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test 4 Flashcards

1
Q

6 functions of urinary system

A

o Filter blood to remove wastes/toxic substances
o Production, storage and elimination of urine
o Regulates fluid and electrolyte balance
o Regulates blood PH
o Regulates blood volume and blood pressure
o Regulates erythropoiesis

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2
Q

kidney functions

A

filter blood and produce urine

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3
Q

ureter

A

move urine from kidneys to bladder

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4
Q

urethra

A

moves urine from bladder to exterior

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5
Q

urinary bladder

A

stores urine

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6
Q

Kidney location and structure

A

retroperitoneal-outside/behind abdominal cavity
Renal cortex
Renal Medulla

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7
Q

kidneys surrounded by three external layer

A

 renal fascia
 adipose capsule
 renal capsule

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8
Q

Nephron: definition and structure

A

major functional unit of the kidney. Urine production begins here. Empties into collecting system.
o Renal corpuscle: filters blood
o Renal tubule: collects filtrate

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9
Q

Collecting system

A

series of tubules that receive filtrate from nephron and further modify it

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10
Q

parts of collecting system

A

Cortical and medullary collecting ducts and papillary collecting ducts and papilla and minor calyx

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11
Q

Types of nephrons

A

Cortical nephron and Juxtamedullary nephron

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12
Q

what’s the difference between the types of nephrons

A

Cortical nephron: primarily in cortex. Branch into peritubular capillaries. And Juxtamedullary nephron: extend into medulla. Peritubular capillaries connected to long straight capillaries

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13
Q

which nephron is more abundant

A

Cortical nephron

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14
Q

Urine production

A

eliminates metabolic waste products while minimizing loss of water and nutrients

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15
Q

urea

A

most abundant organic waste from protein catabolism

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16
Q

creatinine

A

product of creatine phosphate catabolism

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17
Q

uric acid

A

product of nucleic acid catabolism

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18
Q

renal failure

A

results in buildup of toxic wastes

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19
Q

dialysis

A

medical process for those who have lost kidney functions. Machine that filters blood.

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20
Q

Filtration

A

kind of transport: passive movement of fluid and solutes direction of movement: blood in glomerular capillaries to filtrate inside renal corpuscle (blood to filtrate). Driven by hydrostatic pressure

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21
Q

Reabsorption

A

active or passive movement of water solute from filtrate in renal tubule back to blood in peritubular capillaries

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22
Q

Secretion

A

active transport of water and solutes from blood in peritubular capillaries to filtrate in renal tubule

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23
Q

Paracellular route

A

substances pass between adjacent tubule cells

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24
Q

Transcellular route

A

substances must move through tubules cells

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25
Q

diffusion and osmosis are examples of

A

passive transport

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26
Q

active transport requires

A

an energy input

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27
Q

facilitated diffusion and active transport are examples of

A

carrier-mediated transport and require protein pumps

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28
Q

Carriers (channels) are specific and can be saturated (what happens if channels get saturated

A

all binding sites are filled and can start seeing the substance in urine

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29
Q

transport maximum

A

maximal blood solute levels that can be transported

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30
Q

renal threshold

A

plasma concentration at which a specific compound appears in urine because the TM has been reached

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31
Q

Renal corpuscle

A

Glomerular (Bowman’s) capsule and the glomerulus

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32
Q

What are podocytes

A

cells that form the visceral layer of the capsule of the renal corpuscle

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33
Q

what are filtration slits

A

between podocytes and part of filtration membrane. Must fit in these area in order to filter.

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34
Q

how filtration works

A

it is only selective based on size: only small particles filtered (proteins and cells are not filtered)

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35
Q

Components of filtration membrane

A

made of pores of fenestrated capillaries, basal lamina, and filtration slits of podocytes

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36
Q

Hydrostatic pressure

A

pressure in glomerulus

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37
Q

GHP and filtration

A

favors filtration

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38
Q

CHP and filtration

A

opposes filtration

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39
Q

GCOP

A

osmotic pressure and pulls water into capillaries, so it opposes filtration

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40
Q

Net filtration pressure equation

A

= GHP – CHP-GCOP
o 0 or negative =no filtration
o Positive number = filtration

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41
Q

What is GFR

A

amount of filtrate produced by both kidneys per minute

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42
Q

what does GFR depend on

A

GFR depends on blood pressure (higher BP means higher GFR)

