LO 18 Flashcards

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1
Q

List the structures of the urinary system

A
  1. Kidneys (2)
  2. Ureters (2)
  3. Bladder
  4. Urethra
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2
Q

Describe the location of the kidneys

A
  1. Under 11th rib, just above waistline
  2. Retroperitoneal - The area in the back of the abdomen behind the peritoneum
  3. With hands on hips, touch thumbs on backbone – kidney just above thumbs
  4. Right kidney usually a little lower than left
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3
Q

Describe the internal structure of the kidneys

A
  1. Renal Cortex - Outer portion
  2. Renal Medulla - Inner portion
  3. Renal Pyramids - Triangular divisions of medulla
  4. Renal Papilla - Narrow, innermost end of a pyramid
  5. Renal Pelvis - Expansion of upper end of ureter
  6. Calyces (major & minor) - Divisions of renal pelvis
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4
Q

The __________ is the basic structural & functional unit of kidneys and comprises the __________ & __________

A
  1. Nephron
  2. Renal corpuscle
  3. Renal tubule
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5
Q

What is the purpose of the nephron and how many are there per kidney?

A
  1. Process/filter blood
  2. > 1 million/kidney
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6
Q

What 2 structures comprise the renal corpuscle

A
  1. Bowman’s capsule
  2. Glomerulus
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7
Q

Describe the Bowman’s Capsule

A
  1. Cup-shaped top of nephron
  2. Surrounds glomerulus
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8
Q

Describe the Glomerulus

A
  1. Network of blood capillaries
  2. Diameter of shorter afferent arteriole > longer efferent arteriole
  3. high BP in glomerular capillaries required to filter wastes from blood
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9
Q

List the structures of the renal tubule

A
  1. Proximal convoluted tubule
  2. Loop of Henle/Henle’s loop
  3. Distal convoluted tubule
  4. Collecting tubule
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10
Q

Describe the proximal convoluted tubule

A
  1. First segment off of Bowman’s capsule
  2. Proximity is to the glomerulus
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11
Q

Describe the loop of Henle

A

Straight, desc. limb with a hairpin turn and a straight ascending limb

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12
Q

Describe the distal convoluted tubule

A

The part of the renal tubule distal to the loop of Henle

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13
Q

Describe the collecting tubule

A

Straight extesion of the renal tubule

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14
Q

What components of the nephron are in the cortex?

A
  1. Renal corpuscle
  2. Proximal convoluted tubule
  3. Distal convoluted tubule
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15
Q

What components of the nephron are in the medulla?

A
  1. Loop of Henle
  2. Collecting tubule
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16
Q

Describe the Juxtaglomerular apparatus (JA)

A
  1. Located between the afferent arteriole and distal convoluted tubule
  2. Cells regulate blood volume and blood pressure by secreting renin when blood plasma volume is low
  3. Renin is released when BP in kidneys is low, it initiates vasoconstriction and increases BP
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17
Q

Describe Erythropoietin

A
  1. A hormone produced by specialized cells called interstitial cells found in the peritubular area of the kidney
  2. Regulates the production & maturation of RBC in the bone marrow
  3. Chronic kidney problems often lead to anemia
  4. Link between cardiovascular and urinary system
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18
Q

Describe the flow of urine through the structures of the kidneys

A
  1. Collecting tubules
  2. Pyramids
  3. Calyx
  4. Renal pelvis
  5. Ureter
  6. Bladder
  7. Urethra
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19
Q

What are the 3 steps of the formation of urine?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
20
Q

Describe filtration of urine

A
  1. Continually happening renal corpuscle
  2. BP from blood flowing through the glomerulus pushes/filters H20 & dissolved substances (filtrate) into Bowman’s capsule into the tubules
  3. BP affects filtration
  4. Normal glomerular filtration rate = 125ml/min 🡪180L glomerular filtrate/day
  5. …but we don’t want to lose everything via filtration….
21
Q

Describe the reabsorption of urine

A
  1. movement of substances out of filtrate/urine into blood direction: renal tubules to peritubular capillaries
  2. Prevents loss of substances that the body needs
  3. H20, glucose, other nutrients, Na+, other ions are reabsorbed via active & passive transport mechanisms
  4. Begins in proximal convoluted tubule, but continues in all renal tubules
  5. The majority of water from the 180L/day of glomerular filtrate is reabsorbed via osmosis from proximal tubules
22
Q

Describe the role of glucose in reabsorption

A
  1. Active transport: proximal tubules to the peritubular capillary blood
  2. Diabetes mellitus – excess glucose can’t be reabsorbed, so is excreted (glycosuria)
23
Q

Describe the role of sodium chloride (salt) in reabsorption

A
  1. Na+: actively transported from tubules to blood
  2. Cl-: passively moves from tubules to blood (attracted by Na+)
24
Q

Describe the role of potassium in reabsorption

A
  1. Filtered at glomerulus and partially reabsorbed in the loop of Henle
  2. Some secreted in urine
  3. Consumption of diuretics means more potassium lost in urine
25
Q

Describe the secretion of urine

A
  1. Opposite of reabsorption
  2. Movement of substances from blood in peritubular capillaries to urine forming in distal & collecting tubules
  3. Other substances such as H+, K+ certain drugs are moved via active transport from blood to urine for secretion
  4. Ammonia/urea (cell biproducts) moved from blood via diffusion to urine for secretion this is critical to maintaining blood pH as ammonia/urea are highly acidic (acid/alkaline balance)
26
Q

How does the body control urine volume?

