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ANPH 215 - Anatomy and Physiology > Outcome 12 - Genitourinary System > Flashcards

Outcome 12 - Genitourinary System Flashcards

1
Q

describe the location of the kidneys.

A
  • retroperitoneal and around T12-L3
  • right kidney typically lower than left
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2
Q

what are the 3 outer layers that surround the kidneys?

A
  • renal fascia (anchors)
  • perirenal fat capsule (protection)
  • fibrous capsule (protection and shape)
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3
Q

what is the medial indentation on the kidney called? What can be found entering/exiting here?

A

renal hilum
- contains ureter, blood and lymph vessels and nerves

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4
Q

what is the outer region of the kidney?

A

renal cortex

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5
Q

what is the inner region of the kidney?

A

renal medulla

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6
Q

are the renal columns considered cortex or medulla?

A

cortex

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7
Q

what is each cone shaped region of the medulla called?

A

renal pyramid

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8
Q

where is the renal papilla found?

A

at the apex of each renal pyramid

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9
Q

where are the nephrons found?

A

within the renal parenchyma (cortex and medulla)

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10
Q

list the structures that urine flows through, after leaving the nephrons.

A

collecting duct –> papillary duct –> minor calyx –> renal pelvis –> ureter

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11
Q

what are some of the functions of the kidney?

A
  • regulation of ions, pH, blood volume, BP, blood glucose
  • maintain osmolarity
  • hormone production
  • excretes waste
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12
Q

How do the kidneys regulate pH?

A

by excretion of H+ and conserving HCO3-

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13
Q

how do kidneys regulate bp?

A

bp drops = secretion of renin

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14
Q

what are some hormones that the kidneys produce?

A

calcitriol and erythropoietin

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15
Q

what is gluconeogenesis?

A

use of amino acids to create glucose

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16
Q

what is osmolarity?

A

the number of dissolved particles (molecules, ions) per litre of solution

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17
Q

what is blood osmolarity?

A

~300 mOSm/L

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18
Q

each hilum expands into a cavity in the kidney and is called ____ ____.

A

renal sinus

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19
Q

describe the renal artery.

A

abdominal aorta –> renal artery
- renal artery is an end artery (if it’s block, there will be no flow in)

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20
Q

what view is the best to image the kidneys?

A

posterior view

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21
Q

people with horseshoe kidneys will need both _____ and _____ imaging.

A

posterior and anterior

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22
Q

what layer of the kidney connects it to the peritoneum?

A

renal fascia connects superficially

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23
Q

what does the renal lobe consists of?

A

a pyramid, region of cortex and 1/2 of the adjacent column

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24
Q

what is the renal parenchyma? what does it consist of?

A

the function portion of the kidney
- has the renal cortex and renal pyramids

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25
Q

why are kidneys very vascular?

A
  • they get rid of wastes from blood
  • control blood volume and bp
  • control ionic composition of blood
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26
Q

what is the renal blood flow?

A

~1200 mL/min

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27
Q

what is the glomerulus?

A

a ball of capillaries that is sandwiched between two sets of arterioles
*unique to kidneys

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28
Q

afferent arteriole ______ (in/out) of kidney
efferent arteriole ______ (in/out) of kidney

A

afferent - in kidney
efferent - out kidney

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29
Q

what is the path of blow flow in the kidneys?

A

renal artery –> segmental arteries –> interlobar arteries –> arcuate arteries –> cortical radiate arteries –> afferent glomerular arterioles –> glomerular capillaries –> efferent glomerular arterioles –> peritubular capillaries –> per tubular venues –> cortical radiate veins –> arcuate veins –> interlobar veins –> renal vein

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30
Q

nephrons regenerate. t/f

A

they don’t.
we only have a set number of nephrons (1M/kidney)

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31
Q

what are the two major parts of the nephron? and what are their functions?

A
  1. renal corpuscle - filters plasma
  2. renal tubule - where the filtered fluid goes
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32
Q

what are the two parts that make up the renal corpuscle?

A
  1. glomerulus
  2. glomerular capsule (bowman’s capsule)
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33
Q

what’s the function of the glomerular capsule?

A

it filters plasma

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34
Q

what are podocytes?

A

simple modified squamous epithelial cells that make up the visceral layer of the capsule

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35
Q

what are the 3 parts of the renal tubule?

A
  1. proximal convoluted tubule
  2. nephron loop (loop of Henle)
  3. distal convoluted tubule
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36
Q

what type of nephron is found more superficially in the cortex and has a short loop of henle?

A

cortical nephrons

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37
Q

what type of nephron is found deeper into the cortex layer and has a long loop of henle?

