Module 19: Urinary System Flashcards
Function of ureters
Transport urine from kidneys(renal pelvis) to the bladder
Function of bladder
Store urine
Function of urethra
External release of urine
How are kidneys positioned
Retroperitoneal
7 Functions of Urinary System
- regulate electrolytes
- regulates blood pH
- maintains blood concentration (osmolarity)
- regulates blood volume
- regulates blood pressure
- excretes wastes
- produces and releases of hormones
Controls levels of various anions and cations
Regulation of electrolytes
Control of pH by secretion H+ into the urine and return of HCO3 back to blood
Regulation of pH
Control of blood concentration
Maintenance of blood osmolarity
Adjusts blood volume by conserving or eliminating urine
Regulation of blood volume
Adjusts blood pressure by conserving or eliminating Na+ and urine
Regulation of blood pressure
Excretion of ammonia, urea, bilirubin, creatinine, Utica acid, and other wastes
Excretion of wastes
Calcitriol (active vitamin D) to increase calcium levels; erythropoietin to increase RBD production
Production of hormones
Release of glucose, produced by gluconeogenesis, into the blood
Regulation of blood glucose level
From deep to superficial list the 3 layers of tissue in the kidney
Renal capsule
Adipose capsule
Renal fascia
Renal capsule
Protect and maintain shape of kidney
Adipose capsule
Protect and maintain position of kidney in abdominal cavity
Renal fascia
Anchors kidney to abdominal wall and neighboring structures
2 regions of of the kidney
Renal cortext
Medulla
Triangular structures within the medulla that appear striated due to the presence of the renal tubules and ducts
Renal pyramid
Is the renal pyramid striated or non-striated
Striated due to renal tubules and ducts
Outermost region & extends between the renal pyramids
Cortex
Renal pyramids
• renal papillae
• drain into the calyces
Medulla
Functional unit of the kidney (1 million per kidney)
Nephrons
Minor calyx(calyces)
8-18 per kidney
Major calyx(calyces)
2-3 per kidney
Each kidney has 2-3 major calyces which will drain into one large cavity called the ___________
Renal pelvis
Path of urine drainage in kidney
Collecting duct ➡️ papillary duct ➡️ minor calyx ➡️ major calyx ➡️ renal pelvis ➡️ ureter ➡️ urinary bladder
Path of Renal Blood Flow
Abdominal aorta ➡️ renal artery ➡️ segmental arteries ➡️ interlobar arteries ➡️ arcuate arteries ➡️ interlobular arteries ➡️ Afferent Arterioles ➡️ glomerular capillaries ➡️ efferent Arterioles ➡️ peritubular capillaries ➡️ interlobular veins ➡️ arcuate veins ➡️ interlobar veins ➡️ renal vein ➡️ inferior vena cava
2 unique vascular features of the kidneys
- Glomerular capillaries are positioned between two groups of Arterioles
- There are 2 sets of capillaries
• glomerular capillaries
• peritubular capillaries
Located in the cortex and is the structure of the nephron that filters the blood
Renal corpuscle
Because it isn’t blood anymore and it still isn’t urine yet, what is it called in the renal corpuscle
Glomerular filtrate
Receives fluid from the filtration process(glomerular filtrate)
Glomerular capsule
3 renal functions
- glomerular filtration
- tubular reabsorption
- tubular secretion
Production of glomerular filtrate through the filtration of waste-laden blood by the glomerulus
Glomerular filtration
Process of returning important substances from the glomerular filtrate back to the bloodstream
Tubular reabsorption
Process of transporting substances from the bloodstream into the glomerular filtrate
Tubular secretion
Because it isn’t blood anymore and it still isn’t urine yet, what is it called in the renal corpuscle
Glomerular Filtrate
Receives fluid from the filtration process(glomerular filtrate)
Glomerular capsule
3 pressures that contribute to glomerular filtration
GBHP: Glomerular blood(capillary) hydrostatic pressure
CHO: capsular hydrostatic pressure
BCOP: blood colloid osmotic pressure
GBHP
Glomerular Blood(capillary) Hydrostatic Pressure
Cause by: blood pressure in capillaries
Action: favors filtration
mmHg: 55
CHP
Capsular hydrostatic pressure
Caused by: fluid present in capsular space
Action: opposes filtration
mmHg: 15
BCOP
Blood colloid osmotic pressure
Caused by: osmotic pressure from proteins remaining in the plasma
Action: opposes filtration
mmHg: 30
Net Filtration Pressure
GBHP - CHP - BCOP = NFP(Net Filtration Pressure)
55 - 15 - 30 = 10 mmHg
Blood minus the formed elements (cells) and the majority of the plasma proteins
Glomerular filtrate
Through filtration _______% of the plasma becomes part of the filtrate
16-20%
Process of returning important substances from the glomerular filtrate back to body
Tubular reabsorption
How much filtrate is reabsorbed
99%
65% water, 100% glucose, 50% urea
2 routes that a substance can be reabsorbed from
- Paracellular reabsorption: between renal tubule cells
2. Transecellular reabsorption: through renal tubule cells
The majority of solute and water reabsorption occurs in
The proximal convoluted tubule
To maximize reabsorption capacity, cells of the proximal convoluted tubule are ______________ with prominent ___________.
