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UG-urinary system Flashcards

1
Q

where does the kidney lie in the abdomen?

A

retroperitoneal

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2
Q

which kidney sits lower in the abdomen and why?

A

right

-to accommodate for the liver on the right side

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3
Q

outline the kidneys vasculature

A

aorta->renal artery->segmental artery->interlobar artery->arcuate artery->cortical radiate artery->afferent artery->glomerulus->efferent arterioles->vasa recta

cortical radiate vein->arcuate->interlobar vein->renal vein->inferior vena cava

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4
Q

what is the ureter?

A

Tube that transports urine from kidney to bladder

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5
Q

what are the ureters supplied by?

A

Supplied by gonadal arteries, common iliac artery and internal iliac arteries

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6
Q

what are the 3 points of constriction of the ureter?

A

Pelviureteric junction, pelvic brim and vesicoureteric junction

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7
Q

which muscle lines the bladder?

A

detrusor

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8
Q

which direction does the bladder expands?

A

superiorly

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9
Q

what is the trigone?

A

internal surface of the base of the bladder

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10
Q

where does the urethra form?

A

at the neck of the bladder

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11
Q

where does the urethra form in males?

A

in the male the prostate surrounds the top of the urethra – touching the inferior bladder

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12
Q

how is the male bladder held in place?

A

by the puboprostatic gland

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13
Q

how is the female bladder held in place?

A

pubovesical ligament

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14
Q

what structures make up the renal corpuscle?

A
  • glomerulus

- bowman’s capsule

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15
Q

what does blood enter the renal corpuscle through?

A

afferent arteriole

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16
Q

what does blood exit the renal corpuscle through?

A

efferent arteriole

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17
Q

what are the 3 layers of the capillary wall of the glomerulus?

A

endothelium, basement membrane and podocytes which form pedicels

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18
Q

what is the bowman’s capsule?

A

Bowman’s capsule is a layer of epithelium that surrounds glomerulus

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19
Q

what do fenestrations of the capillary walls do?

A

restrict the size of molecules and ions being filtered out (things like large proteins and RBCs are retained)

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20
Q

which 2 cell types are next to the renal corpuscle?

A

juxtaglomerular

macula densa

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21
Q

what is a nephron?

A

functional unit of kidney

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22
Q

what does a nephron consist of?

A
  • renal corpuscle (glomerulus and bowman’s capsule)

- renal tubule (proximal convoluted tubule, Loop of Henle, distal convoluted tubule and collecting duct)

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23
Q

which part of the loop of henle are macula densa cells situated?

A

DCT

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24
Q

describe the movement of ions in the PCT

A

In PCT, main movements of ions are sodium and HCO3 from tubule lumen to blood via cells of PCT and H+ from blood to tubular fluid

