M3: Urinary System Flashcards
excretes fluid waste as it maintains fluid balance and blood volume
URINARY SYSTEM
It also regulates blood composition, helps to maintain blood pressure, monitors and maintains red blood cell levels, and assists in vitamin D synthesis.
URINARY SYSTEM
responsible for monitoring and adjusting the ionic composition of the blood, regulating the pH of the blood, maintaining blood glucose levels, and producing hormones that regulate calcium levels
URINARY SYSTEM
It does all this with four organs:
(1) pairs of kidneys and (2) ureters, (3) the urinary bladder, and (4) the urethra.
lies behind the peritoneum, protected by strong back muscles and fat.
URINARY SYSTEM
organs responsible for filtering the blood
Kidneys
transport and excrete the resulting urine.
ureters, urinary bladder, and urethra
TRUE or FALSE
Urine is not the goal of the urinary system, but rather is formed as a by-product of the system’s functions
TRUE
All waste materials removed from the blood by the urinary system leave the body in __________
urine
________ filter blood and produce hormones
kidneys
These two fist-sized, bean-shaped organs lie immediately beneath the back musculature, embedded in a protective layer of fat.
kidneys
The kidneys are ___________, meaning they lie posterior to the peritoneal membrane.
retroperitoneal
Consequently, _________ are designed to cover the kidney area, and boxers and ultimate fighters are not permitted to punch opponents in the back.
football pads
Due to the placement of the liver, the ______ kidney is slightly lower than the _______.
right ; left
The kidneys themselves are covered with a tough outer membrane, the ___________
renal capsule
A large renal artery enters the kidney at the __________.
hilus
____________ of the blood from every heartbeat gets shunted through the renal arteries to the kidneys.
One quarter
The ________ provides exit for the equally large renal vein, as well as a portal for the kidney’s nerves and lymphatic vessels, and the ureter.
hilus
The __________ contains a large blood supply, and it is here that filtration occurs.
renal cortex
TRUE or FALSE
Blood enters the kidneys via the renal artery, and filtered blood leaves through the renal vein.
TRUE
involved in the fine-tuning of this filtrate
renal medulla
transports the final waste product, the urine, from the kidneys to the ureters.
renal pelvis
A ___________ through a kidney reveals a uniform outer cortex and an irregular inner medulla.
sagittal section
appears grainy and solid, and portions of it dip between the renal pyramids of the medulla.
cortex
cone-shaped structures formed from an accumulation of collecting ducts draining formed urine from the renal cortex to the renal pelvis.
renal pyramids
the area adjacent to the hilus and is where urine is collected and passed to the ureters.
renal pelvis
coated in a protective mucous membrane and lined with many layers of cells to prevent significant osmosis or diffusion from the urine into the cells.
renal pelvis
TRUE or FALSE
Among other substances, urine contains nitrogenous wastes filtered from the blood.
TRUE
Compounds containing nitrogen, such as urea, that are produced during protein metabolism.
nitrogenous wastes
TRUE or FALSE
Blood flow through the kidneys is highly structured and regulated
TRUE
TRUE or FALSE
A full quarter of the blood flow from each heartbeat is sent to the kidneys rather than to the body tissues.
TRUE
Blood enters the kidneys via the __________
renal artery
The ___________ branches into the segmental arteries that supply each renal pyramid of the kidneys, and these segmental arteries give rise to the interlobular arteries that dive between renal pyramids.
renal artery
The _____________ then take the blood to the renal cortex, where it is further divided into arcuate arteries, afferent arterioles, efferent arterioles, and capillaries.
interlobular arteries
Recall that afferent means “arriving” and efferent means “exiting.” In this case, afferent arterioles arrive at the filtering unit, while efferent arterioles exit the filtering unit, or ___________.
glomerulus
Filtered blood winds its way through the kidney via the _______________, where it moves to capillaries and is then collected by the arcuate veins.