Cuboidal epithelium, Microvilli
Present on surfaces of cells to actively reabsorbed many of the solutes
Transport proteins
Each transport protein has a transport speed limit
Transport maximum
The presence of solute above the limit will result in
Excretion of the excess solute in the urine
Loss of glucose in the urine
Glucosuria
- 90% water reabsorption
- As go solutes, so goes water
- water follows concentration gradient throughout most of the nephron
Obligatory reabsorption
- 10% of water reabsorption
- variable water random prion to adapt to specific needs
- regulates by ADH in the renal tubules and collecting ducts
Facultative reabsorption
Transport of substances from the bloodstream to the glomerular filtrate
Tubular secretion
2 main functions of tubular secretion
- Secretion of H+ ions control pH
2. Hydrogen and Ammonium ions are secreted and bicarbonate conserved to maintain physiological pH
Where does tubular secretion occur
Throughout the nephrons
What substances are secreted in tubular secretion
H+, K+, NH4+, creatinine, and some drugs
Renal influence of the Renin-Angiotensin-Aldosterone System
Stimulus: ⬇️ blood pressure = ⬇️ pressure in Afferent Arterioles = Juxtaglomerular cells secrete hormone renin = Renin converts angitensinogen to angiotensin l = angiotensin converting enzyme converts angiotensin l to angiotensin ll = angiotensin ll causes vasoconstriction of Afferent Arterioles, enhanced Na, Cl, and H20 reabsorption, and stimulates adrenal cortex to secrete aldosterone = aldosterone signals cells in collecting ducts to reabsorbed more Na, Cl, and H20 and secrete more K+
Renal influence of ADH
- osmotic rotors in hypothalamus detect ⬆️ blood solute in concentration
- posterior pituitary secreted ADH
- ADH stimulates insertion of H2O channel proteins(aquaporin-2) in cells of collecting duct
- ⬆️ H2O permeability and reabsorption of water
_________ implies two fluids flowing in opposite directions
Countercurrent
2 countercurrent mechanisms
- countercurrent multiplier
* countercurrent exchange
Countercurrent multiplier
- interstitial fluid and glomerular filtrate become progressively more concentrated the deeper they are in the medulla (because H2O is reabsorbed from the filtrate as it flows down the descending limb)
- ascending limb cells actively transport solutes into interstitial fluid (but limb is not permeable to water)…..solutes are leaving filtrate and water isn’t = becomes less concentrated as it flows up the ascending limb
- water & urea are reabsorbed by collecting duct cells. Water diffuses into vasa recta. Urea recycling: exchange of urea between renal tubules and interstitial fluid
Summary:
- as filtrate flows down descending limb it becomes more concentrated(water reabsorption)
- as filtrate flows up ascending limb it becomes less concentrated (reabsorption of Na+ and Cl- by active transport)
Countercurrent exchange
Vasa recta & urea cycling
Vasa recta
- supplies cells with oxygen and nutrients
- allows for easy water reabsorption
Urea cycling
- water and urea reabsorbed from collecting duct
- water diffuse into vasa recta
- urea can diffuse into lower portions of nephron loop
Volume of normal urine
1-2 L per day
Color of normal urine
Variable shades of yellow
Turbidity of normal urine
Clear
Odor of normal urine
Variable ammonia-like odor
pH of normal urine
Variable: 4.5-8
Average: 5-6.5
Specific gravity of urine
1.005-1.025
Measures the nitrogen in the blood due to amount of urea present
Blood urea nitrogen(BUN)
_______ is a waste product of muscle tissue
Creatinine
Creatinine is a waste product of muscle tissue
Plasma creatinine
Increased amounts in the blood commonly represent a ___________ glomerular filtration rate
Decreased
2 lab tests to evaluate renal function
Blood urea nitrogen (BUN)
Plasma creatinine
To provide an extra energy reserve in muscle, the body uses _______
Creatine
What are the ureters lined with
Transitional epithelium
What does secreted mucus in the ureters do
Protect the epithelium from coming into direct contact with urine(slightly acidic)
What does transitional epithelium do for the ureters
Allows the ureter to stretch with variable volumes of urine
How long are the ureters
25-30cm long
3 ways that help ureters transport urine
Peristalsis
Hydrostatic pressure
Gravity
Where do the ureters attach to bladder
Obliquely to the base
Describe structure of bladder
Hollow, distensible organ
How much does the bladder hold
700-800 ml
Triangular-shaped area formed by openings of the ureters and urethra
Trigone
Folds(Rugae) in mucous membrane lining of bladder allow _________.
