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Anatomy & Physiology 2 > Urinary > Flashcards

Urinary Flashcards

1
Q

What are the 8 functions of the kidney?

A

Regulating total water volume and total solute concentration in water
Regulating ECF ion concentrations
Ensuring long-term acid-base balance
Removal of metabolic wastes, toxins, drugs
Endocrine functions
-Renin - regulation of blood pressure
-Erythropoietin - regulation of RBC production
Activation of vitamin D
Gluconeogenesis during prolonged fasting

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2
Q

What are the 4 organs of the urinary system?

A

kidney, ureters, urinary bladder, urethra

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3
Q

The R/L kidney is lower because ___

A

R kidney lower than L because crowded by liver

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4
Q

The renal hilum leads to the ___ where ___ (4) enter/exit.

A

into the renal sinus where nerves, vessels, lymphatics, ureter enter/exit

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5
Q

the ___ gland rests on top of the kidney

A

adrenal

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6
Q

What are the layers of surrounding supporting tissue of the kidney? (3) What do they do?

A

Renal fascia - Anchoring outer layer of dense fibrous connective tissue
Perirenal fat capsule - Fatty cushion
Fibrous capsule - Prevents spread of infection to kidney

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7
Q

the renal cortex appears ___.

A

granular

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8
Q

The renal medulla is composed of ___ separated by ___.

A

medullary pyramids separated by renal columns

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9
Q

Compare and contrast the male and female urethras. (2)

A
  • male urethra much longer

- male has 2 functions: urine discharge & secretion semen

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10
Q

Identify the major blood vessels associated with the kidney & trace the path of blood through the kidney - Lab

A
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11
Q

Trace the path of filtrate/urine from the renal corpuscle to the urethral opening.

A

peritubular capillaries > PCT > nephron loop > DCT > collecting duct > renal column > minor calyx > major calyx > renal pelvis > ureter

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12
Q

What are the 2 main parts of a nephron?

A

Renal corpuscle

Renal tubule

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13
Q

The ___ of the kidney allows filtrate formation.

A

glomerulus

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14
Q

What cells make up the nephron in each part? - image

A
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15
Q

What are the 2 layers of the glomerular capsule? What cells make up each? What do the visceral layer cells create and allow through into where?

A
  • Parietal layer - simple squamous epithelium
  • Visceral layer - podocytes
  • Filtration slits between foot processes allow filtrate to pass into capsular space
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16
Q

What are the 3 parts of a renal tubule?

A

Proximal convoluted tubule
Proximal → closest to renal corpuscle
Nephron loop
Distal convoluted tubule

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17
Q

Where is the PCT confined to? What kind of cells are they made of? What 2 special structures of the cell does the PCT have? What is its functions? (2)

A
  • confined to cortex
  • cuboidal cells
  • dense microvilli (brush border ↑surface area); large mitochondria
  • secretion & absorption
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18
Q

The nephron has a ___ descending limb and ___ ascending limb,

A
  • descending thin limb

- Thick ascending limb

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19
Q

Distal convoluted tubules (DCT) do not have ___. Its function is ___. Where is it confined to?

A

Cuboidal cells with very few microvilli
Function more in secretion than reabsorption
Confined to cortex

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20
Q

List the three major processes in urine formation and where each occurs in the nephron and collecting system.

A

Glomerular filtration

  • produces cell/protein free filtrate (blood plasma minus proteins)
  • takes place in renal corpuscle

Tubular reabsorption

  • Selectively returns substances from filtrate in renal tubules/collecting ducts to blood
  • takes place in renal tubules/collecting ducts

Tubular secretion

  • substances from blood to filtrate in renal tubules and collecting duct
  • takes place in renal tubules/collecting ducts
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21
Q

What are the 2 types of cells in the collecting duct? What do they do? Which one has microvilli?

A

principal - Maintain water and Na+ balance

intercalated - help maintain acid-base balance of blood (microvilli)

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22
Q

What passes the filtration membrane? What does not pass? Does nitrogenous waste pass?

A

Water, solutes smaller than plasma proteins (glucose, aa, nitrogenous waste) pass; normally no cells pass

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23
Q

Where are the cortical nephrons? Juxtamedullary nephrons? What do juxtamedullary nephrons have? They are important in the production of ___.

A

-cortical = cortex

Juxtamedullary = invade medulla

  • Ascending limbs have thick and thin segments
  • vasa recta
  • production of concentrated urine
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24
Q

Renal tubules are associated with these 2 capillary beds.

A

Glomerulus

Peritubular capillaries

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25
Q

Glomerulus vs peritubular capillaries.

BP in the glomerulus is ___ because ___ (2). They are specialized for ___. They are fed and drained by ___

BP in peritubular capillaries is ___ because they contain ___. They are specialized for ___ (2). They are fed by ___ and drained by ___.