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43
Q

Autoregulation

A

ability of neprhons to adjust their own blood flow and GFR

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44
Q

myogenic

A

stretch receptors in afferent arteriole detect pressure changes and respond to adjust GFR

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45
Q

tubuloglomerular mechanisms

A

the glomerulus receives feedback on the status of downstream tubular fluid and adjusts filtration rate accordingly

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46
Q

changes in the afferent and efferent arterioles control

A

blood pressure in the glomerulus and therefore GFR

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47
Q

 BP low/GFP low

A

= dilate arteriole/constrict efferent arteriole. Goal: high BP and high GFR

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48
Q

 BP high/GFP high

A

= constrict afferent arteriole/dilate the efferent arteriole. Goal: low BP/low GFR

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49
Q

JGA

A

macula densa of DCT + smooth muscle of arterioles

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50
Q

JGA Hormonal regulation

A

JGA cells secrete rennin and EPO

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51
Q

Renin-angiotensin-aldosterone system

A

renin converts angiotensinogen to angiotensin I and then ACE converts angiotensin I to Angiotensin II

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52
Q

renin is released in response

A

low BP (low GFR) and low filtrate concentration in DT

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53
Q

low BP causes

A

low GFR, causes release of renin, causes activation of angiotensin II, causes increase in blood volume, causes increase in BP and therefore increase in GFR.

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54
Q

ANP

A

released in response to high BP and GFR

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55
Q

high BP causes

A

ANP/ BNP release, which causes an increase in GFR, which leads to more fluid loss and therefore less blood volume and less blood volume means lower BP.

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56
Q

recycling urea

A

helps pull water by osmosis

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57
Q

the countercurrent exchanger in the vasa recta

A

blood and filtrate go in opposite directions. Descending vasa recta absorbs NaCl, and the ascending vasa recta absorbs water

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58
Q

DT and collecting duct secretion

A

depending on needs substances can be secreted. Potassium, HCO3, and ammonium ions

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59
Q

DT and collecting duct selective reabsorption

A

body has a choice (selective based on needs). Na+, Ca2+, HCO3, water, urea. 85% of water and 90% of sodium reabsorbed.

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60
Q

aldosterone causes

A

more Na reabsorption and K loss

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61
Q

ADH causes

A

more water reabsorption (by increasing the number of aquaporins in membrane of DT and collecting duct

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62
Q

in collecting duct urine gets?

A

concentrated and its volume is reduced

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63
Q

Obligatory water reabsorption

A

85% in Proximal tubule and loop, through osmosis driven by medullary concentration

64
Q

Facultative water reabsorption

A

(15 %, controlled by ADH, in Distal Tubule and collecting duct and requires aquaporins) more aquaporins means more reabsorption, which produces a smaller amount of concentrated urine. No ADH= no aquaporins, which means no water reabsorption and large amounts of diluted urine.

65
Q

slit like opening in ureter

A

prevents back flow

66
Q

rugae

A

series of ridges produced by folding of the wall the bladder

67
Q

detrusor muscle

A

around the bladder

68
Q

urethra is longer in

A

males

69
Q

pH scale

A

low H+=high PH=basic. High H+=low PH=acidic

70
Q

acid

A

dissociates to release H+

71
Q

base

A

reduces the amount of free hydrogen in solution

72
Q

Strong acid

A

completely dissociates in solution

73
Q

Weak acid

A

does not dissociate completely

74
Q

Strong base

A

dissociates completely

75
Q

Weak base

A

do not dissociate completely

76
Q

Volatile acids

A

can move from liquid to gas

77
Q

carbonic acid is a

A

volatile acid

78
Q

Fixed acids

A

only stay in solution. Remain in body until excreted

79
Q

Organic acids

A

byproducts of metabolism

80
Q

Normal range of ECF pH

A

7.35-7.45

81
Q

Sources of H+ gains

A

from GI tract and metabolism

82
Q

Sources of H+ losses

A

kidneys and lungs

83
Q

Chemical Buffer systems

A

combination of weak acid and its anion. Are the first response, but a temporary solution

84
Q

Protein buffer systems

A

know that amino group accepts H (base) and carboxyl group can donate H (acid) and act as buffer; know that only free or terminal amino acids can do that; know that hemoglobin is a buffer

85
Q

Phosphate buffer systems

A

you only need to know that it’s the major ICF (intracellular fluid) buffer

86
Q

Carbonic-acid bicarbonate buffer system

A

most important ECF buffer

87
Q

how does the Carbonic-acid bicarbonate buffer system work?

