Unit 21 - The Urinary System Flashcards
1
Q
There are several organs included in the “urinary system”.
A
a. Kidneys
b. Ureters
c. Urinary bladder
d. Urethra
2
Q
The kidneys filter waste products from the bloodstream and convert the filtrate into _____
A
“urine”.
3
Q
The ureters, urinary bladder, and the urethra are collectively known as the _____
because they transport the urine out of the body
A
“urinary tract”
4
Q
The kidneys control the volume of interstitial fluid and blood under the direction of certain hormones
A
True
5
Q
1) As the kidneys filter the blood, they are also indirectly measuring the oxygen
level in the blood.
2) If blood oxygen levels are reduced, cells in the kidney secrete a hormone called
________
A
“erythropoietin” (EPO).
6
Q
Erythropoietin acts on stem cells in the _____ to increase erythrocyte production
A
bone marrow
7
Q
The kidneys are _____ since only their anterior surface is covered with the parietal peritoneum and their posterior aspect lies directly against the posterior
abdominal wall
A
retroperitoneal
8
Q
The superior pole of each kidney is about the level of the __ vertebra and the inferior pole is about the level of the ____ vertebra
A
T12, L3
9
Q
The right kidney is positioned about 2 cm inferior to the left kidney to accommodate the large size of the liver.
A
True
10
Q
An ___ rests on the superior surface of each kidney
A
adrenal gland
11
Q
The kidney has a concave medial border called the ____ where vessels, nerves, and the ureter connect to the kidney.
A
“hilum”
12
Q
Each kidney is surrounded and supported by several tissue layers:
A
The innermost layer is the “fibrous capsule”
The next layer is “perinephric fat” (adipose capsule),
The “renal fascia” is external to the perinephric fat and is composed of dense irregular connective tissue.
The “paranephric fat” is the outermost layer surrounding the kidney.
13
Q
The _____ maintains the kidneys shape, protects it from trauma, and helps prevent infectious pathogens from entering the kidney.
A
fibrous capsule
14
Q
This layer, which is also called perirenal fat, completely surrounds the kidney and offers cushioning and insulation
A
“perinephric fat”
15
Q
This layer anchors the kidney to the posterior abdominal wall and the parietal peritoneum
A
“renal fascia”
16
Q
It is composed of adipose connective tissue and lies between the renal fascia and the parietal peritoneum.
A
“paranephric fat”
17
Q
When a kidney is sectioned along a coronal plane an outer ____ and an inner ____ can be seen
A
“renal cortex”, “renal medulla”
18
Q
The medulla tends to be a darker shade than the cortex.
A
True
19
Q
Extensions of the cortex, called _____, project into the medulla and subdivide it into _____
A
“renal columns”, “renal pyramids”
20
Q
An adult kidney contains ____ renal pyramids.
A
8-15
21
Q
The wide base of a renal pyramid lies at the external edge of the medulla where the cortex and medulla meet
A
True
22
Q
The apex (tip) of the renal pyramid, which is called the _____ projects towards the renal pelvis.
A
“renal papilla”
23
Q
Each renal papilla projects into a funnel-shaped space called the ____
A
“minor calyx”
24
Q
There are between 8-15 minor calyces, in other words, one minor calyx for each renal papilla
A
True
25
Several minor calyces merge to form larger spaces called _____
“major calyces”.
26
Each kidney typically contains ____ major calyces.
two to three
27
Urine from the renal pyramids is collected by the minor calyces and then drained into the major calyces
True
28
The major calyces merge to form a large, funnel-shaped _____, which collects urine and transports it to the ureter
“renal pelvis”
29
Sometimes a physician needs to visualize the kidneys, ureters, and urinary bladder, especially when the flow of urine from one or both of the kidneys into the bladder becomes blocked. A physician may ask for an x-ray study known as an ______, which is produced by injecting a small amount of radiopaque dye into a vein
intravenous (IV) pyelogram
30
A human kidney is divided into 8-15 _____”
“renal lobes
31
A renal lobe consists of a medullary pyramid and some cortical substance from the
renal columns adjacent to it on either side, as well as the cortex external to the
pyramid base
True
32
Blood is carried to a kidney in a _____, which generally arises and extends from the lateral region of the abdominal aorta at the level of the first or second lumbar
vertebra
“renal artery”
33
Arising from the renal artery are additional arteries that branch, and branch again,
to bring blood to the microscopic filtering structures _____ within the kidney.
(nephrons)
34
Venous drainage from the tissues of the kidney eventually merge to form the _____
“renal vein”.
35
refers to greatly diminished or absent renal function caused by the destruction of about 90% of the tissue in the kidney.
Renal failure
36
the two main treatments for renal failure are ____
dialysis or a kidney transplant.
