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Pathophys II - Exam 3 > Mace - Urinary System > Flashcards

Mace - Urinary System Flashcards

1
Q

fxn’s of urinary system (6)

A

excretion of wastes

regulation of blood volume

regulation of blood composition

secretion hormones and enzymes

detoxifies free radicals/drugs

gluconeogenesis

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2
Q

the kidney releases __ in response to low O2

A

EPO

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3
Q

contents of the renal corpuscle (4)

A

glomerulus

visceral capsule layer

glomerular space

parietal capsule layer

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4
Q

nephron structure

A
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5
Q

components of juxtaglomerular (JG) apparatus

A

macula densa cells of DCT

granular cells of afferent arteriole of JG cells

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6
Q

location of filtration

A

renal corpuscle

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7
Q

arterial blood flow of kidney

A

renal a. → segmental a. → interlobal a. → arcuate a. → interlobular a. → afferent arteriole → glomerulus → efferent arteriole → peritubular capillaries AND vasa recta

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8
Q

peritubular capillaries are associated w. the

A

convoluted tubule

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9
Q

the vasa recta is associated w. the

A

nephron loop

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10
Q

veinous blood flow of the kidney

A

renal v. → interlobar v. → arcuate v. → interlobular v → peritubular capillaries AND vasa recta

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11
Q

what structures are in the medulla

A

ascending and descending nephron loop

part of collecting duct

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12
Q

what structures are located in the cortex (5)

A

renal corpuscle

renal tubule

afferent arteriole

efferent arteriole

vascular pole

tubular pole

part of collecting duct

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13
Q

“tubular fluid” means that it is

A

beyond the glomerulus

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14
Q

filtration unit of the glomerulus

A

renal corpuscle

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15
Q

renal corpuscles fed by the

A

afferent arteriole

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16
Q

the renal corpuscle is made of

A

glomerular capillaries

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17
Q

the nephron loop is same-same

A

loop of henle

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18
Q

fluid in the capsular space is

A

filtrate

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19
Q

fluid beyond the capsular space is

A

tubular fluid

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20
Q

starting at the __

fluid is urine

A

papillary duct (apex of pyramid)

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21
Q

flow of fluid thru kidney

A

capsular space → PCT → descending limb of nephron loop → ascending limb of nephron loop → DCT → collecting tubules → collecting duct → papillary duct → minor calyx → major calyx → renal pelvis → ureter → urinary bladder → urethra

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22
Q

fluid is urine when it

A

no longer changes

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23
Q

the movement of substances from the blood w.in the glomerulus into the capsular space

A

glomerular filtration

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24
Q

the movement of substances from the tubular fluid back into the blood

A

tubular reabsorption

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25
Q

the movement of substances from the blood into the tubular fluid

A

tubular secretion

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26
Q

overview of processes of urine formation

A
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27
Q

4 major processes of urine formation

A
  1. filtration
  2. reabsorption
  3. secretion
  4. water conservation
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28
Q

what type of transport is filtration

A

passive

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29
Q

filtration involves separation of particles and fluid according to __

and __

A

size

hydrostatic pressure

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30
Q

what type of transport is reabsorption

A

active AND passive

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31
Q

reabsorption moves substances/particles from filtrate into the __

and requires __ in the membrane of the tubule

A

bloodstream

transport proteins

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32
Q

what type of transport is secretion

A

mostly active

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33
Q

in secretion, substances move from the __ into __

A

bloodstream

filtrate

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34
Q

water conservation involves water __

locally and systemically, and is regulated by __

A

reabsorption

osmotic pressure

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35
Q

3 components of the filtration membrane

A

endothelium of fenestrated capillary

basement membrane of capillary

filtration slits of visceral layer

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36
Q

what type of capillary is associated w. the filtration membrane

A

fenestrated

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37
Q

components of the visceral layer of glomerular capsule

A

pedicels

filtration slits

podocyte cell body

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38
Q

components of filtrate (8)

A

back hug (+ water)

water

glucose

aa

ions

urea

many hormones

vitamins B and C

ketones

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39
Q

what substance is blocked by the filtration slits of the visceral layer

A

small proteins

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40
Q

the endothelium blocks

A

formed elements ->

erythrocytes, thrombocytes, leukocytes

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41
Q

the basement membrane blocks

A

large proteins

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42
Q

net filtration pressure (NFP) of the renal corpuscle is based on

A

glomerular hydrostatic pressure (HPg)

blood colloid osmotic pressure (OPg)

capsular hydrostatic pressure (HPc)

