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Anatomy part 2 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

What is the main function of the urinary system and what are it’s components?

A

It removes excess metabolic wastes, substances in excess, and foreign substances like drugs

Pair of kidneys, a pair of ureters, urinary bladder, and urethra

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2
Q

Give a physical description of a kidney

Where is the kidney located in the body cavity?

A

reddish brown, bean shaped with smooth surface. About 12 centimeters long and 6 centimeters wide in an adult

Its retroperitoneal high on the posterior wall

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3
Q

What area of the kidneys give them their shape?

A

The hilum

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4
Q

What is the fibrous outer layer of the kidney called?

A

Fibrous capsule

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5
Q

What is the functional Unit of the kidney?

What structures is it composed of ?

What do they filter?

A

The nephron

The renal Corpusle and the renal tubule

Blood

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6
Q

What structures make up the renal corpuscle and what are they?

A

The Glomerulus - Network of blood vessels

The Bowman’s Capsule - a “C” shaped structure around the Glomerulus

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7
Q

What are the functions of the Kidney?

A

Remove metabolic waste and excrete via urine

Maintain blood homeostasis
by
Regulation of RBC formation (erythropoietin)
Blood pressure (enzyme renin)
Blood volume (ADH)
Blood Composition and pH
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8
Q

What substances do we absolutely not want to have leave via the urinary system?

A

RBCs or protein

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9
Q

What is the outer layer of the inside of the kidney called?

What is the inner layer called?

A

the Cortex

The medulla

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10
Q

Where is the juxtaglomerular Apparatus?

What is it’s function?

What cells assist and what do they do?

A

It is the point of contact between the afferent arteriole and the Distal convoluted Tubule

It affects the Glomerular filtration rate by manipulating the smooth muscle

Macula Densa cells in the DCT detect NaCl and increase or decrease pressure on the arterioles to control the Glomerular Filtration Rate (GFR)

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11
Q

What is the most common type of nephron and their location?

Where are the rest and what is their name?

A

80% are in the cortex and are called Cortical nephrons

20% have an extended loop of Henle that does into the medulla and are called Juxtamedullary nephrons

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12
Q

What is the function of a Juxtamedullary nephron?

Why can this nephron do this?

A

Produces concentrated urine in times of dehydration

the longer loop gives more surface area for absorption of water and NaCl if needed

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13
Q

What are the main steps of urine formation?

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

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14
Q

What are the blood vessels that filter the water and dissolved materials from blood in the Glomerulus?

What is not filtered out? What cells are responsible for preventing this?

A

Fenestrated Glomerular Capillaries?

Protein is not filtered out

Podocytes

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15
Q

What is Filtration due to?

What is the main force that moves substances by filtration through the glomerular capillaries?

A

Net filtration pressure

Glomerular hydrostatic pressure

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16
Q

What is the hydrostatic pressure of blood and what is it doing?

What are the opposing pressures?

What is the net filtration pressure?

What does the net filtration pressure directly affect?

A

60mmHg and it pushes fluid out of the capillaries

Pressure of the filtrate -18mmHg inside the bowman’s capsule

Osmotic pressure of -32mmHg - the exertion of fluid by proteins in the blood in the kidney tissues.

10mmHg is net

The Glomerular filtration rate

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17
Q

How much fluid do the kidneys produces per minute? What is this called?

Which mechanisms regulate it?

A

125 ml/minute

The glomerular filtration rate

Autoregulation by vasomotor center in the medulla and the Renin- Angiotensin system

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18
Q

Where is the Vasomotor center located in the kidneys? What does it do?

Under normal conditions, What controls it? how does it work?

A

Its located in the medulla and it regulates arteriole smooth muscle allowing for autoregulation.

The parasympathetic autonomous nervous system causes:

Vasoconstriction of the afferent arteriole to decrease GFR when elevated

Vasoconstriction of the efferent arteriole to increase GFR when low

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19
Q

Under abnormal conditions, What happens to the Autoregulation system?

A

It is overridden by the sympathetic nervous system in times of great blood loss or gain.

