M25: Urine, Ureters, Bladder & Urethra Flashcards

1
Q

key hormone involved in producing dilute vs concentrated urine

A

ADH

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1
Q

2 factors that determine if water is reabsorbed

A
  1. OSMOLARITY (solute concentration in vs outside of tubule)
  2. PERMEABILITY OF TUBULE TO WATER
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2
Q

osmolarity inside PCT and cortex

A

300mOsm/L

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3
Q

at which point are solutes most concentrated in renal tubules? why?

A

bottom of loop of henle
highest solute concentration outside of tube pulls water from tube out

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4
Q

formation of concentrated urine

A
  • cause: dehydration, heavy expiration
  • in collecting duct: in the presence of ADH, principle cells remove water (via AQUAPORIN-2) if surrounding interstitial fluid has high osmolarity
  • resulting urine has low water, concentrated solutes
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5
Q

formation of dilute urine

A
  • cause: overhydration, need to get rid of water
  • in collecting duct: ADH inhibited, AQUAPORIN-2 not used in principle cells to reabsorb water
  • resulting urine has high water concentration
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6
Q

colour in urine due to

A
  • urobilin and urochrome (produced in breakdown of bile)
  • colour can also be changed by meds
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7
Q

turbidity (cloudyness) in urine

A

bacteria, dead cells or fat cause cloudiness when urine left standing

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8
Q

urine pH range

A

4.6-8.0
average=6.0

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9
Q

anatomy of ureteres

A
  • 25-30cm long, 1-10mm diameter
  • renal pelvis to bladder
  • retroperitoneal
  • attach to bladder on posterior wall, close to floor of bladder
  • leads into bladder via URETAL OPENINGS
    • PHYSIOLOGICAL VALVE ONLY (no sphincter, closes due to stretch on wall forcing holes closed)
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10
Q

How does urine move through the ureters (3 factors)

A
  • peristalsis
  • gravity
  • hydrostatic pressure
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11
Q

histology of ureters (deep to superficial)

A
  1. MUCOSA
    - transitional epithelium (allows stretch)
    - lamina propria
    - goblet cells produce protective mucous
  2. MUSCULARIS (smooth muscle)
    - inner LONGITUDINAL outer CIRCULAR
    - distal 1/3 has additional longitudinal layer
  3. ADVENTITIA (layer of areolar CT)
    - anchors ureters in place
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12
Q

bladder volume capacity

A

700-800mL

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13
Q

bladder relative to uterus

A

bladder is inferior

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14
Q

anatomy of urinary bladder

A
  • URETHRA (passage for urine to leave body)
  • TRIGONE (very smooth because mucosa layer pulled tight)
  • INTERNAL URETHRAL ORIFACE (bottom of trigone, first of openings out of bladder)
  • RUGAE (folds in mucosa layer that allow for expansion)
  • DETRUSOR MUSCLE
    • 3 layers (longitudinal, circular, longitudinal)
    • contracts to push urine into urethra
      INTERNAL URETHRAL SPHINCTER
    • smooth muscle, opens/closes urethra
      EXTERNAL URETHRAL SPHINCTER
    • skeletal muscle
    • voluntary opening/closing of urethra
      EXTERNAL URETHRAL ORIFACE
    • opening to outside world!
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15
Q

micturation relfex

A

urination reflex
- stretch receptors detect volume 200-400mL
- impulses sent to micturation centre at S2 and S3, reflex triggered
- parasympathetic fibres contract detrusor muscle, relax external and internal sphincter muscles
external sphincter not directly relaxed, skeletal muscle signal is blocked instead
- bladder fullness sends signal to brain (desire to urinate)
- cerebral cortex can initiate micturation or delay it for a period of time

16
Q

What part of the brain controls conscious control of urination?

A

cerebral cortex
affects external urinary sphincter

17
Q

anatomy of male urethra

A
  • 20 cm long
  • layers: mucosa and muscularis

PROSTATIC URETHRA
- passes through prostate
- internal sphincter stops reproductive secretions from entering bladder
- transitional epithelium becomes stratified columnar or ps columnar

INTERMEDITE (MEMBRANOUS) URETHRA
- passes through perineum (floor of pelvic cavity)
- stratified columnar or ps columnar

SPONGY URETHRA
- passes through the penis
- longest segment
- stratified columnar or ps columnar
- becomes stratified squamous near exterior

EXTERNAL URETHRAL ORIFCE

18
Q

perineum

A

floor of pelvic cavity

19
Q

anatomy of female urethra

A
  • 4cm long
  • external orifce between clitoris and vagina
  • layers: mucosa and muscularis
    • transitional, stratified columnar/ps columnar then stratified squamous
    • circular smooth muscle