A

prevents PH changes caused by fixed and organic acids

88
Q

the 2 limitations to the Carbonic-acid bicarbonate buffer system

A

only works if respiratory system works and need enough bicarbonate

89
Q

Carbonic-acid bicarbonate buffer system equation

A

CO2+H2O — H2CO3 — H+ + HCO3-

90
Q

what will drive forward reaction? what will drive reverse?

A

too basic- forward reaction. too acidic= reverse reaction.

91
Q

most important factor affecting pH

A

pCO2

92
Q

relationship between H+, pH and pCO2

A

high pCO2=high H+=low ph. low pCO2=low H+=high Ph

93
Q

Acute phase

A

ph moves rapidly out of normal range/ no compensation

94
Q

compensated phase

A

adjusted back to normal pH but constant compensation

95
Q

normal phase

A

normal pH and no compensation, source of problem is removed

96
Q

what happens to ph and pCO2 during Respiratory acidosis

A

low Ph, high CO2.

97
Q

causes of respiratory acidosis

A

respiratory problems, emphysema, CNS injury, heart failure

98
Q

compensation for acidosis

A

respiratory compensation- increase RR; renal compensation- excretion of H+; reabsorption of HCO3-

99
Q

what happens to ph during metabolic acidosis

A

low ph

100
Q

causes of metabolic acidosis

A

diarrhea, loss in bicarbonate, unable to get rid of acid, producing too much acid

101
Q

what happens to Ph and CO2 during respiratory alkalosis

A

high Ph and low CO2

102
Q

causes of respiratory alkalosis

A

hyperventilation, pain, anxiety

103
Q

compensation for alkalosis

A

decreased RR, excretion of HCO3-; reabsorption of H+

104
Q

what happens to Ph during metabolic alkalosis

A

high ph

105
Q

causes of metabolic alkalosis

A

vomiting, diuretics, too much bicarbonate

106
Q

compensation for metabolic alkalosis

A

decreased RR, excretion of HCO3-; reabsorption of H+

107
Q

what fluids make up the ECF

A

fluid outside cells. Includes plasma of blood, interstitial fluid, and other body fluids

108
Q

ICF

A

intracellular fluid (cytosol)

109
Q

how ECF and ICF are different

A

more than half fluid is inside cells and ICF contains more water

110
Q

Major ICF ions

A

potassium, magnesium, proteins, sulfate, hydrogen phosphate

111
Q

major ECF ions

A

sodium, chloride, calcium, bicarbonate

112
Q

basic principles of regulation

A

o All receptors in ECF not ICF
o Receptors monitor plasma volume and osmotic concentration
o Cells cannot move water by active transport only passively by osmosis – water follows salt

113
Q

Main sources of water gains

A

from drinking, eating, and metabolism

114
Q

water losses

A

urine, feces, exhaled air, insensible and sensible perspiration

115
Q

fluid shifts

A

rapid movement of water between ECF and ICF

116
Q

hypertonic ECF

A

(low fluid, high concentration), shift is out of cells (from ICF to ECF)

117
Q

hypotonic ECF

A

(high fluid, low concentration), shift is into cells (from ECF to ICF)

118
Q

Osmoreceptors

A

in the hypothalamus respond to angiotensin 2 and rise in osmolarity of ECF. Regulates thirst and urination sensation

119
Q

ADH

A

secreted by posterior pituitary upon stimulation from osmoreceptors. Stimulates you to drink more/excrete less

120
Q

Aldosterone

A

secreted by adrenal cortex in response to too much potassium or not enough sodium or in presence of Ang 2. Stimulates to drink more/excrete less

121
Q

Angiotensin II

A

Activated after renin is released by kidneys in response to low BP and blood volume. Stimulates us to drink more/excrete less

122
Q

ANP/BNP

A

secreted by cardiac muscle excreted in response to high BP and increased volume. drink less/excrete more

123
Q

how to get Dehydration

A

Sweating too much, diarrhea, vomiting, diabetes, too many diuretics

124
Q

Dehydration results in

A

hypertonic ECF (hypernatremia), low plasma volume and low BP

125
Q

Response mechanisms to dehydration

A

water shift out of cells (from ICF to ECF); roles of renin-angiotensin, ADH, aldosterone: increase volume (increase thirst and decrease excretion)

126
Q

What is the difference between hypovolemia and dehydration

A

hypovolemia is loosing water and solute (bleeding) no fluid shift because no change in concentration and dehydration is only losing is water. Concentration goes up.