A

Glomerulus

  • blood pressure in glomerulus high because
  • -Afferent arterioles larger in diameter than efferent arterioles
  • -Arterioles are high-resistance vessels
  • specialized for filtration
  • fed and drained by arteriole

Peritubular capillaries

  • low BP because have pores
  • for absorption water & solutes
  • arise from efferent arterioles and drained into venules
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26
Q

The ___ replaces peritubular capillaries in the juxtamedullary nephrons.

A

vasa recta

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27
Q

What are the 3 cells that make up the juxtaglomerular complex? (JGC) What are their functions? Which one secretes renin?

A
  • macula densa - sense NaCl content of filtrate
  • granular cells - sense blood pressure in afferent arteriole; secrete renin
  • extraglomerular mesangial cells - pass signals between macula densa and granular cells
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28
Q

What are the 3 layers of the filtration membrane?

A
  • Fenestrated endothelium
  • Basement membrane (fused basal laminae of two other layers)
  • Foot processes of podocytes with filtration slits (slit diaphragms repel macromolecules)
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29
Q

Macromolecules that get stuck in filtration membranes are engulfed by

A

glomerular mesangial cells

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30
Q

Why do plasma proteins remain in the blood? What does this prevent?

A

maintains colloid osmotic pressure → prevents loss of all water to capsular space

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31
Q

Why is the Glomerular blood pressure high? why this blood pressure is significant for urine formation?

A
  • Because efferent arteriole is high resistance vessel with diameter smaller than afferent arteriole
  • allows for the salts to be pushed out of capillaries without reabsorption occuring
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32
Q

What is the outward force affecting filtration? What is it called? What does it promote? Describe the force.

What is the inward force affecting filtrate formation? (2)

What do these 2 forces ultimately create?

A

Out

  • Hydrostatic pressure in glomerular capillaries = Glomerular blood pressure
  • Outward pressures promote filtrate formation
  • force pushing water, solutes out of blood

In

  • Hydrostatic pressure in capsular space (Pressure of filtrate in capsule)
  • Colloid osmotic pressure in capillaries (“Pull” of proteins in blood)

sum = Net filtration pressure (NFP)
-55 mm Hg forcing out; 45 mm Hg opposing = net outward force of 10 mm Hg

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33
Q

What is the Glomerular Filtration Rate (GFR)? What increases GFR? (3)

A

-Volume of filtrate formed per minute by both kidneys

Increase

  • NFP
  • Total surface area available for filtration
  • Filtration membrane permeability
34
Q

True or false

Most of tubular contents reabsorbed to blood

What is absorbed?

A

true

All organic nutrients, water, ions reabsorbed

35
Q

The 2 types of tubular reabsorption are ___ and the 2 routes are ___.

A
  • Includes active and passive tubular reabsorption

- Transcellular or paracellular routes

36
Q

Describe the trans and paracellular route of tubular reabsorption. Which process is faster?

A

paracellular faster

37
Q

In the proximal convoluted tubules (PCT) how is:

  • Na+ transported into the IF? what does this create? this allows for ___ at the apical membrane
  • how are glucose, aa, some ions, vitamins transported at the apical membrane?
  • how is water transported? what does this create?
  • how are lipid-soluble substances transported?
  • how are other ions & urea transported?
A
38
Q

What are the 2 different types of water reabsorption thru aquaporins? How are they different?

A

obligatory water reabsorption - Aquaporins always present in PCT (proximal convoluted tubule) →
facultative water reabsorption - Aquaporins inserted in collecting ducts only if ADH present (upregulated) →

39
Q

___ is the site of most reabsorption in the nephron. What is reabsorbed? (5) Which ions? (3) Is uric acid reabsorbed?

A

proximal convoluted tuble

-nutrients, Na+, water, ions (Cl-, Ca, K), uric acid/urea

40
Q

In the nephron loop, ___ leaves in the descending limb and ___ in the ascending limb.

A 
descending = water
ascending = solutes
41
Q

Explain why the differential permeability or impermeability of specific sections of the nephron tubules is necessary for urine formation.

A

to maintain certain levels of ions, nutrients, vitamins, and water; for Ion exchange

42
Q

Compare and contrast passive and active tubular reabsorption.

A
  • active requires ATP (either primary or secondary active transport)
  • passive moves down electrical gradient (facilitated diffusion, osmosis - water, diffusion - ions, fat-soluble substances)
43
Q

Most reabsorption occurs in the ___. What gets reabsorbed?

