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Year 2 (&1) NSF Urinary > Urinary recap > Flashcards

Urinary recap Flashcards

1
Q

List structures that make up urinary tract and broadly what they do

A
  1. Kidney
  2. Ureters - convey urine from the kidneys to the bladder
  3. Bladder - storage of urine prior to evacuation
  4. Urethra - convey urine from bladder to outside world
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2
Q

positioning of kidney

What can you palpate in dog

A
  • Located DORSAL abdomen, just behind ribs
  • L caudal to R.
  • In dog may palpate left kidney (difficult if fat), R kidney under costal arch, relatively fixed; L more mobile, position variable. In cat both kidneys palpable and relatively mobile
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3
Q

How much blood supply to kidneys receive?

A

o Kidneys receive 20 – 25% of cardiac output via renal arteries

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4
Q

Function of ureters
- how do they course
enter bladder at waht
- what process moves urine

A
  1. Urine passes from collecting ducts into renal pelvis and then enters ureters – fibromuscular tubes, lined by transitional epithelium. Ureters course retroperitoneally and enter the bladder at the trigone. Urine is moved by peristalsis.
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5
Q

Function bladder

A
  1. Urine collects in the bladder and is stored before voiding. Lined by transitional epithelium, layers of smooth muscle and outer serosa. Innervation and control of micturition is complex - covered in incontinence seminar
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6
Q

Function urethra

A
  1. Conveys urine from neck of the bladder to the outside. 3 layers of smooth muscle, plus external sphincter of voluntary striated muscle. Transitional epithelium apart from terminal part in male – stratified squamous. Male has three parts – prostatic portion, pelvic or membranous portion and cavernous or penile portion
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7
Q

Functions of kidney

A
  1. Regulation of fluid volume and electrolyte homeostasis
    • ECF and blood pressure
    • Osmolarity
    • Ion balance
    • pH
  2. Nitrogenous waste excretion
    • Metabolic waste e.g. urea
    • Urea produced from metabolism of amino acids
    • Got rid off through kidney and urine
    • Formed in the liver
    • Foreign substances e.g. medicines
  3. Production of hormones: modified and/ or produced
    • Activation of vitamin D3
    • Synthesis of erythropoietin – hormone responsible for driving production of RBC in bone marrow
    • Synthesis and release of the enzyme renin – control of blood pressure
  4. Acid-base homeostasis
  5. Synthesis of calcitriol (active vitamin D3 / 1,25-dihydroxycholecaliferol)
  6. Erythropoietin production
  7. Renin production
  8. Blood pressure homeostasis
  9. Catabolism of peptide and protein hormones in renal tubules e.g. gastrin, insulin, glucagon, growth hormone
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8
Q

Nephron

A

functional unit of the kidney composed of tubules and blood vessels (v important for function) that collect the filtrate with will ultimately become urine

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9
Q

Renal anatomy broadly

A
  1. Two distinct regions of the internal anatomy:
  2. outer cortex = filtration to form urine
  3. Glomerulus sits in OC
  4. Inner medulla = collect and excrete urine
  5. Loop and collecting duct
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10
Q

One collecting duct has what entering

A

LOTS of DCT

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11
Q

Blood flow through kideny

A
  1. 20-25% cardiac output passes through renal arteries to be filtered by kidney
  2. REnal artery - segmental arteries - arcuate arteries - interlobular arteries - afferent arteries - glomerulus - efferent arteriole - peritubular capillaries - venules - interlobular veins - arcuate veins - interlobar veins - renal vein
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12
Q

What is unique about the kidney blood supply?

A
  1. Capillary portal system

2. Glomerulus (capillaries, sits between 2 arterioles, the afferent A and efferent A, not V)

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13
Q

Reabsorption in PCT

A
  1. extensive
  2. active and passive
  3. Around 70% of filtrate is reabsorbed in PCT
  4. Peritubular capillaries have v high oncotic pressure
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14
Q

Why is oncotic pressure so high in peritubular capillaries

A

a) Because those caps are derived from efferent arteriole and loads fo filtrate is taken out of system just upstream of efferent arteriole

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15
Q

When filtrate reaches the DCT it is:

A
  1. HyPO osmotic
  2. 90% filtered Na has been reabsorbed
  3. 80% filtered water has been reabsorbed
  4. 100% bicarbonate has been reabsorbed
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16
Q

Clinically what are important things to know what happens to, about kidney

A

what happens to water, Na and K+ ions, Ca and phosphate ions and Acid base

17
Q

If obstruction stops urine output, what will build up?

A

urea, creatinine, K+ and phosphate will build up

• Phosphate is one of the best metrics for whether the animal will recover

18
Q
  1. Explain the forces responsible for filtration
A
  1. Same forces as bulk flow just increased pressure – massive blood supply in afferent arteriole also hydrostatic BUT MUCH greater volume
    BULK flow:
  2. Difference in hydrostatic pressure between 2 sides of filter
  3. Difference in protein-osmotic pressure between 2 sides of filter
19
Q

How does oncotic pressure change in glomerus?

