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Analysis of Urine and Bodily Fluids > The Kidney and Urine Formation > Flashcards

The Kidney and Urine Formation Flashcards

1
Q

The ____ is a very vital organ, which the main fuction is to filter blood and remove toxic wastes.

A

Kidney

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2
Q

Main Functions of the Urinary System

A
  • Regulate blood
  • Regulate volume of blood
  • Regulate amount of solute
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3
Q

____ is the major organ of the excretory system.

A

Kidney

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4
Q

____ is a bean-shaped organ.

A

Kidney

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5
Q

The kidney is a ____-shaped organ.

A

bean

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6
Q

Order of Urine Formation

A
  • Glomerulus
  • Renal tubules
  • PCT
  • Loop of Henle
  • DCT
  • Collecting duct
  • Renal pelvis
  • Ureter
  • Urinary bladder
  • Urethra
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7
Q

____ is the functional unit of the kidney.

A

Nephron

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8
Q

____ is responsible for the urine formation.

A

Nephron

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9
Q

Each kidney contains approximately ____ nephrons.

A

1 to 1.5 million

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10
Q

Both kidneys contain ____ nephrons.

A

2 to 3 million

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11
Q

2 Distinct Areas of the Kidney

A
  • Renal Cortex
  • Renal Medulla
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12
Q

The ____ is the lighter and outer portion of the kidney.

A

Renal Cortex

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13
Q

The ____ is the darker and inner portion of the kidney.

A

Renal Medulla

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14
Q

5 Distinct Areas of the Nephron

A
  • Bowman’s Capsule
  • Glomerulus
  • Proximal Convoluted Tubule
  • Distal Concoluted Tubule
  • Loop of Henle
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15
Q

____ is responsible for the concentration of urine.

A

Loop of Henle

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16
Q

2 Types of Nephron

A
  • Cortical
  • Juxtamedullary
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17
Q

____ of nephrons are cortical nephrons.

A

85%

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18
Q

85% of nephrons are ____.

A

cortical nephrons

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19
Q

Which type of nephron is found on the cortex of the kidneys?

A

Cortical Nephron

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20
Q

Cortical nephron is found on the ____ of the kidneys.

A

cortex

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21
Q

The ____ functions in the removal of wastes and reabsorption of nutrients.

A

Cortical Nephron

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22
Q

____ of the nephrons are juxtamedullary nephrons.

A

15%

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23
Q

15% of the nephrons are ____.

A

juxtamedullary nephrons

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24
Q

____ have longer Loop of Henle that extend deep into the medulla of the kidney.

A

Juxtamedullary nephrons

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25
Q

____ function in the concentration of urine and maintenance of osmotic gradient.

A

Juxtamedullary nephrons

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26
Q

In the medulla, ____ have an increased amount. Therefore, it should be balanced.

A

water and salt

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27
Q

Water and salt have an increased amount in the ____.

A

medulla

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28
Q

Four Renal Functions

A
  • Renal blood flow
  • Glomerular filtration
  • Tubular reabsorption
  • Tubular secretion
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29
Q

The ____ supplies blood to the kidney.

A

Renal artery

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30
Q

The kidneys receive approximately ____ of the blood from the heart.

A

25%

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31
Q

Renal Blood Flow Pattern

A
  1. Renal artery
  2. Afferent arteriole
  3. Glomerulus
  4. Efferent arteriole
  5. Peritubular capillaries
  6. Vasa recta
  7. Renal vein
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32
Q

The varying sizes of the arterioles helps in ____.

A
  • Creating hydrostatic pressure
  • Maintaining consistency of glomerular capillary pressure and renal blood flow
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33
Q

Smaller size of efferent arteriole increases the ____.

A

glomerular capillary pressure

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34
Q

Smaller size of efferent arteriole ____ the glomerular capillary pressure.

A

increases

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35
Q

The ____ surrounds the proximal and distal convoluted tubules.

A

Peritubular capillaries

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36
Q

____ function in immediate reabsorption of essential substances, and final adjustment of the urinary composition.

A

Peritubular capillaries

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37
Q

The ____ are located in the Loop of Henle.