A

proximal convoluted tubule

-K+, H+, NH4+, creatinine, organic acids and bases, HCO3-

44
Q

What are the functions of tubular secretion? (4)

A
  • Disposes of substances (e.g., drugs) bound to plasma proteins
  • Eliminates undesirable substances passively reabsorbed (e.g., urea and uric acid)
  • Rids body of excess K+ (aldosterone effect)
  • Controls blood pH by altering amounts of H+ or HCO3– in urine
45
Q

How does an increase in GFR affect systemic blood pressure?

A

↑ GFR > ↑urine output > ↓ blood pressure, and vice versa

46
Q

What is the goal of the intrinsic and extrinsic controls? What controls them?

A
  • Goal of intrinsic controls - maintain GFR in kidney
  • Act locally within kidney to maintain GFR
  • Goal of extrinsic controls - override intrinsic control and maintain systemic blood pressure
  • Nervous and endocrine mechanisms that maintain blood pressure
47
Q

What does a constant GFR allow?

A

allows kidneys to make filtrate and maintain extracellular homeostasis

48
Q

What are the 2 types of renal autoregulation (intrinsic control)?

A

Myogenic mechanism

Tubuloglomerular feedback mechanism

49
Q

Describe the myogenic mechanism. It is an example of ___ to maintain___. What does this protect against?

A
  • example of intrinsic control to maintain GFR
  • ↑ BP → muscle (granular cells) stretch → constriction of afferent arterioles → restricts blood flow into glomerulus
  • Protects glomeruli from damaging high BP
50
Q

Describe the tubuloglomerular feedback mechanism. It is an example of ___ to maintain___. What cells directs its process? What does it respond to?

A
  • example of intrinsic control to maintain GFR
  • directed by macula densa cells; respond to filtrate NaCl concentration
  • If GFR ↑→ filtrate flow rate ↑→ ↓ reabsorption time → high filtrate NaCl levels → constriction of afferent arteriole → ↓ NFP & GFR → more time for NaCl reabsorption
51
Q

Under normal conditions at rest. Renal blood vessels are ___, and the ___ mechanisms prevail.

A

Renal blood vessels dilated

Renal autoregulation mechanisms prevail

52
Q

For extrinsic control of the sympathetic nervous system, what does a decrease in blood pressure (low ECF) do? (3)

A
  • nor/epinephrine released >
  • Systemic vasoconstriction → increased blood pressure
  • Constriction of afferent arterioles → ↓ GFR → increased blood volume and pressure
53
Q

(if time)

Extrinsic Controls: Renin-Angiotensin- Aldosterone Mechanism

What are the 3 pathways to renin release? by which cells? This ultimately does what to the BP?

A

-release by granular cells

  • Direct stimulation (epi) of granular cells by sympathetic nervous system
  • Stimulation by activated macula densa cells when filtrate NaCl concentration low
  • Reduced stretch of granular cells
  • increase BP
54
Q

aquaporins are always present in the PCT, which results in ___. They are inserted in collecting ducts if ___ is present (upregulated), which results in ___.

A
  • Aquaporins always present in PCT (proximal convoluted tubule) → obligatory water reabsorption
  • Aquaporins inserted in collecting ducts only if ADH present (upregulated) 🡪 facultative water reabsorption
55
Q

Summary of tubular reabsorption and secretion - image.

A
56
Q

What is the function of the ureter?

A

carry urine from kidney to bladder

57
Q

What is the function of the urinary bladder?

A

Muscular sac for temporary storage of urine

58
Q

Relate the anatomy and histology of the bladder to its function.

A
  • Mucosa - transitional epithelial mucosa allows for expansion of detrusor muscles
  • rugae also allows for distension
59
Q

how does the urinary bladder move when it fills with urine and what does it not change?

A

Expands and rises superiorly during filling without significant rise in internal pressure

60
Q

The urethra contains which 2 sphincters? What muscles are they made of?

A

Internal urethral sphincter
-Involuntary (smooth muscle) at bladder-urethra junction

External urethral sphincter
-Voluntary (skeletal) muscle surrounding urethra as it passes through pelvic floor

61
Q

What is the function of the urethra?

A

tube through which urine leaves body, allows for urination

62
Q

What is osmolality? It reflects the ability to cause ___. How do kidneys regulate its homeostasis?

A

Number of solute particles in 1 kg of H2O (water vs solute amount)
Reflects ability to cause osmosis
Kidneys regulate homeostasis with countercurrent mechanism

63
Q

What is the purpose of the countercurrent mechanism? (2) What does the loop of henle and vasa recta act as? What does the collecting duct determine?

A
  • Establish and maintain osmotic gradient (osmolality) to keep materials moving from renal cortex through medulla
  • Allow kidneys to vary urine concentration

The long nephron loops (loop of henle) of juxtamedullary nephrons create the gradient - They act as countercurrent multipliers.