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43
Q

HPg =

OPg =

HP c =

NFP =

A

HPg = 60 mm Hg

OPg = 32 mm Hg

HP c = 18 mm Hg

NFP = 10 mm Hg

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44
Q

afferent (in) pressures include (2)

A

OPg

HPc

(32mmHg+18mmHg = 60)

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45
Q

efferent pressure

A

HPg

(60mmHg)

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46
Q

water, nitrogenous wastes, nutrients and ions are pushed out of the glomerulus into the glomerular capsule

A

glomerular filtration

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47
Q

which of the following would reduce the GFR

a. vasoconstriction of efferent arteriole
b. drop in oncotic pressure
c. vasodilation of afferent arteriole
d. vasoconstriction of afferent arteriole
e. increase in osmotic pressure in glomerular capsule

A

d. vasoconstriction of the afferent arteriole

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48
Q

range of normal renal MAP

A

80 - 180 mmHg

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49
Q

why does renal MAP have a range of 100 mmHg

A

so normal bp fluctuations don’t change GFR

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50
Q

at what point does renal MAP affect bp

A

180 mmHg

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51
Q

the glomerulus filters __ L of filtrate/day

A

180

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52
Q

what happens to MAP w. excessive urine production

A

rises

and decreases w. insufficient urine production

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53
Q

decrease in systemic bp allows __ blood into the glomerulus

to offset a __ in systemic bp

A

more

decrease

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54
Q

in response to decreased systemic bp, the afferent arteriole __

A

dilates

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55
Q

in response to an increase in systemic bp, the afferent arteriole __

and allows __ blood into glomerulus to offset increased systemic pressure

A

vasoconstricts

less

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56
Q

renal autoregulatiion responds to

A

systemic bp

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57
Q

with normal systemic bp,

male gfr =

female gfr =

A

male: 120 ml/min
female: 95 ml/min

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58
Q

afferent arteriole dilation __ perfusion

and afferent arteriole constriction __ perfusion

A

maintains

decreases

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59
Q

sympathetic stimulation

acts directly on __

to __ volume of blood entering glomerulus and

__ GFR

A

arterioles

decrease

decrease

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60
Q

what cells activate the RAAS

A

granular cells

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61
Q

sympathetic stimulation causes __ of mesangial cells,

which results in __ glomerular filtration

A

contraction

decreased

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62
Q

4 consequences of sympathetic stimulation of glomerulus

A

decrease in GFR

decrease in urine production

retention of fluid

maintenance of blood volume

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63
Q

2 components of sympathetic stimulation of glomerulus

A

vasoconstriction of afferent and efferent arterioles

contraction of mesangial cells

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64
Q

what stimulates the RAAS

A

low bp

sympathetic stimulation

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65
Q

steps in RAAS stimulation

A
  1. low bp
  2. JG responds → releases renin into blood
  3. renin activates angiotensinogen → angiotensin I
  4. ACE converts angiotensin I → angiotensin II
  5. angiotensin II binds to effectors
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66
Q

effectors that angiotensin II binds to (4)

A

systemic bv

kidneys

hypothalamus

adrenal cortex

67
Q

effect of angiotensin II on bv

A

vasoconstriction →

increased peripheral resistance →

increased bp

68
Q

effect of angiotensin II on kidneys

A

decreased gfr →

decreased urine output →

maintained bv and bp

69
Q

effect of angiotensin II on hypothalamus

A
  1. activation of thirst center →

increased fluid intake →

increased blood volume →

increased bp

  1. release of ADH → maintains blood volume w. decreased urine output
70
Q

effect of angiotensin II on adrenal cortex

A

release of aldosterone from adrenal cortex → decreased urine output → maintains blood volume

71
Q

net effect of RAAS

A

increased bp

72
Q

what stimulates ADH (3)

A

angiotensin II

low blood volume

increased blood osmolality

73
Q

steps in ADH action

A
  1. stimulus →
  2. hypothalamus responds → stimulates posterior pituitary to release ADH →
  3. ADH binds to effectors
74
Q

effectors of ADH (3)

A

hypothalamus

kidneys

blood vessels

75
Q

effects of ADH on the hypothalamus

A

same as angiotensin II effects

76
Q

effects of ADH on kidneys

A

increased water reabsorption → decreases water lost → maintenance of blood volume AND decrease in blood osmolality