37
a catheter is permanently placed in the peritoneal cavity, to which a bag of dialysis fluid can be attached externally. As this fluid enters the peritoneal cavity, harmful waste products are transferred, or dialyzed, from the blood into the fluid. After several hours, the fluid is drained from the peritoneal cavity and replaced with fresh fluid.
peritoneal dialysis
38
the patient’s blood is cycled through a machine that filters the waste products across a specially designed membrane. The patient must remain stationary for the time it takes to cycle the blood through the dialysis unit while the metabolic waste products are removed.
hemodialysis
39
The kidney is generally removed from the donor by a laparoscopic procedure that removes the kidney through the umbilicus (navel, or belly button) after making a single small incision
Kidney Transplant
40
A kidney transplant from a genetically similar person may successfully restore renal function
True
41
The replacement kidney is attached to an artery and vein in the inferior abdominopelvic region, where it is relatively easy to establish a vascular connection.
inferior abdominopelvic
42
The new kidney rests either on the superior surface of, or immediately lateral to, the urinary bladder.
The diseased kidney is not removed.
True
43
Each kidney is innervated by a mass of sensory and autonomic nervous system fibers
collectively called the _____
“renal plexus”.
44
The renal plexus accompanies each renal artery and enters the kidney through the
______
hilum.
45
The renal plexus contains sympathetic innervation from the _____ segments of the spinal cord and parasympathetic innervation from ______
T10-T12, Cranial Nerve X (vagus nerve).
46
The _______ is responsible for renal blood vessel vasoconstriction that results in decreased blood flow to the nephron and reduced formation of
urine
sympathetic innervation
47
The parasympathetic innervation to the kidney has no known effect.
True
48
Pain from the kidneys is typically referred via the sympathetic pathway to the _____ dermatomes.
T10-T12
49
The ___ are long, fibromuscular tubes that conduct
| urine from the kidneys to the urinary bladder
“ureters”
50
Each ureter tube is about 25 centimeters in length and is _____
retroperitoneal.
51
The ureters originate at the _____ as it exits the ____ of the kidney and then extend inferiorly to enter the posterolateral wall of the base of the urinary bladder.
renal pelvis, hilum
52
The wall of the ureter is composed of three concentric tunics
Mucosa, Muscularis, Adventitia
53
External to the distensible epithelium of the mucosa in the ureter is the _____ composed of a fairly
thick layer of dense irregular connective tissue
lamina propria
54
The continuous production of urine ensures that the ureters are rarely completely
empty. However, as peristaltic waves propel urine through the ureter, the ureter may
be temporarily empty at specific places along its length.
True
At these locations, the mucosa folds to fill the lumen.
55
The external layer of the ureter wall is the ______ which is composed of a dispersed array of collagen and elastic fibers within loose connective tissue.
“adventitia”
56
The ureters are innervated by the autonomic nervous system.
Parasympathetic fibers come from ______, but there are no known effects of this innervation.
Sympathetic fibers come from the ____ segments of the spinal cord.
Cranial Nerve X (vagus nerve)
T11-L2
57
Pain from the ureter (i.e. - such as a kidney stone lodged in the ureter) is referred to the _____ dermatomes.
T11-L5
58
These dermatomes are along a “loin-to-groin” region, so loin-to-groin pain typically means ureter and/or kidney discomfort.
True
59
or kidney stone, is formed from crystalline minerals that build up in the kidney. Over 75% of calculi contain calcium, in combination with either oxalate or phosphate
renal calculus
60
The term ___ refers to the presence of renal calculi anywhere along the urinary tract.
urolithiasis
61
The epithelium of the ureter becomes inflamed as it tries to push the stone along its path, resulting in blood in the urine, called _____
hematuria
62
The most common treatment for renal calculus is ____, whereby ultrasound or shock waves are directed toward the stones to pulverize them into smaller particles that can be expelled in the urine.
lithotripsy
63
a scope is inserted from the urethra into the urinary bladder and ureter to break up and remove the stone.
ureteroscopy
64
The ______ is an expandable, muscular container that serves as a reservoir
for urine.
“urinary bladder”
65
b. The bladder is positioned immediately posterior to the pubic symphysis.
c. In females the urinary bladder is anterioinferior to the uterus and directly anterior to
the vagina.
d. In males, the urinary bladder is anterior to the rectum and superior to the prostate
gland.
True
66
The urinary bladder is a ______ organ since only its superior surface is covered with the parietal peritoneum.
retroperitoneal
67
When empty, the urinary bladder exhibits an ______ shape and when it is full it distends superiorly until it assumes an _____ shape
upside-down pyramidal, oval
68
A fibrous, cordlike _______ extends toward the umbilicus from its origin on the anterosuperior border of the urinary bladder to secure the bladder in
place.
“median umbilical ligament”
69
It is a remnant of the embryonic structure called the “urachus”, which extends
from the superior part of the bladder to the umbilicus
“median umbilical ligament”
70
Ureters enter the posterolateral wall of the urinary bladder through the oblique
______
“ureteral openings”.
71
The constricted _____ of the bladder is located inferiorly and connected with the
urethra.
“neck”
72
A posteroinferior triangular area of the urinary bladder wall, called the ______, is formed by imaginary lines connecting the two ureteral
openings and the urethral opening.
“trigone”
73
The trigone remains immovable as the urinary bladder fills and evacuates
True
74
It functions as a funnel to direct urine into the urethra as the bladder wall contracts to evacuate the stored urine
“trigone”
75
There are four tunics that form the wall of the bladder.