A
  1. Depends on amount of water & dissolved substances (salt) reabsorbed by convoluted tubules.
  2. ADH (Antidiuretic hormone) - Also known as Vasopressin
  3. Aldosterone (adrenal cortex)
  4. ANH (Atrial natriuretic peptide/hormone)
27
Q

How does ADH (Antidiuretic hormone) help control urine volume?

A
  1. ‘H20-retaining’ / ‘urine decreasing’ hormone
  2. Posterior pituitary
  3. Decreases urine volume (collecting tubules become more permeable to water and water is reabsorbed)
28
Q

How does Aldosterone (adrenal cortex) help control urine volume?

A
  1. Salt & H20 retaining hormone
  2. Stimulates tubules to reabsorb sodium/salt at a faster rate – as sodium is reabsorbed, water follows
  3. Decreases urine volume
29
Q

How does ANH (Atrial natriuretic peptide/hormone) help control urine volume?

A
  1. Secreted by atrial wall
  2. ‘Salt and H20 losing’ hormone
  3. Stimulates tubules to secrete more sodium/salt in to the urine and water follows
  4. Increases urine volume
30
Q

__________ refers to the absence of urine

A

Anuria

31
Q

__________ refers to scanty amounts of urine

A

Oliguria

32
Q

_________ refers to unusually large amounts of urine

A

Polyuria

33
Q

Describe the characteristics of normal urine

A
  1. Amount of urine excreted is variable. Usually approximately 1 – 2 litres per day (24 hours).
  2. Colour: Amber yellow, clear (not cloudy).
  3. pH : Average 6 (changes with diet)
34
Q

Describe the structure and function of the ureters

A
  1. Narrow, long tubes
  2. Upper end terminates in the renal pelvis inside kidney
  3. Lined with mucous membrane
  4. Muscular wall performs peristalsis
  5. Drain urine from renal pelvis to urinary bladder
35
Q

Describe the structure and function of the urinary bladder

A
  1. Elastic & muscular
  2. Mucous membrane lining - Lies as rugae when empty
  3. Trigone-risk of bacterial infection
  4. Functions - Storage of urine and voiding
36
Q

Describe the location of the urinary bladder

A
  1. Behind pubis symphysis
  2. Female: anterior to uterus
  3. Male: rests on prostate
37
Q

Describe the structure and functions of the urethra

A
  1. Narrow tube: bladder to exterior
  2. Mucous membrane lining (allows UTIs to move up)
  3. Much longer in men
  4. Urinary meatus (opening to the exterior)
  5. Passage of urine: bladder to exterior
  6. Passage of male reproductive fluid (semen) from the body
38
Q

________ is the passage of urine from the body

A
  1. Micturition
  2. Aka: urination, voiding, emptying the bladder
39
Q

Describe the regulatory sphincters involved in the passage of urine from the body

A
  1. Internal urethral sphincter (involuntary) – bladder exit
  2. External urethral sphincter (‘voluntary’) – around urethra
40
Q

Describe the emptying reflex (recall reflexes = spinal cord!)

A
  1. Receptors in bladder wall sense amount of ‘stretch’
  2. Sensory message sent to spinal cord
  3. Motor message sent to bladder wall to contract - Internal sphincter relaxes - External sphincter relaxes (voluntary to some degree!) - urination
  4. Bladder wall permits storage of urine with little increase in pressure until a volume of 300 to 400 ml is reached (volume at which urination typically occurs); adult bladder can hold 500 to 1,000 ml of urine
41
Q

__________ refers to urine produced in kidneys but not voided from bladder

A

Urinary retention

42
Q

__________ refers to no urine produced in kidneys but bladder is normal

A

Urinary suppression

43
Q

__________ refers to urine voided involuntarily

A

Incontinence

  1. May be caused by spinal injury, stroke or age-related
  2. Can be treated to some degree
  3. Retention of urine may cause cystitis (bladder infection)
44
Q

Describe Cystitis (Bladder infection)

A
  1. Amounts voided are small
  2. Extreme urgency, frequency
  3. Pain on urination is common
45
Q

Describe Interstitial cystitis (Overactive bladder)

A
  1. Not due to infection
  2. Extreme urgency and frequency
  3. Amounts voided are small
  4. Can be treated to some degree
46
Q

Describe the function of kidneys

A
  1. Urine formation is essential for homeostasis & life!
  2. Kidney failure requires dialysis
  3. > 20% of cardiac output flows through the kidney each minute
  4. High rate of blood flow required to filter metabolic toxins & waste products out of blood
  5. Important electrolytes & other substances are retained (homeostasis)
  6. Clean metabolic waste products from the blood; toxins and nitrogenous wastes (e.g. ammonia, urea) are eliminated via urine
  7. Regulate fluid/water & electrolyte levels
  8. Stabilize pH (acid/alkaline balance)
  9. Regulate levels of many chemicals in blood