session 1

Question 1

what is the functional unit of the kidney? describe it

Answer 1

nephron

pale>>corticol region

dark>>medullary region

kidneys cant regenerate new nephrons, and the # decline wiht age!

Question 2

functions of kidney

Answer 2

Function of the Kidney

– Regulation: control the concentrations of key substances in extracellular fluid

– Excretion: excretes waste products

– Endocrine: synthesis of renin, erythropoietin, prostaglandins

– Metabolism: active form of Vitamin D, catabolism of insulin, PTH calcitonin

Question 3

describe fluid compartments of the body

Answer 3

plasma contains cells and large organic molecules but interstitial fluid normally doesn’t

Question 4

what is the predominent cation and anion in the ECF?

Answer 4

ECF:

Cation>> Sodium Na+

Anion>> Chloride Cl-

Question 5

kidenys function by making large amount of an ultra-filtrate of plasma

Answer 5

means plasma w/out cells and large organic molecules

Question 6

efferent and afferent arterioles bring blood to and from kidney, creating a high constant filtration pressure.

why is this improtsnt?

Answer 6

the pressure is important in in driving small molecules and water out of the plasma at a rate of 125ml/min or (180L per day)

this is the GFR!

(GFR) describes the flow rate of filtered fluid through the kidney

Question 7

why does the kidney consume so much oxygen?

Answer 7

bc when the ultrafiltrate enter kidneys tubules 99% of it is reabsorbed! and this process is metabolically very demanding!

Question 8

how much blood flow does the kindey need?

why is it necessaryit gets this much?

Answer 8

it needs (4ml/min/g) to deliver the oxygen and glucose needed to maintain their activity

Question 9

location of kidney

Answer 9

(ureter travels at tips of transverse processes)

lower border>> L2/3

Question 10

layers of kidney

Answer 10

Question 11

Structure of Kidney

Answer 11

kidneys can be divided into2 steps each of which their anatomical correlate:

1) filtration= glomeruli
2) resoptio and excretion= tubular system

Question 12

water and osmoalarity

Answer 12

water likes people! ( what keep the partay going)

Question 13

kidenys effect ECF directly!

Answer 13

indirect effect on ICF

Question 14

what happens if u fail to control the ECF volume?

Answer 14

changes in BP, tissue fluid and cell function!

Question 15

The pH of extra cellular fluid is critical

what does it depend on?

Answer 15

• Depends in part on the concentration of bicarbonate in plasma
• Failure to control bicarbonate concentration will have serious consequences

Question 16

______L is filitered, but then is reabsorbed, leaving____L left for excretion

Answer 16

180L is filitered, but then is reabsorbed, leaving 1L left for excretion

Question 17

where is EPO released?

Answer 17

ibrocytes in the cortex release the hormone erythropoietin, which stimulates the formation of red blood cells in the bone marrow. Modified fibrocytes of the medulla secrete prostaglandins which are able to decrease blood pressure

Question 18

Answer 18

Question 19

where is the major site of reabsorption taken place? what sort of things r reabsorbes there?

how do these reabsorbed material leave? via what?

Answer 19

PCT

– ~60-70% of Na and water

– ~80-90% of K+

– ~90% of HCO3-

– Normally, 100% of glucose and a.a

– Water follows osmotic gradients, so filtrate remains isotonic with plasma

– Reabsorbed materials leave by peritubular capillaries

Question 20

what r the 2 memebranes of the epithelial cells lining th tubules?

Answer 20

apical (lumnal) and basolateral side

Question 21

describe the free ion distribution across cell membranes

Answer 21

Question 22

how can particles transport across cell membranes?

Answer 22

transcellulary and paracellulary

Question 23

what r the different types of transport?

Answer 23

Active transport: moves solutes from a region of their lower to a higher concentration (needs energy)

1. -Primary: transport coupled DIRECTLY to an energy source (ex: Na-K atpase pump, H+ atpase, Ca+ atpase)
2. -Secondary: (coupled transport or co-transport) 3aks primary, 2 or more substances interact w/ a specific membrane protein (Carrier) & r trasnported together across membrane

Osmosis: transport of water from areas of high to low concentration

Question 24

how is Na+ reabsorbed in thick acending limb, distal tubule, collecting duct,

Answer 24

Thick asceding

via Na+/K+/2Cl- cotransporter (apical side)

via /Na-K atpase pump (basolateral side)

Distal

Enac,

Na/Cl cotransporter

collecting duct

Enac

Question 25

what is Tm? transport maximum ## Footnote *use Glucose as ex*

Answer 25

for most substances that r actived reabsorbed or secreted, there is a ***LIMIT RATE at which the solute can be transported.*** * when the amount of solute delivered to the transport systems **exceeds** the capacity of the carrier proteins & specific enzymes ivolved int eh transport process!* * (ex : Tmax of glucose is 375mg/min, whereas the filtered load of glucose is only 125 ml/min, if G increases above 375, the excess glucose is not reabsorbed and is passsed to urine)* ***TRansporters ma ysta8bilon more than they can!***

Question 26

decribe the Relationship between **glucose filtration, reabsorption and excretion to the plasma glucose concentration**

Answer 26

Question 27

function of Anti-dieuretics

Answer 27

reduce Na+ reabsorbtions

Question 28

Answer 28

Question 29

Answer 29

Question 30

Answer 30

Question 31

Why are the kidneys described as being retroperitoneal organs?

