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Reproductive System > Urinary Physiology > Flashcards

Urinary Physiology Flashcards

1
Q

what happens to blood when it filtered

A
  1. remove its cells and proteins
  2. almost everything is reclaimed from filtrate
  3. specific things are added to filtrate
  4. filtrate becomes urine
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2
Q

how many times a day does the kidney filter’s the body’s blood plasma volume

A

60x each day

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3
Q

at rest how much of the body’s oxygen is used by the kidneys

A

20-25%

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4
Q

filtrate

A

blood plasma minus its proteins; produced by glomerular filtration

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5
Q

urine

A

metabolic wastes and unneeded substances; produced from filtrate

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6
Q

3 process of urine formation

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
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7
Q

glomerular filtration

A

produces cell and protein-free filtrate

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8
Q

tubular reabsorption

A

process of selectively reclaiming substances from filtrate and moving them back into blood
- typically, 99% water, and all glucose and amino acids are reabsorbed
- can be active (ATP-requiring) or passive

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9
Q

tubular secretion

A

process of selectively moving substances from blood into filtrate

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10
Q

3 layers of the filtration membrane

A
  • fenestrated endothelium of glomerular capillaries
  • basement membrane
  • foot processes of podocytes of the glomerular capsule
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11
Q

fenestrated endothelium of glomerular capillaries

A

allows all blood components except cells to pass

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12
Q

basement membrane

A

allows solutes; blocked all but small proteins

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13
Q

foot processes of podocytes of the glomerular capsule

A

filtration slits between foot processes, stop all remaining macromolecules

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14
Q

outward pressure

A

forces that promote the formation of filtrate

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15
Q

hydrostatic pressure in glomerular capillaries (HPgc)

A

glomerular blood pressure
- chief force pushing water, solutes out of blood across the filtration membrane
- quite high (55mmHg) compared to most capillary beds
- maintained by the smaller size of efferent arterioles versus the afferent arteriole

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16
Q

inward pressures

A

forces that inhibit the formation of filtrate

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17
Q

hydrostatic pressure in the capsular space (HPcs)

A

pressure exerted by the filtrate in the glomerular capsule (15mmHg)

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18
Q

colloid osmotic pressure in glomerular capillaries (OPgc)

A

the “pull” of the proteins in the blood (30mmHg)

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19
Q

Net filtration pressure (NFP)

A

the sum of forces
- 55mmHg forcing out
- 45mmHg forcing in
- Net: 10mmHg of outward force

  • NFP is the main controllable factor for determining glomerular filtration rate (GFR)
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20
Q

what pressure is responsible for forming filtrate

A

net filtration pressure (NFP)

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21
Q

glomerular filtration rate (GFR)

A

the volume of filtrate formed by both kidneys per minute
- normal GFR = 120 - 125 mL/min

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21
Q

slide 8

A
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21
Q

regulation of GFR

A
  • GFR is regulated to serve 2 important needs
  • the kidneys need a relatively constant GFR to continue making filtrate
  • the body needs a relatively constant blood pressure
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22
Q

what happens during an increase GFR

A

increases urinary output and decreases BP

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23
Q

what happens during a decrease of GFR

A

decreases urinary output and increases BP

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24
Q

two types of controls

A
  • intrinsic controls
  • extrinsic controls
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25
Q

Intrinsic controls

A

work locally within the kidney to maintain GFR - renal autoregulation

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26
Q

extrinsic controls

A

neural and hormonal controls that maintain systemic blood pressure

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27
Q

What range of MAP is intrinsic control

A
  • range of 80 to 180mmHg, intrinsic controls maintain a constant GFR
  • when MAP is outside of this range, extrinsic controls take over
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28
Q

Myogenic mechanism

A

smooth muscle contracts when stretched
- increased BP -> muscles stretch -> constriction of afferent arteriole
- decreased BP -> dilation of afferent arteriole

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29
Q

what is the goal of myogenic mechanism

A

protect the glomerulus from high BP by restricting blood flow, maintain normal NFP and GFR

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30
Q

tubuloglomerular feedback mechanism

A

directed by the macula densa cells
- responds to NaCl concentration
- GFR increases -> flow of filtrate increases -> decreased time for reabsorption -> higher levels of NaCl in filtrate

