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DPT 503 > the urinary system > Flashcards

the urinary system Flashcards

1
Q

what is the primary function of the kidneys?

A

cleanse the blood (filter it)

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2
Q

kidney maintain the body’s internal environment by:

A
  • Regulating total water volume and total solute concentration in water
  • Regulating ion concentrations in extracellular fluid (ECF)
  • Ensuring long-term acid-base balance
  • Excreting metabolic wastes, toxins, drugs
  • Producing erythropoietin (regulates blood pressure and renin (regulates RBC production)
  • Activating vitamin D
  • Carrying out gluconeogenesis, if needed
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3
Q

upper parts of both kidneys are protected by what?

A

thoracic cage

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4
Q

perirenal fat provides what?

A

cushioning

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5
Q

lower parts of the kidneys are susceptible to what?

A

blunt trauma
(especially right kidney)

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6
Q

renal artery is especially vulnerable to injury from what?

A

rapid deceleration during car crashes, lead to laceration or thrombosis

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7
Q

what is hematuria and what is it an important sign of?

A

blood in urine and is an important sign of such trauma

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8
Q

internal kidney has three distinct regions, what are they?

A
  1. renal cortex
  2. renal medulla
  3. renal pelvis
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9
Q

where is the renal cortex?

A

granular-appearing superficial

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10
Q

where is the renal medulla?

A

deep to cortex, composed of cone-shaped medullary (renal) pyramids

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11
Q

what does the renal pelvis do?

A

urine flow

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12
Q

the order of urine flow:

A

renal pyramid
minor calyx
major calyx
renal pelvis
ureter

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13
Q

what is the major unit in the kidneys that produce urine?

A

nephrons

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14
Q

what are the 2 main parts of the nephrons?

A

renal corpuscle
renal tubule and collecting ducts

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15
Q

what is in the renal corpuscle?

A

glomerulus
glomerulus capsule (bowsman capsule)

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16
Q

what is the glomerulus?

A

tuft of capillaries composed of fenestrated endothelium

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17
Q

the renal tubule is about _____________ long

A

3 cm (1.2 in)

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18
Q

three major parts of the renal tubule:

A
  1. proximal convoluted tubule
  2. nephron loop
  3. distal convoluted tubule
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19
Q

where is the proximal convoluted tubule and what does it do?

A

proximal, closest to renal corpuscle
functions in reabsorption and secretion

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20
Q

the nephron loop was formerly called what?

A

loop of henle

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21
Q

what does the nephron loop look like? what two limbs does it have?

A

U-shaped structure

descending limb
ascending limb

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22
Q

where are the distal convoluted tubule? and what does it do?

A

distal, farthest from renal corpuscle
function more in secretion than reabsorption

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23
Q

distal convoluted tubule drains into a . . .

A

collecting duct

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24
Q

collecting ducts receive what?

A

filtrate from many nephrons

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25
Q

where does the collecting duct run through?

A

medullary pyramids

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26
Q

why do the ducts fuse together?

A

to deliver urine through papillae into minor calyces

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27
Q

2 major groups of nephrons:

A
  1. cortical nephrons
  2. juxtamedullary nephrons
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28
Q

cortical nephrons make up _____of nephrons and are almost entirely in _________.

A

85%
cortex

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29
Q

what are the juxtamedullary nephrons?

A

long nephron loops that deeply invade medulla

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30
Q

juxtamedullary nephrons ascending limbs have _______ and ______ segments

A

thick and thin

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31
Q

juxtamedullary nephrons are important in production of what?

A

concentrated urine

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32
Q

blood pressure is high where?

A

in glomerulus

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33
Q

blood pressure is low where?

A

peritubular capillaries

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34
Q

the 3 nephron capillary beds:

A

glomerulus
peritubular capillaries
vasa recta

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35
Q

the capillary beds in the renal tubule:

A

glomerulus
peritubular capillaries

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36
Q

glomerulus capillaries are specialized for what?

A

filtration

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37
Q

glomerulus are fed and drained by what?

A

arterioles

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38
Q

why is blood pressure high in glomerulus?

A

arterioles are high-resistance vessels

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39
Q

what are peritubular capillaries?

A

porous capillaries adapted for absorption of water and solutes

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40
Q

where do peritubular capillaries arise from?

A

efferent arterioles

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41
Q

peritubular capillaries empty into where?

A

venules

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42
Q

whart are vasa recta?

A

long, thin-walled vessels parallel to long nephron loops of juxtamedullary

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43
Q

where does vasa recta arise from?

A

efferent arterioles serving juxtamedullary nephrons

44
Q

what does vasa recta function in?

A

formation of concentrated urine

45
Q

each nephron has one what?

A

juxtaglomerular complex (JGC)

46
Q

juxtaglomerular complex (JGC) involves modified portions of:

A
  • distal portion of ascending limb of nephron loop
  • afferent (sometimes efferent) arteriole
47
Q

why is the juxtaglomerular complex important ?

A

important in regulating rate of filtrate formation and blood pressure

48
Q

_______ of fluid processed daily, but only ______ of urine is formed.

A

180 L
1.5 L

49
Q

kidneys filter body’s entire plasma volume ______ times each day

A

60

50
Q

kidneys consume ______ of oxygen used by body at rest

A

20-25%

51
Q

urine is produced from what?

A

filtrate

52
Q

urine is _____ of original filtrate

A

<1%

53
Q

urine contains what?

A

metabolic wastes and unneeded substances

54
Q

three processes are involved in urine formation and adjustment of blood composition:

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
55
Q

what does glomerular filtration do?