The vasa recta preserve the gradient - They act as countercurrent exchangers.

the collecting ducts determine the final concentration and volume of urine

64
Q

The loop of henle act as ___, which means they ___ the gradient. The multiplier depends on 3 properties. One is ___ The other 2 is as follows: In the descending limb, ___ is permeable. Hence osmolality increase/decrease. In the ascending limb, ___ is permeable (specifically these 2 ions are absorbed in the thick/thin segment).

A
  • Countercurrent Multiplier
  • create the gradient
  • fluid flowing in opposite directions in adjacent parallel sections

Descending limb

  • permeable to water that leaves the filtrate
  • increases osmolality

Ascending limb

  • permeable to solutes so osmolality decreases
  • Na and Cl reabsorbed in thick segment
65
Q

Vasa recta is responsible for the ___, that ___ medullary gradient. It does so by (2).

A
  • countercurrent exchanger, maintains gradient
  • removal of salt from interstitial space
  • remove reabsorbed water
66
Q

Describe the mechanism for overhydration/dehydration with ADH - image.

A

-if dehydrated, not too much water in urine so expel mostly ions

67
Q 
Overhydration = small/large volume dilute/concentrated urine
Dehydration = small/large volume dilute/concentrated urine
A 
overhydration = large volume dilute urine
dehydration = small volume concentrated urine
68
Q

Where does urine conveying begin from kidneys to bladder

A

L2 as continuation of renal pelvis

69
Q

As bladder pressure increases, ___ close, preventing backflow of urine.

A

distal ends of the ureters

70
Q

Describe the role of kidney in vitamin D activation.

A

PTH stimulates activation of vitamin D by calcitriol by the kidneys, which accelerates Ca ion absorption in the small intestine

71
Q

Describe the role of kidney in regulating erythropoiesis.

A
  • Erythropoietin (EPO) stimulates formation of erythrocytes
  • when kidney cells become hypoxic (O2 deficient) unable to degrade hypoxia-inducible factor (HIF)
  • as HIF accumulates, EPO synthesis & release accelerates
72
Q

Describe the function of the juxtaglomerular apparatus. What are the 3 types of cell found and what do they do? What happens when there is high salt concentration? Low salt?

A

-function = maintain blood pressure and glomerular flow rate

  • macula densa = picks up on the amount of salt in the distal convoluted tubule
  • granular cells = senses blood pressure; regulate the constriction/dilation of afferent arteriole
  • extraglomerular mesangial cells = pass signals between the macula densa and granular cells
  • lots of salt in blood (too much pressure) = granular cells widens artery so not as much hydrostatic pressure & reduces amount of salt being pushed out because so much salt is already there
  • less salt = arteries constrict to pull more salt
73
Q

In the distal convoluted tubule and collecting duct, reabsorption is regulated by ___, specifically (4). Each of these regulate

A 
Reabsorption hormonally regulated
Antidiuretic hormone (ADH) – Water
Aldosterone – Na+ (therefore water)
Atrial natriuretic peptide (ANP) – Na+
PTH – Ca2+
74
Q

How does ADH affect reabsorption in the DCT & collecting duct? What organ is it released by?

A

Released by posterior pituitary gland

Causes collecting ducts to insert aquaporins → increase water reabsorption

75
Q

Aldosterone affects reabsorption in the ___ (2). What does this do? (2)

A
  • Targets collecting ducts and distal DCT
  • Promotes synthesis of apical Na+ and K+ channels for Na reabsorption; water follows
  • increase blood pressure; decrease K+ levels
76
Q

atrial natriuretic peptide (ANP) affects reabsorption in the ___ (2). How does this work?

A
  • DCT & collecting duct
  • Released by cardiac cells if blood volume or pressure elevated
  • Reduces blood Na+ → decreased blood volume and blood pressure
77
Q

PTH affect reabsorption in the ___ (2). What ion does it re/absorb?

A
  • DCT & collecting duct

- increase Ca2+ reabsorption

78
Q

What are the 2 different types of water reabsorption thru aquaporins? How are they different?

A

Aquaporins always present in PCT (proximal convoluted tubule) → obligatory water reabsorption
Aquaporins inserted in collecting ducts only if ADH present (upregulated) → facultative water reabsorption

79
Q

Explain how the urinary system relates to other body systems to maintain homeostasis.

A

Muscular/nervous system - regulation of K, Ca, Na in ECF crucial for muscle contractility & neural function

Nervous system - SNS controls renin-angiotensin-aldosterone mechanism

Endocrine - ADH, aldosterone, ANP regulate renal reabsorption of water & electrolytes; produce EPO

80
Q

most reabsorption is by ____

A

secondary active transport

81
Q

alcohol is a dieuretic why?

A

inhibits ADH

Anatomy & Physiology 2 (14 decks)

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