A

V little protein forced out of g caps so oncotic pressure gets increasingly greater

20
Q

How come filtration occurs across whole capillary bed?

A

In theory, across whole bed of glomerular capillaries, the hydrostatic pressure would keep forcing fluid out until balanced out by oncotic pressure
In practise SUCH big blood flow and pressure differential, pressures don’t abalnce out  filter WHOLE length of glomerular caps until E arteriole

21
Q

3 factors that mean filtration is so large

A
  1. large SA due to many capillaries
  2. Greater pressure than in cap beds
  3. Huge volume of blood going through this system
22
Q

what is GFR and how does this vary?

A
  1. GFR is Vol of fluid filtered from glomerular capillaries into bowman’s space per minute
  2. Varies with metabolic mass of animal:
23
Q

70% volume is reabsorbed.

Why design something that filters lots out and reabsorbs most back within a few seconds

A
  1. Anything filtered into nephron (20 mins) is destined for removal in the urine unless it is reabsorbed
  2. E.g. quick way of getting rid of poisons in blood!
24
Q

Where does the bulk reabsorption occur and what is it described as being?

A
  1. PCT
  2. selective but unregulated:
    s - most things aren’t so fat soluble won’t get through membranes (channels
    U - no hormonal type control
25
Q

What is tubular reabsorption?

A

process of returning important substances from filtrate back into renal interstitium and then into renal blood supply (back into bod)

26
Q

What is reabsorbed from tubular lumen to cap lumen?

A

glucose, electrolytes, vitamins, water, amino acids, small proteins that might have inadvertently escaped from blood into filtrate

27
Q

What processes occur in tubular reabsorption?

A
  1. Active transport, osmosis, solvent drag, Co transporters (Na/Glucose)
28
Q

Name and describe the diff types of tubular reabsorption

A
  1. Paracellular reabsorption - passive process that occurs between adjacent tubule cells (tight junctions don’t completely seal off interstitial fluid from tubule fluid)
  2. Transcellular reabsorption - movement through an individual cell
29
Q

What is the membrane closest to blood called and membrane closes to lumen

A

BASOLATERAL membrane - blood side

APICAL MEMBRANE - lumen side

30
Q

When is glucose secreted in urine?

A
  1. The rate of reabsorption of glucose is limited by the number of protein transporters
  2. Excretion of glucose in urine occurs when overcome all these glucose transporters
  3. If not absorbed in PCT it will be in urine
31
Q

secretion in PCT

A

provides an additional (or in some cases only opportunity) to increase urinary excretion of specific substances
Secretion is:
1. Always active (usually linked to Na+ transport) always against conc gradient
2. Not regulated in PCT
3. Substances have to be ionized

32
Q

Why is the PCT so good at reabsorption?

A
  1. Large SA
  2. single layer of epithelial cells
  3. peritubular capillaries continuous with efferent arterioles and have a v high oncotic pressure
  4. high concentration of Na+ K+ ATPase
  5. asymmetrical distribution of Na+ H+ ATPase
  6. High conc carbonic anhydrase!
33
Q

Why are a large number of environmental toxins highly lipid soluble?

A
  1. Lipid soluble substances can readily cross Cell membranes
  2. once got into filtrate no control over what happens
  3. As water is absorbed form filtrate a diffusion gradient is set up, promoting reabsorption
  4. it is therefore difficult to excrete highly lipid soluble substances via the urine.
    Why Many poisons are highly lipid soluble
34
Q

Why do animals with chronic kidney failure have inc Urea in blood?

A
  1. CKF have reduced GFR
  2. Urea is lipid soluble
  3. normal about 50% reabsorbed but then filtered out again adn so on
  4. decreased GFR - lots more urea reabsorbed
  5. urea is retained, animal feels really ill:(
35
Q

Secretion is:

A
  1. Always active (usually linked to Na+ transport) always against conc gradient
  2. Not regulated in PCT
  3. Substances have to be ionized
36
Q

Summary of bulk, mostly unregulated reabsorption in PCT

A
  1. Mainly in PCT (70% origional filtrate colume
  2. Water reabsorbed here by osmosis in PCT following extraction of Na and Cl from tubular fluid
  3. Main energy for this transport from lumen of PCT back to plasma is action of Na/K pump
  4. In turn fuels secondary AT (glucose, aa, ions), diffusion, (urea, other solutes) and osmosis (water)
  5. Normal conditions certain solutes e.g. glucose are totally reabsorbed under normal conditions before leaving PCT

Year 2 (&1) NSF Urinary (7 decks)

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