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anatomy and physiology > urinary (renal) system > Flashcards

urinary (renal) system Flashcards

1
Q

what are the 4 main parts of the urinary system

A

kidneys
bladder
ureter (from kidney to bladder)
urethra (bladder to exterior)

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2
Q

where are the adrenal glands located and what to they secrete

A

on top of the kidneys. secreted adrenaline and aldosterone

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3
Q

what is the function of the ureter

A

carry urine from kidney to bladder

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4
Q

what are the 6 functions of the kidney

A 
regulate body fluid volume
electrolyte balance
formation of urine/excretion of metabolic waste
acid-base balance
production of hormones and enzymes
activation of vit d
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5
Q

what is the function of the bladder

A

reservoir for storing urine (holds up to 250-300ml)

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6
Q

draw urinary system

A

draw it

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7
Q

what is the function of the urethra

A

pass bladder from bladder to exterior

4cm in women/18-20cm in men

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8
Q

what % of body weight is fluid and where is it distributed

A

70% (32-40L)
intracellular fluid (25L)
Interstitial fluid (11L)
Plasma (3-5L)

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9
Q

what do you call the concentration of solutes in body fluid

A

osmolality (mOsm per KgH2o-1)

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10
Q

draw and label kidney

A

draw it

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11
Q

what supplies the kidneys with blood

A

renal vein and artery

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12
Q

what is the name of the functional unit within the kidney

A

nephron

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13
Q

how many kidney nephrons are there per kidney

A

1 million

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14
Q

draw and label nephron

A

draw it

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15
Q

what are the 2 types of nephron

A 
cortical nephron- most are this type of nephron (only a little into medulla)
juxtamedullary nephron (deep into medulla)
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16
Q

what are the 4 functions of the nephron

A

Glomerular filtration - creates plasma like filtrate of blood
Tubular reasborbtion - removes useful solutes from filtrate back to blood
Tubular sectretion - removes additional waste from blood
water conservation - removes water from urine and returns it to blood

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17
Q

blood enters the renal corpustule (glomerular capsule) at high or low pressure

A

high

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18
Q

what is the inside of the glomerulus made up of in order for it to filter efficiently

A

fenestrations (pores in endothelial cells) and pedicels (filtration slits)

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19
Q

what is Glomerular Filtration

A

GF = filtration of a protein free plasma from the glomerulus to the Bowmans capsule

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20
Q

what is the GFR (glomerular filtration rate) for males and females

A

females (115ml/min) 160 litres per day

males (125ml/min) 180 litres per day

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21
Q

how do you work out GFR (glomerular filtration rate)

A

Urine concentration x urine volume (produced in a given time period) divided by plasma concentration

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22
Q

what is creatinine

A

Serum creatinine (a blood measurement) is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys

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23
Q

where does most of the absorption take place within the kidney nephron

A

proximal convoluted tubule

24
Q

where are 100% of glucose and 100% of amino acids reabsorbed within the nephron by secondary active transport

A

proximal convoluted tubule

25
Q

what else, beside glucose and amino acids are absorbed at the proximal convoluted tubule

A

sodium - 65% (active transport)

water - 65% (osmosis)

26
Q

what is glucose in the urine called

A

glycosuria (usually due to untreated diabetes mellitus)

27
Q

what is reabsorbed at the loop of Henle

A

sodium - 25%

water - 25%

28
Q

what is the name of the unique kidney mechanism which means that concentrated urine can be produced when there is a need to conserve water

A

counter current mechanism

29
Q

what is reabsorbed/excreted at the distal convoluted tubule

A

sodium - 8-10% (regulated by hormones here)
water - 8-10% (regulated by hormones here)
potassium also secreted

30
Q

what does aldosterone do

A

stimulate sodium reabsorption in the distal tubule which increases blood volume

31
Q

what does atrial natriuetic peptide do

A

increases soduim excretion which decreases blood volume

32
Q

what does anti diuretic hormone (ADH) do

A

increases reabsorbtion of water at the collecting ducts increasing blood volume and blood pressure

33
Q

describe the hormonal control process in 6 stages

A

1) Decresed plasma volume means decreased arterial blood pressure
2) Decreased pressure recorded by macular densa cells of distal convoluted tubule leads to release of renin (enzyme)
3) Renin converts angiotensinogen (inactive) to angiotensin 1 (still inactive)
4) ACE (Angiotensin-converting enzyme) converts angiotensin 1 to angiotensin 2 (active)
5) Angiotensin 2 acts on the adrenal gland to secrete Aldosterone and ADH
6) Aldosterone and ADH increase sodium Na+ reabsorption and therefore water reabsorption to increase blood volume