A

Vasa recta

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38
Q

Peritubular capillaries are found in the ____.

A

renal tubules

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39
Q

Vasa recta is found in the ____.

A

Loop of Henle

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40
Q

____ functions in the exchange of water and salt.

A

Vasa recta

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41
Q

Vasa recta functions in the exchange of ____.

A

water and salt

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42
Q

Total renal blood flow

A

1,200 mL/min

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43
Q

Total renal plasma flow

A

600 - 700 mL/min

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44
Q

The glomerulus consists of a coil of approximately ____.

A

8 capillary lobes

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45
Q

The glomerulus is located within the ____.

A

Bowman’s capsule

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46
Q

The ____ forms the beginning of the renal tubule.

A

Bowman’s capsule

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47
Q

TRUE OR FALSE.

Bowman’s capsule is a part of the glomerulus

A

False

Reason: It is a part of the renal tubules

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48
Q

The glomerulus serves as a ____ of blood.

A

non-selective filter

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49
Q

The ____ serves as a non-selective filter of blood.

A

Glomerulus

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50
Q

Glomerulus filters blood with molecular weights ____.

A

less than 70,000 Daltons

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51
Q

Can amino acid be filtered?

A

Yes, but 100% is reabsorbed because it is essential

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52
Q

Can urea be filtered?

A

Yes

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53
Q

____% of urea is reabsorbed.

A

40

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54
Q

____% of urea is excreted.

A

60

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55
Q

Can protein be filtered?

A
  • Based on size yes, because it weighs 69k Daltons.
  • Based on charge no, because it is negative, and the glomerulus has a shield of negativity. Therefore, it will repel.
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56
Q

Fluid as it leaves the glomerulus shows the filtrate to have a specific gravity of ____.

A

1.010

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57
Q

Cellular Structure of the Glomerulus

A
  1. Capillary wall membrane (endothelial cells)
  2. Basement membrane (basal lamina)
  3. Visceral epithelium of the Bowman’s Capsule
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58
Q

____ are different from other capillary walls because they have pores.

A

Endothelial cells

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59
Q

Endothelial cells differ from other capillary walls because they have ____.

A

Pores (fenestrated endothelium)

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60
Q

____ increase cellular permeability but do not allow large molecules and blood cells.

A

Pores

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61
Q

____ are foot processes on the inner layer of Bowman’s capsule.

A

Podocytes

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62
Q

Podocytes are found in the ____.

A

inner layer of Bowman’s Capsule

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63
Q

____ is a force that pushes the fluid out of the blood capilaries.

A

Hydrostatic Pressure

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64
Q

____ resist the hydrostatic pressure. It pushes the fluid into the blood capillaries.

A

Oncotic Pressure

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65
Q

Our oncotic pressure is the ____.

A

Albumin

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66
Q

An autoregulatory mechanism is found within the ____.

A

Juxtaglomerular apparatus

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67
Q

An ____ is found within the juxtaglomerular apparatus.

A

autoregulatory mechanism

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68
Q

Autoregulatory Mechanisms

A
  • Juxtaglomerular cells (JG cells)
  • Macula Densa
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69
Q

____ is found on the afferent arteriole.

A

Juxtaglomerular cells (JG cells)

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70
Q

____ produces the hormone renin when blood pressure is low.

A

Juxtaglomerular cells (JG cells)

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71
Q

JG cells produce ____ when blood pressure is low.

A

renin

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72
Q

When do JG cells produce the hormone renin?

A

When the blood pressure is low

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73
Q

When BP is high, the JG cells ____ the afferent arteriole.

A

constrict

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74
Q

When BP is low, the JG cells ____ the afferent arteriole.

A

dilate

75
Q

JG cells are found on the ___.

A

afferent arteriole

76
Q

____ is found on the distal convoluted tubule.

A

Macula Densa

77
Q

Macula Densa is found on the ____.

A

Distal Convoluted Tubule (DCT)

78
Q

____ sense the changes in blood pressure, especially when decreased.

A

Macula Densa

79
Q

____ sends signal to JG cells to produce hormone.

A

Macula Densa

80
Q

What will happen without Oncotic pressure?