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31
Q

response of tubuloglomerular feedback mechanism

A

the afferent arteriole is constricted -> NFP and GFR are reduced -> increased time for NaCl reabsorption

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32
Q

why do extrinsic controls regulate GFR

A

to maintain systemic BP

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33
Q

neural control by the Sympathetic nervous system (normal conditions)

A

renal blood vessels are dilated, intrinsic controls running

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34
Q

neural control by the sympathetic nervous system (abnormal conditions)

A

(Low BP) norepinephrine, epinephrine are released
- system vasoconstriction to raise BP
- constriction of the afferent arteriole will decrease GFR
- blood volume and blood pressure increase

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35
Q

rening-angiotensin-aldosterone mechanism

A

the body’s main mechanism for increasing blood pressure

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36
Q

3 pathways to releasing renin from the granular cells

A
  • direct stimulation of granular cells by the SNS
  • stimulation of the granular cells by activated macule densa cells – when NaCl concentration in filtrate is low
  • reduced stretch of granular cells
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37
Q

anuria

A

abnormally low urine output (<50 mL/day)

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38
Q

two routes for tubular reabsorption

A
  • transceullular
  • paracellular
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39
Q

transcellular

A

reabsorbed substances travel through cells of the tubule

40
Q

paracellular

A

reabsorbed substances travel between cells of the tubule

41
Q

what is the site of most reabsorption

A

PCT

42
Q

what is reabsorbed from the filtrate in the PCT?

A
  • all the nutrients (glucose + Amino acids)
  • 65% of sodium + water
  • most electrolytes
  • nearly all uric acid and 1/2 of the urea
43
Q

reabsorption in the nephron loop

A

reabsorption of water is no longer coupled to solute reabsorption

44
Q

descending limb

A

water can leave, but solute cannot

45
Q

ascending limb

A

solute can leave, but water cannot

46
Q

reabsorption in the DCT

A

varies with the body’s current needs – it is hormonally regulated
- most of the water and solutes have already been reabsorbed

47
Q

anti-diuretic hormone (ADH)

A

released by the posterior pituitary gland, can cause an increase in reabsorption of water

48
Q

aldosterone

A

increases blood pressure and decreases K+ levels by promoting the reabsorption of Na+

49
Q

atrial natriuretic peptide (ANP)

A

released by cardiac atrial cells, decreases blood volume and blood pressure by reducing the reabsorption of Na+

50
Q

parathyroid hormone

A

increases reabsorption of Ca2+ by the DCT

51
Q

what is secreted in tubular secretion

A

K+, H+, ammonia, creatinine, organic acids and bases

52
Q

tubular secretion is important for

A
  • disposing of substances - drugs and metabolites - that are bound to plasma proteins
  • eliminating undesirable substances - urea and uric acid - that were passively reabsorbed
  • ridding the body of excess K+ - the aldosterone effect
  • controlling pH by altering amounts of H+ or HCO3- in urine
53
Q

urinalysis

A

the examination of urine for signs of disease – can aid in the detection of illegal substances and help to diagnose disease

54
Q

renal clearance

A

the volume of plasma that the kidneys can clear of a particular substance within a given time
- can determine GFR, detect glomerular damage

55
Q

normal GFR

A

120 - 125mL/min

56
Q

chronic renal disease

A

a GFR < 60 mL/min x 3 months
- rate of filtrate formation decreases, nitrogenous wastes accumulate in blood, pH becomes acidic
- most often seen with diabetes mellitus and hypertension

57
Q

renal failure

A

a GFR < 15 mL/min
- formation of filtrate dramatically decreases or completely stops
- uremia

58
Q

symptoms of renal failure

A

fatigue, anorexia, nausea, mental status changes, cramps

59
Q

treatment of renal failure

A

hemodialysis or kidney transplant

60
Q

uremia

A

blood in the urine – ionic and hormonal imbalances, metabolic abnormalities, toxic molecule accumulation

61
Q

chemical composition of urine

A

95% water
5% solutes

62
Q

nitrogenous wastes of urine

A
  • urea
  • uric acid
  • creatinine
63
Q

urea

A

largest solute component; formed from breakdown of amino acids

64
Q

uric acid

A

product of nucleic acid and metabolism

65
Q

creatinine

A

metabolite of creatine phosphate – found in large amounts in skeletal muscle

66
Q

normal solutes in urine

A

urea, Na+, K+, creatinine, uric acid
- Ca2+, Mg2+, HCO3- are occasionally seen in small amounts