34
Q

why is acid-based balance important

A

PH measures the concentration of hydrogen ions in blood

35
Q

what is the average PH of blood

A

arterial PH 7.45

venous PH 7.35

36
Q

describe when acid-based balance becomes dangerous

A

PH below 7.35 is acidosis (depression of CNS, disorientation, coma)
PH above 7.45 is alkalosis (convulsions, respiratory spasms)

37
Q

describe 3 metabolic processes which affect Acid-base balance

A

1) carbonic acid formation: CO2 + H2O ↔ H2CO3 (carbonic acid) ↔H+ (hydrogen) + HCO3- (bicarbonate)
2) catabolism of organic nutrients meat and proteins produce sulphuric acid and phosphoric acid
3) metabolism of fatty acids during fat metabolism and lactic acid from muscles during excercise

38
Q

the lungs can maintain acid-based balance by blowing off CO2 but how do the kidneys do it

A

they increase or decrease the excreation of hydrogen and bicarbonate as required…
e.g If PH falls (becomes more acidic) hydrogen excretion is increased and bicarbonate conserved. this is reversed should PH rise.
Also bicarbonate is generated as a bi product of amino acid breakdown in kidneys; this process generates ammonium (NH4+ an acid which can be quickly excreted)

39
Q

what is the usual PH of urine

A

6

40
Q

what is the chemical composition of urine

A

95% water

5% solutes

41
Q

what is the osmolality range of urine

A

50 mOsm/kg1 - 1200 mOsm/kg1 (dehydrated - higher concentration)

42
Q

the kidney (and liver) convert vit D to active metabolites but what are they required for

A

regulation of blood levels of calcium and phosphate

43
Q

how is bladder function controlled (6 steps)

A

1) stretch receptors in wall of bladder activated at around 200mls of urine
2) sensory fibres in pelvic nerve relay to sacral region of spinal chord
3) inter-neuron relays sensation to thalamus and then into cerebral cortex (u become aware)
4) parasympathetic motor fibre in pelvic nerve relay to post-ganglionic neuron
5) stimulating detrusor muscle (wall of bladder) to contract
6) micturition (weeing) occurs when external urethral sphincter relaxes

44
Q

what is the single largest cause of renal failure

A

diabetes (also hypertension and kidney cancer)

45
Q

what are kidney stones

A

build up of calcium, oxalate or phosphate

46
Q

how do you treat kidney stones

A

litotripsy (sound waves break up stones)
surgery
reduce calcium intake
increase fluid uptake

47
Q

what are symptoms of kidney stones

A

lower back pain
nausea/vom
haematuria (blood in urine)
associated infection

48
Q

what is glomerulonephritus

A

inflammation of the kidney glomeruli causes impaired filtering. due to post-infection complication etc. blood and protein in urine

49
Q

what is acute kidney failure

A

sudden loss of kidney function. due to very low blood pressure, blockage of renal blood supply, toxic injury (eg alcohol), ureter or bladder obstruction

50
Q

explain the stages of kidney disease/failure

A

Normal GFR = 90-140ml/min
5 stages
stage 1 = <15ml/min (requires transplant or dialysis)

51
Q

what are the symptoms of renal failure

A 
high BP
anaemia
peripheral neuropathy (nerve damage)
itchy skin
metabolic acidosis
52
Q

what are the early warning signs of renal failure

A

high BP
Frequent urination
difficult or painful urination
swollen hands or feet

53
Q

what can urinalysis detect

A

proteinuria (most abundant is albumin) normally around 30mg/day however clinical proteinuria >300mg/day

54
Q

what else can be tested in urine

A

1) creatinine clearance (GFR) - break down of muscle metabolism (90-140ml/min)
2) serum creatinine (0.6-1.2 mg/dl)
3) blood urea nitrogen - break down of protein (7-20 mg/dl)

55
Q

how can you treat CKD

A

Control blood pressure
diet
dialysis (haemodialysis into blood or peritoneal into peritoneum dialysis)
transplant

56
Q

aside hypertension and diabetes what other 3 factors may increase risk

A

obesity,
genetic factors,
race: south asia and Caribbean (due to prevalence of diabetes)

anatomy and physiology (15 decks)

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