From here, the pathway reverses, moving through interlobular and segmental veins, and finally leaving the kidneys through the __________
efferent arterioles ; renal vein
Beyond cleaning blood, the kidneys also produce the hormones ________ and _____________, which regulate the concentration of calcium and formed elements in blood.
calcitriol and erythropoietin
the active form of vitamin D, helps maintain blood calcium levels.
Calcitriol
stimulates production of new red blood cells.
Erythropoietin
another hormone produced by the kidneys is involved in fluid balance.
Renin
TRUE or FALSE
The kidneys can be composed of a million or more nephrons, packed together under the renal capsule. There are nephrons scattered throughout the cortex.
TRUE
Those near the surface are referred to as _____________, while those deeper in the cortex are ______________.
cortical nephrons ; juxtamedullary nephrons
TRUE or FALSE
When observing a kidney under a light microscope, it becomes obvious that the organ is in fact a large collection of these small nephrons, each responsible for filtering a portion of the blood that passes through the kidney.
TRUE
the filtering unit of the kidney
Nephron
nephrons that reside near the medulla of the kidney, yet still in the cortex. (juxta = near)
Juxtamedullary
TRUE or FALSE
The large blood supply that enters the kidneys is diverted through ever-smaller arteries and arterioles until it winds its way to a knotted vessel at the beginning of each nephron.
TRUE
That vessel knot is called a _________, formed from an incoming arteriole.
glomerulus
A ___________ (also called Bowman’s capsule) surrounds the glomerulus
glomerular capsule
The blood vessel leaving each nephron then breaks into __________ capillaries, which wind around the entire nephron before collecting into venules and eventually the renal vein.
peritubular
The ________ is the site of blood filtration, where wastes are removed and any necessary ions and nutrients that were filtered out of the blood are returned to the circulatory system.
nephron
capillaries that surround the nephron (peri=around; tubular=nephron tubules).
peritubular capillaries
The waste material filtered into Bowman’s capsule remains in the fluid within a second part of the nephron: the __________.
tubule
The nephron’s tubule has three sections:
- The proximal convoluted tubule (PCT)
- A loop called the nephron loop or the loop of Henle
- A distal convoluted tubule (DCT) connected to a collecting duct
The tubule that extends from the glomerular capsule is the _____________________.
proximal convoluted tubule
TRUE or FALSE
Proximal means “close to,” and convoluted means “having twists or coils.”
TRUE
This part of the tubule does have plenty of twists and turns. From the _______, the newly filtered fluid is transported into the loop of the nephron (also called the loop of Henle).
PCT
The loop dives down into the medulla and back up to the cortex, where it joins with the __________________.
distal convoluted tubule (DCT)
_________ means “further from,” indicating that this coiled tubule lies some distance from the glomerulus.
Distal
The ________ leads directly to the collecting duct.
DCT
One collecting duct gathers newly formed urine from a series of nephrons and drains it to the __________
renal pelvis
These collecting ducts comprise the majority of the _____________
renal pyramids
TRUE or FALSE
The urine that reaches the renal pelvis is almost ready for excretion from the body. As it travels through the rest of the urinary system, it is subjected to small adjustments in composition before it is voided or released.
TRUE
TRUE or FALSE
The body maintains more nephrons than it needs. This situation is not characteristic of the human body—usually when there is an excess of proteins, compounds, or structures, the body will break down the excess and retain only the bare minimum needed for survival.
TRUE
TRUE or FALSE
We have enough filtering capacity in one kidney to provide all the cleansing and monitoring of fluid balance necessary for life.
TRUE
TRUE or FALSE
Having two kidneys allows the luxury of having “spare parts” should something happen to render one kidney nonfunctional.
TRUE
TRUE or FALSE
Maintaining spare nephrons guarantees that urinary function will not be compromised by small infections or slight damage to the kidneys.