A

All fluid will come out of our body and may lead to Edema

81
Q

What is the difference between the compositions of the filtrate and plasma?

A

The absence of protein

82
Q

____ is a hormone system within the body that is essential for the regulation of blood pressure and fluid balance.

A

Renin-Angiotensin-Aldosternone System (RAAS)

83
Q

RAAS is mainly comprised of three hormones: ____.

A
  • Renin
  • Angiotensin
  • Aldosterone
84
Q

RAAS will be activated if the body has ____.

A

Decreased:
* Blood pressure
* Sodium concentration
* Water

85
Q

Low plasma sodium content ____ water retention within the circulatory system.

A

decreases

86
Q

Changes in blood pressure and plasma sodium content are monitored by ____.

A
  • Juxtaglomerular cells (afferent arteriole)
  • Macula densa (DCT)
87
Q

The activation of RAAS should be inhibited when blood pressure is high by taking ____.

A

Losartan

88
Q

RAAS Cascade of Reaction

A
  1. Renin reacts with Angiotensinogen to produce the inactive hormone called Angiotensin I.
  2. Angiotensin I passes through the lungs and Angiotensin-converting enzyme activates it.
  3. Angiotensin II corrects renal blood flow by either of the following:
    * Dilate afferent arteriole, constrict efferent arteriole
    * Stimulate sodium reabsorption
    * Triggers adrenal cortex to release Aldosterone
    * Triggers hypothalamus to produce ADH
89
Q

How will RAAS act?

Decreased BP

A

Dilation of afferent arteriole and constriction of efferent arteriole

90
Q

How will RAAS act?

Decreased salt concentration

A

Triggers adrenal cortex to relsease Aldosterone

91
Q

How will RAAS act?

Decreased water content

A

Triggers the hypothalamus to produce Antidiuretic hormone

92
Q

The molecules that were filtered by the glomerulus will come back to the circulation and will be reabsorbed in the ____.

A

proximal convoluted tubule

93
Q

Cellular Mechanisms Involved in Tubular Reabsorption

A
  • Active Transport
  • Passive Transport
94
Q

____ requires energy to transport important substances from the renal tubule going to the peritubular capillaries.

A

Active transport

95
Q

For active transport to occur, the substance to be reabsorbed must ____.

A

combine with a carrier protein

96
Q

Active transport is responsible for the reabsorption of the following substances: ____.

A
  • Glucose, amino acids, salts (PCT)
  • Chloride (Ascending loop)
  • Sodium (PCT and DCT)
97
Q

Determine which location is the substance reabsorbed

Glucose

A

PCT

98
Q

Determine which location is the substance reabsorbed

Amino acid

A

PCT

99
Q

Determine which location is the substance reabsorbed

Salt

A

PCT

100
Q

Determine which location is the substance reabsorbed

Chloride

A

Ascending Loop of Henle

101
Q

Determine which location is the substance reabsorbed

Sodium (via active transport)

A

PCT and DCT

102
Q

Through ____, the substance moves from a low concentration to a higher concentration.

A

active transport

103
Q

In the ____ mechanism, substances move from high concentration to a lower concentration.

A

Passive transport

104
Q

The movement of molecules across a membrane as a result of differences in their concentration or electric potential is called ____.

A

gradient

105
Q

____ is the plasma concentration at which active transport stops.

A

Renal threshold (maximal reabsorptive capacity)

106
Q

Can we maintain the specific gravity of 1.010 once it leaves the PCT?

A

Yes

107
Q

Renal concentration begins in the ____.

A

descending and ascending loops of Henle

108
Q

____ is where the filtrate exposed to the high osmotic gradient of the renal medulla.

A

descending and ascending loops of Henle

109
Q

Loop of Henle is important in the ____.

A

reabsorption of water and sodium (salt)

110
Q

____ is reabsorbed in the descending loop of Henle.

A

water

111
Q

Water is reabsorbed in the ____.

A

descending loop of Henle

112
Q

____ is reabsorbed in the ascending loop of Henle.

A

Salt

113
Q

Salt is reabsorbed in the ____.

A

ascending loop of Henle

114
Q

Passive reabsorption of water takes place in all parts of the nephron except the ____.

