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Physio II (Exam 2) > Topic 6 Urine Formation overview > Flashcards

Topic 6 Urine Formation overview Flashcards

1
Q

Renal Function top reasons? (4)

A
  • Regulation of water and electrolyte balances*
  • Regulation of body fluid osmolality and electrolyte* concentrations
  • Regulation of blood pressure*
  • Regulation of acid-base balance
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2
Q

Urea comes from ?

A

amino acid metabolism

Secreted in urine

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3
Q

Creatinine comes from?

A

from muscle creatine

Creatine used to create phosphocreatine which serves as energy source for production of ATP in muscle. Each day 1 to 2% of muscle creatine converted to creatinine
Secreted in urine

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4
Q

Uric acid comes from ?

A

from nucleic acids

Secreted in urine

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5
Q

End products of hemoglobin break down to what?

A

bilirubin

Secreted in urine

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6
Q

Fluid / salt intake usually depends on what?

A

individual eating / drinking habits

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7
Q

Kidneys are able to respond to what levels of fluctuation of Na concentration with still small changes in ECF Vol? (mEq/day)

A
  • 10 mEq/day to 1500mEq/day
  • Able to respond to huge differences in sodium intake with relatively small changes in ECF volume or [Na+]
  • Also true for most other electrolytes
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8
Q

Kidneys work with what other systems for acid base regulation?

A

Lungs

Body Buffer Systems

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9
Q

sulfuric and phosphoric acid come from what?

A

Byproducts of protein metabolism

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10
Q

Acid base Regulation. what do Lungs and kidneys control?

A

-Lungs remove carbon dioxide
-Kidneys control hydrogen ion and bicarbonate
concentration and only way to remove sulfuric and phosphoric acid

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11
Q

Almost all erythropoietin is secreted from where?

A

Kidney

which stimulates red blood cell production by hematopoietic stem cells in bone marrow

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12
Q

What is a major stimulus for Erythropoietin production?

A

hypoxia

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13
Q

Patient’s with severe renal disease will develop what bc of lack of production of erythropoietin?

A

severe anemia due to lack of erythropoietin production

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14
Q

Glucose Synthesis occurs when?

A
  • During prolonged fasting

- Significant quantities can be produced from kidneys

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15
Q

Gluconeogenesis (aka glucose synthesis)

A

-Kidneys synthesis glucose from amino acids and other precursors during fasting

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16
Q

Glomerular Capillaries - high hydrostatic pressure produces/causes what? what mmHg?

A 
High pressure (60mmHg) produces high/rapid
rate of fluid filtration
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17
Q

Peritubular Capillaries - low hydrostatic pressure produces/permits what? what mmHg

A 
Low pressure (13 mmHg) produces high/rapid
rate fluid reabsorption
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18
Q

Each kidney weighs what approx? gms

A

150 grams

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19
Q

By adjusting the resistance of afferent and efferent arterioles the kidneys can regulate what?

A

hydrostatic pressure in both glomerular and peritubular capillaries this changing glomerular filtrate and tubular reabsorption.

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20
Q

Peritubular capillaries empty into what?

A

vessels of venous system

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21
Q

% of all nephrons that are juxtamedullary nephrons?

A

20 to 30% of all

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22
Q

Each kidney contains how many nephrons?

A

800,000-1 million nephrons

23
Q

After age 40 what happens to the # of nephrons?

A

lose 10% every 10 years

24
Q

Each nephron contains what two things>

A

1) glomerulus - where fluid filtered (tuft of glomerular capillaries)
2) Long tubule - where filtered fluid is converted into urine

25
Q

Micturition - what kind of reflex?

A

An Autonomic reflex but can be inhibited/facilitated by centers in cerebral cortex or brain stem (voluntary)

26
Q

what is Micturition?

A

process by which bladder empties when it becomes filled

27
Q

Detrusor muscle - type of muscle?

A

smooth muscle chamber

muscle fibers go in all directions

28
Q

Urinary bladder inner lining what?

