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Medicine yr1 > UG-urinary system > Flashcards

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
Q

how are ions transported across the PCT

A

Na+ is transported via:

  • glucose co-transport
  • Na+/H+ antiporter
  • Na+/K+ pump (active transport)
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26
Q

which reaction in the PCT is catalysed by carbonic anhydrase?

A

h+ + hco3- —->h2co3—->co2 + h2o

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27
Q

what is the DL permeable to?

A

water only

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28
Q

what is the AL permeable to?

A

ions/ salt

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29
Q

which ions diffuse out of thin AL?

A

na+ cl-

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30
Q

what hormone stimulates cells in the DCT to reabsorb more Na+ and secrete more K+ into the tubular fluid?

A

aldosterone

31
Q

what does more ion reabsorption result in?

A

more water retention-increasing blood volume

32
Q

what percentage of Na+ absorption occurs in the PCT?

33
Q

what percentage of Na+ absorption occurs in the DCT?

34
Q

what percentage of Na+ absorption occurs in the LoH?

A

25% in thick AL

35
Q

outline the steps of the countercurrent multiplier system

A
  • 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
Q

where is urine produced?

37
Q

where do papillae at the end of nephrons converge?

A

minor calyces

38
Q

where do minor calyces converge?

A

major calyces

39
Q

where do major calyces meet?

A

renal pelvis

40
Q

where does the renal pelvis lead to?

41
Q

where does urine travel where it is stored for excretion?

A

kidney->bladder

42
Q

outline the process of micturation

A
  • 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
Q

which nerves stimulate detrusor muscle contraction and inhibit the internal urethral sphincter?

A

-Parasympathetic fibres originate as the pelvic splanchnic nerves from S2-S4

44
Q

which nerve stimulates the closure of the sphincter vesicae?

A

Sympathetic fibres originate in L1-L2, descending via the hypogastric plexuses

45
Q

which nerve controls the external sphincter?

A

Somatic fibres control external sphincter through the pudendal nerve S2-S4

46
Q

what does GFR stand for?

A

Glomerular filtration rate

47
Q

what is GFR?

A

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
Q

Do external changes in blood pressure affect GFR?

A

no as GFR autoregulates

49
Q

what is the normal filtration rate?

A

125 mL/min

50
Q

what is the formula for measuring GFR?

A

GFR= UV/P

U=solute conc in urine
V=vol of urine excreted per min
P=solute conc in plasma

51
Q

what does RPF stand for?

A

renal plasma flow

52
Q

what is RPF?

A

Amount of blood PLASMA that flows through glomerulus per min

53
Q

what is normal RPF?

A

625 mL/min

54
Q

how do you calculate FF/

A

FF= GFR/ RPF

55
Q

what is normal FF?

A

125/625= 20%

56
Q

what is RPC?

A

renal plasma clearance-the amount of blood cleared of the substance by the kidney each minute

57
Q

when is RPC equal to GFR?

A

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
Q

which substance clearance equals GFR?

A

inulin clearance

59
Q

when can GFR be calculated in practice?

A

Can be calculated when the substance being measured to calculate GFR is filtered freely, not secreted or reabsorbed, not toxic or not metabolised

60
Q

what is creatinine?

A

metabolite of creatine secreted by kidney epithelial cells in low amounts

61
Q

why is creatinine generally used in practice over inulin?

A
  • easier to measure

- inulin more effective but added intravenously as infused at a steady state-more expensive and less convenient

62
Q

what are the 4 mechanisms of regulating GFR?

A

INTRINSIC:
Myogenic, tubuloglomerular

EXTRINSIC
hormonal and neural mechanisms

63
Q

describe myogenic autoregulation of GFR

A

-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
Q

describe tubuloglomerular autoregulation

A
  • 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
Q

which cells are involved in tubuloglomerular autoregulation

A

macula densa

66
Q

which hormones are involved in hormonal regulation of GFR

A
  • Angiotensin 2 – a vasoconstrictor

- Atrial Natriuretic Peptide (ANP)

67
Q

how does angiotensin 2 affect GFR?

A

-vasoconstrictor narrows afferent and efferent arterioles – reducing renal blood flow and as a result – reducing GFR

68
Q

how does atrial natriuretic peptide (ANP) regulate GFR?

A

Atrial Natriuretic Peptide (ANP) triggers the relaxation of the glomerular mesangial cells – increasing capillary SA and hence increasing renal blood flow and GFR

69
Q

outline neural regulation of GFR

A
  • 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
Q 
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
71
Q

How much % of Na+ absorption in nephron occurs in Loop of Henle?
A-65%
B-25%
C-45%

72
Q 
Where does blood flow to after leaving the segmental artery?
A-Arcuate artery
B-Interlobar artery
C-Cortical Radiate artery
D-Glomerular Capillary
73
Q

Which arteriole, afferent or efferent, has a wider lumen?

Medicine yr1 (55 decks)

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