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Anatomy and Physiology 2 > module 7 urinary system > Flashcards

module 7 urinary system Flashcards

1
Q

What are the primary organs of the urinary system

A

2 kidneys, 2 ureters, 1 bladder, 1 urethra

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2
Q

ureter drains from what and into what

A

from kidney; into urinary bladder

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3
Q

what is the function of the kidney

A

fluid homeostasis, filtrate waste, blood volume homeostasis and the chemical composition of blood

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4
Q

what is the shape of the kidney

A

bean, size of soup can, 5oz,

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5
Q

where is the kidney located

A

R is lower than L because of liver as it lies between T12 and L3

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6
Q

Where is the renal hilus and what enters

A

medial surface of kidney: concave:

ureter, blood vessel and nerves enter in the hilus and leads to interior sinus

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7
Q

What is the renal sinus

A

space just inside the kidney- hilus leads to it

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8
Q

what are the 3 specialized tissues in the kidney

A

inner: renal capsule: tough fibrous outer: protect from injury and infection
2. adipose capsule: fatty layer outside renal protect from trauma
outer: renal fascia: dense fibrous connective tissue keeps kidney connected in abdominal cavity

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9
Q

What are the 3 regions of the kidney

A

renal cortex, renal medulla, renal pelvis

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10
Q

Describe the renal cortex

A

just inside renal capsule: continuous outer region with several cortical columns extend down between pyramids

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11
Q

what is in the renal cortex

A

glomular capsule and distal/proximal tubule section of nephron along with associated blood vessels

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12
Q

Describe the renal medulla

A

deep in kidney

divided into pyramids

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13
Q

What is in the renal medulla

A

Loop of henle and collecting ducts

sections of nephron w/associated blood vessels

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14
Q

Describe the renal pelvis

A

centermost section of kidney
funnel shaped tube connects to ureter as leaves hilus
ureter transports to bladder to be stored

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15
Q

What are the extensions of the renal pelvis called and their function

A

Calyces: collect urine

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16
Q

What is the blood pathway of the renal arteries and their branches to afferent arteriole

A

renal artery->segmental->lobar->interlobar artery->arcuate artery->interlobular artery->afferent artery-supplies glomerular capillaries

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17
Q

What is the blood pathway of renal vein after filtration

A

filtration->efferent arterioles->peritubular or vasa recta capillaries->interlobular vein->arcuate vein->interlobar vein->renal vein

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18
Q

what is the renal plexus

A

it is how the kidney and nervous system interact

fibers follow renal arteries to kidneys

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19
Q

what system adjusts the diameter of renal artery there regulating the renal blood flow

A

input from sympathetic nervous system

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20
Q

describe ureter and its function

A

thin muscular tube; carry urine from kidney to bladder; begins as a continuation of renal pelvis

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21
Q

what are the ureterovesical valves and what do they prevent

A

sphincters located where ureter enter bladder

help prevent urine back flow toward kidney

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22
Q

what are the 3 tissue layers of the wall of the ureter

A

inner: transitional epithelium
middle muscular : 2 sheets: 1 longitudinal and other circular
outer: adventitia: fibrous connective tissue

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23
Q

distention of which layer of the ureter causes contraction to push urine through

A

middle muscular layer

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24
Q

Describe the bladder

A

hollow, muscular, elastic pouch: receives and stores urine

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25
Q

where is the bladder located in males? females

A

males: base of bladder in front of rectum, behind pubic symphysis
female: below uterus, in front of vagina, max capacity is lower in females

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26
Q

where does the ureter open into the bladder

A

uretal orifice

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27
Q

what begins at the base of the bladder

A

urethra

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28
Q

what is the opening called that is triangular shaped in bladder and is smooth

A

trigone

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29
Q

what are the 3 tissues of the bladder wall

A

outer: adventitia: fibrous connective
middle: muscular detrusor muscle- inner and outer longitudinal layer
inner: mucosal: transitional epithelium

