Lesson 18-19 - Urinary System Flashcards

1
Q

the urinary system contains four principal organs

A
  1. two kidneys
  2. two ureters
  3. urinary bladder
  4. urethra
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2
Q

functions of the kidney (4)

A
  • filer blood and excrete toxic metabolic wastes
  • regulate blood volume/pressure/osmolarity
  • regulate electrolytes
  • regulate acid-base balance
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3
Q

the kidneys secrete _____, which stimulates production of RBCs

A

erythropoietin

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4
Q

the kidneys help regulate _____ levels by participating in _____ synthesis

A

calcium; calcitriol

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5
Q

the kidneys clear _____ from blood

A

hormones

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6
Q

the kidneys detoxify…

A

free radicals

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7
Q

in starvation, the kidneys synthesize what from what?

A

glucose from amino acids

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8
Q

waste

A

any substance that is useless to the body or present in excess of the body’s needs

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9
Q

metabolic waste

A

waste substance produced by the body

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10
Q

among the most toxic are _____ waste

A

nitrogenous

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11
Q

nitrogenous wastes (3)

A
  • urea
  • uric acid
  • creatinine
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12
Q

urea comes from the breakdown of…

A

protein

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13
Q

uric acid comes from the breakdown of…

A

nucleic acid

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14
Q

creatinine comes from the breakdown of…

A

creatine phosphate

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15
Q

blood urea nitrogen (BUN)

A

level of nitrogenous waste in the blood

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16
Q

azotemia

A

elevated BUN (blood urea nitrogen)

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17
Q

azotemia may indicate..

A

renal insufficiency

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18
Q

azotemia may progress into _____

A

uremia

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19
Q

uremia is characterized by…(4)

A

diarrhea, vomiting, dyspnea, and cardiac arrhythmia stemming from the toxicity of nitrogenous wastes

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20
Q

excretion

A

separating wastes from body fluids and eliminating them; carried out by four body system

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21
Q

four systems of excretion

A
  1. respiratory
  2. integumentary
  3. digestive
  4. urinary
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22
Q

four systems of excretion: respiratory

A

expels CO2, water, and small amounts of other gases

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23
Q

four systems of excretion: integumentary

A

expels water, inorganic salts, lactate, and urea in sweat

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24
Q

four systems of excretion: digestive system

A

expels water, salts, CO2, lipids, bile pigments, cholesterol, and other metabolic wastes

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25
Q

four systems of excretion: urinary system

A

expels many metabolic wastes, toxins, drugs, hormones, salts, H+, and water

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26
Q

each kidney weighs about

A

150g

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27
Q

renal hilum

A

receives renal nerves, blood vessels, lymphatics, and ureter

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28
Q

the kidneys lie against the _____ abdominal wall at the level of what vertebrae?

A

posterior; T12-L3

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29
Q

why is the right kidney slightly lower than the left?

A

large right lobe of the liver

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30
Q

the kidneys are _____peritoneal, along with what other renal organs?(4)

A

retro; ureters, urinary bladder, renal artery/vein, and adrenal glands

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31
Q

renal fascia

A

immediately deep to parietal peritoneum

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32
Q

function of the renal fascia

A

binds kidney to the abdominal wall

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33
Q

perirenal fat capsule

A

cushions kidney and holds it in place

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34
Q

fibrous capsule

A

encloses the kidney protecting it from trauma and infection

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35
Q

_____ fibers extend from the fibrous capsule to the renal fascia

A

collagen

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36
Q

renal parenchyma

A

glandular tissue that forms urine

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37
Q

renal sinua

A

medial cavity that contains blood and lymphatics vessels, nerves, and urine-collecting structures

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38
Q

two zones of renal parenchyma

A
  • renal cortex
  • renal medulla
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39
Q

the boundary between the renal cortex and medulla is called…

A

corticomedullary junction

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40
Q

renal columns

A

extensions of the cortex that project inward toward the sinus

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41
Q

renal pyramids

A

triangular shaped structures in the renal medulla

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42
Q

the base of renal pyramids is adjacent to the _____, while the apex projects towards the _____ _____

A

cortex, renal sinus

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43
Q

renal papilla

A

the apex of a renal pyramid

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44
Q

lobe of kidney

A

one pyramid and its overlying cortex separated from other lobes by the renal column

