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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
the movement of substances from the blood into the tubular fluid
tubular secretion
26
overview of processes of urine formation
27
4 major processes of urine formation
1. filtration 2. reabsorption 3. secretion 4. water conservation
28
what type of transport is filtration
passive
29
filtration involves separation of particles and fluid according to \_\_ and \_\_
size hydrostatic pressure
30
what type of transport is reabsorption
active AND passive
31
reabsorption moves substances/particles from filtrate into the \_\_ and requires __ in the membrane of the tubule
bloodstream transport proteins
32
what type of transport is secretion
mostly active
33
in secretion, substances move from the __ into \_\_
bloodstream filtrate
34
water conservation involves water \_\_ locally and systemically, and is regulated by \_\_
reabsorption osmotic pressure
35
3 components of the filtration membrane
endothelium of fenestrated capillary basement membrane of capillary filtration slits of visceral layer
36
what type of capillary is associated w. the filtration membrane
fenestrated
37
components of the visceral layer of glomerular capsule
pedicels filtration slits podocyte cell body
38
components of filtrate (8)
**back hug (+ water)** water glucose aa ions urea many hormones vitamins B and C ketones
39
what substance is blocked by the filtration slits of the visceral layer
small proteins
40
the endothelium blocks
formed elements -\> erythrocytes, thrombocytes, leukocytes
41
the basement membrane blocks
large proteins
42
net filtration pressure (NFP) of the renal corpuscle is based on
glomerular hydrostatic pressure (HPg) blood colloid osmotic pressure (OPg) capsular hydrostatic pressure (HPc)
43
HPg = OPg = HP c = NFP =
HPg = 60 mm Hg OPg = 32 mm Hg HP c = 18 mm Hg NFP = 10 mm Hg
44
afferent (in) pressures include (2)
OPg HPc (32mmHg+18mmHg = 60)
45
efferent pressure
HPg | (60mmHg)
46
water, nitrogenous wastes, nutrients and ions are pushed out of the glomerulus into the glomerular capsule
glomerular filtration
47
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
d. vasoconstriction of the afferent arteriole
48
range of normal renal MAP
80 - 180 mmHg
49
why does renal MAP have a range of 100 mmHg
so normal bp fluctuations don't change GFR
50
at what point does renal MAP affect bp
180 mmHg
51
the glomerulus filters __ L of filtrate/day
180
52
what happens to MAP w. excessive urine production
rises *and decreases w. insufficient urine production*
53
decrease in systemic bp allows __ blood into the glomerulus to offset a __ in systemic bp
more decrease
54
in response to decreased systemic bp, the afferent arteriole \_\_
dilates
55
in response to an increase in systemic bp, the afferent arteriole \_\_ and allows __ blood into glomerulus to offset increased systemic pressure
vasoconstricts less
56
renal autoregulatiion responds to
systemic bp
57
with normal systemic bp, male gfr = female gfr =
male: 120 ml/min female: 95 ml/min
58
afferent arteriole dilation __ perfusion and afferent arteriole constriction __ perfusion
maintains decreases
59
sympathetic stimulation acts directly on \_\_ to __ volume of blood entering glomerulus and \_\_ GFR
arterioles decrease decrease
60
what cells activate the RAAS
granular cells
61
sympathetic stimulation causes __ of mesangial cells, which results in __ glomerular filtration
contraction decreased
62
4 consequences of sympathetic stimulation of glomerulus
decrease in GFR decrease in urine production retention of fluid maintenance of blood volume
63
2 components of sympathetic stimulation of glomerulus
vasoconstriction of afferent and efferent arterioles contraction of mesangial cells
64
what stimulates the RAAS
low bp sympathetic stimulation
65
steps in RAAS stimulation
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
66
effectors that angiotensin II binds to (4)
systemic bv kidneys hypothalamus adrenal cortex
67
effect of angiotensin II on bv
vasoconstriction → increased peripheral resistance → increased bp
68
effect of angiotensin II on kidneys