77
Q

effects of high ADH on bv

A

same as angiotensin II

78
Q

net effects of ADH

A

increased bp

increased bv

decreased blood osmolality

79
Q

what stimulates aldosterone (ALDO) (3)

A

angiotensin II

decreased plasma Na

increased plasma K

80
Q

steps in ALDO action

A
  1. stimulus
  2. adrenal cortex responds → releases aldosterone into blood →
  3. aldosterone binds to effectors
81
Q

effector of ALDO

A

kidney

82
Q

actions of ALDO on kidney (4)

A

increases K+ secretion into tubular fluid

increases Na/H2O reabsorption into blood

decreases Na/H2O loss in urine

increases K+ lost in urine

83
Q

net effects of ALDO

A

plasma Na maintained

plasma K+ decreased

urine output decreased

blood volume and bp maintained

84
Q

anti natriuretic peptide is stimulated by

A

atrial wall stretch

85
Q

steps of ANP action

A
  1. atrial stretch →
  2. atria respond → release ANP into blood →
  3. ANP binds to receptors
86
Q

effectors of ANP

A

systemic bv

kidney

87
Q

effect of ANP on systemic bv

A

vasodilation → decreased peripheral resistance and bp

88
Q

ANP causes __ of the afferent arteriole

and __ of the mesangial cells

A

dilation

relaxation

→

increase in GFR

increase in urine production

loss of additional fuid

decrease in blood volume

89
Q

relaxation of the mesangial cells causes

A

increased filtration at glomerulus

90
Q

effect of ANP on kidneys

A
  1. increased GFR → increased urine output → decreased bv and bp
  2. decreased release of renin, aldosterone, ADH
91
Q

an increase in glomerular filtration rate will __ urine production

A

increase

92
Q

renal autoregulation __ GFR

at __L/day

despite changes in __

A

maintains

180

systemic bp

93
Q

decreased systemic bp →

increased systemic bp →

A

vasodilation of afferent arteriole

vasoconstriction of afferent arteriole

94
Q

vasoconstriction of afferent arteriole uses __ feedback (2)

A

myogenic

tubuloglomerular

95
Q

SNS decreases GFR by (2)

A

afferent arteriole vasoconstriction

mesangial cell contraction

96
Q

mesangial contraction decreases (2)

A

filtration surface area

urine production

→ maintains blood volume

97
Q

ANP increases GFR by (2)

A

afferent arteriole vasodilation

mesangial cell relaxation

98
Q

mesantial cell relaxation increases (2)

A

filtration surface area

urine production

→ decreases blood volume

99
Q

peritubular capillary has low __ pressure

and high __ pressure

A

low hydrostatic

high colloid

100
Q

movement of substances from tubule into blood

A

tubular reabsorption

101
Q

movement of substances from blood into tubule

A

tubular secretion

102
Q

movement of substances across and epithelial cell

A

transcellular transport

103
Q

movement of substances between epithelial cells

A

paracellular transport

104
Q

summary of PCT and peritubular transports

A
105
Q

what structure is responsible for glucose reabsorption

A

PCT

106
Q

the glucose transporter reabsorbs __ glucose in blood plasma

A

230mg/100ml max

107
Q

normal urine glucose

A

0

108
Q

normal bg

A

~100

109
Q

aldosterone/Na action stimulates production of __ (2)

in order to __

A

Na channels AND Na/K pump

maintain sodium gradient

110
Q

antagonist to glucose reabsorption at PCT

A

ANP at PCT

111
Q

steps in glucose reabsorption

A
  1. glucose is transported up its concentration gradient by secondary active transport into tubule cell of PCT
  2. glucose diffuses down its concentration gradient by facilitated diffusion into peritubular capillary
112
Q

