Renal II Flashcards
Filling of the bladder activates stretch receptors initiating the _______ reflex
micturition
What is the more common term for micturition?
Urination
______ undergo continuous rhythmic contractions (pacemaker cells)
Ureters
Movement of fluid from the kidney to the urinary bladder occurs with the help of _____ (standing up) and ________ ______
gravity, rhythmic contractions
Bladder has a thick wall of ______ muscle, specifically ______ smooth muscle which contains ____ junctions in a ______ pattern
smooth, unitary, gap, uniform
_______ muscle: the smooth muscle that makes up the wall of the bladder, makes up most of the wall
Detrusor
The sensory information will not only come the _______ region of the spinal cord, but there will be ______ tracts (spinothalamic tracts), up to the _____, to the ____, then into different regions of the _______ _____ so that you become actively aware that you need to urinate. Then you will have ______ tracts that go from the cortex down to this network to either allow or inhibit urination
sacral, ascending, thalamus, pons, cerebral cortex, descending
_____ sphincter of the bladder: smooth muscle, passively contracted
Inner
_____ sphincter of the bladder: skeletal muscle, stays contracted
External
Arrange these statements according to “Micturition:”
1. Stretch receptors fire
2. Parasympathetic neurons fire. Motor neurons stop firing
3. Smooth muscle contracts. Internal sphincter is passively pulled open. External sphincter relaxes
1, 2, 3
Urge to urinate appears around ___ml
200
Once exceeding ___ml internal sphincter forced open, leading to reflexive opening of external sphincter and loss of voluntary opposition
500
~___ml left in bladder after micturition
10
An increase in the volume of fluid in the bladder leads to an _______ of the wall and an activation of _____ receptors
expansion, stretch
The activation of stretch receptors in the bladder causes an ↑ in ________ activity, a ↓ in __________ activity, and a ↓ in ? activity
sympathetic, parasympathetic, somatic motor neuron
A decrease in sympathetic activity towards the bladder causes a ?
relaxation of the internal urethral sphincter
An increase in parasympathetic activity towards the bladder causes a ?
contraction of the detrusor muscle
A decrease in somatic motor neuron activity towards the bladder causes a ?
Relaxation of external urethral sphincter
The relaxation of the internal urethral sphincter and the contraction of the detrusor muscle combined cause ?
the opening of the external urethral sphincter
The relaxation of external urethral sphincter causes ?
the opening of the external urethral sphincter
The combination of the opening of the internal urethral sphincter and the opening of the external urethral sphincter cause ?
Micturition
What is incontinence?
The inability to control urination voluntarily
What causes incontinence in infants?
Corticospinal connections necessary for voluntary control have yet to be established
What are some other causes of incontinence?
Damage to internal or external sphincter
Spinal cord damage
Aging
- Loss in muscle tone
- CNS problems
- Prostate growth in males
Fluid volume is important because it dictates blood volume which dictates ____ _____
blood pressure
Homeostatic mechanisms for fluid/ electrolyte balance focus on maintaining four parameters: ?
- Fluid volume
- Osmolarity
- Concentrations of individual ions
- pH
One of the main goals for fluid electrolyte balance is ____ ______ – maintaining a relatively constant stable value for the 4 parameters
mass balance
Kidneys can only adjust what is already in the body, so when we need _____ adjustments that’s when behavioral mechanisms play an essential role
external
The body is in a state of constant _____. We ingest ~ 2L of fluid containing 6-15 grams of _____ and we take in ______ amount of other ions (K+, H+, Ca2+, HCO3- and phosphate ions)
flux, NaCl, varying
Whatever comes in must be excreted if not needed, this is known as ____ ______ and the ______ are the primary route. There are _____ amounts lost in feces and sweat and the ______ lose water and help remove H+ and HCO3- by excreting CO2
mass balance, kidneys, small, lungs
Behavioral mechanisms also play an essential role in ______ and _____ _______
thirst, salt appetite
We concerned with homeostasis of these substances for the following reasons:
1. H2O and Na+ determine ECF ______ and _______
2. K+ balance can cause problems with ______and ______ function
3. ____ is involved in many processes in the body
4. H+ and HCO3- determine the body ____
- volume, osmolarity
- cardiac, muscle
- Ca2+
- pH
ECF osmolarity affects cell _____
volume
Maintaining osmolarity in the body is important because water can cross most cell membranes freely due to _______ channels
aquaporin
Extracellular fluid is usually ______
isotonic
Its important to maintain normal osmolarity to maintain most normal cell volumes and hence normal cell _______
functioning
Some cells have independent mechanisms for maintaining cell volume:
- _____ ______ cells are constantly exposed to hypertonic ECF and produce organic solutes such as sugar alcohols and amino acids to match their intracellular osmolarity to the ECF
- Some cells use changes in cell volume to initiate ______ _______, liver cells beginning protein and glycogen synthesis (swell)
Renal tubule, cellular responses
In a hypotonic solution, the cell becomes ____
In a isotonic solution, the cell becomes _______
In a hypertonic solution, the cell becomes _______
lysed, normal, shriveled
Fluid and electrolyte balance is an integrative process involving the ________, _________ and _____ systems as well as ________ responses
respiratory, cardiovascular, renal, behavioral
True or False: there is overlap between the pathways that integrate fluid and electrolyte balance?
