Part 2: Anatomy and Physiology of the Kidney and Bladder

Question 1

How much does each kidney weigh?

Answer 1

150 grams

Question 2

When standing the kidneys are located at what vertebral levels?

Answer 2

L1-L4

Question 3

What is the space behind the peritoneum called?

Answer 3

Retroperitoneal

Question 4

What three structures are in the medulla?

Answer 4

1. renal pyramids
2. major calyces
3. minor calyces

Question 5

1. The medulla consists of how many renal pyramids?

2. Base is at the ____ while the tip is called the ___.

Answer 5

1. 8 to 10

2. cortical medullary border, papilla

Question 6

(3) contract to propel urine to the bladder

Answer 6

calyces, renal pelvis, and ureter

Question 7

Kidney innervation via ____?

Answer 7

T12

Question 8

___ innervation reaches to individual nephrons

Answer 8

sympathetic

Question 9

Sympathetic innervation stimulates _____ which causes(2)

Answer 9

signals for constriction of arterioles, decreases flow of fluids and urine output

Question 10

Sympathetic innervation can also signal kidneys to (2)

Answer 10

1. increase sodium reabsorption

2. increase renin release

Question 11

1. % of cardiac output (____)
2. ___ blood flow
3. # capillary beds separated by ___
4. list them

Answer 11

1. 22%, (1100ml/min)
2. unique
3. 2, efferent arterioles
4. glomerular and peritubular capillaries

Question 12

Glomerular capillaries -

1. ___ hydrostatic pressure (___ mmHg)
2. causes ___

Answer 12

1. High, 60

2. rapid fluid filtration

Question 13

Peritubular capillaries -

1. ___ hydrostatic pressure (___ mmHg)
2. allows for ___

Answer 13

1. lower, 13

2. rapid fluid reabsorption

Question 14

What is the functional unit of the kidney?

Answer 14

Nephron

Question 15

Each kidney has about # nephrons

Answer 15

800,000 to 1,000,000

Question 16

What are the 2 different nephron structures/areas?

Answer 16

1. Cortical nephron

2. juxtamedullary nephron

Question 17

What are two unique characteristics about juxtamedullary nephron?

Answer 17

1. significantly longer Loop of Henle

2. penetrates deeper into medulla

Question 18

Kidney cannot regulate ___

Answer 18

new nephrons

Question 19

1. After about 40 yo there is a ___ in the number of functional nephrons
2. % every # years
3. our bodies ___ and we maintain ___

Answer 19

1. decrease
2. 10% every 10 years
3. adapt, homeostasis

Question 20

1. ___ are encased in the ___
2. fluid filtered from the ___
3. list the 7 steps to get through the kidneys

Answer 20

1. glomerular capillaries, Bowman’s capsule
2. glomerular capillaries
3. Bowman’s capsule, proximal tubule, loop of henle, distal tubule, connecting tubule, collecting duct, renal pelvis

Question 21

Cortical Nephron -

1. ___ loops of henle
2. only barely penetrate into the ___
3. % of the nephrons
4. surrounded by ___ called ___

Answer 21

1. short
2. medulla
3. 70-80%
4. specialized peritubular capillaries, vasa recta

Question 22

Juxtamedullary Nephron -

1. ___ loops of henle
2. penetrates deep into the ___
3. % of nephrons
4. surrounded by ___ called ___

Answer 22

1. long
2. medulla
3. 20-30%
4. specialized peritubular capillaries, vasa recta

Question 23

1. Urinary bladder is made up of what type of muscle with # main parts
2. List them

Answer 23

1. smooth, 2

2. body and neck

Question 24

1. ___ of the urinary bladder is primary part of the bladder where urine collects
2. ___ passes __ and __ from the body, attaches to the ___

Answer 24

1. body

2. neck, inferior and anterior, urethra

Question 25

Urinary bladder -

1. ___ muscle
2. fibers are ___
3. low resistance to ___ between muscle cells, ___ spreads quickly, what happens?
4. contraction - increases pressure by # mmHg
5. major step in ___

Answer 25

1. detrusor
2. intertwined
3. electrical impulse, action potential, whole bladder contracts at once
4. 40-60
5. emptying the bladder

Question 26

1. Urinary bladder has a structure called the ___
2. on the ___ wall of the bladder
3. ureters enter the bladder at the ___
4. surface is made of ___ mucosa
5. contrast to the ____ of the rest of the bladder mucosa

Answer 26

1. trigone
2. posterior
3. upper trigone
4. smooth
5. folded rugae

Question 27

Ureters -

1. obliquely enters the bladder through the ___
2. penetrates 1-2cm through the (2)
3. the tone of the detrusor muscle shuts down the ___, prevents ___

Answer 27

1. detrusor muscle
2. detrusor and the mucosa
3. ureters, backflow of urine

Question 28

Bladder Neck -

1. location
2. composed of (2)
3. muscle here is the ___
4. What does this muscle do?

Answer 28

1. posterior urethra
2. detrusor muscle and elastic tissue
3. internal sphincter
4. prevents emptying the bladder until the pressure rises above the critical threshold

Question 29

1. Urethra passes through the ___
2. External sphincter muscle is made of ___ muscle
3. under ___ control
4. can consciously contract to prevent ___

Answer 29

1. urogenital diaphragm
2. smooth
3. voluntary
4. urination

Question 30

What is the innervation of the urinary bladder (3)?

Answer 30

Pudendal nerve, sympathetic innervation, pelvic nerves

Question 31

Pudendal nerve has ___ nerve fibers and innervates the ___

Answer 31

somatic, external bladder sphincter

Question 32

Sympathetic innervation -

1. through the ___ nerves (___)
2. stimulates ___

Answer 32

1. hypogastric, L2

2. blood supply to the bladder

Question 33

Pelvic Nerves -

1. through the ___
2. ___ cord segments

Answer 33

1. sacral plexus

2. S2, S3

Question 34

Sensory and Motor Nerve Fibers -

1. Sensory fibers detect ___ of the bladder wall
2. ___ fibers innervate the detrusor muscle

Answer 34

1. stretch

2. parasympathetic motor

Question 35

List the five steps of urine flow

Answer 35

1. nephron
2. collecting ducts
3. renal calyces
4. ureters
5. bladder

Question 36

Flow from collecting ducts to renal calyces -

1. causes ___
2. occurs in the (2)
3. forces urine from the ___ to the ___

Answer 36

1. peristaltic contractions
2. renal pelvis and ureters
3. kidneys to the bladder

Question 37

Ureters -

1. innervated by (2) nerves
2. ___ muscle causes ___ of the ureters
3. Increased due to ____ stimulation
4. decreased due to ___ stimulation

Answer 37

1. sympathetic and parasympathetic
2. smooth visceral, contraction
3. parasympathetic
4. sympathetic

Question 38

Ureterorenal Reflex -

1. Ureters contain a lot of ___ fibers
2. if there is severe pain (kidney stone) ___ occurs, ___ reflex occurs back to the ___
3. Which causes constriction of the ____, in turn ___ flow of fluid into the kidney with a blocked ureter

Answer 38

1. pain
2. reflex constriction, sympathetic, kidney
3. renal arterioles, decreases