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45
Q

minor calyx

A

little cup that surrounds the papilla of each pyramid collecting its urine

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46
Q

major calyx

A

formed by convergence of 2-3 minor calyces

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47
Q

renal pelvis

A

formed by convergence of 2-3 major calyces

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48
Q

ureter

A

a tubular continuation of the renal pelvis that drains urine to the urinary bladder

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49
Q

each nephron is composed of two principal parts

A
  • renal corpuscle
  • renal tubule
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50
Q

renal corpuscle

A

filters the blood plasma

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51
Q

renal tubule

A

long, coiled tube that converts that filtrate into urine

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52
Q

the portions of the renal tubule (4)

A
  • proximal convoluted tubule (PCT)
  • loop of henle (nephron loop)
  • distal convoluted tubule (DCT)
  • collecting duct (CD)
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53
Q

the renal corpuscle consists of..(2)

A

the glomerulus and a two-layered glomerular capsule

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54
Q

structure of the glomerular capsule

A
  • parietal (outer) layer
  • visceral (inner) layer
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55
Q

glomerular capsule: parietal layer is composed of…

A

simple squamous epithelium

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56
Q

glomerular capsule: visceral layer consists of…

A

podocytes that wrap around the capillaries of the glomerulus

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57
Q

capsular space

A

separates the two layers of the glomerular capsule

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58
Q

mesangial cells

A

pack the spaces amount the glomerular capillaries

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59
Q

mesangial cells regulate

A

blood flow and phagocytize debris

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60
Q

renal tubule

A

duct leading away from the glomerular capsule and ending at the tip of the medullary pyramid

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61
Q

the renal tubule is divided into four regions

A
  1. proximal convoluted tubule
  2. nephron loop
  3. distal convoluted tubule
  4. collecting duct
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62
Q

which portion of the renal tubule is the longest and most coiled region?

A

proximal convoluted tubule

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63
Q

which portion of the renal tubule absorbs 99% of all glucose, amino acids, etc?

A

proximal convoluted tubule

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64
Q

the proximal convoluted tubule is lined with…(2)

A
  • simple cuboidal epithelium
  • with prominent mircovilli
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65
Q

the descending limb of the nephron loop absorbs…

A

water

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66
Q

the ascending limb of the nephron loop absorbs…

A

Na+ and Cl-

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67
Q

the thick segment of the nephron loop is composed of…

A

simple cuboidal epitheloum

68
Q

the thin segment of the nephron loop is composed of…

A

simple squamous epithelium

69
Q

the thick segment of the nephron loop is impermeable to…

A

water

70
Q

the thin segment of the nephron loop is VERY permeable to…

A

water

71
Q

the thick/thin segment of the nephron loop has many mitochondria

A

thick

72
Q

the distal convoluted tubule begins…

A

shortly after the ascending limb re-enter the cortex

73
Q

the distal convoluted tubule is composed of…

A

cuboidal epithelium without the microvilli

74
Q

collecting duct

A

receives fluid from the DCTs of several nephrons as it passes back into the medulla

75
Q

numerous collecting ducts converge where?

A

toward the tip of the medullary pyramid

76
Q

papillary duct

A

formed by merging of several collecting ducts

77
Q

where are juxtamedullary nephrons positioned?

A

close to the medulla

78
Q

juxtamedullary nephrons loop can extend as far as…

A

the apex of a renal pyramid

79
Q

which type of nephron sometimes has no nephron loop at all?

A

cortical

80
Q

what type of nephron is the majority of them?

A

cortical

81
Q

renal plexus

A

nerves and ganglia wrapped around each renal artery

82
Q

what nephrons are almost solely responsible for maintaining the osmotic gradient in the medulla?

A

juxtamedullary

83
Q

what does the renal plexus issue?

A

nerve fibers to blood vessels and convoluted tubules of the nephron

84
Q

the renal plexus carries what kind of innervation?

A

sympathetic innervation from the abdominal aorta

85
Q

stimulation from the renal plexus reduces/increases glomerular blood flow and rate of urine production

A

reduces

86
Q

how does the renal plexus responds to falling blood pressure?

A

stimulating the kidneys to release renin

87
Q

renin

A

an enzyme that activates hormonal mechanisms to restore blood pressure to trigger the renin-angiotensin system

88
Q

four stages of blood plasma to urine

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
  4. water conservation
89
Q

fluid has three different names as it passes through the nephron

A
  • glomerular filtrate
  • tubular filtrate
  • urine
90
Q

fluid has three different names as it passes through the nephron: glomerular filtrate

A

fluid in the capsular space

91
Q

what is the difference between blood plasma and glomerular filtrate?