A

ascending loop of Henle

115
Q

The walls of the ____ is impermeable to water.

A

ascending loop of Henle

116
Q

The walls of the ascending loop of Henle is impermeable to ____.

A

water

117
Q

Why is the ascending loop of Henle impermeable to water?

A

To maintain the osmotic gradient within the medulla

118
Q

As the filtrate goes down to the descending loop, the osmolarity ____ because water is reabsorbed.

A

increases

119
Q

As the filtrate goes up to the ascending loop of Henle, the osmolarity ____ because salt is reabsorbed.

A

decreases (goes back to normal)

120
Q

____ is the selective reabsorption process to maintain the osmotic gradient of the medulla.

A

Countercurrent mechanism

121
Q

Passive transport is responsible for the reabsorption of the following substances: ____.

A
  • Water (PCT, Descending loop, Collecting ducts)
  • Urea (PCT, Ascending loop)
  • Sodium (Ascending loop)
122
Q

Determine which location is the substance reabsorbed

Water

A
  • PCT
  • Descending loop of Henle
  • Collecting ducts
123
Q

Determine which location is the substance reabsorbed

Urea

A
  • PCT
  • Ascending loop of Henle
124
Q

Determine which location is the substance reabsorbed

Sodium (via passive transport)

A

Ascending loop of Henle

125
Q

The final concentration of the filtrate through the reabsorption of water begins in the ____ and continues in the ____.

A

late distal convoluted tubule; collecting duct

126
Q

Reabsorption depends on the ____.

A
  • Osmotic gradient in the medulla
  • Antidiuretic hormone (ADH) or Vasopressin
127
Q

Production of ADH is determined by ____.

A

the state of body’s hydration

128
Q

Saan nagi-instruct na mag-conserve ng water?

hshshhsh hindi q alam paano i-english censya n guys….

A

Collecting ducts

129
Q

____ are receptors of Antidiuretic hormone (ADH).

A

Aquaporins

130
Q

If the body is hydrated, aquaporins are ___.

A

closed

131
Q

If the body is dehydrated, aquaporins are ____.

A

opened

132
Q

Deficiency in antidiuretic hormone is clinically known as ____.

A

Diabetes Insipidus

133
Q

Types of Diabetes Insipidus

A
  • Nephrogenic
  • Hypothalamic
134
Q

Which Type of Diabetes Insipidus?

Aquaporins are not responsive, but the body produces enough ADH.

A

Nephrogenic

135
Q

Which Type of Diabetes Insipidus?

The problem is in the hypothalamus; complete deficiency.

A

Hypothalamic

136
Q

Type 2 diabetes insipidus lead to ____.

A

Polyuria

137
Q

In diabetes insipidus, the body’s hydration is ____, ADH levels are ____, and urine volume is _____.

A

decreased, decreased, increased

138
Q

Concept of ADH Control

Increased body hydration

A

Decreased ADH + Increased Urine Volume

139
Q

Concept of ADH Control

Decreased body hydration

A

Increased ADH + Decreased Urine Volume

140
Q

____ involves the passage of substances from the blood in the peritubullar capillaries to the tubular filtrate.

A

Tubular Secretion

141
Q

Major Functions of Tubular Secretion

A
  • Elimination of waste products not filtered by glomerulus
  • Regulate acid-base balance by secreting Hydrogen ions
142
Q

Why can’t some substances be filtered by the glomerulus?

A

Because they are bound to plasma proteins

143
Q

When protein-bound substances enter the peritibular capillaries, they develop a high affinity for the ____, and dissociate from their carrier proteins.

A

tubular cells

144
Q

The major site for removal of non-filtered substances is the ____.

A

Proximal convoluted tubule

145
Q

How do our kidneys regulate acidosis via tubular secretion?

A

By secreting Hydrogen ions into the urine

146
Q

How do our kidneys regulate alkalosis via tubular secretion?

A

By excreting bicarbonate in the urine (or secreting hydrogen ions)

147
Q

The standard tests used to measure the filtering capacity of the glomeruli is the ____.

A

Clearance Tests

148
Q

A ____ measures the rate at which the kidneys are able to remove a filterable substance from the blood.