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30
Q

Describe the bladder when its empty

when full

A

when empty: collapses into a pyramid shape because of the elasticity
when filling: swells into pear shape and rises in abdomen cavity; muscular wall stretches, rugae extend to help capacity of bladder

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31
Q

how much urine can bladder hold

A

moderately full: 500mL of urine

capacity is 1000mL

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32
Q

Describe the urethra

A

thin wall tube carry urine from urinary bladder out of body
mucosal lining of urethra start as transitional cells as exit bladder come stratified columnar and then stratified squamous cells near external urethral spinctor

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33
Q

Describe the internal urethral spinctor

A

involuntary controlled: located near bladder and keep urethra closed to prevent urine from leaving bladder

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34
Q

Describe external urethral sphinctor

A

voluntary controlled: composed of skeletal muscle, surround uretrha as pass through pelvic floor

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35
Q

what are the differences in the urethra between males and females

A

female: urethra is shorter, only carries urine
male: 5x longer, carry both urine and semen from body- functions only 1 system at a time

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36
Q

what are the 3 regions of the male urethra

A

prostatic: run with prostate
membranous: run with urogenital diaphragm
spongy: run w/in penis: opens to external urethral opening

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37
Q

What is a UTI

A

Urinary Tract Infection
female urethra is short and external opening is close to anus
poor hygiene after defection can easily carry fecal bacteria into urethra- bacteria enter and travel to bladder causes UTI

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38
Q

What is the nephron

A

structural and functional unit of the kidney

over 1,000,000

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39
Q

What is the function of the nephron

A

control concentration of water and solutes in blood
reabsorb needed material
excrete rest as urine- eliminates waste, regulates: blood volume, pH, pressure and controls electrolyte balance

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40
Q

what are the 2 parts of the nephron and how are they connected

A

glomerular capsule: filters blood
renal tubule: reabsorb needed material+ collecting duct carry remaining material away as urine
2 parts are connected by tubule and collecting ducts

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41
Q

what are the 3 parts of the renal tubule

A

proximal convoluted tubule: PCT
loop of henle
distal convoluted tubule: DCT

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42
Q

What is the renal corpuscle

A

composed of glomerulus

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43
Q

what is the glomerulus

A

network of tiny blood capillaries surrounded by glomerular( Bowmen) capsule(double walled squamous epithelial cup)

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44
Q

what do the glomular capillaries lie inbetween

A

the afferent and efferent arterioles

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45
Q

describe the afferent arteriole

A

fed by interlobular artery, larger than efferent
the difference in diameter causes increase in BP in glomerular capillaries: force H20 and solutes out of blood making filtration possible

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46
Q

What is filtrate

A

H20 and solutes that have left the blood and entered glomerular capsule

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47
Q

What is a cortical nephron and what % of kidney is the nephron

A

85%
found in cortex region of kidney
small portion in loop of henle which goes into medulla

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48
Q

what are juxtamedullary nephrons

A

remaining 15% of nephrons in the kidney

pass deeply into medulla because of location and longer loop of henle

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49
Q

Describe the PCT structure and function

A

surrounds renal tube+ secrete unwanted substance

reabsorbs H20 and solutes from glomerular filtrate into decreased pressure peritubular capillaries

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50
Q

Describe the Loop of Henle

A

has 2 limbs: ascending and descending( ascending is first)
descending allow H20 loss
ascending allow NaCL loss

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51
Q

Describe the DCT

A

allow for hormonally control reabsorption of water and solutes
secretes unwanted substances

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52
Q

when is filtrate considered urine

A

when reaches renal pelvis

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53
Q

what is the collecting duct

A

urine drains into this duct after passing through tubulues

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54
Q

what are the papillary ducts

A

many collecting ducts form this

drain into calyces and subsequently into renal pelvis and out of kidney by what of ureter

