Module 19: Urinary System Flashcards
1
Q
Function of ureters
A
Transport urine from kidneys(renal pelvis) to the bladder
2
Q
Function of bladder
A
Store urine
3
Q
Function of urethra
A
External release of urine
4
Q
How are kidneys positioned
A
Retroperitoneal
5
Q
7 Functions of Urinary System
A
- regulate electrolytes
- regulates blood pH
- maintains blood concentration (osmolarity)
- regulates blood volume
- regulates blood pressure
- excretes wastes
- produces and releases of hormones
6
Q
Controls levels of various anions and cations
A
Regulation of electrolytes
7
Q
Control of pH by secretion H+ into the urine and return of HCO3 back to blood
A
Regulation of pH
8
Q
Control of blood concentration
A
Maintenance of blood osmolarity
9
Q
Adjusts blood volume by conserving or eliminating urine
A
Regulation of blood volume
10
Q
Adjusts blood pressure by conserving or eliminating Na+ and urine
A
Regulation of blood pressure
11
Q
Excretion of ammonia, urea, bilirubin, creatinine, Utica acid, and other wastes
A
Excretion of wastes
12
Q
Calcitriol (active vitamin D) to increase calcium levels; erythropoietin to increase RBD production
A
Production of hormones
13
Q
Release of glucose, produced by gluconeogenesis, into the blood
A
Regulation of blood glucose level
14
Q
From deep to superficial list the 3 layers of tissue in the kidney
A
Renal capsule
Adipose capsule
Renal fascia
15
Q
Renal capsule
A
Protect and maintain shape of kidney
16
Q
Adipose capsule
A
Protect and maintain position of kidney in abdominal cavity
17
Q
Renal fascia
A
Anchors kidney to abdominal wall and neighboring structures
18
Q
2 regions of of the kidney
A
Renal cortext
Medulla
19
Q
Triangular structures within the medulla that appear striated due to the presence of the renal tubules and ducts
A
Renal pyramid
20
Q
Is the renal pyramid striated or non-striated
A
Striated due to renal tubules and ducts
21
Q
Outermost region & extends between the renal pyramids
A
Cortex
22
Q
Renal pyramids
• renal papillae
• drain into the calyces
A
Medulla
23
Q
Functional unit of the kidney (1 million per kidney)
A
Nephrons
24
Q
Minor calyx(calyces)
A
8-18 per kidney
25
Major calyx(calyces)
2-3 per kidney
26
Each kidney has 2-3 major calyces which will drain into one large cavity called the ___________
Renal pelvis
27
Path of urine drainage in kidney
Collecting duct ➡️ papillary duct ➡️ minor calyx ➡️ major calyx ➡️ renal pelvis ➡️ ureter ➡️ urinary bladder
28
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
29
2 unique vascular features of the kidneys
1. Glomerular capillaries are positioned between two groups of Arterioles
2. There are 2 sets of capillaries
• glomerular capillaries
• peritubular capillaries
30
Located in the cortex and is the structure of the nephron that filters the blood
Renal corpuscle
31
Because it isn't blood anymore and it still isn't urine yet, what is it called in the renal corpuscle
Glomerular filtrate
32
Receives fluid from the filtration process(glomerular filtrate)
Glomerular capsule
33
3 renal functions
* glomerular filtration
* tubular reabsorption
* tubular secretion
34
Production of glomerular filtrate through the filtration of waste-laden blood by the glomerulus
Glomerular filtration
35
Process of returning important substances from the glomerular filtrate back to the bloodstream
Tubular reabsorption
36
Process of transporting substances from the bloodstream into the glomerular filtrate
Tubular secretion
37
Because it isn't blood anymore and it still isn't urine yet, what is it called in the renal corpuscle
Glomerular Filtrate
38
Receives fluid from the filtration process(glomerular filtrate)
Glomerular capsule
39
3 pressures that contribute to glomerular filtration
GBHP: Glomerular blood(capillary) hydrostatic pressure
CHO: capsular hydrostatic pressure
BCOP: blood colloid osmotic pressure
40
GBHP
Glomerular Blood(capillary) Hydrostatic Pressure
Cause by: blood pressure in capillaries
Action: favors filtration
mmHg: 55
41
CHP
Capsular hydrostatic pressure
Caused by: fluid present in capsular space
Action: opposes filtration
mmHg: 15
42
BCOP