A large blood loss causes vasoconstriction of the afferent arterioles decreasing GFR

A large blood volume gain causes vasodilation of afferent arterioles, increasing GFR

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20
Q

How does the AR system know when do decrease the GFR when a large amount of blood has been lost and how does it tie in with the Renin-Angiotensin system?

A

Receptors in the juxtaglomerular apparatus detect this in 2 ways:

Baroreceptors in JG cells of afferent arteriole detect a decrease in stretch because of the decrease in bloodpressure and secrete the enzyme renin

Chemo receptors in the macular densa cells in the DCT detect a decrease in Na+, K+, and Cl-. They then stimulate JG cells to secrete more renin

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21
Q

What is the pathway of the Renin-Angiotension Aldosterone system?

A

Angiotensinogen is produced by the liver and when the kidneys detect a low blood volume they release renin.

Renin converts angiotensinogen to ANG 1

ANG 1 is converted to ANG 2 via angiotensin converting enzyme (ACE) that is secreted by the lungs

ANG 2 cause the adrenal glands to secrete Aldosterone

Aldosterone causes H2O, Na+ retention, increasing blood pressure

22
Q

What are the effects of the Renin-Angiotension System?

A

Efferent arterioles vasoconstrict, increasing GHSP

Adrenal Cortex secretes Aldosterone targeting the DCT (increasing H2O and Na+ absorption which increases GHSP, and restores GFR back to normal)

Posterior Pituitary secretes ADH targeting the DCT increasing H2O reabsorption.

Hypothalamuus triggers thirst
which increases fluid intake, increasing BV, which increases BP

23
Q 
What is tubular reabsorption?
Where does it mostly take place?
What is the method of movement?
What blood vessels are involved?
What substances are being reabsorbed into the blood stream?
A

Substances move from the renal tubules back into the bloodstream after being filtered out

The PCT

Diffusion (except with the PCT reabsorbs 70%)

The peritubular capillaries

GLUCOSE, water, urea, proteins creatine, electrolytes, amino and lactic acids

24
Q 
What is tubular secretion?
Where does it take place?
What blood vessels are involved 
What is the method of movement?
What substances are being secreted?
A

substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules.

Mostly Distal Convoluted tubules

Peritubular capillaries

Active transport

Metabolic wastes primarily, K+ if high

25
Q

How does the body prevent large amounts of fluid from being lost in urine?

A

ADH promotes the reabsorption nof water through the DCT, works like a negative feedback mechanism

26
Q

Describe the process in which ADH affects urine concentration?

A

When the concentration of water in the blood decreases the hypothalamus signals the posterior pituitary to release ADH.

ADH causes the distal convoluted tubules and collecting ducts to increase water reabsorption

Urine becomes more concentrated and volume decreases

27
Q

What is Urea?
What does a plasma concentration mean?
How much is recycled?
How is it reabsorbed?

A

by-product of amino acid metabolism

Protein in the diet

80% is recycled

Passive process

28
Q

What is Uric Acid?
How is it reabsorbed?
How much is secreted and excreted?

A

By-product of nucleic acid metabolism

Active transport

10% is secreted and excreted

29
Q

What is the composition of Urine?

A 
95% water
urea
uric acid
creatinine
amino acids, electrolytes and drugs
30
Q

What is the renal pelvis?

A

The expanded area of the renal tubule that is near the kidney

31
Q

What is renal clearance?

What does it indicated?

A

the rate at which a chemical is removed from the plasma

Indicates kidney efficiency

32
Q

What is the pathway of urine leaving the body?

A 
collecting ducts to
minor and major calyces 
renal pelvis
ureters
urinary bladder
urethra
33
Q

How long are the Ureters?

What are the 3 layers and what makes them up?

A

25 Centimeters

Inner mucous coat - transitional epithelium

Middle muscular coat - smooth muscle layer

Outer Fibrous serosa - fibrous CT

34
Q

What is peristalsis?

A

moving urine

35
Q

Where is the Urinary bladder located? in males and females?