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55
Q

Describe the glomerular capillaries

A

highly coiled, formed from afferent arterioles, leaving as efferent arteriole
specialized for filtration: force fluid and solute out of blood and into glomular capsule
99% of glomular filtrate reabsorbed through renal tubule and return to blood in peritubular capillary bed

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56
Q

Describe Peritubular capillaries

A

closely follow renal tubules- drain into interlobular vein

adapted for absorption, reclaim H20 and solute from filtrate because of decreased pressure

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57
Q

Describe the Vasa Recta

A

follows loop of Henle in juxtamedulllary nephron of medulla

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58
Q

what is micturition

A

urination: empty bladder

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59
Q

what is the process for urination

A

urge felt at about 200mL of liquid- cause bladder wall to distend, intitiate visceral reflex arc-> detrursor muscle contracts and internal sphincter relaxes, force stored during through internal sphincter into urethra to be expelled

60
Q

which sphincter can be ignored

A

external as it is voluntary

if reaches 100% capacity- external sphincter becomes involuntary

61
Q

define incontinence

A

inability to control urination voluntarily
normal in infants and later in life/dementia
nervous system injury/stroke

62
Q

define urinary retention

A

inability to expel stored urine
common after general anesthesia
in males occurs dur to overgrowth of prostate
catheters may be necessary to insert in urethra to allow bladder to empty

63
Q

how many times a day do kidneys filter entire blood plasma

how much of resting energy is used for this process

A

60x/day

25% of resting energy

64
Q

how many gallons of glomerular filtrate contain H20, nutrients and ions are removed daily

A

47 gallons

65
Q

by the time filtrate enters collecting ducts how much is actually urine

A

.5 gallon

other 99% is returned to blood

66
Q

what 3 processes happen for body to filter all blood and return important elements

A

filtration: glomerulus
reabsorption: renal tubules
secretion: renal tubules

67
Q

Describe glomerular filtration

A

mechanical: no energy required
takes place across porous membrane- lie between capillaries and interior glomerular casuple
depends on opposing pressure exerted w/in glomerular capsule and glomerulus capillary
measured in mmHg: milimeters of mercury

68
Q

What is HP in glomerular filtration

A

Hydrostatic pressure of blood
amount found inside the blood in capillaries:
drives fluid out of capillaries
varies from person to person, dependent on BP from heart and vessels

69
Q

What is Colloid Osmotic Pressure( COP)

A

oncotic pressure
dependent on # of protein in plasma
opposes blood HP by drive fluid back into capillary bed
draws H20 out of filtrate

70
Q

What is normal range for COP and what happens if out of range

A

normal range 25-32mmHG

if out of this range causes damage to glomerulus

71
Q

What is Capsular Hydrostatic pressure

A

mechanical pressure exerted by recoil of elasticity inside glomerular arteriole
opposes blood HP by driving fluid back into glomerular capillaries

72
Q

What is Net filtration Pressure

A

difference in pressure between outgoing and incoming forces at glomerulus
pressure which filtrate enter the PCT

73
Q

What is the glomerular filtration rate( GFR)

A

amount of blood filtered by glomerulus over time

74
Q

what is normal GFR rate

A

120-125mL/min or 180L/day
due to surface area glomerular artery, large degree filtration membrane permeability and moderate net filtration pressure

75
Q

What causes and increase/decrease in GFR and why is constant rate importatn

A

increase in GFR caused by increase arterial BP in kidney
decrease in GFR caused by increase in glomerular osmotic pressure: dehydration normal cause
maintenance important: adequate reabsorption H20 and other substances from filtrate and filtering of wastes

76
Q

what is the result if GFR is too fast or too slow

A

too fast: substance are not adequately reabsorbed

too slow: nearly all filtrate reabsorbed: including wastes

77
Q

What are the 3 mechanisms that regulate GFR

A

Renal autoregulation
nervous system
Hormonal: Renin-angiotensin-aldosterone: RAA

78
Q

Describe renal autoregulation

A

kidney determines own rate of blood flow by controlling diameter of afferent and efferent arterioles
able to maintain constant GFR despite change in arterial BP in rest of body