A

juxtamedullary nephrons

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38
Q

what is the flow of fluid through a cortical nephron?

A

bowman’s capsule –> proximal convoluted tubule –> descending limb of the nephron loop –> ascending limb of the nephron loop –> distal convoluted tubule –> collecting duct

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39
Q

what is the flow of fluid through a juxtamedullary nephron?

A

bowman’s capsule –> proximal convoluted tubule –> descending limb of the nephron loop –> thin ascending limb of the nephron loop –> thick ascending limb of the nephron loop –> distal convoluted tubule –> collecting duct

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40
Q

what percentage of nephrons are cortical? juxtamedullary?

A

cortical - 80-85%
juxta - 15-20%

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41
Q

looking at the different cell types within the tubules, where does most of the reabsorption occur?

A

proximal convoluted tubule (65%)

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42
Q

which cells have receptors for aldosterone and ADH? where are they located?

A

principal cells found in the last part of the DCT and throughout the collecting duct

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43
Q

what are intercalated cells important for?

A

pH balance and secretion of calcium

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44
Q

what is macula densa?

A

a bundle of columnar tubule cells at the final part of the ascending limb + afferent arterioles

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45
Q

what are the walls of the afferent arteriole made of?

A

modified smooth muscle fibers - juxtaglomerular cells (renin)

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46
Q

what are the 3 steps to urine formation?

A
  1. glomerular filtration
  2. tubular reabsorption
  3. Tubular secretion
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47
Q

during glomerular filtration, where does water and solute go from and into?

A

BLOOD from glomerular capillaries through the filtration membrane and into the glomerular capsule

water and solute from:
BLOOD to GLOMERULAR CAPSULE (in the renal corpuscle)

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48
Q

what is the fluid called when it enters the capsular space?

A

glomerular filtrate

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49
Q

what happens during tubular reabsorption?

A

glomerular filtrate moves into the renal tubules where 99% of the filtered water and solute will go back into the blood

water and solute from:
renal tubules to blood by peritubular capillaries

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50
Q

what happens during tubular secretion?

A

transfer of waste, drugs and excess ions from blood into tubule cells + lumen of renal tubule

waste, drugs and excess ions from:
BLOOD to tubule cells + lumen of renal tubule

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51
Q

what are the two layers of filtration membrane?

A
  1. glomerular capillary vessel wall
  2. podocytes (visceral capsule)
52
Q

what does the filtration membrane let pass? and what doesn’t go through?

A

pass - water and solutes
no pass - blood cells and plasma proteins

53
Q

what are the three reasons filtration is much higher in the glomerulus?

A
  1. higher surface area in the glomerular capillaries
  2. thin and porous filtration membrane
  3. glomerular capillary blood pressure is high
54
Q

what is the equation of the net filtration pressure (NFP)?

A

NFP = GBHP - CHP - BCOP
NFP = 10 mmHg

55
Q

what is GBHP?

A

glomerular blood hydrostatic pressure
55 mmHg

56
Q

what is CHP?

A

capsular hydrostatic pressure
15 mmHg

57
Q

what is BCOP?

A

blood colloid osmotic pressure
30 mmHg

58
Q

what is the glomerular filtration rate? what is the normal GFR in a male? female?

A

gfr = amount of filtrate formed in the renal corpuscles of both kidneys/minute
male - 125 mL/min
female - 105 mL/min

59
Q

what are the two mechanisms that are used to regulate GFR?

A
  1. adjustment in blood flow in and out of glomerulus
  2. altering the glomerular capillary SA to compensate and maintain GFR
60
Q

_____ (dilated/contracted) afferent arteriole + ______ (dilated/contracted) efferent arteriole = INCREASE GFR

A

dilated afferent + contracted efferent = increase GFR

61
Q

_____ (dilated/contracted) afferent arteriole + ______ (dilated/contracted) efferent arteriole = DECREASED GFR

A

contracted afferent + dilated efferent = DECREASED GFR

62
Q

________ (increase/decrease) capillary SA = INCREASE GFR

A

increase cap SA = increase GFR

63
Q

________ (increase/decrease) capillary SA = DECREASE GFR

A

decrease cap SA = decrease GFR

64
Q

what are three mechanisms to maintain constant GFR?

A
  1. autoregulation
  2. neural regulation
  3. endocrine regulation
65
Q

what are the two mechanisms for autoregulation?

A
  1. myogenic mechanism
  2. tubuloglomerular feedback
66
Q

what happens if the GFR is too high? too low?

A

too high = needed substances may not be reabsorbed
too low = waste products may not be excreted

67
Q

what is myogenic mechanism?