What is the opening for the ureters in the Urinary bladder called?

A

Contacts the anterior wall of uterus and vagina in female

And lies posteriorly against the rectum in males

Area of Trigone

36
Q

What are the 4 layers of the urinary bladder?

A

inner mucous coat
submucous coat
muscular coat
outer serous coat

37
Q

What type of muscle is the detrusor?

external urethral sphincter

A

smooth

skeletal

38
Q

How big is the urethra in females and in males?

What so special about the male urethra vs female?

A

4 cm runs obliquely

17.5 cm

its for urinary and reproduction

39
Q

What is micturition?

What is the sequence of events?

A

The process of urination

When the bladder distends from being full, the stretch receptors in the bladder send signals to the sacral-spinal chord to begin the process.

Parasympathetic nervous system sends signals to the detractor muscles, causing rhythmic contractions.

This causes an urgent need to urinate

external urethral sphincter relaxes and impulses from the brain facilitate the reflex

detrusor muscle contracts, and urine is expelled through the urethra

Neurons in the micturition center fatigue, the detrusor muscle relaxes, bladder starts to fill again

40
Q

Is the urinary system severely affected by age related problems?

When do people lose a third of their kidney mass?

A

No, but they do become slower at removing

80

41
Q 
What is chronic renal failure?
How do we test for it?
What causes the majority of cases?
What is the parameters for diagnosis?
How many stages?
How do we treat?
A

Progressive loss of renal function

Blood test high for creatinine, means kidneys have an inability to excrete waste

75% of cases are caused by diabetes

GFR<60/min

5 stages

Angiotension II antagonist drugs, dialysis, transplant

42
Q

Glomerulonephritis ?
Symptoms?
What causes it?
Treatment?

A

Inflamation of the glomeruli

Hematurina (blood in urine)
Proteinuria (protein in urine)

infection of some sort, fusion of podocytes , fibrosis within glomerulus

Control hypertension, treat underlying conditions, dialysis, kidney transplant

43
Q 
Renal cell carcinoma?
Where does it start and who is most vulnerable?
Symptoms?
diagnosis?
Treatment?
A

Most common type of kidney cancer

starts in lining of tubules in the kidneys
men ages 50-70

Hematurina, abdominal pain, weight loss, swelling of veins around the testicles

blood tests, renal arteriography, ultrasound

nephrectomy (removal of all or part of kidney)
Could include bladder and surrounding tissues
chemotherapy

44
Q

What is gout?
symptoms?
diagnosis?
treatment?

A

Uric acid in blood crystalize and deposits in joints, tendons, and tissues

joint pain, fatigue, high fever

observe crystals in joint fluid, e-rays, blood tests

NSAIDs, steroids, lifestyle changes

45
Q

What are kidney stones?

what are they called in your kidney, ureter, and bladder?

when could you expect an obstruction

How are they treated?

A

Renal calculus - crystal aggregation formed in kidneys

Nephrolithiasis
Ureterolithiasis
Cystolithiasis

> 3 mm

Pain control, NSAIDs, surgical intervention

46
Q

What is Incontinence?
What are some causes?
Where is it most prevalent?
Treatment?

A

Involuntary excretion of urine

Polyuria - diabetes, polydipsia (excessive drinking)
Enlarged prostate or prostate cancer
Caffeine can stimulate the bladder

women - 35% in women > 60

Bladder retraining, pelvic floor therapy, medication, surgery

47
Q

What is the blood supply to the kidneys called?

A

The vasa recta

48
Q

Which cells secrete renin?

Which cells are like scaffolds for the capillaries in the glomerula?

A

Granulosa cells

mesengial cells

49
Q

Why is angiotension II bad in large quantities?

A

It remodels the Heart

50
Q

What is the negative feedback for ACE?

What prevenets ANG II from reaching the adrenal glands?

What prevents the adrenal glands from producing aldosterone?

A

ACE inhibitors

Sartans

Spironolactone

Anatomy part 2 (15 decks)

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