79
Q

Describe how the nervous system regulate GFR

A

takes over in times of emergencies
afferent arteriole diameter narrowed by sympathetic fibers
releases epinephrine: decrease renal blood flow and decrease GFR
long periods of time with decreased blood to cell of kidney is damaging to kidneys

80
Q

when does RAA respond

A

when body BP is too low

81
Q

what is angiotensiongen

A

pre-enzyme: produced by liver: freely circulates blood

82
Q

what is renin

A

enzyme released by juxtaglomerular cell of nephron when BP drops

83
Q

How does RAA work

A

when renin is released, it causes constriction of efferent and afferent arterioles and signals angiotensiogen to be converted to angiotensin 1
in the lungs: angiotensin 1 is converted to angiotensin 2 signaling thirst in hypothalamus
water intake increase BP and blood volume
angiotensin 2 causes vasoconstriction to increase peripheral BP
angiotensin 2 reaches adrenal cortex and aldosterone is released
aldosterone cause renal tubules to absorb more NaCL- increasing water retention
overall helps in reabsorption of water and sodium from filtrate

84
Q

What is tubular reabsorption

A

process of fluid and substances moving from filtrate back into blood
If tubular reabsorption didn’t occur-entire plasma drained away as urine in 1 hour
hormonally regulated; active or passive

85
Q

what is diffusion and is it active or passive

A

process that does not require energy and passive

active means: pumps ATP driven and require energy

86
Q

where is the greatest amount of tubular reabsorption occur

A

in cells of PCT

87
Q

What substances are actively reabsorbed in PCT

A

glucose and amino acids

65% of Na+, 65% H2O, 90% HCO3-, 50% chloride, 50% K+ reclaimed from filtrate along with most ca, phosphate and magnesium

88
Q

How do the ascending and descending loops act differently from each other in loop of henle

A

H2O leaves descending but not ascending

Na+ and K+ leave ascending but not descending

89
Q

What is reabsorbed in loop of henle

A

25% Na, 15% H20, 40% K, reabsorbed in pertubular capillaries to return to blood

90
Q

How much of various filtrates remain after being filtered in PCT and loop of Henle and in DCT

A

10% of Na and CL, 20% H20 remain once reaching DCT

91
Q

what conditions can be controlled by ions channelled through DCT and collecting ducts

A

abnormal BP, low blood volume, low Na+ or high K+ in fluid

92
Q

What is tubular secretion

A

removing substances from peritubular capillaries

93
Q

What regulates urine concentration and volume

A

kidneys: they maintain homeostasis

94
Q

What is countercurrent flow

A

movement of fluids in opposite direction through adjacent channels
ex: filtrate in nephron flows in 1 direction through renal tubules while blood in adjacent flows in opposite direction

95
Q

what is the purpose of the countercurrent flow

A

help kidney to establish and maintain osmotic gradient from renal cortex to medulla

96
Q

what is the osmotic gradient

A

concentration of solutes inside a solution measure in milliosmoles/liters

97
Q

what does isomotic mean

A

fluid inside/outside have same concentration

98
Q

osmotic characteristic of filtrate when entering PCT is

A

300

99
Q

when does solute concentration increase

A

in descending limb of loop of henle: hair pin turn filtrate increase 1200 mOsm/L

100
Q

what is urea

A

substance converted from ammonia to be excreted as urine

101
Q

where is the concentration of urea high

where is the concentration of urea lower

A

in DCT and cortex of collecting ducts because tubules in cortex are impermeable to it: high
medullary collecting duct as it is highly permeable to it- contributes to high osmolarity until concentrations are equal inside/out of duct