TRUE
Urine formation begins in the __________ and is finalized in the _________, through the processes of filtration, active transport, and osmosis.
glomerulus ; renal pelvis
As blood passes through the glomerulus of the nephron, most of the liquid is forced out of the arteriole and into the ________ of the nephron.
lumen
This first step of urine formation is termed ________________. Water, nitrogenous wastes, nutrients, and salts are all forced from the blood at this point.
glomerular filtration
Glomerular blood pressure is higher than ______________. This increase is partially caused by the kinking and twisting of the glomerular vessels.
systolic blood pressure
TRUE or FALSE
To filter the blood, the blood pressure must overcome the pressure of the fluid already in the capsule (capsular pressure), as well as the osmotic pressure of the blood itself.
TRUE
TRUE or FALSE
the glomerular system relies on pressure, there is a lower limit to its functioning.
TRUE
If your systolic pressure drops below _________, blood in the glomerulus will not be forced through the glomerular wall because glomerular pressure will not rise high enough to force plasma from the blood vessels.
40 mmHg
TRUE or FALSE
Serious complications can result because the aqueous portion of the blood cannot filter into the nephron and therefore cannot be cleansed.
TRUE
Three criteria must be met to filter blood plasma through the glomerulus:
- Blood pressure must be high enough to force plasma out of the glomerular vessel walls.
- The fluid already in the glomerulus must have a low enough pressure to allow more fluid to be forced into the nephron tubules.
- The osmotic pressure of blood in the peritubular capillaries must be high enough to draw water back into the capillaries from the nephron tubule.
The filtration of blood occurs in the glomerulus, but the resulting filtrate must be processed by the rest of the nephron.
Glomerular filtration
During filtration, the formed elements and plasma proteins remain in the ____________ because they are too large to pass through the cells that line the glomerulus.
glomerular vessel
The __________ left in the capillary blood are essential because they set up the osmotic gradient that later pulls most of the water from the filtrate back into the blood.
proteins
Every day, approximately ________ of fluid are filtered from the blood, but only a small fraction of that is excreted.
180 L
When we work out, we lose water and electrolytes through our ______
sweat
The electrolytes we lose include:
sodium, potassium, calcium, and magnesium, as well as traces of zinc, iron, chromium, nickel, and lead.
some people lose up to __________ of fluid an hour while exercising.
3 pounds
TRUE or FALSE
Water will replace the volume lost but will not add any electrolytes. Sports drinks that include sodium, potassium, and carbohydrates may in fact replenish our fluids more quickly.
TRUE
As filtrate passes through the nephron, ions and water are returned to the peritubular capillaries in a process called ____________, the second step in urine formation.
tubular reabsorption
Approximately 65% of the filtered water is returned to the blood immediately at the ______. Glucose, amino acids, and salts are also returned to the bloodstream.
PCT
The walls of the _________________ have a large surface area to accommodate all this reabsorption.
proximal convoluted tubule
The cells that line the PCT are covered with __________. These cells are adjacent to the endothelial cells of the peritubular capillaries, creating a thin layer that allows diffusion from the tubule to the blood.
microvilli
Essential ions and water are sent back to the blood via ________ and ________.
osmosis and diffusion
Glucose is returned to the blood by ____________.
facilitated diffusion
TRUE or FALSE
The walls of the PCT have a finite number of glucose receptors to pick up glucose from the filtrate. Normally, there are more than enough receptors to remove all the glucose from the filtrate and return it to the blood.
TRUE
movement of substances across a membrane from high concentration to low with the assistance of a carrier molecule.
facilitated diffusion
Waste products and other unwanted substances too large to filter from the blood at the glomerulus, such as steroids and drug breakdown products, are actively secreted into the filtrate at the _____________.
distal convoluted tubule.
_____________ is the third step in urine formation. Tubular secretion provides a final fine-tuning of the dissolved compounds in the blood.
Tubular secretion
TRUE or FALSE
Most of the breakdown products of drugs, both pharmaceutical and recreational, are too large to be filtered out at the glomerulus and must be secreted, or actively pushed into the nephron.