67
Q

abnormal solutes in urine

A

blood proteins, WBCs, and bile pigments – presence of these can indicate pathology

68
Q

freshly voided urine (color)

A

clear - pale to deep yellow

69
Q

urochrome

A

pigment that results from the body’s destruction of hemoglobin

70
Q

more concentrated urine (color)

A

deeper in color

71
Q

abnormal colors of urine

A
  • pink, brown, red
  • caused by certain foods, medications, drugs, vitamins, presence of bile/blood
72
Q

what does cloudy urine indicate

A

UTI

73
Q

odor of urine

A
  • only slightly aromatic when fresh
  • upon standing, develops an ammonia odor as bacteria metabolizes urea
  • may be altered by some drugs, foods, and diseases
74
Q

pH of urine

A
  • slightly acidics (pH = 6, range 4.5-8
  • acidic (high protein) or alkaline (vegetarian) diets will alter pH
  • prolonged vomiting and UTI can also raise pH
75
Q

specific gravity of urine

A
  • ratio of the mass of a substance to the mass of an equal volume of distilled water
  • urine’s specific gravity ranges from 1.001 to 1.035
76
Q

ureters

A

slender tubes that actively carry urine away from the kidneys towards the bladder

77
Q

as bladder pressure increases what happens to the ureters

A

the distal ends of the ureters prevent backflow of urine into the ureters

78
Q

urinary bladder

A
  • smooth, collapsible, muscular sac for temporary storage of urine
  • retroperitoneal, on the pelvic floor, posterior to public symphysis
79
Q

urinary bladder (males)

A

prostate lies inferior to the bladder neck

80
Q

urinary bladder (females)

A

bladder is anterior to the vagina and uterus

81
Q

trigone

A

smooth triangular area outlined by the openings for 2 ureters and the urethra

82
Q

layers of the bladder wall

A
  1. mucosa
  2. muscular layer
  3. fibrous adventitia
83
Q

mucosa

A

transitional epithelial mucosa

84
Q

muscular layer

A

thick detrusor muscle with 3 layers of smooth muscle
- inner and outer are longitudinal
- middle layer is circular

85
Q

fibrous adventitia

A

superior surface is covered by peritoneum

86
Q

when urine storage is empty what happens

A

the bladder collapses and rugae appear

87
Q

during filling what happens to the bladder

A

the bladder expands and rises superiorly, but there is no significant rise in internal pressure

88
Q

moderately full bladder

A
  • 12 cm/5 in long
  • 500mL/1 pint of urine
89
Q

max capacity of urine

A

1000mL - an overfilled bladder can burst

90
Q

urethra

A

muscular tube that drains the urinary bladder
- mucosal lining is largely pseudostratified columnar epithelium – transitional epithelium near the bladder – stratified squamous near the external opening

91
Q

urethral sphincters

A
  • internal urethral sphincters
  • external urethral sphincters
92
Q

internal urethral sphincters

A

involuntary/smooth muscle at the bladder-urethral junction – contracts to open

93
Q

external urethral sphincters

A

voluntary/skeletal muscle surrounding the urethra as it passes the pelvic floor – relaxes to open

94
Q

urethra (female)

A
  • 3-4cm/1.5 in long
  • tightly bound to the anterior vaginal wall
  • external urethral orifice is anterior to the vaginal orifice
95
Q

urethra (male)

A
  • carries both semen and urine
  • much longer – 20 cm/8 in – has 3 named regions
96
Q

3 regions of male urethra

A
  • prostatic urethra
  • intermediate/membranous urethra
  • spongy urethra
97
Q

prostatic urethra

A

2.5 cm
- within prostrate gland

98
Q

intermediate/membranous urethra

A

2 cm
- passes through urogenital diaphragm from prostate to root of penis

99
Q

spongy urethra

A

15 cm
- passes through the penis, opens via external urethral orifice

100
Q

3 simultaneous events of micturition (urination)

A
  1. contraction of the detrusor muscle by ANS
  2. opening of internal urethral sphincters by ANS
    - opens via contraction
  3. opening of external urethral sphincters by somatic nervous system
    - opens via relaxation

Reproductive System (3 decks)

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