True
_________ and ________ systems are under neural control and are quite rapid, _____ responses occur more slowly because kidneys are primarily under endocrine and neuroendocrine control
Cardiovascular, respiratory, renal
A decrease in blood volume causes a decrease in blood pressure, which trigger?
Volume receptors in atria and carotid/aortic baroreceptors
The volume receptors in atria and carotid/aortic baroreceptors trigger _______ reflexes
homeostatic
After the homeostatic reflexes are triggered, it activates the:
__________ system: ↑ CO, vasoconstriction
________: ↑ thirst, ↑ water intake, ↑ ECF and ICF volume
These combined ____ blood pressure
______: conserve salt and water to minimize further volume loss
Cardiovascular, Behavior, ↑, Kidneys
________ receptors: low pressure baroreceptors that exist primarily in the atria as well as a few different areas and they respond to atrial filling and its an indicator of overall blood volume
Volume
Water makes up ___-___% of our body weight, 2/3 is ____ and 1/3 ____
50-60, ICF, ECF
Water intake must match _______
excretion
Under normal conditions water loss in urine is a _______ mechanism, other mechanisms become significant during conditions like ______ ______ and ______
regulated, excessive sweating, diarrhea
The primary _____ source of water is through our digestive tract while the main _____ source is urine and can be regulated
input, output
Fecal water loss and insensible water loss is normally relatively _____
stable
Our autoregulatory systems only work in response to ______ not _______
hypertension, hypotension
The concentration, or osmolarity, of urine is a measure of how much water is ______ by the kidneys
excreted
When removal of excess water required, the kidneys produce ____ volume of _____ urine. If the kidneys need to conserve water, ____ volume of _______ urine is produced
large, dilute, low, concentrated
_______: removal of excess urine
Diuresis
The kidneys control urine concentration by varying the amounts of water and Na+ reabsorbed in the _____ nephron (distal tubule and collecting duct)
- To produce dilute urine the distal nephron must reabsorb solute without allowing ? by osmosis aquaporins
- To produce concentrated urine, the distal nephron must reabsorb water and little ______.
distal, water to follow, solute
The ______ limb is only permeable to water but not to solutes (water will be reabsorbed), while the ________ limb is mainly permeable to solutes but not water (solutes will be reabsorbed)
descending, ascending
________ controls water reabsorption
Vasopressin
How do the distal tubule and collecting duct alter their permeability to water?
Adding or removing water pores in the apical membrane under the direction of the posterior pituitary hormone vasopressin (AVP), aka antidiuretic hormone (ADH)
If water levels are high then there is ____ release of AVP in the body, and in response to that, the channels will be removed from the apical membrane which then prevents water _______
low, reabsorption
With ______ vasopressin, the collecting duct is freely permeable to water. Water leaves by osmosis and is carried away by the vasa recta capillaries. Urine is concentrated
In the ______ of vasopressin, the collecting duct is impermeable to water and the urine is dilute
maximal, absence
Within the _____ layer of these cells you’d have multiple types of aquaporin channels. But on the _____ membrane, you have a different subtype of aquaporin channels known as AQP2, the APQ2 channels are under ______ control
basolateral, apical, hormonal
Vasopressin will be driven in response to ____ osmolarity, ____ blood volume, and ____ blood pressure. Vasopressin will be secreted in response to “we need to _____ more water”
high, low, low, reabsorb
Vasopressin receptor: ___ receptor
V2
Vasopressin release is not an “?” response its constantly ______-
all or none, adjusted