular Filtration

A

forms urine using capillary exchanges w/ water and solutes and blood plasma pass through capillaries in glomerular space.

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27
Q

Forces Involved in Glomerular Function

A

High BP in glomerulus makes kidneys vulnerable to hypertension
It can lead to rupture of glomerular capillaries, produce scarring of the kidneys (nephrosclerosis), and atherosclerosis of renal blood vessels, ultimately leading to renal failure by blockage.

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28
Q

Stage 2: Tubular ReabsorptionTwo routes of reabsorption

A

process of reclaiming water and solutes from tubular fluid and returning them to blood.
transcellular and paraclleular route

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29
Q

Transcellular route

A

Substances pass through cytoplasm of PCT epithelial cells and out their base

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30
Q

Paracellular route

A

Substances pass between PCT cells
Junctions between epithelial cells are leaky and allow significant amounts of water to pass through
Solvent drag—water carries a variety of dissolved solutes with it
Reabsorbed fluid is ultimately taken up by peritubular capillaries

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31
Q

How is Sodium reabsorption created.

Two types of transports proteins in apical cell surface responsible for sodium uptake.

A

Creates osmotic and electrical gradients that absorb water and other solutes, sodium is most abundant in filtrate w/ steep concentration gradients favoring diffusion into epithelial cells.
symports and antiport

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32
Q

Symport

A

that simultaneously bind sodium and another solute such as glucose, amino acids or lactate

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33
Q

antiport

A

Sodium hydrogen anti-port that pulls sodium into cell while pumping out hydrogen into tubular fluid.

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34
Q

Sodium is prevented from accumulating

A

in epithelial cells by sodium potassium pump in basal surface of epithelium. Pumping sodium out to extracellular fluid too much doesn’t build up.
Sodium is picking up by peritubular capillaries and returned to blood

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35
Q

Chloride movement in urine

A

Negative chloride ions follow positive sodium ions by electrical attraction w/ various antiports in apical cell membrane absorbing chloride in exchange for other anions they eject into tubular fluid w/ potassium and chloride symport.

36
Q

other ions movement in urine

A

Potassium, magnesium, and phosphate ions diffuse through the paracellular route with water
Phosphate is also cotransported into the epithelial cells with Na+
Some calcium is reabsorbed through the paracellular route in the PCT, but most Ca2+reabsorption occurs later in the nephron

37
Q

Glucose transported

A

Glucose is cotransported w/ Na+ by sodium-glucose transport (SGLT) proteins normally all glucose is reabsorbed

38
Q

Nitrogenous wastes excretion

A

Nephron reabsorbs about half of urea in tubular fluid
Concentration remaining in blood is safe
PCT reabsorbs uric acid, but later portions of the nephron secrete it
Creatinine is not reabsorbed – it is passed in urine

39
Q

Kidneys produce how much urine and how is this done?

A

kidneys produce 180 L of filtrate everyday that is condensed to 1-2 L of urine. 2/3 of water in filtrate reabsorbed in PCT reabsorbed solutes and solutions makes it hypertonic to tubule fluid as water follows solute by osmosis PCT reabsorbed at constant rate aka obligatory water reabsorption.

40
Q

Tubular Secretion

A

takes chemicals from capillary blood and secretes them into tubular fluid
Purposes of secretion in PCT and nephron loop include
acid-base balance
waste removal
clearance of drugs and contaminants

41
Q

Acid–base balance

A

Secretion of varying proportions of hydrogen and bicarbonate ions helps regulate pH of body fluids

42
Q

Waste removal

A

Urea, uric acid, bile acids, ammonia, and a little creatinine are secreted into the tubule secreted into tubule

43
Q

Clearance of drugs and contaminants

A

Examples include: morphine, penicillin, and aspirin

Some drugs must be taken multiple times per day to keep up with renal clearance .

44
Q

Water Conservation

A

The kidney eliminates metabolic wastes from the body, but prevents excessive water loss
As the kidney returns water to the tissue fluid and bloodstream, the fluid remaining in the renal tubules passes as urine, and becomes more concentrated

45
Q

How is control of water loss maintained

A

How concentrated the urine becomes depends on body’s state of hydration
Water diuresis—drinking large volumes of water will produce a large volume of hypotonic urine w/
Cortical portion of CD reabsorbs NaCl, but it is impermeable to water
Salt is removed from the urine but water stays in
Urine concentration may be as low as 50 mOsm/L
Hypertonic urine w/ hydration absorbing more overall of salts and water flowing more slowly through tubes w/ more time for reabsorption

46
Q

what happens if GFR is too high?