A

rugae

29
Q

Trigone

A

above bladder neck

its inner mucosa (lining) is smooth

30
Q

Micturition 2 steps?

A
  1. Bladder fills, tension rises above threshold level

2. A nervous reflex (micturition reflex) empties bladder or causes conscious desire to pee

31
Q

Bladder Innervation, main supply of nerves come from ?

A

Pelvic nerves

32
Q

Pelvic nerves

A

sensory nerve fibers - detect stretch

motor nerve fibers - parasympathetic fibers

33
Q

Pudendal nerve

A

Skeletal motor fibers come thru this nerve to the ext. sphincter.
–skeletal muscle fibers provide Somatic (voluntary) control of external sphincter

34
Q

Sympathetic control (innervation) of bladder via what nerves?

A
  • hypogastric nerves

- Control mainly the blood vessels (as opposed to controlling contraction.

35
Q

Ureters well supplied with what type of nerves?

A

pain nerves

36
Q

Ureterorenal Reflex stimulated by what?

A

pain impulses in ureters causing a sympathetic reflex back to kidney to constrict renal arterioles thereby decreasing U.O. from kidney.
Important for preventing excessive flow of fluid into pelvis of a kidney w/a blocked ureter

37
Q

Stimulated when blocked ureters respond with intense reflex constriction which sends sympathetic stimulation back to kidneys to constrict renal arterioles

A

Ureterorenal Reflex

38
Q

prevents excessive flow of fluid into pelvis of a kidney w/a blocked ureter

A

Ureterorenal Reflex

39
Q

Renal calyces act as what?

A

pacemaker for peristaltic contraction of smooth muscle forcing urine down into the renal pelvis, down the ureters into the bladder

40
Q

Increased stretch of calyces increases what rate?

A

peristaltic rate

41
Q

Parasympathetic innervation does what to peristalsis (peristaltic contractions in Ureter)?

A

enhances peristalsis (peristaltic contractions in Ureter)

42
Q

sympathetic innervation does what to peristalsis (peristaltic contractions in Ureter)?

A

inhibits peristalsis (peristaltic contractions in Ureter)

43
Q

The normal tone of the detrusor muscle does what?

A

Prevents backflow from bladder to ureters, aka REFLUX, esp when a person builds up in bladder during micturition or bladder compression (aka esp during bladder contraction)

44
Q

If ureter is not long enough to pass through wall of bladder, what will occur?

A

reflux

45
Q

Peristaltic waves down/along ureter increases pressure within ureter to do what to bladder?

A

to open passage to bladder

so region passing through bladder wall opens and allows urine to flow

46
Q

Urination occurs when inhibitor signals are stronger than what signals to do what?

A

voluntary constrictor signals being sent to external sphincter

47
Q

Micturition contractions stimulated by what?

A

stretch receptors/reflex, initiated by sensory stretch receptors in bladder wall

Provides positive feedback to stretch receptors resulting in further increase in pressure

48
Q

What are micturition contractions ?

A

Tonic pressure changes during filling of the bladder, periodic acute increase in pressure that last sec-min, caused by micturition reflex.

49
Q

As bladder fills more and more what happens to the micturition reflex?

A

inhibited time decreases (more frequent contractions) and resulting contractions become more powerful

50
Q

Once micturition reflex is strong enough it stimulates inhibitor signals to where?

A

the external sphincter

51
Q

Once Micturition Reflex begins it is what?

A

“Self regenerative”
initial contraction activates stretch receptors to cause a greater increase in sensory impulses, cycle of contractions repeat until there is a strong degree of contractions
After a while it starts to fatigue and permits bladder relaxation for some time and than starts again.

52
Q

Internal sphincter–tone

A

holds urine in bladder

smooth muscle

53
Q

External sphincter

A

–skeletal muscle
–voluntary control by nervous system
–conscious prevention of urination

Physio II (Exam 2) (6 decks)

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