127
Q

causes of overhydration

A

Renal failure, too much IV fluid, too much water, low or no ADH

128
Q

over hydration results in

A

hypotonic ECF (hyponatremia), increased plasma volume and BP

129
Q

Response mechanisms to overhydration

A

water shift into cells (from ECF to ICF); role of ANP/BNP (decrease thirst and increase excretion)

130
Q

What is the difference between hypervolemia and over hydration

A

hypervolemia is both water and electrolytes gained. Results in edema. No fluid shift because no change in concentration and overhydration is water gain and concentration change

131
Q

difference between total amount and the concentration of an ion

A

o Total amount of ions= how much solute

o Concentration of ions = total amount/ amount dissolved in

132
Q

o fluid balance is critical factor that determines

A

electrolyte balance

133
Q

Sodium imbalance is, while potassium imbalance is

A

sodium balance is more common while potassium balance is more dangerous

134
Q

sources of Na gains

A

absorption though GI tract

135
Q

sources of Na losses

A

excretion by kidneys and perspiration

136
Q

water follows

A

salt

137
Q

fluid loss and gain affects the concentration of electrolytes

A

fluid gains lower concentration and fluid losses increases concentration

138
Q

Hypernatremia

A

higher than normal concentration of sodium. caused by fluid loss. Detected by osmoreceptors stimulates same mechanisms as response to dehydration

139
Q

Hyponatremia

A

lower than normal concentration of sodium caused by overhydration or rapid loss of sodium. Detected by osmoreceptors in brain and stimulates same mechanisms as response to overhydration.

140
Q

sources of K gains

A

absorption through GI

141
Q

sources of K losses

A

excretion by kidneys

142
Q

Hyperkalemia

A

lower than normal potassium concentration. caused by- inadequate intake, diuretics causes more negative resting membrane potential, which leaves cells less responsive to stimuli

143
Q

Hypokalemia

A

higher than normal potassium levels caused by pH or ECF, renal failure, burns. Results in more positive resting membrane potential or excitable cells, such as cardiac arrhythmias.

144
Q

Calcium balance. what is it important for and what hormones do you need to stay in balance?

A

important for muscle contractions. PTH and Vit. D are important for balance

145
Q

what causes hypercalcemia

A

higher than normal calcium concentration. caused by hyperparathyroidism, excess vitamin D, bone disorders, and renal failure

146
Q

hypocalcemia

A

lower than normal calcium concentration. caused by Ca and Vitamin D dietary deficiency, PTH deficiency, chronic renal failure

147
Q

where is the JGA located

A

between the renal corpuscle and the afferent/efferent arteriole

148
Q

what does the JGA do?

A

regulates blood flow to the glomerulus and secretes EPO and renin

149
Q

effects of low level neural stimulation

A

causes increase in GFR

150
Q

effects of high level neural stimulation

A

causes constriction of afferent arterioles and decrease in GFR. Ex: warm weather and exercise

151
Q

parts of renal tubule

A

proximal tubule, nephron loop, and distal tubule

152
Q

what happens to the filtrate as it travels through the tubule?

A

the filtrate changes as it travels through the tubule.

153
Q

proximal tubule function

A

some secretion but mainly reabsorption.

154
Q

what is reabsorbed in the proximal tubule

A

sodium, potassium, Cl-, PO4-, HCO3-

155
Q

difference between thick and thin nephron loop

A

thick: reabsorption of ions: sodium chloride, calcium, and magnesium. thin: reabsorption of water

156
Q

during Medullary concentration gradient concentration is higher in

A

medulla, because of countercurrent mechanisms and urea

157
Q

what needs to be present for urine concentration at the collecting duct

A

ADH

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