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Phys III Exam 4 > Part 2 > Flashcards

Part 2 Flashcards

1
Q

How many kidneys doesn one have?

A

2

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2
Q

How much does each kidney weigh?

A

150grams

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3
Q

When you are standing, where are the kidneys located?

A

L1-4 in the retroperitoneal space

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4
Q

What is the retroperitoneal space?

A

Space behind peritoneum

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5
Q

How many renal pyramids are in the medulla?

A

8-10

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6
Q

Where is the base of the pyramids?

A

Cortical medullary border

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7
Q

What is the tip of the pyramid called?

A

Papilla

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8
Q

PApilla connect with what other structure?

A

Minor calyces

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9
Q

Which structures contract to propel urine to the bladder?

A

Calyces, renal pelvis, ureter

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10
Q

What vertebral level innervated the kidney?

A

T12

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11
Q

Does the kidney receive sympathetic or parasympathetic?

A

Sympahetic

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12
Q

What does sympathetic stimulation do in the kidneys?

A

Signals for constriction of arterioles, which in turn decreases urine output

Increase sodium absorption

Increase renin release

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13
Q

What percentage of cardiac output goes through the kidneys?

A

22%

1100mL/min

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14
Q

What are the 2 capillary beds and what are they separated by?

A

Glomerular and peritubular capillaries separated by efferent arterioles

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15
Q

Describe the blood flow in the glomerular capillaries.

A

High hydrostatic pressure that causes rapid fluid filtration

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16
Q

Describe the blood flow in thd peritubular capillaries.

A

Low hydrostatic pressure that allows for rapid fluid reabsorption

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17
Q

What is the functional unit of the kidney?

A

Nephron

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18
Q

How many nephrons does the kidney have?

A

800,000 to 1,000,000

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19
Q

What are the two parts to a nephron?

A

cortical nephron and juxtamedullary nephron

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20
Q

Describe the cortical nephron.

A

short loop of Henle, only barely penetrate into the medulla, 70-80% of the nephrons, surrounded by peritubular capillaries

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21
Q

Go through the pictures in the notes and make sure you can label them, just in case.

A

…

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22
Q

Can the kidney regenerate new nephrons?

A

no

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23
Q

How much and how often do we lose nephrons?

A

after about 40 years we loose about 10% every 10 years

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24
Q

How can we maintain kidney function if we lose so many nephrons every year?

A

adapt via homeostasis

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25
Q

Glomerular capillaries are encased in what?

A

Bowman’s capsule

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26
Q

What is the pathway for fluid in the kidney?

A

glomerular capillaries–> bowman’s capsule–>proximal tubule–>loop of henle–>distal tubule–>connecting tubule–>collecting duct–>renal pelvis

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27
Q

Describe the pathway for the kidney blood flow into the kidney.

A

renal artery, interlobar arteries, arcuate arteries, afferent arterioles, glomerular capillaries, efferent arterioles, peritubular capillaries

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28
Q

Describe the pathway for the kidney blood flow out of the kidney.

A

peritubular capillaries, interlobular vein, arcuate vein, interlobar vein, renal vein

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29
Q

Describe the juxtamedullary nephron

A

long loops of henle, penetrate deep into the medulla, 20-30% of nephrons, surrounded by specialized peritubular capillaries called vasa recta

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30
Q

What are the specialized peritubular capillaries that surround the juxtamedullary nephron?

A

vasa recta

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31
Q

What are the two main parts of the bladder?

A

body and neck

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32
Q

Describe the body of the bladder.

A

primary part of the bladder where the urine collects

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33
Q

Describe the neck of the bladder.

A

passes inferior and anterior from the body and attaches to the urethra

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34
Q

What is the muscle called that empties the bladder?

A

detrusor muscle

35
Q

What kind of muscle is the detrusor muscle?

A

smooth muscle with intertwined fibers

36
Q

What kind of impulse is there between detrusor muscle cells?

A

low-resistance impulse

the AP spreads quickly and the whole bladder contracts at once

37
Q

By how much does the detrusor muscle increase the pressure in the bladder?

A

40-60mmHg

38
Q

What is the major step in emptying the bladder?

A

detrusor muscle contraction

39
Q

What is a trigone?

A

the triangle on the posterior wall of the bladder

40
Q

Where do the ureters enter the bladder?

A

obliquely in the upper trigone and goes through the detrusor muscle

41
Q

What is the surface of the trigone like compared to the rest of the bladder?

A

smooth mucosa instead of folded and rugged

42
Q

How many centimeters does the ureter penetrate the bladder?

A

1-2cm

43
Q

What shuts down the ureters? Why?

A

tone of the detrusor muscle to prevent backflow of the urine

44
Q

What is another name for the bladder neck?

A

posterior urethra

45
Q

The bladder neck is composed of what?