A

Clearance test

149
Q

____ is the most common test that determines which particular kidney function has a problem.

A

Clearance test

150
Q

____ is the earliest glomerular filtration test because of its presence in all urine specimens.

A

Urea clearance

151
Q

____ is a polymer of fructose.

A

Inulin

152
Q

____ is not a normal body constituent because it is exogenous.

A

Inulin

153
Q

____ is the gold standard. Although it was the original reference method for clearance tests, it is currently not used for glomerular filtration testing.

A

Inulin clearance

154
Q

____ is a very common clearance test.

A

Creatinine clearance

155
Q

What specimen is required for creatinine clearance test?

A

24 hour urine

156
Q

____ present in human plasma react in the chemical analysis.

A

Chromogens

157
Q

____ may help counteract the falsely elevated rates caused by tubular secretion.

A

Chromogens

158
Q

____ inhibit tubular secretion of creatinine, thus causing falsely low serum levels.

A

Medications

Ex. gentamicin, cephalosphorins, and cimetidine

159
Q

Creatinine clearance formula

A

Urine Creatinine (mg/dL) x Urine Volume (mL/min) / Plasma Creatinine (mg/dL)

160
Q

Normal values of creatinine clearance in Males

A

107 - 139 mL/min

161
Q

Normal values of creatinine clearance in Females

A

87 - 107 mL/min

162
Q

Calculated Glomerular Filtration Estimates

A

Cockroft and Gault

163
Q

Cockroft and Gault variables

A
  • Age
  • Weight
  • Gender (if female, multiply the computed value by 0.85)
164
Q

Cockroft and Gault formula

A

(140-age)(weight in kg) / 72 x serum creatinine (mg/dL)

165
Q

Modification of Diet in Renal Disease (MDRD) variables

A
  • Age
  • Gender
  • Ethnicity (if black, multiply the computed value by 1.1880)
  • BUN
  • Serum albumin
166
Q

Renal function test

A
  • Injection of radionucleotides such as, 125I-iothalamate
  • Beta 2 microglobulin
  • Cystatin C
167
Q

Tubular reabsorption tests

A
  • Fishberg test (water deprivation test)
  • Mosenthal test

Both are now OBSOLETE

168
Q

The ____ deprives the patient of water for 24 hours.

A

Fishberg test

169
Q

Specific gravity for Fisheberg test

A

greater than or equal to 1.025

170
Q

The ____ compare the day and night urine specific gravity and volume.

A

Mosenthal test

171
Q

Renal concentration ability

A
  • Osmolarity
  • Specific gravity
172
Q

____ is affected only by the number of particles present.

A

Osmolarity

173
Q

____ depends on the number of particles present in a solution and the density of these particles.

A

Specific gravity

174
Q

____ determine the freezing point if any solution by supercooling and measuring the amount of sample to approximately 27 C.

A

Freezing point osmometer

175
Q

____ measures the due point.

A

Vapor pressure osmometer

176
Q

____ is the temperature at which water vapor will be condensed to a liquid.

A

Due point

177
Q

Factors to consider because of their influence on true osmolarity readings

A
  • Lipemic serum
  • Lactic acid
  • Volatile substances
178
Q

Lipemic serum

A

Produces erroneous results with both vapor pressure and freezing point osmometers

Mas matagal mag-condense and freeze

179
Q

Lactic acid

A

Falsely elevated if serum samples are not separated or refrigerated within 20 minutes

180
Q

Volatile substances

A

Vapor pressure osmometers do not detect the presence of volatile substances

181
Q

Tubular secretion and renal blood flow tests

A
  • P-aminohippuric acid (PAH) test
  • Phenolsulfonphthalein (PSP) dye

Both should be excreted

182
Q
  • Exogenous
  • Loosely bound to plasma proteins, which permits its complete removal as the blood passes through the peritubular capillaries.
A

PAH Test

183
Q

The ability of the kidney to produce an acid urine depends on the tubular secretion of hydrogen ions and production and secretion of ammonia by the cells of the distal convoluted tubule.

A

Titratable acidity and Urinary Ammonia

Analysis of Urine and Bodily Fluids (3 decks)

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