102
Q

What is ADH and its function

A

hormone produced in hypothalamus and released posterior pituitary
inhibits urine output by increasing # of channels in cells o collecting ducts
connected to body degree of hydration
responds to hemorrhage

103
Q

which factors contribute to dehydration

A

excessive water loss- sweat, vomit, diarrhea

104
Q

what is a hemorrhage and how does ADH respond

A

large amount of blood loss which results in a drop in BP

ADH responds by retain 99% of water in filtrate, kidney excretes little volume that is highly concentrated

105
Q

what is the osmolarity when ADH is released compared to not being released

A

when released as high as 1200

when not released as low as 65

106
Q

what is aldosterone

A

hormone secreted by adrenal cortex in adrenals: works with RAA system
acts to place several ion channels inside the collecting ducts

107
Q

What are 2 actions of aldosterone

A

acts on the sodium-hydrogen channel: increases reabsorption of Na+ through secretion of Hydrogen( sodium pumped out, H+ pumped in for secretion)
sodium potassium pump: sodium is pumped out and K+ is pumped in for secretion

108
Q

what is the overall result of aldosterone

A

increase blood volume and BP when needed

can be triggered by high K+ or low Na+

109
Q

what are diuretics

A

substances act on nephron to increase urinary output

most diuretic drugs decrease Na+ reabsorption, less H2O is absorbed

110
Q

what are 2 examples of diuretics and their effects

A

caffeine: cause renal tubules to increase in diameter, increase amount of flow through tubules
alcohol: inhibit release of ADH

111
Q

what are cardiovascular baroreceptors

A

exert control over nephron to regulate blood volume
found in aortic arch and carotid sinus arteries under control of vagus and glossopharyngeal nerves
mechanorecptor: detect stretch inside vessels

112
Q

how do cardiovascular baroreceptors regulate blood volume

A

if blood volume and BP rise baroreceptor inhibit sympathetic nervous system signal kidneys which dilates the afferent arteriole that brings blood to the glomerulus.
causes increase in filtration rate, increases output of water and sodium, reduces blood volume to normalize pressure

113
Q

what are the characteristics of normal urine

A

clear and a pale yellow
has a distinctive odor: but not pungent
ammonia at end of urination: because of bacterial break down of urea

114
Q

what causes the color of urine

A

urochrome: pigment derived from breakdown of hemoglobin

115
Q

What are abnormal characteristic of urine

A

cloudy: pus- could be UTI
foods, drugs, blood
fruity smell: diabetics

116
Q

What is the normal pH and density of urine

A

pH: 4.5-8: diet high in citrus/veg- more basic, high in protein more acidic
density: 1.003-1.035`

117
Q

what is the composition of urine

A

95% water, 5% solutes
urea is most abundant solute: 2%
other wastes: uric acid, creatine, ammonia
solutes: Na, phosphate, sulfate calcium, magnesium, chloride, bicarbonate ion

118
Q

where is water found in the body

A

intracellular: inside cells: 60% of fluid in the body
extracellular: outside cells: 40%

119
Q

what are the 2 sections of the extracellular fluid

A

plasma: fluid portion of blood contain 3L or 8% total
interstitial: fluid in microscopic space between cells contain 12L or 32% total

120
Q

what does the acid-base pH balance refer to

A

balance of concentration of hydrogen in blood

121
Q

what is the pH scale

A

ranges 0-14

0=acidic, 14= basic

122
Q

what is the normal pH of arterial blood and what indicates alkalosis and acidosis

A

7.35-7.45
alkalosis is arterial blood above 7.45
acidosis is arterial blood below 7.35

123
Q

What controls the blood acidity

A

chemical buffers, brain stem respiratory and renal system

124
Q

What is included as part of chemical buffers

A

anion: negative charged ion: HCO3-
cation: positive charged ion: ammonium NH4+
combinations of weak acid and its cation or weak base and its anion