decreased gfr → decreased urine output → maintained bv and bp
69
effect of angiotensin II on hypothalamus
1. activation of thirst center → increased fluid intake → increased blood volume → increased bp 2. release of ADH → maintains blood volume w. decreased urine output
70
effect of angiotensin II on adrenal cortex
release of aldosterone from adrenal cortex → decreased urine output → maintains blood volume
71
net effect of RAAS
increased bp
72
what stimulates ADH (3)
angiotensin II low blood volume increased blood osmolality
73
steps in ADH action
1. stimulus → 2. hypothalamus responds → stimulates posterior pituitary to release ADH → 3. ADH binds to effectors
74
effectors of ADH (3)
hypothalamus kidneys blood vessels
75
effects of ADH on the hypothalamus
same as angiotensin II effects
76
effects of ADH on kidneys
increased water reabsorption → decreases water lost → maintenance of blood volume AND decrease in blood osmolality
77
effects of high ADH on bv
same as angiotensin II
78
net effects of ADH
increased bp increased bv decreased blood osmolality
79
what stimulates aldosterone (ALDO) (3)
angiotensin II decreased plasma Na increased plasma K
80
steps in ALDO action
1. stimulus 2. adrenal cortex responds → releases aldosterone into blood → 3. aldosterone binds to effectors
81
effector of ALDO
kidney
82
actions of ALDO on kidney (4)
increases K+ secretion into tubular fluid increases Na/H2O reabsorption into blood decreases Na/H2O loss in urine increases K+ lost in urine
83
net effects of ALDO
plasma Na maintained plasma K+ decreased urine output decreased blood volume and bp maintained
84
anti natriuretic peptide is stimulated by
atrial wall stretch
85
steps of ANP action
1. atrial stretch → 2. atria respond → release ANP into blood → 3. ANP binds to receptors
86
effectors of ANP
systemic bv kidney
87
effect of ANP on systemic bv
vasodilation → decreased peripheral resistance and bp
88
ANP causes __ of the afferent arteriole and __ of the mesangial cells
dilation relaxation → increase in GFR increase in urine production loss of additional fuid decrease in blood volume
89
relaxation of the mesangial cells causes
increased filtration at glomerulus
90
effect of ANP on kidneys
1. increased GFR → increased urine output → decreased bv and bp 2. decreased release of renin, aldosterone, ADH
91
an increase in glomerular filtration rate will __ urine production
increase
92
renal autoregulation __ GFR at \_\_L/day despite changes in \_\_
maintains 180 systemic bp
93
decreased systemic bp → increased systemic bp →
vasodilation of afferent arteriole vasoconstriction of afferent arteriole
94
vasoconstriction of afferent arteriole uses __ feedback (2)
myogenic tubuloglomerular
95
SNS decreases GFR by (2)
afferent arteriole vasoconstriction mesangial cell contraction
96
mesangial contraction decreases (2)
filtration surface area urine production → maintains blood volume
97
ANP increases GFR by (2)
afferent arteriole vasodilation mesangial cell relaxation
98
mesantial cell relaxation increases (2)
filtration surface area urine production → decreases blood volume
99
peritubular capillary has low __ pressure and high __ pressure
low hydrostatic high colloid
100
movement of substances from tubule into blood
tubular reabsorption
101
movement of substances from blood into tubule
tubular secretion
102
movement of substances across and epithelial cell
transcellular transport
103
movement of substances between epithelial cells
paracellular transport
104
summary of PCT and peritubular transports
105
what structure is responsible for glucose reabsorption
PCT
106
the glucose transporter reabsorbs __ glucose in blood plasma
230mg/100ml max
107
normal urine glucose
0
108
normal bg
~100
109
aldosterone/Na action stimulates production of __ (2) in order to \_\_
Na channels AND Na/K pump maintain sodium gradient
110
antagonist to glucose reabsorption at PCT
ANP at PCT
111
steps in glucose reabsorption
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
the glucose symporter brings glucose in __ its gradient and is dependent on \_\_
against Na concentration
113
where is H2O reabsorbed