the glucose symporter brings glucose in __ its gradient

and is dependent on __

A

against

Na concentration

113
Q

where is H2O reabsorbed

A

PCT

DCT

CD

114
Q

__% of water is reabsorbed in PCT

A

65

obligatory

115
Q

__% of water is reabsorbed in nephron loop

A

10%

116
Q

additional H2O is reabsorbed by __ via

increased # of __

A

osmosis

aquaporins

117
Q

water reabsorbed from existing aquaporins

A

obligatory reabsorption

118
Q

regulated H2O reabsorption is same-same

A

facultative H2O reabsorption

119
Q

new aquaporins created to increase water absorption

A

facultative reabsorption

120
Q

where is K+ reabsorbed and secreted

A

collecting tubules

121
Q

__ cells in the collecting tubules reabsorb K+ constantly

A

type A intercalated

122
Q

principal cells have varying K+ secretion based on __ levels

A

aldosterone

123
Q

__% of K+ is reabsorbed in the nephron loop

A

10-20%

124
Q

__% of K+ is reabsorbed in the PCT

A

60-80%

125
Q

target of spironolactone

A

principal cells

126
Q

PTH __ reabsorption of PO4 in PCT

A

inhibits

127
Q

PTH __ reabsorption of Ca in the DCT

A

stimulates

128
Q

inhibited reabsorption of PO4 in the PCT and stimulation of reabsorption of Ca in the DCT leads to __ PO4 in urine

A

increased

129
Q

80-90% of bicarbonate is reabsorbed in the __

and 10-20% of bicarbonate is reabsorbed in the __

A

PCT

nephron loop

130
Q

regulation of bicarbonate and H+ reabsorption and secretion is done in the __

based on __

A

collecting duct

pH

131
Q

glucose and aa are reabsorbed from the glomerular filtrate by

A

PCT

132
Q

medullary gradient relies on the __

A

nephron loop

133
Q

site the of the majority of reabsorption

A

pct

134
Q

reabsorption is __

and secretion is __

A

passive

active

135
Q

during reabsorption, what substances move from the tubule into the blood (4)

A

nutrients

water

ions

PO43 (unless inhibited by PTH)

136
Q

during secretion, what substances move from the blood into the tubule (2)

A

some drugs

nitrogenous wastes

137
Q

where is the site of countercurrent multiplier and countercurrent exchange

A

nephron loop and vasa recta

138
Q

function of nephron loop and vasa recta (2)

A

continues reabsorption of water and ions

nephron loops of juxtamedullary nephrons establish interstitial fluid concentration gradient

139
Q

sites of regulation (2)

A

DCT

collecting ducts

140
Q

Na reabsorption is regulated by (2)

A

aldosterone

ANP

141
Q

water reabsorption is regulated by (2)

A

aldosterone

ADH

142
Q

how do the DCT and collecting ducts regulate K+

A

amt secreted in the urine at intercalated and principal cells

143
Q

Ca reabsorption is increased by

A

PTH

144
Q

pH is regulated by

A

intercalated discs

145
Q

2 ways intercalated discs regulate pH

A

secrete H+ and retain bicarb

secrete bicarb retain H+

146
Q

average daily urine production

A

1-1.5 L

147
Q

contents of urine (4)

A

ions

water

nitrogenous wastes

some hormones

148
Q

urine should NOT contain (2)

A

formed elements

nutrients

149
Q

tunics of the bladder deep to superficial (3)

A

submucosa

lamina propria/mucosa

transitional epithelium

150
Q

3 components of control of urination

A

storage reflex

micturition reflex

voluntary

151
Q

storage reflex is under __ control (2)

A

sympathetic (spinal reflex)

somatic

152
Q

the micturition reflex is under __ control

A

mechanoreceptors

parasympathetic → pons

153
Q

voluntary control of urination is controlled by the

A

cerebral cortex

154
Q

storage reflex sympathetic component

A

contraction of internal urethral sphincter → inhibits contraction of detrusor m and micturition

155
Q

somatic component of storage reflex

A

contracts external urethral shincter

156
Q

__ receptors sense when there is 250 mL of urine in the bladder,

which initiates the __ reflex

A

mechanoreceptors

micturition

157
Q

PSNS component of micturition reflex

A

efferent pelvic n in sacral region induces inhibition of SNS → motor fibers contract detrusor m and relax internal sphincter → stimulates micturition

158
Q

voluntary control of urination includes (3)

A

prevents urination

sensory → vision, voluntary

inhibits PNS

159
Q

which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass thru

A

PCT

160
Q

creatinine has a renal clearance of 140 mL/min due to the fact that

A

it is secreted by the renal tubules

161
Q

why is the card here?

A

brainscape wouldn’t let me delete it

162
Q

because a great deal of active transport that occurs here, the __ of all nephrons collectively account for about 6% of one’s daily resting ATP and caloric consumption

A

PCT

163
Q
A

Pathophys II - Exam 3 (8 decks)

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