Blood colloid osmotic pressure
Caused by: osmotic pressure from proteins remaining in the plasma
Action: opposes filtration
mmHg: 30
43
Net Filtration Pressure
GBHP - CHP - BCOP = NFP(Net Filtration Pressure)
55 - 15 - 30 = 10 mmHg
44
Blood minus the formed elements (cells) and the majority of the plasma proteins
Glomerular filtrate
45
Through filtration _______% of the plasma becomes part of the filtrate
16-20%
46
Process of returning important substances from the glomerular filtrate back to body
Tubular reabsorption
47
How much filtrate is reabsorbed
99%
| 65% water, 100% glucose, 50% urea
48
2 routes that a substance can be reabsorbed from
1. Paracellular reabsorption: between renal tubule cells
| 2. Transecellular reabsorption: through renal tubule cells
49
The majority of solute and water reabsorption occurs in
The proximal convoluted tubule
50
To maximize reabsorption capacity, cells of the proximal convoluted tubule are ______________ with prominent ___________.
Cuboidal epithelium, Microvilli
51
Present on surfaces of cells to actively reabsorbed many of the solutes
Transport proteins
52
Each transport protein has a transport speed limit
Transport maximum
53
The presence of solute above the limit will result in
Excretion of the excess solute in the urine
54
Loss of glucose in the urine
Glucosuria
55
* 90% water reabsorption
* As go solutes, so goes water
* water follows concentration gradient throughout most of the nephron
Obligatory reabsorption
56
* 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
57
Transport of substances from the bloodstream to the glomerular filtrate
Tubular secretion
58
2 main functions of tubular secretion
1. Secretion of H+ ions control pH
| 2. Hydrogen and Ammonium ions are secreted and bicarbonate conserved to maintain physiological pH
59
Where does tubular secretion occur
Throughout the nephrons
60
What substances are secreted in tubular secretion
H+, K+, NH4+, creatinine, and some drugs
61
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+
62
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
63
_________ implies two fluids flowing in opposite directions
Countercurrent
64
2 countercurrent mechanisms
* countercurrent multiplier
| * countercurrent exchange
65
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)
66
Countercurrent exchange
Vasa recta & urea cycling
67
Vasa recta
- supplies cells with oxygen and nutrients
| - allows for easy water reabsorption
68
Urea cycling
- water and urea reabsorbed from collecting duct
- water diffuse into vasa recta
- urea can diffuse into lower portions of nephron loop
69
Volume of normal urine
1-2 L per day
70
Color of normal urine
Variable shades of yellow
71
Turbidity of normal urine
Clear
72
Odor of normal urine
Variable ammonia-like odor
73
pH of normal urine
Variable: 4.5-8
Average: 5-6.5
74
Specific gravity of urine
1.005-1.025
75
Measures the nitrogen in the blood due to amount of urea present
Blood urea nitrogen(BUN)
76
_______ is a waste product of muscle tissue
Creatinine
77
Creatinine is a waste product of muscle tissue
Plasma creatinine
78
Increased amounts in the blood commonly represent a ___________ glomerular filtration rate
Decreased
79
2 lab tests to evaluate renal function
Blood urea nitrogen (BUN)
| Plasma creatinine
80
To provide an extra energy reserve in muscle, the body uses _______
Creatine
81
What are the ureters lined with
Transitional epithelium
82
What does secreted mucus in the ureters do
Protect the epithelium from coming into direct contact with urine(slightly acidic)
83
What does transitional epithelium do for the ureters
Allows the ureter to stretch with variable volumes of urine
84
How long are the ureters
25-30cm long
85
3 ways that help ureters transport urine
Peristalsis
Hydrostatic pressure
Gravity
86
Where do the ureters attach to bladder
Obliquely to the base
87
Describe structure of bladder
Hollow, distensible organ
88
How much does the bladder hold
700-800 ml
89
Triangular-shaped area formed by openings of the ureters and urethra
Trigone
90
Folds(Rugae) in mucous membrane lining of bladder allow _________.