A

glomerular filtrate has almost no protein

92
Q

fluid has three different names as it passes through the nephron: tubular fluid

A

fluid from the proximal convoluted tubule through the distal convoluted tubule

93
Q

fluid has three different names as it passes through the nephron: urine

A

fluid within the collecting duct and beyond (no real changes minus water content)

94
Q

glomerular filtration

A

water and some solutes pass from blood within the glomerulus into the capsular space of the nephron

95
Q

filtration membrane

A

barrier through which filtered fluid passes

96
Q

three portions of the filtration membrane

A
  • fenestrated endothelium of the capillary
  • the basement membrane
  • filtration slits
97
Q

three portions of the filtration membrane: fenestrated endothelium of the capillary

A

contains large filtration pores that are highly permeable but small enough to exclude RBCs

98
Q

three portions of the filtration membrane: basement membrane

A

proteoglycan gel with a negative charge, excluding molecules greater than 8nm

99
Q

three portions of the filtration membrane: filtration slits

A

podocyte foot processes (pedicles) wrap around the capillaries creating negatively charged filtration slits between them

100
Q

almost any molecules smaller than _____ nm can pass freely through the filtration membrane

A

3

101
Q

things that can pass through the filtration membrane (8)

A

water, electrolytes, glucose, fatty acids, amino acids, nitrogenous wastes, vitamins

102
Q

Some substances of low molecular weight are bound to plasma proteins and cannot get through the membrane (3)

A

calcium, iron, thyroid hormone

103
Q

proteinuria (albuminuria)

A

albumin in urine

104
Q

hematuria

A

blood in urine

105
Q

blood hydrostatic pressure (BHP)

A

60 mmHg

106
Q

why is BHP high in the glomerular capillaries?

A

because afferent arteriole is larger than the efferent

107
Q

hydrostatic pressure in the capsular space

A

18 mmHg

108
Q

why is the hydrostatic pressure so low in the capsular space?

A

due to high filtration rate and accumulation of fluid in the capsule

109
Q

colloid osmotic pressure (COP) of bloos

A

32 mmHg

110
Q

net filtration pressure (NFP)

A

BHP - (HP of capsular space) - COP

111
Q

glomerular filtration rate (GFR)

A

amount of filtrate formed per minute by the two kidneys combined

112
Q

filtration coefficient (Kf)

A

depends on permeability and surface area of filtration barrier

113
Q

what happens if GFR is too high? (2)

A
  • fluid flows through the renal tubules too rapidly for them to reabsorb the usual amount of water and solute
  • urine output rises, increasing chance of dehydration and electrolyte depletion
114
Q

what happens if GFR is too low?

A

wastes are reabsorbed and azotemia may occur

115
Q

what is the only way to adjust GFR from moment to moment?

A

change glomerular blood pressure

116
Q

changes in glomerular blood pressure occur through three mechanisms

A
  • renal autoregulation
  • sympathetic control
  • hormonal control
117
Q

renal autoregulation

A

the ability of the nephrons to adjust their own blood flow and GFR without external control

118
Q

what does renal autoregulation enable the kidneys to do?

A

maintain relatively stable GFR

119
Q

renal autoregulation happens in two ways

A
  • myogenic mechanism
  • tubuloglomerular feedback
120
Q

myogenic mechanism

A

if arterial blood pressure increases, the afferent arteriole is stretched which leads to afferent arteriole constriction which reduced blood flow into the glomerulus

121
Q

tubuloglomerular feedback

A

when GFR is high, the macula densa secretes ATP which ultimately stimulates nearby granular cells to constrict the afferent arteriole to reduce GFR

122
Q

granular cells secrete _____ if blood pressure is low to trigger what pathway?

A

renin; renin-angiotensin-aldosterone system

123
Q

_____ nerve fibers richly innervated the renal blood vessels

A

sympathetic

124
Q

these two things constrict the afferent arteriole in strenuous exercise

A
  • sympathetic nervous system
  • adrenal epinephrine
125
Q

sympathetic nervous system’s effect on the afferent arteriole (2)

A
  • reduces GFR and urine output
  • redirects blood from the kidneys to other organs
126
Q

renin-angiotensin-aldosterone mechanism: in response to a drop in BP, _____ (type of receptor) in the _____ and ____ stimulate the _____ nervous system

A

baroreceptors; carotid, aorta, sympathetic

127
Q

renin-angiotensin-aldosterone mechanism: _____ fibers trigger release of _____ by kidney’s _____ cells

A

sympathetic, renin, granular

128
Q

renin converts….