A

produces cell and proteins free filtrate

56
Q

what does tubular reabsorption do?

A

selectively returns 99% of substances from filtrate to blood in renal tubules and collecting ducts

57
Q

what does tubular secretion do?

A

selectively moves substances from blood to filtrate in renal tubules and collecting ducts

58
Q

what is the first step in how the kidneys make urine?

A

glomerular filtration

59
Q

glomerular is a . . .

A

passive process

60
Q

no ____________ is required for glomerular filtration

A

metabolic energy

61
Q

hydrostatic pressure forces fluids and solutes through the _________________ into the glomerular capsule

A

filtration membrane

62
Q

where does the filtration membrane lie?

A

between the blood and the interior of the glomerular capsule

63
Q

filtration membrane is a porous membrane that allows what?

A

free passage of water and solutes smaller than plasma proteins

64
Q

plasma proteins remain in the blood to maintain what?

A

colloid osmotic pressure

65
Q

by the plasma proteins remaining in blood it prevents what?

A

loss of all water to capsular space

66
Q

proteins in filtrate indicate what?

A

membrane problem

67
Q

blood is coming from the afferent arteriole and has to get into the glomerular capillaries through hydrostatic pressure; so where is the hydrostatic pressure in that equation?

A

hydrostatic pressure is in afferent

68
Q

outward pressures are . . .?

A

forces that promote filtrate formation

69
Q

hydrostatic pressure in ______________ is essentially glomerular blood pressure

A

glomerular capillaries (HP gc)

70
Q

inward pressures are. . .?

A

forces inhibiting filtrate formation

71
Q

what are 2 types of inward pressures?

A

hydrostatic pressure in capsular
colloid osmotic pressure in capillaries

72
Q

what does hydrostatic pressure in capillaries do?

A

filtrate pressure in capsule (15 mmHg)

73
Q

what does colloid osmotic pressure in capillaries do?

A

“pull” of proteins in blood (30 mmHg)

74
Q

what is net filtration pressure (NFP):

A

sum of forces

75
Q

NFP is the main controllable factor determining what?

A

glomerular filtration rate (GFR)

76
Q

what is glomerular filtration rate (GFR)?

A

volume of filtrate formed per minute by both kidneys

77
Q

GFR is directly proportional to:

A
  • net filtration pressure
  • total surface area available for filtration
  • filtration membrane permeability
78
Q

why is constant GFR important?

A

it allows kidneys to make filtrate & maintain extracellular homeostasis

79
Q

what regulates glomerular filtration?

A

intrinsic control
extrinsic control

80
Q

goal of intrinsic controls:

A

renal autoregulation
maintain GFR in kidney

81
Q

goal of extrinsic controls:

A

maintain systemic blood pressure

82
Q

_________ and ____________ are main extrinsic controls

A

nervous system
endocrine system

83
Q

GFR effects . . .

A

systemic blood pressure

84
Q

increased GFR causes increased __________, which lowers ___________ and vice versa

A

urine output
blood pressure

85
Q

two types of renal autoregulation:

A
  1. myogenic mechanism
  2. tubuloglomerular feedback mechanism
86
Q

what is myogenic mechanism?

A

local smooth muscle contracts when stretched

87
Q

increased BP causes muscle to ___________, leading to constriction of ____________________________

A

stretch
afferent arterioles in glomerulus

88
Q

decreased BP causes ___________ of afferent arterioles in the glomerulus

A

dilation

89
Q

what is tubuloglomerular feedback mechanism?

A

Flow-dependent mechanism directed by macula densa cells in the juxtaglomerular complex

90
Q

what does the tubulglomerular feedback mechanism respond to?

A

filtrate NaCl concentration

91
Q

if GFR increases then . . .

A

filtrate flow rate increases leading to decreased reabsorption time causing high NaCl levels to filtrate

92
Q

feedback mechanism causes . . .

A

constriction of afferent arterioles which lowers NFP and GRF allowing more time for NaCl reabsorption

93
Q

extrinsic control involves:

A
  • neural and hormonal mechanisms
  • sympathetic nervous system
94
Q

what is the purpose of extrinsic controls?

A

regulate GFR to maintain systemic blood pressure

95
Q

extrinsic controls will override renal intrinsic controls if . . .

A

blood volume needs to be increased

96
Q

___________________ is released by the ________________________ & ______________ is released by ____________________________

A

norepinephrine
sympathetic nervous system
epinephrine
adrenal medulla

97
Q

releasing norepinephrine and epinephrine causes :

A

systemic vasoconstriction
constriction of afferent arterioles
blood volume & pressure increases

98
Q

systemic vasoconstriction increases what?

A

blood pressure

99
Q

constriction of afferent arterioles decreases what?

A

GFR

100
Q

what is the main mechanism for increasing blood pressure?

A

renin-angiotensin-aldosterone mechanism

101
Q

renin is released by . . .

A

granular cells

102
Q

what raises blood pressure when it is low?

A

RAAS

103
Q

any change in blood volume or pressure stimulates what?

A

distal convoluted tubule (DCT) and collecting duct to reverse the change

104
Q

alter Na+ and H2O reabsorption is regulated by:

A

aldosterone
ADH
ANP

105
Q

when there is LOW bp ________ and _________ absorb ______ water with the help of ______________ and ______ working together

A

DCT and collecting ducts
more
aldosterone & ADH

106
Q

what does HIGH blood volume causes what?

A

a stretch in the atrium which triggers a release of ANP

107
Q

ANP inhibits the release of what?

A

ADH and aldosterone

DPT 503 (14 decks)

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