Distension
91
Contracts to assist in excreting urine
Detrusor muscle
92
3 muscle fiber layers of detrusor muscle
Inner-longitudinal
Middle-circular
Outer-longitudinal
93
Internal and external urethral sphincters
Internal: involuntary
External: voluntary
94
Release of urine from the bladder, urination or voiding
Micturition
95
Is Micturition voluntary or involuntary
Both
96
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
97
How long is male urethra
20 cm (8in) long
98
3 regions of male urethra
Prostatic
Membranous
Spongy
99
How long are females urethra
4cm(1.5in)
100
Where are females urethra located
Between clitoris and vaginal opening
101
Shorter length of female urethras contribute to ________
Bladder infections
102
T/F: the Males urethra is shared with the reproductive system
True
103
The fluids in the body account for _____ of overall body mass
60%
104
2/3 of the total fluid in the body is _________
Intracellular (fluid within cells)
105
1/3 of total fluid in body is _______
Extra cellular (fluid outside cells)
106
Fluid in the tissues that is "bathing" the cells
Interstitial fluid
107
Is interstitial fluid part of the Intracellular or extracellular fluid
Extracellular
108
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
109
The main extracellular space for fluid is the ___________________
Interstitial compartment
110
A small volume of water is gained through ATP synthesis and is called ____________
Metabolic water
111
Water gain and water loss are supposed to be ________
Equal
112
Where is the thirst center located
Hypothalamus
113
A condition that occurs when water loss exceeds water gain
Dehydration
114
Function of thirst center
Detects increases in blood osmolarity
115
2 things dehydration does
⬇️ blood pressure
| ⬆️ blood osmolarity
116
Other receptors for dehydration include the kidneys, baroreceptors in the arteries, and neurons in the mouth that detect dryness
🙂
117
2 mechanisms to regulate daily water gain
Thirst center
| Dehydration
118
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
119
For cells not to shrink or swell, the ________ of both fluids has to be the same
Osmolarity
120
Kidneys excrete water at a rate of ________
15 ml/min
121
Distribution of anions and cations that are higher extracellular
Sodium
Chloride
Bicarbonate
Calcium
122
Distribution of anions and cations that are higher Intracellularly
```
Protein anions
Potassium
Magnesium
Phosphate
Sulfate
```
123
Units to express electrolyte levels
Milliequivalents/Liter (mEg/L)
124
Reflects the concentration of anions or cations in a given volume
Milliequivalents/Liter (mEq/L)
125
One _______ is the positive or negative charges equal to the amount of charges in _______ of H+ ions
Equivalent, 1 mole
126
A milliequivalent is
1/1000 of an equivalent
127
Molecules that have the ability to bind to H+, this reducing the pH of the solution
Buffers
128
Do buffers remove H+ from the body
No. They bind to them. The Hydrogen ions become Hydrogen atoms
129
3 common buffering systems
* Protein buffering system
* Carbonic acid-bicarbonate buffering system
* phosphate buffering system
130
Hyperventilation _______ pH
Increases
131
Hypoventilation _______ pH
Decreases
132
An increase in ________ results in an increase in H+, so any condition causing the accumulation of _____ will result in lower pH
CO2, CO2
133
T/F: changes in rate and depth of ventilation does not alter the blood pH
False! It does alter pH
134
T/F: pH alterations can take place in a couple of minutes
True
135
Metabolic reactions produce large amounts of _______
Acids
136
The kidneys can secrete large amounts of ___
H+
137
How can kidneys secrete large amounts of H+
* H+ are exchanged for Na+ in proximal convoluted tubule
| * proton pumps in collecting duct
138
The collecting ducts can secrete ______ when the pH is low and _____ when the pH is high
H+, HCO3-
139
Normal blood pH
7.35-7.45
140
Blood pH below 7.35
Acidosis
141
Blood pH above 7.45
Alkalosis
142
- 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
143
- sediment from centrifuged urine sample is viewed using a light microscope
• white blood cells, RBC's, yeast, bacteria, etc.