PCT DCT CD
114
\_\_% of water is reabsorbed in PCT
65 *obligatory*
115
\_\_% of water is reabsorbed in nephron loop
10%
116
additional H2O is reabsorbed by __ via increased # of \_\_
osmosis aquaporins
117
water reabsorbed from existing aquaporins
obligatory reabsorption
118
regulated H2O reabsorption is same-same
facultative H2O reabsorption
119
new aquaporins created to increase water absorption
facultative reabsorption
120
where is K+ reabsorbed and secreted
collecting tubules
121
\_\_ cells in the collecting tubules reabsorb K+ constantly
type A intercalated
122
principal cells have varying K+ secretion based on __ levels
aldosterone
123
\_\_% of K+ is reabsorbed in the nephron loop
10-20%
124
\_\_% of K+ is reabsorbed in the PCT
60-80%
125
target of spironolactone
principal cells
126
PTH __ reabsorption of PO4 in PCT
inhibits
127
PTH __ reabsorption of Ca in the DCT
stimulates
128
inhibited reabsorption of PO4 in the PCT and stimulation of reabsorption of Ca in the DCT leads to __ PO4 in urine
increased
129
80-90% of bicarbonate is reabsorbed in the \_\_ and 10-20% of bicarbonate is reabsorbed in the \_\_
PCT nephron loop
130
regulation of bicarbonate and H+ reabsorption and secretion is done in the \_\_ based on \_\_
collecting duct pH
131
glucose and aa are reabsorbed from the glomerular filtrate by
PCT
132
medullary gradient relies on the \_\_
nephron loop
133
site the of the majority of reabsorption
pct
134
reabsorption is \_\_ and secretion is \_\_
passive active
135
during reabsorption, what substances move from the tubule into the blood (4)
nutrients water ions PO43 (unless inhibited by PTH)
136
during secretion, what substances move from the blood into the tubule (2)
some drugs nitrogenous wastes
137
where is the site of countercurrent multiplier and countercurrent exchange
nephron loop and vasa recta
138
function of nephron loop and vasa recta (2)
continues reabsorption of water and ions nephron loops of juxtamedullary nephrons establish interstitial fluid concentration gradient
139
sites of regulation (2)
DCT collecting ducts
140
Na reabsorption is regulated by (2)
aldosterone ANP
141
water reabsorption is regulated by (2)
aldosterone ADH
142
how do the DCT and collecting ducts regulate K+
amt secreted in the urine at intercalated and principal cells
143
Ca reabsorption is increased by
PTH
144
pH is regulated by
intercalated discs
145
2 ways intercalated discs regulate pH
secrete H+ and retain bicarb secrete bicarb retain H+
146
average daily urine production
1-1.5 L
147
contents of urine (4)
ions water nitrogenous wastes some hormones
148
urine should NOT contain (2)
formed elements nutrients
149
tunics of the bladder deep to superficial (3)
submucosa lamina propria/mucosa transitional epithelium
150
3 components of control of urination
storage reflex micturition reflex voluntary
151
storage reflex is under __ control (2)
sympathetic (spinal reflex) somatic
152
the micturition reflex is under __ control
mechanoreceptors parasympathetic → pons
153
voluntary control of urination is controlled by the
cerebral cortex
154
storage reflex sympathetic component
contraction of internal urethral sphincter → inhibits contraction of detrusor m and micturition
155
somatic component of storage reflex
contracts external urethral shincter
156
\_\_ receptors sense when there is 250 mL of urine in the bladder, which initiates the __ reflex
mechanoreceptors micturition
157
PSNS component of micturition reflex
efferent pelvic n in sacral region induces inhibition of SNS → motor fibers contract detrusor m and relax internal sphincter → stimulates micturition
158
voluntary control of urination includes (3)
prevents urination sensory → vision, voluntary inhibits PNS
159
which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass thru
PCT
160
creatinine has a renal clearance of 140 mL/min due to the fact that
it is secreted by the renal tubules
161
why is the card here?
brainscape wouldn't let me delete it
162
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
PCT
163

Pathophys II - Exam 3 (8 decks)

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