TRUE
in this sense, actively transported from the blood to the filtrate.
Secreted
TRUE or FALSE
The loop of the nephron and the collecting duct remove even more water from the filtrate, serving to precisely regulate fluid loss.
TRUE
Once the filtrate has passed through the nephron and collecting ducts and reaches the renal pelvis, it is finally referred to as __________.
urine
TRUE or FALSE
Water can still be removed as the urine sits in the remaining organs of the urinary system, but the salt content is relatively stable.
TRUE
While in the renal pelvis, water can continue to leave the urine, concentrating the salts in the urine, which can lead to the formation of ______________.
kidney stones
These rock-like masses, usually composed of calcium oxalate, can grow large enough to block renal flow.
kidney stones
extremely painful as they move through the urinary pelvis. Stones may grow large enough to become lodged in the kidney or the ureters. Some __________ are jagged or pointy, making them even more likely to jam.
kidney stones
TRUE or FALSE
Removal of kidney stones rarely requires medical assistance. Drinking lots of water and resting as the stone moves through the renal pelvis and ureter often do the trick, but some stones are too large to pass.
TRUE
These may be broken apart by ultrasound waves so the fragments can be excreted. Because __________ often reappear, patients are advised to avoid foods high in calcium, eat less protein, and drink more fluids, especially water.
kidney stones
Digesting _________ releases sulfurous amino acids into the urine, lowering the pH of the urine. Kidney stones form more readily in an acidic environment.
protein
chemical compound composed of calcium ions bound to the oxalate ion (C2O42–).
calcium oxalate
a typical small kidney stone is seen here on the tip of a finger. Stones can be as large as a pearl or even, rarely, a golf ball.
Kidney stone
From the renal pelvis, urine travels down the ureters, to the __________.
urinary bladder
The _______ are long, thin muscular tubes lined with mucosa.
ureters
The ________ loop behind the urinary bladder and enter it at the base.
ureters
carry urine from the renal pelvis to the urinary bladder.
Ureters
They are approximately 20 centimeters long and curl behind the urinary bladder to enter from the trigone, at the base of the bladder.
Ureters
These tubes are ringed with smooth muscle, which helps propel the urine to the bladder.
Ureters
With every heartbeat, blood is pushed into the ___________ and filtered.
glomerulus
TRUE or FALSE
As more urine is produced, it pushes what is already formed into the ureters, where small peristaltic contractions move the urine toward the bladder.
TRUE
The ___________ is a hollow, variable-sized organ. It lies in the pelvic cavity, posterior to the pubic bones and the pubic symphysis.
urinary bladder
The base of the bladder includes the _________, the triangular area where the two ureters enter, and the urethra exits.
trigone
The bladder is lined with ___________ to allow for expansion without tearing or destroying the integrity of the inner lining.
transitional epithelium
TRUE or FALSE
The empty bladder is the size of a walnut, but it can stretch to hold up to 800 mL of fluid in males and slightly less in females.
TRUE
Discharging urine from the bladder is variously called _______, _______, or ________. This reflex involves both smooth and skeletal muscles.
urinating, voiding, or micturition
The __________ causes contraction of the walls of the bladder and relaxation of the internal urethral sphincter muscle.
micturition reflex
Urine moves down into the __________, pressing on the external sphincter muscle. At this point, you can consciously control the opening of the external urinary sphincter.
urethra
TRUE or FALSE
If you choose not to empty the bladder, the urge to urinate will subside until the next 300 mL collects in the bladder.
TRUE
ring of involuntary smooth muscle that keeps the urethra closed.
internal urethral sphincter
ring of voluntary skeletal muscle that closes the urethra.
external sphincter muscle
TRUE or FALSE
As we mature, we learn to anticipate and control this reflex, but we cannot delay micturition indefinitely.
TRUE
TRUE or FALSE
The bladder continues to expand, and a second reflex will begin shortly.