Microscopic UA test
144
Renal corpuscle consists of
- glomerulus
| - glomerular capsule
145
Two groups of structures that makeup nephron
Renal corpuscle
| Renal tubules
146
Renal tubules consists of
- proximal convoluted tubule
- nephron loop
- distal convoluted tubule
147
Filtering structure of nephron
Renal corpuscle
148
Tightly-coiled tubule attached directly to glomerulus
Proximal convoluted tubule
149
Tightly-coiled tubules farther away from glomerulus
Distal convoluted tubule
150
Several distal convoluted tubules come together to form a _________
Collecting duct
151
Many collecting ducts merge to form ______
Papillary duct
152
Two types of nephrons
Cortical
| Justanedullary
153
80-85% of nephrons
Cortical
154
15-20% nephrons
Juxtamedullary
155
Nephron loop extends only a short distance into medulla
Cortical nephron
156
Nephron loop extends deep into medulla
Juxtamedullary nephron
157
- Densely-packed columnar cells in the ascending nephron loop
- arranged next to the Afferent arteriole
Macula densa
158
Specialized smooth muscle cells of the Afferent arteriole that control vessel in diameter
Juxtaglomerular cells
159
Together, the macula densa and juxtaglomerular cells...
Control the blood pressure and filtration rate in kidneys
160
3 layers of tissue that form the filtration membrane
Capillary endothelium
Basal lamina
Podocytes
161
This contains fenestrated capillaries and limits passage of formed elements.
Capillary endothelium
162
Connective tissue membrane and limits passage of large proteins
Basal lamina
163
Specialized epithelium formed from the glomerular capsule.
• Pedicels form the slit membrane
• limits passage of small proteins
Podocytes
164
Small spaces between pedicels
Filtration slits
165
The amount of glomerular filtrate formed each minute
Glomerular filtration rate
166
3 regulatory mechanisms to control GFR
1. Renal autoregulation
2. Neural regulation
3. Hormonal regulation
167
3 ways of renal autoregulation
- Myogenic mechanism
| - Tubuloglomerular feedback
168
Constricting or dilating the Afferent and efferent Arterioles to control GFR
Myogenic mechanism
169
Tubulomerular feedback
- macula densa detects ⬆️ Na+, Cl- and water
| - ⬇️ release of nitric oxide = vasoconstriction of Afferent Arterioles
170
Neural regulation
⬆️ sympathetic control
• ⬆️ norepinephrine
• constriction of Afferent arteriole = ⬇️ GFR
171
2 hormones that contribute to hormonal regulation
Angiotensin ll
| Atrial natriuretic peptide (ANP)
172
Angiotensin ll
* vasoconstrictor
| * ⬇️ GFR
173
Atrial natriuretic peptide (ANP)
* vasodilator
| * ⬆️ GFR
174
Milliosmole
Number of parts
175
Milliequivalent
Number of charges
176
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+
177
Carbonic acid-bicarbonate buffering system
Bicarbonate ion (weak base) can bind to H+ to form carbonic acid (weak acid)
178
Phosphate buffering system
Monohydrogen phosphate(weak base) can bind H+ and form dihydrogen phosphate (weak acid)
179
Respiratory acidosis
Changes: accumulation of excess CO2
Causes:
- Hypoventilation
- emphysema
- overdose of respiratory-suppressive drugs
180
Respiratory alkalosis
Changes: exhalation of too much CO2
Causes:
- severe anxiety
- oxygen deficiency
181
Metabolic acidosis
Changes:
- ⬇️ plasma HCO3
- non-respiratory acid accumulation
- failure of kidneys to secrete H+
Causes:
- diarrhea
- ketosis, lactic acidosis, etc
- renal dysfunction
182
Metabolic alkalosis
Changes:
- non-respiratory acid loss
- excessive HCO3
Causes:
- vomiting
- alkaline drugs (antacids)