A

detrusor muscle and elastic tissue

46
Q

What is the muscle that surrounds the base of the neck of the bladder?

A

internal sphincter

47
Q

What does the internal sphincter do?

A

prevents emptying of the bladder until the pressure rises above critical threshold

48
Q

What does the urethra pass through?

A

urogenital diaphragm

49
Q

What is the muscle that surrounds the distal part of the neck of the bladder?

A

external sphincter

50
Q

Describe the external sphincter muscle.

A

made of smooth muscle and is under voluntary control so we can consciously prevent urination

51
Q

The pudendal nerve innervates what part of the bladder?

A

external sphincter

52
Q

What kind of fibers does the pudendal nerve have?

A

somatic nerve fibers

53
Q

What stimulates the rest of the bladder?

A

sympathetic innervation from the hypogastric nerves (L2)

54
Q

What does the hypogastric nerve stimulate in the bladder?

A

blood supply to the bladder

55
Q

Where do the pelvic nerves come from?

A

through the sacral plexus (S2, 3)

56
Q

What do sensory and motor nerve fibers do in the bladder?

A

sensory fibers detect stretch of the bladder wall and parasympathetic motor fibers innervate the detrusor muscle

57
Q

What is the pathway of the flow of urine?

A

nephron, collecting duct, renal calyces, ureters, bladder

58
Q

When urine flow from the collecting ducts goes to the renal calyces, what happens?

A

this causes peristaltic contractions that occur in the renal pelvis and ureters

59
Q

What does the peristaltic contraction in the renal pelvis and ureters do?

A

forces urine from kidneys into bladder

60
Q

What are the ureters stimulated by?

A

sympathetic and parasympathetic stimulation

61
Q

What kind of muscle is the ureter?

A

smooth visceral muscle

62
Q

What happens when the ureters are stimulated by parasympathetics? Sympathetics?

A

parasympathetic- increased peristalsis

sympathetic- decreased peristalsis

63
Q

What is the ureterorenal reflex?

A

when sympathetic nerves cause reflex constriction all the way back into the kidney

64
Q

What does the ureteorenal reflex do?

A

constrictes the renal arterioles and decreases flow of fluid into the kidney with the blocked ureter

65
Q

Describe the pathway of micturition.

A

bladder progressively fills, tension on bladder wall rises above a threshold level, micturition reflex, nervous reflex, bladder empties/urge to urinate, pee

66
Q

What are initiated as the bladder fills with urine?

A

sensory stretch receptors

67
Q

Describe micturition contractions

A

they vary in length of contraction and intensitry and generally increase as more urine is added to the bladder

68
Q

Is the micturition reflex self-regenerative?

A

yes

69
Q

What causes further activation of the stretch receptors?

A

the initial contracture of the detrusor muscle

70
Q

Describe what happens after the initial contracture of the detrusor muscle.

A

there is an increase in relfex contraction, the cycle repeats multiple times until the regenerative cycle begins to fatigue, bladder relaxes

71
Q

What happens to the micturition if the bladder was not emptied?

A

the reflex is eventually inhibited for a certain amount of time (minutes to hours)

72
Q

What happens to the micturition reflex as the bladder continues to fill?

A

there is an increase in frequency and intensity of the micturition reflex

73
Q

What happens to the micturition reflex when we decide to empty the bladder?

A

reflex passes through the pudendal nerves to the external sphincter, which relaxes that muscle and urination occurs

74
Q

What kind of reflex is the micturition reflex?

A

autonomic

75
Q

Urination is facilitated or inhibited by centers where?

A

in the pons and cerebral cortex

76
Q

Describe the final control the upper brain centers have on micturition?

A

keep the micturition reflex partially inhibited until urination is desired
keep tonic contraction of the external bladder sphincter, even through the micturition reflex
when urination is desired, these centers cause concurrent micturition reflex and relaxation of external bladder sphincter

77
Q

Describe voluntary urination.

A

you can contract abdominal muscles to increase the pressure in the bladder, which increases the urine that enters the bladder neck, which stretches the bladder walls and stimulates the stretch receptors (micturition reflex)

78
Q

Does voluntary urination empty the bladder?

A

yes (or mostly)

79
Q

What starts the micturition reflex?

A

sensory stretch receptors in the bladder wall

80
Q

The external anal sphincter is controlled by what nerve?

A

pudendal

81
Q

The bladder is innervated by what nerve cord segments?

A

S2 and 3

82
Q

What muscle is responsible for contraction of the bladder?

A

detrusor

83
Q

When a patient is in a standing position, approximately where should the kidneys be located?

A

between L1 and L4

84
Q

Juxtamedullary nephrons are distinct from nephrons in that they….?

A

have a significantly longer loop of Henle

Phys III Exam 4 (4 decks)

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