TRUE
TRUE or FALSE
Just as we are not able to hold our breath until we die, we cannot retain urine until the bladder bursts. When the bladder reaches 700 to 800 mL, micturition occurs despite our best efforts to control the external urethral sphincter.
TRUE
When _________ occurs, the urine leaves the body via the urethra, a single tube extending from the trigone of the bladder to the exterior.
micturition
In females, the _______ is a short 5 cm, emptying in front of the vaginal opening.
urethra
The male _______ is almost four times longer because it runs the length of the penis.
urethra
The urinary and _________ systems join in the male, sharing the male urethra.
reproductive
In the female, the two systems are separate. The female ________ carries only urine, and the female reproductive tract opens at the vagina.
urethra
The female _______ is quite short compared to the male. This leads to more common UTIs in females, although they do also occur in males.
urethra
Because the female urethra is so much shorter, it is more common for women to develop _________________ than men.
urinary tract infections (UTIs)
__________ outside the body can travel the short distance up the urethra and colonize the bladder, resulting in painful urination, often accompanied by bleeding from the irritated bladder walls. (If the urine contains glucose, the bacteria multiply even faster.)
Bacteria
________ are serious infections that must be cleared up, usually by taking antibiotics. If bacteria are allowed to remain in the bladder, it can eventually travel up the ureters and colonize the pelvis and tubules of the kidney.
UTIs
______________ are painful and serious because they block normal kidney function and can lead to kidney failure.
Kidney infections
TRUE OR FALSE:
It is worth noting that the urinary system returns key nutrients—carbohydrates, lipids, and proteins—to the body without altering their amount.
TRUE
IDENTIFICATION:
osmotic pressure of a solution
Osmolarity
IDENTIFICATION:
a substance dissolved in a solvent
Solute
IDENTIFICATION:
We excrete or reabsorb many substances in an effort to keep our blood volume relatively constant and our blood pH at roughly _______
7.4
TRUE OR FALSE:
It is a function of the urinary system to regulate these nutrients.
FALSE; it is not
IDENTIFICATION:
It is produced by removing solutes from the forming urine leaving the nephron.
Dilute Urine
IDENTIFICATION:
It is produced by the reabsorption of water at the loop of the nephron and the collecting duct.
Concentrated Urine
formed in the neurons of the hypothalamus and secreted by the posterior lobe of the pituitary gland, located on the undersurface of the brain, in response to blood volume.
ADH (antidiuretic hormone)
IDENTIFICATION:
if you drink less water than you need, ADH will be secreted to preserve the volume of water in your body.
ADH Feedback System
TRUE OR FALSE:
An antidiuretic hormone will decrease the urine volume
TRUE
IDENTIFICATION:
are powerful vasodilators that increase blood volume and blood pressure.
- atrial natriuretic peptide (ANP)
- brain natriuretic peptide (BNP)
TRUE OR FALSE:
Your body cannot achieve peak function without good hydration.
TRUE
IDENTIFICATION:
Body pH must be held within a narrow range of ____ to ______
7.35 to 7.45
IDENTIFICATION:
It is a noninvasive way to understand the events occurring in the body. If a person has been taking illicit drugs, prescribed medications, or even diet supplements, indications of those compounds will show up in the urine.
Urinalysis (UA)
When the sample tested positive in urinalysis, they are then put into an analytical machine called the _________?
Gas Chromatograph-Mass Spectrometer (GC/MS)
ENUMERATION:
What are the four abnormal components of urine that indicate serious complications?
- Albumin
- Hemoglobin
- Glucose
- Casts
IDENTIFICATION:
Urine usually contains _________, which gives it that yellow color.
urochrome
IDENTIFICATION:
Small structures formed by mineral or fat deposits on the walls of the renal tubules.
Casts
IDENTIFICATION:
is a small protein that, if present in the urine, must be entering at the glomerulus.
Albumin
IDENTIFICATION:
Proteins in the urine are diagnosed as ________?