Answer 31

Structures that lie behind the peritoneum are termed "retroperitoneal".

Question 32

At approximately what vertebral level would you find the right kidney? At approximately what vertebral level would you find the left kidney?

Answer 32

RIGHT\>\> T12‐ L1/3 LEFT\>\> T11‐ L1

Question 33

In relationship to the Aorta and the IVC, where do the left renal **vein** and right renal arteries pass?

Answer 33

**Left renal vein** Left renal vein passes in front of the aorta **Right renal artery** Right renal artery passes behind the IVC (vein is so VEIN so meaaaaan)

Question 34

Answer 34

Question 35

From the hilum, describe the course of the ureter

Answer 35

Question 36

In females what does the phrase “water under the Bridge refer to?

Answer 36

In females, the ureters pass through the mesometrium and under the ***uterine arteries*** on the way to the urinary bladder.

Question 37

What is the term used to describe the junction between the Pelvis of the kidney and the ureter?

Answer 37

pelvi‐ ureteric (or uteropelvic) junction

Question 38

What is the term used to describe the junction between the ureter and the bladder?

Answer 38

Question 39

where the most common sites for stones becoming lodged in the urinary tract are located.

Answer 39

1. Pelviureteric junction, 2. Bifurcation of the common iliac artery 3. Where ureter enters the bladder

Question 40

what bony landmarks that you can see on the X‐ray would show you the approximate course of the ureter?

Answer 40

1. L1‐2 is about the hilum 2. Ureter runs along close to the tip of transverse processes 3. Across SI joint

Question 41

How long is the urethra in the adult male and female?

Answer 41

Male ~20 cm Female ~4 cm

Question 42

Label different regions of the male urethra/ penis

Answer 42

Question 43

label structures that surround kidneys

Answer 43

Question 44

Describe the course of the ureters and the relationships to the uterine vessels, ovary/vas and the urethra in both males & females

Answer 44

**in males:** that the ureter passes **under ductus deferens**, superior to seminal vesicles **in women:** that the ureter descends **posterior to ovary** & into base of broad ligament, passing **under uterine artery**

Question 45

Identify the musculature of the bladder

Answer 45

* the bladder wall contains specialised smooth muscle, known as **detrusor muscle**. * Its fibres r orientated in 3 directions, longitudinal, transverse, oblique. * It receives innervation from both the sympathetic & parasympathetic nervous systems. * in region of the bladder neck, the detrusor muscle runs circularly as *involuntary internal sphincter*

Question 46

Question 47

Question 48

identify the anatomical position of the bladder

Answer 48

* lies **posterio**r to pubic bones and pubic symphysis * *empty* is tetrahedron in shape and lies entirely within the true pelvic cavity; * *spherical* when full & may reach as high as umbilicus

Question 49

structure of bladder, its ureteric openings

Answer 49

* It is hollow, highly distensible, and tetrahedral in shape. * 2 ureteric openings at **superolateral corners** and **internal urethral opening** inferiorly * has a triangular area defined by these openings that is called the **trigone** * has a ridge between 2 urethral openings called the ***interureteric fold***

Question 50

what is the trigone of the bladder?

Answer 50

in the bladder the mucosa is thrown into ***rugae*** except within **trigone,** which is *smooth.*

Question 51

Shape of the Bladder, external feautures!

Answer 51

Question 52

what is significant about the apex of the bladder?

Answer 52

at the anterior angle or apex of the bladder is a site of attachment of **urachus**—*fibrous remnant of fetal allantois*, ## Footnote which is seen as median umbilical ligament on anterior abdominal wall

Question 53

Identify the anatomical position of the prostate

Answer 53

**inferiorly** to the neck of the bladder **superiorly** to the external urethral sphincter **posteriorly** to the prostate lies the *_ampulla of the rectum_* *with the levator ani muscle lying inferolaterally to the gland.*

Question 54

what follows the efferent arteriole?

Answer 54

Question 55

Describe the course of the ureters and the relationships in the pelvis to the iliac vessels

Answer 55

Question 56

blood supply in kidney

Answer 56

renal artery\> segmental\> interlobar\> arcuate\> interlobular\> afferent\> glomerulus\> efferent\> vasa recta\> peritubular capillaries\> venous outflow

Question 57

layers of kidney

Answer 57

Question 58

Behind the parietal peritoneum what muscle do the ureters lie on? Which boney land mark defines the course of the ureter in the abdomen

Answer 58

Psoas major Tips of the transverse processes

Question 59

Blood supply of ureters

Answer 59

The blood supply for the ureter is a ***segmental artery*** from the renal, gonadal, vesicle and uterine arteries