125
Q

Which 3 systems are chemical buffers

A

bicarbonate: acts as buffer of interstitial and plasma fluids
phosphate: buffers in urine and intracellular fluid
protein: main buffer intracellular fluid

126
Q

what are the compositions of the bicarbonate, phosphate and protein systems as chemical buffers

A

bicarbonate: weak carbonic acid and bicarbonate
phosphate: weak acid (H2PO4) and mono hydrogen phosphate
protien: includes amino acids, hemoblogin, plasma proteins: 3x buffer capacity of all other systems

127
Q

the respiratory center is responsible for

A

removing CO2 from blood

adding O2 to blood

128
Q

what monitors the levels of CO2 in the blood

A

chemoreceptors in the medulla of the brain stem

129
Q

what is reaction 1

A

CO2+H2O->H2CO3->H+ +HCO3-

130
Q

what is formed when carbonic acid dissasociates in water

A

H+ and HCO3-

131
Q

what is hyperventilation

A

increase in respiratory rate decreasing the amount of CO2 in the blood

132
Q

what is hypoventilation

A

when respiratory system is depressed, blood pH is more alkaline, allows CO2 to accumulate

133
Q

how is hyperventilation and hypoventilation resolved

A

hyperventilation: reaction 1 is pushed to the Left as CO2 is removed- using up H+ which causes pH to rise and balance restored
hypoventilation: reaction 1 is push to the R: forms more H+ ion, pH falls- more acidic and balance restored

134
Q

define respiratory acidosis and respiratory alkalosis

A

respiratory acidosis: imbalance of pH due to CO2 retention

respiratory alkalosis: imbalance of pH due to CO2 removal

135
Q

which major system is used to manage acid-base imbalances caused by daily metabolic processes

A

renal control system

functions: excrete or reabsorb bicarbonate

136
Q

what is the acid base balance dependent on

A

secretion of H+ ion and conversion of bicarbonate

137
Q

How is respiratory acidosis characterized

A

lower pH because of higher PCO2
caused by shallow breathing/limited gas exchange
causes renal system to fix by renal compensation

138
Q

How is respiratory alkalosis characterized

A

higher pH because of lower PCO2
almost always caused by hyperventilation
causes renal system to fix by renal compensation

139
Q

How is metabolic acidosis characterized

A

low pH, normal CO2, low bicarbonate
caused by buildup of acidic materials: acetic acid( alcohol), lactic acid, diabetic ketosis, extreme diarrhea
correction through respiratory compensation

140
Q

How is metabolic alkalosis characterized

A

high pH, normal CO2, high bicarbonate
causes: vomit, intake excess antacids, constipation
correction through respiratory compensation

141
Q

what are the normal blood serum levels
pH
PCO2
HCO3-

A

7.35-7.45 pH
35-45 mm
22-26 mEq/L

142
Q

what is the process for determining if a patient is in acids or alkalosis and what is commentating if anything

A
  1. determine if patient is in acidosis or alkalosis
  2. determine if problem from respiratory or metabolic
  3. determine if condition is compensated
  4. if condition is compensated: what action is body taking
143
Q

state values seen for respiratory acidosis: table 4.1

A

pH<7.35
PCO2>45 if causing condition
HCO3- > 26 if being compensated
body compensate: increased kidney retention of HCO3-

144
Q

state values seen for respiratory alkalosis: table 4.1

A

pH>7.45
PCO2<35 if causing condition
HCO3-<22 if being compensated
body compensated: decreased kidney retention of HCO3-

145
Q

state values seen for metabolic acidosis: table 4. 1

A

pH <7.35
PCO2<35 if being compensated
HCO3-<22 if causing condition
body compensated: hyperventilation to increase CO2 elimination

146
Q

state values seen for metabolic alkalosis: table 4. 1

A

pH> 7.45
PCO2>45 if being compensated
HCO3>26 if causing condition
body compensated: hypoventilation to decrease CO2 elimination

Anatomy and Physiology 2 (8 decks)

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