Proteinuria
IDENTIFICATION:
It indicates bleeding in the upper urinary tract.
Hemoglobin
IDENTIFICATION:
Glucose in the urine signifies _________ _________
diabetes mellitus
TRUE OR FALSE:
A substantial number of casts always indicates serious kidney trouble
TRUE
IDENTIFICATION:
substance exchange via diffusion across a membrane, artificially mimicking the kidney.
Dialysis
IDENTIFICATION:
They are both inflammations of the nephron of the kidney.
Nephritis and Glomerulonephritis
IDENTIFICATION:
General term for blockage of renal blood circulation, with subsequent shutdown of the nephrons.
Glomerulonephritis
IDENTIFICATION:
Swelling of the nephron itself, but the end results are the same.
Nephritis
IDENTIFICATION:
Dialysis between blood and another fluid.
Hemodialysis
IDENTIFICATION:
a membrane that lines the abdominal cavity.
Peritoneum
IDENTIFICATION:
After 300 mL of urine fills the bladder, the ____________ ______ is stimulated.
micturition reflex
TRUE OR FALSE:
ADH prevents the loss of water, causing the production of concentrated urine.
TRUE
IDENTIFICATION:
regulates sodium reabsorption, effectively retaining water and sodium in the body.
Aldosterone
IDENTIFICATION:
If the blood is too ____, the kidneys can excrete hydrogen ions and send bicarbonate ions back to the blood.
Acidic
IDENTIFICATION:
If the blood is too ____, the kidneys will return hydrogen ions to the blood and excrete bicarbonate ions.
Basic
IDENTIFICATION:
This disease causes cysts to form in the kidneys, destroying normal kidney tissue.
Polycystic Kidney Disease
TRUE OR FALSE:
Polycystic Kidney Disease is not inherited
FALSE; it is inherited
TRUE OR FALSE:
Without properly functioning kidneys, blood composition cannot be maintained, and homeostasis will be lost.
TRUE
TRUE OR FALSE:
In mild cases, the patient may require dialysis or even a kidney transplant.
FALSE; in severe cases
TRUE OR FALSE:
The pH of normal urine ranges between _____ and _____
4.6 and 8.0
IDENTIFICATION:
is also called water intoxication and can lead to death if not treated properly.
Hyponatremia (Low Sodium Levels)
IDENTIFICATION:
High Levels of Ketone Bodies in the urine are called ______?
Ketonuria
IDENTIFICATION:
An above-normal leel of bilirubin in urine is called
Bilirubinuria
IDENTIFICATION:
The presence of urobilinogen in urine is called _____?
urobilinogenuria
IDENTIFICATION:
What are the most common complication when donating a kidney?
Bleeding and Infection at the incision site
TRUE OR FALSE:
An individual cannot live and function with one healthy kidney
FALSE; an individual can live and function with one healthy kidney
TRUE OR FALSE:
Kidney donation has no effect on a woman’s ability to conceive.
TRUE
TRUE OR FALSE:
-Kidney transplants are highly successful transplant operations, with almost 80% patient and organ survival rate after 1 year.
TRUE
__________ can and does occur in all age brackets, genders, and social levels, but it is far more common in elderly women.
Incontinence
the inability to prevent urine leakage.
Incontinence
An estimated __________ Americans suffer incontinence, yet most do not require surgery.
12 million
There are three types of incontinence determined by the underlying cause of the problem, each with the same result:
- Stress incontinence
- Urge incontinence
- Overflow incontinence
the leaking of urine during physical exertion.
Stress incontinence
the inability to quell the urge to urinate.
Urge incontinence
the overflowing of the urinary bladder caused by waiting too long before urinating, as happens in young children who are learning to control their sphincter muscles.
Overflow incontinence
difficult or infrequent defecation, leading to dry, potentially painful fecal evacuation.
Constipation
TRUE or FALSE
Treatment for incontinence is tailored to the cause. Muscular strengthening exercises or behavioral modification may be recommended.
TRUE