A

vasoconstriction of afferent arterioles as a response to overstretching

68
Q

what is tubuloglomerular feedback?

A

inhibiting nitric oxide (NO) release from juxtaglomerular apparatus which results in the vasoconstriction of afferent arterioles

69
Q

blood vessels of the kidneys are influenced by _____ (ANS) fibers which releases ______.

What does this NT do?

A

sympathetic ANS fibers - releases NE
NE - causes vasoconstriction of afferent arterioles

70
Q

which hormone reduces gfr?

A

angiotensin II

71
Q

which hormone increases gfr?

A

atrial natriuretic peptide (ANP)

72
Q

how does the hormone that reduces gfr work?

A

it causes vasoconstriction of both afferent and efferent arterioles = reducing blood flow

73
Q

how does the hormone that increases gfr work?

A

stimulated by the stretching of the atria (increased blood volume) = secretion of ANP = relaxation of mesangial cells = increase capillary SA for filtration

74
Q

where in the nephron do we find reabsorption and secretion happening?

A

collecting ducts

75
Q

what is paracellular reabsorption?

A

when fluid leaks between cells in the proximal convoluted tubules in a passive process
- tight junctions in these epithelial cells of PCT are leaky

76
Q

what is transcellular reabsorption?

A

when substances pass from the lumen from apical cell membrane
- movement across cytosol and then through the basal membrane and into interstitial fluid
*form of active transport (Na+/K+ ATPase pump)

77
Q

what are 2 types of PASSIVE transportation that occurs during tubular reabsorption/secretion?

A
  1. simple diffusion
  2. facilitated diffusion
78
Q

what are 2 types of ACTIVE transportation that occurs during tubular reabsorption/secretion?

A

primary and secondary active transport

79
Q

what are 2 types of OSMOTIC transportation that occurs during tubular reabsorption/secretion?

A
  1. obligatory water reabsorption
  2. facultative water reabsorption
80
Q

what is simple diffusion?

A

movement down concentration or electrochemical gradient

81
Q

what is facilitated diffusion?

A

movement down the concentration or electrochemical with assistance from a carrier molecule (i.e. ion channel gate)

82
Q

what is primary active transport?

A

use of energy produced by hydrolysis of A’‘\TP and transporters to pump substance across the membrane (Na+/K+ ATPase pump)

83
Q

what is secondary active transport?

A

coupling the movement of ions and electrochemical gradients

84
Q

what do you call membrane proteins that moves two or more ions in the SAME direction?

A

symporters

85
Q

what do you call membrane proteins that moves substances in OPPOSITE directions?

A

antiporter

86
Q

what is the difference between diffusion and osmosis?

A

osmosis is in relation to H2O
H2O following the concentration gradient

87
Q

what is obligatory water reabsorption?

A

about 80% of H2O moving is following sodium, chloride and glucose

88
Q

what is facultative water reabsorption?

A

about 20% of H2O is regulated by ADH (which means the adaptation based on need)
*in DCT and collecting duct

89
Q

what does angiotension II do? what stimulates it?

A

it increases the reabsorption of Na+ and water
which increases blood volume and pressure

stimulated by low blood vol./pressure –> release of renin

90
Q

what does aldosterone do? what stimulates it?

A
  • increase secretion of K+ and reabsorption of Na+ and water = increase blood volume and pressure

stimulated by the increase of angiotensin II and plasma K+

91
Q

what does ADH do? what stimulates it?

A
  • increase reabsorption of water = increase blood volume + decrease blood osmotic pressure

stimulated by decrease in blood vol. or increase in blood osmotic pressure

92
Q

what does ANP do? what stimulates it?

A
  • inhibits reabsorption of Na+ and water
  • suppresses secretion of aldosterone and ADH
    = increases urine output and decrease blood vol./pressure

stimulated by the increase of blood volume due to stretching of atria

93
Q

what does PTH do? what stimulates it?

A
  • increases the reabsorption of Ca2+
  • increase excretion of HPO42-
    = increase Ca2+ and decrease HPO42- in plasma

stimulated by the decreased level of Ca+ in plasma

94
Q

what is the anastomosis that occurs during kidney transplantation?

A
  • between the internal iliac artery and external iliac vein
  • ureter anastomosis or direct implantation into bladder
95
Q

what substances are mostly reabsorbed?

A

water, proteins, Na+, Cl-, HCO3-, glucose (*zero in urine), K+

96
Q

what is not reabsorbed?

A

creatinine + urea (some but not a lot)

97
Q

what gives urine its color?