A

Fluid flows through renal tubules too rapidly for them to reabsorb the usual amount of water and solutes
Urine output rises
Chance of dehydration and electrolyte depletion

47
Q

what happens if GFR is too low

A

Wastes are reabsorbed

Azotemia may occur

48
Q

renal auto regulation

A

the ability of the nephrons to adjust their own blood flow and GFR without external (nervous or hormonal) control. Have rate and waste management
Enables kidney to maintain a relatively stable GFR in spite of changes in systemic blood pressure
Two methods of autoregulation: myogenic mechanism and tubuloglomerular feedback

49
Q

Sympathetic nerve fibers

A

richly innervate the renal blood vessels
Sympathetic nervous system and adrenal epinephrine constrict the afferent arterioles in strenuous exercise or acute conditions like circulatory shock.
Reduces GFR and urine output
Redirects blood from the kidneys to the heart, brain, and skeletal muscles
GFR may be as low as a few milliliters per minute

50
Q

urinalysis

A

examination of physical and chemical properties of urine

51
Q

appearance

A

varies from clear to deep amber depending on state of hydration

52
Q

odor

A

bacteria degrade urea to ammonia, some foods and diseases impart particular aromas

53
Q

specific gravity

A

compares urine sample’s density to that of distilled water

Density of urine ranges from 1.001 to1.028 g/mL

54
Q

osmolarity

A

Osmolarity(blood = 300 mOsm/L)

Ranges from 50 mOsm/L to 1,200 mOsm/L in dehydrated person

55
Q

pH

A

pH—range: 4.5 to 8.2, usually 6.0 (mildly acidic)

56
Q

chemical composiiton

A

95% water, 5% solutes
Normalto find: urea, NaCl, KCl, creatinine, uric acid, phosphates, sulfates, traces of calcium, magnesium, and sometimes bicarbonate, urochrome, and a trace of bilirubin
Abnormalto find: glucose, free hemoglobin, albumin, ketones, bile pigments

57
Q

volume

A

Normalvolume for average adult—1 to 2 L/day
Polyuria—output in excess of 2 L/day
Oliguria—output of less than 500 mL/day
Anuria—0 to 100 mL/day

58
Q

Yellow color urine

A

due to urochrome pigment from breakdown of hemoglobin (RBCs)

59
Q

Cloudiness or blood

A

could suggest urinary tract infection, trauma, or stones; or might just be contamination with other fluids

60
Q

Pyuria:

A

pus in the urine

61
Q

Hematuria:

A

blood in urine due to urinary tract infection, trauma, or kidney stones

62
Q

anuria causes

A

Low output from kidney disease, dehydration, circulatory shock, prostate enlargement
Low urine output of less than 400 mL/day, the body cannot maintain a safe, low concentration of waste in the plasma (leads to azotemia)

63
Q

Diabetes—

A

any metabolic disorder resulting in chronic polyuria
At least four forms of diabetes
Diabetes mellitus type 1,type 2,and gestational diabetes

64
Q

Diabetes in urine

A

High concentration of glucose in renal tubule
Glucose opposes the osmotic reabsorption of water
More water passes in urine (osmotic diuresis)
Glycosuria—glucose in the urine

65
Q

Diabetesinsipidus

A

ADHhyposecretioncauses not enough water to be reabsorbed in the collecting duct
More water passes in urine

66
Q

Diuretics

A

any chemical that increases urine volume. Impairs countercurrent stopping stuff from entering renal medulla.Reducing body’s fluid volume and blood pressure
Some act on nephron loop (loop diuretic): inhibit Na+–K+–Cl−symport
Impairs countercurrent multiplier reducing the osmotic gradient in the renal medulla
Collecting duct unable to reabsorb as much water as usual

67
Q

cafeeine

A

Some increase GFR: Caffeine dilates the afferent arteriole

Some reduce tubular reabsorption of water:

68
Q

alcohol

A

Alcohol inhibits ADH secretion

69
Q

diurhetics are used to treat

A

Diuretics are commonly used to treat hypertension and congestive heart failure by reducing the body’s fluid volume and blood pressure

70
Q

Renal Function Tests

A 
Tests for diagnosing kidney disease- 
Evaluating their severity
Monitoring their progress
Determining renal clearance
Determining glomerular filtration rate
71
Q

Renal Clearance

A

the volume of blood plasma from which a particular waste is completely removed in one minute important for understanding how your kidneys are functioning determined by glomerular filtration, tubular secretion, tubular reabsorption. . Urea influences clearance w/ renal clearance used for other things and urinalysis.