Mucosa, Submucosa, Muscularis, Adventitia
76
Is there rugae in the urinary bladder?
Yes
77
Within the trigone region the mucosa is smooth, thick, and lacking rugae
True
78
The “muscularis” in the urinary bladder consists of three layers of smooth muscle collectively called the
“______
detrusor muscle”.
79
At the neck of the urinary bladder an involuntary ______ is formed by the smooth muscle that encircles the urethral opening
“internal urethral sphincter”
80
The parietal peritoneum covers only the superior surface of the urinary bladder
True
81
Arterial blood vessels from the ______ extend to the urinary bladder and penetrate its wall from branches of the internal iliac artery.
internal iliac artery
82
Venous blood from the urinary bladder drain into the ______
internal iliac veins.
83
The expulsion of urine from the bladder is called ______
“urination” or “micturation”
84
Urination is initiated by a complex sequence of events called the _____
“micturation reflex”
85
The bladder is supplied by both parasympathetic and sympathetic nerve fibers of the autonomic nervous system.
(a) The parasympathetic fibers come from the micturation reflex center located in the spinal cord segments _____
- Nerve fibers from this region relax the internal urethral sphincter so that urine can pass through and stimulate contraction of the detrusor muscle.
- Thus, the parasympathetic fibers stimulate micturation
(b) The sympathetic fibers are from the _____ segments of the spinal cord.
- These fibers cause contraction of the internal urethral sphincter and inhibit contraction of the detrusor muscle.
- Thus, the sympathetic fibers inhibit micturation
S2-S4.
T11-L2
86
Micturation center will be initially triggered when the urinary bladder contains about _____ of urine
250 milliliters
87
The person’s conscious decision to urinate causes relaxation of the ______.
external urethral sphincter
88
occurs when bacteria (most commonly E. coli) or fungi enter and multiply within the urinary tract
urinary tract infection (UTI)
89
Women are more prone to UTIs because they have a short urethra that is close to the anus, allowing bacteria from the GI tract to more readily enter the female urethra
True
90
A UTI often develops first in the urethra, an inflammation called ______
urethritis
91
If the UTI infection spreads to the urinary bladder, ____ results
cystitis
92
Occasionally, bacteria from an untreated UTI can spread up the ureters to the kidneys, a condition termed _____
pyelonephritis
93
difficult and painful urination, called ____
dysuria
94
A UTI can be diagnosed through _____, a test of the urine that can reveal the presence of inflammatory cells, blood, and bacteria or fungi.
urinalysis
95
The ____ is a fibromuscular tube that exits the urinary bladder through the
urethral opening from its anteroinferior surface and conducts urine to the exterior of
the body.
“urethra”
96
The luminal lining of the urethra is a protective mucous membrane that houses clusters of mucin-producing cells called _____
urethral glands.
97
The ______ is the involuntary, superior sphincter surrounding the neck of the bladder where the urethra originates.
“internal urethral sphincter”
98
The ______ is inferior to the internal urethral sphincter and is formed by skeletal muscle fibers of the urogenital diaphragm.
“external urethral sphincter”
99
The male urethra is relatively long and is partitioned into three segments.
Prostatic Urethra, Membranous Urethra, Spongy Urethra
100
the most dilatable portion of the urethra. It extends through the prostate gland,
immediately inferior to the male bladder, where multiple small prostatic ducts
enter it. It is surrounded by several layers of smooth muscle
Prostatic Urethra
101
the shortest and least dilatable portion of the male
urethra. It extends from the inferior surface of the prostate gland through the urogenital diaphragm. As a result it is surrounded by skeletal muscle that forms
the external urethral sphincter
“membranous urethra”
102
the longest part of the male urethra. It is encased within
| a cylinder of erectile tissue in the penis called the corpus spongiosum and extends to the “external urethral orifice”.
“spongy urethra”
103
With age comes a gradual reduction in kidney size accompanied by reduced blood flow
to the kidneys and a decrease in the number of functional nephrons.
True
104
Lastly, control of the urethral sphincters may be lost, leading uncontrolled micturation ______
(incontinence)
105
as the urinary bladder
develops during the sixth week, a fibrous cord, called the “______ extends from the
developing bladder to the umbilicus.
urachus”
106
Occasionally a _____ is presented in a newborn and is discovered when
urine is passed through the umbilicus, especially if there is a urethral obstruction.
“patent urachus”
107
the failure of a kidney to develop
Renal agenesis
108
Failure of one kidney to develop, called _____
unilateral renal agenesis
109
bilateral renal agenesis is invariably fatal.
Yes
110
can be present if the developing kidney fails to migrate from the pelvic cavity to the abdominal cavity.
Pelvic Kidney
111
develops when the inferior parts of the left and right kidneys fuse as they try to ascend from the pelvic cavity into the abdominal cavity.
horseshoe kidney
112
are extra kidneys that develop.
It is more common to see a ______, from a duplicated ureteric bud, traveling to a single kidney.
Supernumerary kidneys
duplicated or bifid ureter