Distension
Contracts to assist in excreting urine
Detrusor muscle
3 muscle fiber layers of detrusor muscle
Inner-longitudinal
Middle-circular
Outer-longitudinal
Internal and external urethral sphincters
Internal: involuntary
External: voluntary
Release of urine from the bladder, urination or voiding
Micturition
Is Micturition voluntary or involuntary
Both
Micturition reflex
- stretch receptors stimulate when bladder = 200-400ml
- parasympathetic response = detrusor muscle contracts and internal urethral sphincter relaxes
- conscious..bladder full
- voluntary inhibition of somatic neurons to external urethral sphincter
- voiding
How long is male urethra
20 cm (8in) long
3 regions of male urethra
Prostatic
Membranous
Spongy
How long are females urethra
4cm(1.5in)
Where are females urethra located
Between clitoris and vaginal opening
Shorter length of female urethras contribute to ________
Bladder infections
T/F: the Males urethra is shared with the reproductive system
True
The fluids in the body account for _____ of overall body mass
60%
2/3 of the total fluid in the body is _________
Intracellular (fluid within cells)
1/3 of total fluid in body is _______
Extra cellular (fluid outside cells)
Fluid in the tissues that is “bathing” the cells
Interstitial fluid
Is interstitial fluid part of the Intracellular or extracellular fluid
Extracellular
Plasma, glomerular filtrate, lymph, CSF, GI, synovial, eats, eyes, pleural, pericardial, and peritoneal fluids are all part of which…the Intracellular of extra cellular
Extracellular
The main extracellular space for fluid is the ___________________
Interstitial compartment
A small volume of water is gained through ATP synthesis and is called ____________
Metabolic water
Water gain and water loss are supposed to be ________
Equal
Where is the thirst center located
Hypothalamus
A condition that occurs when water loss exceeds water gain
Dehydration
Function of thirst center
Detects increases in blood osmolarity
2 things dehydration does
⬇️ blood pressure
⬆️ blood osmolarity
Other receptors for dehydration include the kidneys, baroreceptors in the arteries, and neurons in the mouth that detect dryness
🙂
2 mechanisms to regulate daily water gain
Thirst center
Dehydration
Condition where there’s a decrease in interstitial concentration and water moves into the Intracellular space and cause cellular swelling, and if sever enough, cellular death
Water intoxication
For cells not to shrink or swell, the ________ of both fluids has to be the same
Osmolarity
Kidneys excrete water at a rate of ________
15 ml/min
Distribution of anions and cations that are higher extracellular
Sodium
Chloride
Bicarbonate
Calcium
Distribution of anions and cations that are higher Intracellularly
Protein anions Potassium Magnesium Phosphate Sulfate
Units to express electrolyte levels
Milliequivalents/Liter (mEg/L)
Reflects the concentration of anions or cations in a given volume
Milliequivalents/Liter (mEq/L)
One _______ is the positive or negative charges equal to the amount of charges in _______ of H+ ions
Equivalent, 1 mole
A milliequivalent is
1/1000 of an equivalent
Molecules that have the ability to bind to H+, this reducing the pH of the solution
Buffers
Do buffers remove H+ from the body
No. They bind to them. The Hydrogen ions become Hydrogen atoms
3 common buffering systems
- Protein buffering system
- Carbonic acid-bicarbonate buffering system
- phosphate buffering system
Hyperventilation _______ pH
Increases
Hypoventilation _______ pH
Decreases
An increase in ________ results in an increase in H+, so any condition causing the accumulation of _____ will result in lower pH
CO2, CO2
T/F: changes in rate and depth of ventilation does not alter the blood pH
False! It does alter pH
T/F: pH alterations can take place in a couple of minutes
True
Metabolic reactions produce large amounts of _______
Acids
The kidneys can secrete large amounts of ___
H+
How can kidneys secrete large amounts of H+
- H+ are exchanged for Na+ in proximal convoluted tubule
* proton pumps in collecting duct
The collecting ducts can secrete ______ when the pH is low and _____ when the pH is high
H+, HCO3-
Normal blood pH
7.35-7.45
Blood pH below 7.35
Acidosis
Blood pH above 7.45
Alkalosis
- urine dipstick test
- 1-10 absorbent pads, each detecting a different chemical
• protein, glucose, bilirubin, blood, evidence of white blood cells and bacteria
Biochemical UA test
- sediment from centrifuged urine sample is viewed using a light microscope
• white blood cells, RBC’s, yeast, bacteria, etc.