A

angiotensinogen into angiotensin 1

129
Q

the lungs and kidneys have this enzyme that converts angiotensin 1 to angiotensin 2

A

angiotensin-converting enzyme (ACE)

130
Q

angiotensin 2

A

a hormone that acts in several ways to restore fluid volume and blood pressure

131
Q

angiotensin II is a potent _____

A

vasoconstrictor; raised blood pressure throughout the body

132
Q

angiotensin II constricts _____ arterioles in the kidney’s

A

efferent; raising GFR despite low BP

133
Q

constriction of the efferent arteriole lowers BP where?

A

peritubular capillaries enhancing reabsorption of NaCl and water

134
Q

angiotensin II stimulates the adrenal cortex to secrete _____

A

aldosterone

135
Q

aldosterone

A

promotes Na+ and water reabsorption in the PCT

136
Q

angiotensin II stimulates the posterior pituitary to release…

A

antidiuretic hormone

137
Q

antidiuretic hormone

A

promotes water reabsorption by the collecting duct

138
Q

what hormone stimulates third and encourages water intake?

A

angiotensin II

139
Q

aminoaciduria

A

amino acids found in urine

140
Q

tubular reabsorption

A

process of reclaiming water and solutes from tubular fluid and returning them to blood

141
Q

glucose is cotransported with sodium during reabsorption by….

A

sodium-glucose transporters (SGLTs)

142
Q

urea is reabsorbed with _____

A

water

143
Q

nephrons reabsorbs about half of urea in ______ fluid

A

tubular

144
Q

obligatory water reabsorption

A

in the PCT, water reabsorbed independent of hormones at a constant rate

145
Q

two thirds of water in filtrate is reabsorbed where?

A

PCT

146
Q

reabsorption of solutes makes the _____ cells and tissue fluid _____ to tubular fluid

A

tubule; hypertonic

147
Q

peritubular capillaries reabsorb water and solutes that leave the _____ surface of the tubular epithelium

A

basal

148
Q

reabsorption occurs by…(2)

A
  • osmosis
  • solvent drag
149
Q

purposes of secretion of PCT and nephron loop include: acid-base balance

A

secretion of varying proportions of hydrogen and bicarbonate ions help regulate pH of body fluids

150
Q

purposes of secretion of PCT and nephron loop include: waste removal

A

urea, uric acids, bile acids, ammonia, excess ions, and a little creatinine are secreted into the tubule

151
Q

purposes of secretion of PCT and nephron loop include: clearance of drugs and contaminants

A

such as morphine, penicillin, and aspirin; some drugs must be taken multiple times per day to keep up with renal clearance

152
Q

ions leave the nephron loop leave cells by….

A

active transport and diffusion

153
Q

NaCl remains in tissue fluid of the ______ ______

A

renal medulla

154
Q

tubular fluid is _____ as it enters the distal convoluted tubule

A

dilute (very dilute)

155
Q

DCT and the collecting duct reabsorb variable amounts of _____ and _____ and are regulated by these hormone

A

water, salt
- aldosterone
- atrial natriuretic peptide
- ADH
- parathyroid hormone

156
Q

aldosterone

A

steroid hormone that stimulates reabsorption of sodium and secretion of potassium

157
Q

aldosterone is secreted by the adrenal cortex when… (2)

A
  • blood Na+ concentration falls of K+ concentration rises
  • drop in BP stimulates renin release, leading to aldosterone secretion
158
Q

aldosterone acts on which portions of the nephron? (3)

A
  • thick segment of the ascending loop of Henle
  • DCT
  • cortical portion of collecting ducts
159
Q

antidiuretic hormone

A

stimulates water retention by the kidney

160
Q

what does ADH do to the nephron?

A

makes the collecting duct more permeable to water to cause more water reabsorption

161
Q

the collecting duct can produce a _____ urine

A

hypertonic

162
Q

as urine passes through the increasingly _____ medulla, water leaves the CD by _____, ______ urine

A

salty, osmosis, concentrating

163
Q

ADH stimulates an increase in ______ _____ in the collecting ducts to cause more water reabsorption

A

aquaporin channels

164
Q

ureters are ______peritoneal

A

retro

165
Q

wall of the bladder consists of (4)

A
  • muscularis called the detrusor
  • the trigone
  • mucosa lined with urothelium (transitional epithelium)
  • rugae