72
Q

Glomerular Filtration rate

A

Often need to measure GFR to assess kidney disease
Cannot use clearance rate of urea, because reabsorption and secretion of urea influence its clearance
Need a substance that is not secreted nor reabsorbed at all so that all of it in the urine gets there by glomerular filtration

73
Q

Kidneys convert blood plasma to urine in four stages what are they and briefly describe each stage

A

Glomerular filtration- plasma-like filtrate water and some solutes but no protein in blood pass through capillaries of glomerulus into capsular space of nephron.
Tubular reabsorption- removes useful solutes from filtrate, returns them to blood
Tubular secretion-removes additional wastes from blood, adds them to the filtrate
Water conservation- removes water from urine and returns it to blood; concentrates waste

74
Q

Glomerular filtrate—

A

the fluid in the capsular space, Similar to blood plasma except that it has almost no protein

75
Q

Tubular fluid—

A

fluid from the proximal convoluted tubule through the distal convoluted tubule
Substances have been removed or added by tubular cells

76
Q

Urine—

A

fluid that enters the collecting duct

Undergoes little alteration beyond this point except for changes in water content.

77
Q

Renal calculus (kidney stone)

A

—hard granule of calcium phosphate, calcium oxalate, uric acid, or a magnesium salt called struvite
Form in the renal pelvis can block passage from calyxes to ureter or can block ureter can cause infections further up in kidneys. w/ lots of innervation causing great pain. Not a lot of smooth muscle for innervation to push out.
Usually small enough to pass unnoticed in the urine flow
Large stones might block renal pelvis or ureter and can cause pressure buildup in kidney which destroys nephrons. Usually passing blood as well.
Passage of large jagged stones is excruciatingly painful and may damage ureter causing hematuria

78
Q

Urinary tract Infection (UTI) what are the three things it can cause?

A

Cystitis—infection of the urinary bladder
Especially common in females due to short urethra
Frequently triggered by sexual intercourse
Can spread up the ureter causing pyelitis
Pyelitis—infection of the renal pelvis
Pyelonephritis—infection that reaches the cortex and the nephrons
Can result from blood-borne bacteria

79
Q

Voiding Urine-

A

sympathetic activity post-ganglionic to detrusor muscles to internal common iliac to be excited to close so urine doesn’t pass through.
Between acts of urination, the bladder fills
Detrusor muscle relaxes
Urethral sphincters are tightly closed
Sympathetic activity in upper lumbar spinal cord stimulates postganglionic fibers to the detrusor muscle (relax it) allowing for internal urethral sphincter (excite it)
Somatic motor fibers from upper sacral spinal cord travel through pudendalnerve to supply the external sphincter to allow voluntary control

80
Q

Micturition

A

—the act of urinating

81
Q

Micturition reflex—

A

involuntary spinal reflex that partly controls urination (steps 1–4)
Stretch receptors detect filing of bladder, transmit afferent signals to the spinal cord
Signals return to bladder from spinal cord (S2 or S3) via parasympathetic fibers in the pelvic nerve
Efferent signals excite detrusor muscl
Efferent signals relax internal urethral sphincter (male); urine is involuntary voided if not inhibited by the brain

82
Q

Voluntary control of micturition

A

(steps 5–8)
For voluntary control, the micturition center in the pons receives signals from stretch receptors
If it is timely to urinate, the pons returns signals to spinal interneurons that excite detrusor and relax internal urethral sphincter(male); urine is voided
If it is untimely to urinate, signals from the pons excite spinal interneurons that keep external urethral sphincter contracted; urine is retained in the bladder
If it is timely to urinate, signals from the pons cease, and external urethral sphincter relaxes; urine is voided

83
Q

There are times when the bladder is not full enough to trigger the micturition reflex but one wishes to “go” anyway

A

Valsalva maneuver used to compress bladder

Excites stretch receptors early to get the reflex starteD

84
Q

Renal insufficiency

A

—a state in which the kidneys cannot maintain homeostasis due to extensive destruction of their nephrons. nephrons work overtime to compensate for kdineyfunction cant do for too long.
Causes of nephron destruction
Hypertension, chronic kidney infections, trauma, prolonged ischemia and hypoxia, poisoning by heavy metals or solvents, blockage of renal tubules in transfusion reaction, atherosclerosis, or glomerulonephritis

85
Q

What happens during renal insufficiency for compensation?

A

Nephrons can regenerate and restore kidney function after short-term injuries
Other nephrons work overtime to compensate for kidney function but they cannot do this for too long. Can survive with one-third of one kidney
When 75% of nephrons are lost, urine output of 30 mL/hr is insufficient (normal 50 to 60 mL/hr) to maintain homeostasis
Causes azotemia, acidosis, and uremia develops, also anemia

86
Q

Hemodialysis—

A

procedure for artificially clearing wastes from the blood
Wastes leave bloodstream and enter dialysis fluid as blood flows through a semipermeable cellophane tube; also removes excess body water

87
Q

Urine Storage and Elimination.

A

Urine is produced continually
Does not drain continually from the body
Urination is episodic—occurring when we allow it
Made possible by storage apparatus and neural controls for timely release

A&P II 2nd Half (4 decks)

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