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25
how are ions transported across the PCT
Na+ is transported via: - glucose co-transport - Na+/H+ antiporter - Na+/K+ pump (active transport)
26
which reaction in the PCT is catalysed by carbonic anhydrase?
h+ + hco3- ---->h2co3---->co2 + h2o
27
what is the DL permeable to?
water only
28
what is the AL permeable to?
ions/ salt
29
which ions diffuse out of thin AL?
na+ cl-
30
what hormone stimulates cells in the DCT to reabsorb more Na+ and secrete more K+ into the tubular fluid?
aldosterone
31
what does more ion reabsorption result in?
more water retention-increasing blood volume
32
what percentage of Na+ absorption occurs in the PCT?
65%
33
what percentage of Na+ absorption occurs in the DCT?
10%
34
what percentage of Na+ absorption occurs in the LoH?
25% in thick AL
35
outline the steps of the countercurrent multiplier system
- Blood runs firstly passes the top of the thick ascending limb – where salt concentration in the blood is low and salt concentration in the interstitial fluid is too - As the peritubular capillary (which is fenestrated) moves down – capillary and tubule concentration increases in concentration - The peritubular capillary is high in salt as it moves up the descending limb – encouraging water to move by osmosis back into the capillary
36
where is urine produced?
nephrons
37
where do papillae at the end of nephrons converge?
minor calyces
38
where do minor calyces converge?
major calyces
39
where do major calyces meet?
renal pelvis
40
where does the renal pelvis lead to?
ureter
41
where does urine travel where it is stored for excretion?
kidney->bladder
42
outline the process of micturation
- urethral sphincter and pelvic floor relax | - The detrusor muscle contracts and urine passes from the bladder and out of the body via the urethra
43
which nerves stimulate detrusor muscle contraction and inhibit the internal urethral sphincter?
-Parasympathetic fibres originate as the pelvic splanchnic nerves from S2-S4
44
which nerve stimulates the closure of the sphincter vesicae?
Sympathetic fibres originate in L1-L2, descending via the hypogastric plexuses
45
which nerve controls the external sphincter?
Somatic fibres control external sphincter through the pudendal nerve S2-S4
46
what does GFR stand for?
Glomerular filtration rate
47
what is GFR?
The amount of fluid passing from the blood, across the basement membrane, into the Bowman’s Space (millilitres per minute into the glomerular filtrate)
48
Do external changes in blood pressure affect GFR?
no as GFR autoregulates
49
what is the normal filtration rate?
125 mL/min
50
what is the formula for measuring GFR?
GFR= UV/P U=solute conc in urine V=vol of urine excreted per min P=solute conc in plasma
51
what does RPF stand for?
renal plasma flow
52
what is RPF?
Amount of blood PLASMA that flows through glomerulus per min
53
what is normal RPF?
625 mL/min
54
how do you calculate FF/
FF= GFR/ RPF
55
what is normal FF?
125/625= 20%
56
what is RPC?
renal plasma clearance-the amount of blood cleared of the substance by the kidney each minute
57
when is RPC equal to GFR?
If a substance is in the blood in a steady state, freely filtered at the glomerulus and not secreted or reabsorbed then clearance = GFR
58
which substance clearance equals GFR?
inulin clearance
59
when can GFR be calculated in practice?
Can be calculated when the substance being measured to calculate GFR is filtered freely, not secreted or reabsorbed, not toxic or not metabolised
60
what is creatinine?
metabolite of creatine secreted by kidney epithelial cells in low amounts
61
why is creatinine generally used in practice over inulin?
- easier to measure | - inulin more effective but added intravenously as infused at a steady state-more expensive and less convenient
62
what are the 4 mechanisms of regulating GFR?
INTRINSIC: Myogenic, tubuloglomerular EXTRINSIC hormonal and neural mechanisms
63
describe myogenic autoregulation of GFR
-As BP increases GFR increases -However, stretching occurs in the smooth muscle fibres of afferent arteriole -In response – smooth muscle contacts narrowing the arteriole lumen (For low BP the efferent arteriole contracts)
64
describe tubuloglomerular autoregulation
- The macula densa detects a rise in systemic BP - This is accomplished by detecting a greater concentration of Na+ and Cl- in the filtration fluid – as there is less time for the fluid to be absorbed by tubule - Macula densa cells inhibit the release of nitric oxide (NO) from cells in the juxtaglomerular cells (which would cause vasodilation)
65
which cells are involved in tubuloglomerular autoregulation
macula densa
66
which hormones are involved in hormonal regulation of GFR
- Angiotensin 2 – a vasoconstrictor | - Atrial Natriuretic Peptide (ANP)
67
how does angiotensin 2 affect GFR?
-vasoconstrictor narrows afferent and efferent arterioles – reducing renal blood flow and as a result – reducing GFR
68
how does atrial natriuretic peptide (ANP) regulate GFR?
Atrial Natriuretic Peptide (ANP) triggers the relaxation of the glomerular mesangial cells – increasing capillary SA and hence increasing renal blood flow and GFR
69
outline neural regulation of GFR
- Baroreceptors in the carotid body and the arch of the aorta detect high blood pressure – sends signal to medulla - The medulla sends a signal via sympathetic fibres to the kidneys to secrete noradrenaline – which are detected by alpha-1 receptors of smooth muscle - Causes vasoconstriction of afferent arteriole to maintain GFR
70
``` Which muscle(s) contract when there is a desire to void the bladder just before micturition? A-Pelvic floor muscles B-Urethral sphincter C-Psoas Major muscles D-Detrusor muscle ```
D
71
How much % of Na+ absorption in nephron occurs in Loop of Henle? A-65% B-25% C-45%
B
72
``` Where does blood flow to after leaving the segmental artery? A-Arcuate artery B-Interlobar artery C-Cortical Radiate artery D-Glomerular Capillary ```
B
73
Which arteriole, afferent or efferent, has a wider lumen?
afferent

Medicine yr1 (55 decks)

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