Microscopic UA test
Renal corpuscle consists of
- glomerulus
- glomerular capsule
Two groups of structures that makeup nephron
Renal corpuscle
Renal tubules
Renal tubules consists of
- proximal convoluted tubule
- nephron loop
- distal convoluted tubule
Filtering structure of nephron
Renal corpuscle
Tightly-coiled tubule attached directly to glomerulus
Proximal convoluted tubule
Tightly-coiled tubules farther away from glomerulus
Distal convoluted tubule
Several distal convoluted tubules come together to form a _________
Collecting duct
Many collecting ducts merge to form ______
Papillary duct
Two types of nephrons
Cortical
Justanedullary
80-85% of nephrons
Cortical
15-20% nephrons
Juxtamedullary
Nephron loop extends only a short distance into medulla
Cortical nephron
Nephron loop extends deep into medulla
Juxtamedullary nephron
- Densely-packed columnar cells in the ascending nephron loop
- arranged next to the Afferent arteriole
Macula densa
Specialized smooth muscle cells of the Afferent arteriole that control vessel in diameter
Juxtaglomerular cells
Together, the macula densa and juxtaglomerular cells…
Control the blood pressure and filtration rate in kidneys
3 layers of tissue that form the filtration membrane
Capillary endothelium
Basal lamina
Podocytes
This contains fenestrated capillaries and limits passage of formed elements.
Capillary endothelium
Connective tissue membrane and limits passage of large proteins
Basal lamina
Specialized epithelium formed from the glomerular capsule.
• Pedicels form the slit membrane
• limits passage of small proteins
Podocytes
Small spaces between pedicels
Filtration slits
The amount of glomerular filtrate formed each minute
Glomerular filtration rate
3 regulatory mechanisms to control GFR
- Renal autoregulation
- Neural regulation
- Hormonal regulation
3 ways of renal autoregulation
- Myogenic mechanism
- Tubuloglomerular feedback
Constricting or dilating the Afferent and efferent Arterioles to control GFR
Myogenic mechanism
Tubulomerular feedback
- macula densa detects ⬆️ Na+, Cl- and water
- ⬇️ release of nitric oxide = vasoconstriction of Afferent Arterioles
Neural regulation
⬆️ sympathetic control
• ⬆️ norepinephrine
• constriction of Afferent arteriole = ⬇️ GFR
2 hormones that contribute to hormonal regulation
Angiotensin ll
Atrial natriuretic peptide (ANP)
Angiotensin ll
- vasoconstrictor
* ⬇️ GFR
Atrial natriuretic peptide (ANP)
- vasodilator
* ⬆️ GFR
Milliosmole
Number of parts
Milliequivalent
Number of charges
Protein buffering system
- most abundant buffering system in plasma and Intracellular fluid
- carboxyl function group can bind H+
- side chains on 7 of 20 amino acids can bind H+
Carbonic acid-bicarbonate buffering system
Bicarbonate ion (weak base) can bind to H+ to form carbonic acid (weak acid)
Phosphate buffering system
Monohydrogen phosphate(weak base) can bind H+ and form dihydrogen phosphate (weak acid)
Respiratory acidosis
Changes: accumulation of excess CO2
Causes:
- Hypoventilation
- emphysema
- overdose of respiratory-suppressive drugs
Respiratory alkalosis
Changes: exhalation of too much CO2
Causes:
- severe anxiety
- oxygen deficiency
Metabolic acidosis
Changes:
- ⬇️ plasma HCO3
- non-respiratory acid accumulation
- failure of kidneys to secrete H+
Causes:
- diarrhea
- ketosis, lactic acidosis, etc
- renal dysfunction
Metabolic alkalosis
Changes:
- non-respiratory acid loss
- excessive HCO3
Causes:
- vomiting
- alkaline drugs (antacids)