A

urochrome from the breakdown of bile and urobilin from breakdown of hemoglobin

98
Q

what does BUN (blood urea nitrogen) test for?

A
  • measures the blood nitrogen levels from waste product urea
99
Q

which tests indicate a decrease in renal function?

A

too high BUN and/or too high creatinine

100
Q

what does creatinine test for?

A
  • measures the level of creatinine in the blood
    – creatinine = product of creatine phosphate breakdown in skeletal muscles
101
Q

what is renal plasma clearance?

A

the volume of blood that is cleared of a substance per unit of time (mL/min)

102
Q

what does high renal plasma clearance indicate? low renal plasma clearance?

A

high = efficient excretion
low = inefficient excretion

103
Q

what is the ideal substance used to test for renal plasma clearance? why?

A

inulin
- bc it is filtered by glomerulus but not reabsorbed or secreted
- clearance of inulin should = gfr

104
Q

what is renal plasma flow?

A
  • the amount of blood plasma that passes through the kidneys in one minute
105
Q

how is renal plasma flow measured? what is the typical renal plasma flow?

A

substance used needs to be cleared from the blood in a single pass
typical - 650 mL/min, about 55% of renal blood flow

106
Q

what are diuretics? how does it work?

A
  • used to increase urine formation
  • slows down reabsorption in tubules which causes diuresis (increased urine flow rate) + decreases blood volume
107
Q

what diuretic inhibits Na+ reabsorption?

A

caffeine

108
Q

what diuretic inhibits secretion of ADH?

A

alcohol

109
Q

how does urine move in the ureters to bladder?

A

peristalsis of smooth muscle walls + hydrostatic pressure and gravity

110
Q

what is the trigone?

A

the small triangular area in the inferior wall of the bladder
- consists of the two ureteral openings and the internal urethral orifice

111
Q

the internal urethral sphincter is ______, while the external urethral sphincter is _______.

A

internal - involuntary
external - voluntary

112
Q

what is the discharge of urine (urinating/voiding) called?

A

micturition

113
Q

what is the last portion of the urinary tract?

A

urethra

114
Q

what is the flow of urine formation?

A

afferent arteriole –> glomerular capillaries –> bowman’s capsule –> proximal convoluted tubule –> loop of henle (descending and ascending) –> distal convoluted tubule –> collecting duct –> papillary duct –> minor calyx –> major calyx –> renal pelvis –> ureter –> bladder –> urethra

115
Q

how long does a typical female cycle range from?

A

24-36 days

116
Q

what are the 4 phases of the female reproductive cycle?

A
  1. menstrual phase
  2. preovulatory phase
  3. ovulatory phase
  4. postovulatory phase
117
Q

what is the menstrual phase?

A

about the first 5 days of the cycle
- shedding of the endometrium (inner most layer of uterus)
- in the ovaries, follicles are starting to develop which may take months to complete

118
Q

what is the preovulatory phase? what is occurring?

A

time between end of menstruation and ovulation (about days 6-13)
- repair of the endometrium is occurring and it doubles in thickness
- in the ovaries, a single secondary follicle becomes dominant, tertiary follicle, and maturation is continuing

119
Q

which part of the cycle makes up for most of the difference in women’s cycle lengths?

A

preovulatory phase

120
Q

what is happening during the ovulation phase?

A

about day 14.

the secondary oocyte is released from the ruptured tertiary follicle and is swept into the fallopian (uterine) tubes

121
Q

what is mittelscmerz?

A

the pain caused by the rupturing of the tertiary follicle during the ovulation phase

122
Q

what is the post ovulatory phase?

A

between ovulation and next menstruation (about 14 days long or days 15-28 (during a 28 day cycle))

123
Q

what is occurring in the ovaries during the post ovulatory phase?

A
  • in the ovaries, the follicle collapses and is now the corpus luteum
  • corpus luteum secretes hormones that stimulate the preparation of the endometrium for possible fertilized ovum (lasts for about 2 weeks if no fertilization occurs)
124
Q

what is occurring in the fallopian tubes during the post ovulatory phase?

A

fertilization needs to occur within 24 hours of the oocyte release or the oocyte will continue towards uterus and disintegrate

125
Q

at minimum, first 5 days = _______, next 5 days = _______

A

first 5 days = menstruation
next 5 days = preovulatory

126
Q

when does the production of human chorionic gonadotropin (hCG) start?

A

about 8 days after fertilization from the embryo

127
Q

what does the hCG do?

A

it stimulates the secretion of hormones from the corpus luteum which promotes the endometrial development

ANPH 215 - Anatomy and Physiology (14 decks)

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