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Lecture Exam 3 - Anatomy > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Kidney Functions

A

filter blood plasma, reg. blood volume and pressure, the osmolarity of body fluids, secretes enzyme (renin), secretes erythropoietin, reg. PCO2 and acid-base balance, detoxify, promotes glucogenesis, completes step in calcitrol

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2
Q

waste vs metabolic waste

A

Waste- Any substance that is useless to the body
Toxins
Drugs
Hormones
Salts
Hydrogen ions
Excess water
Metabolic waste- produced by the body
CO2
Nitrogenous wastes

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3
Q

Cell process for prodcuing nitrogenous wastes

A

Urea
50% of nitrogenous wastes
protein catabolism
proteins→amino acids →NH2 removed →forms ammonia → liver converts to urea
Uric acid
nucleic acid catabolism
Creatinine
creatinine phosphate catabolism

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4
Q

Azotemia

A

build up of nitrogenous wastes in the blood

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5
Q

Uremia

A

toxic effects as wastes accumulate

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6
Q

excretion

A

Separation of wastes from body fluids and eliminating them

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7
Q

Waste of respiratory system

A

CO2

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8
Q

waste of integumentary system

A

water, salts, lactic acid, urea

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9
Q

waste of digestive

A

water, salts, CO2, lipids, bile pigments, cholesterol

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10
Q

waste of urinary system

A

many metabolic wastes, toxins, drugs, hormones, salts, H+ and water

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11
Q

three layers of connective tissue of a kidney

A

Renal Fascia

Perirenal fat (adipose) capsule

Fibrous (renal) capsule

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12
Q

Renal parenchyma

A

glandular tissue that forms urine
2 Zones
Cortex – outer 1 cm
Medulla – pyramids

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13
Q

renal sinus

A

cavity within the kidney
contains blood & lymphatic vessels, nerves, urine collecting ducts and fat

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14
Q

renal columns

A

Renal columns – extensions of cortex that project toward the renal sinus
divide medulla into renal (medullary) pyramids

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15
Q

renal pyramids

A

6 to 10 with the broad base facing cortex and renal papilla facing sinus

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16
Q

lobe

A

one pyramid and its overlying cortex

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17
Q

Minor Calyx

A

cup that nestles the papilla of each pyramid and collects its urine

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18
Q

Major calyces

A

formed by the convergence of two or three minor calyces

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19
Q

Renal pelvis

A

formed by the convergence of two or three major calyces

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20
Q

Ureter

A

tubular continuation of the pelvis that drains the urine down to the urinary bladder

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21
Q

Kidneys account for only .4% of body weight, but they receive about _____ of the cardiac output (renal fraction)

A

21%

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22
Q
A
  • interlobar arteries - up renal columns, between pyramids
  • arcuate arteries - over pyramids
  • cortical radiate arteries - up into cortex
    Branch into afferent arterioles: each supplying one nephron
    This leads to a ball of capillaries—glomerulus
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23
Q

Renal vein empties into ______

A

inferior vena cava

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24
Q

Blood is drained from the glomerulus by

A

efferent arterioles

-lead to peritubular capillaries
or vasa recta
-cortical radiate veins
-arcuate veins
-interlobar veins

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25
Q

cortex you find

A

peritubular capillaries

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26
Q

medulla you find

A

vasa recta

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27
Q

Nephron

A

-functional unit of kidneys

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28
Q

part of the nephron: Renal corpuscle

A

filters the blood plasma

  • contains a glomerulus & glomerular (Bowman’s) capsule that encloses glomerulus
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29
Q

Part of the nephron: Renal tubule

A

a long coiled tube that converts the filtrate into urine

-contains a duct that leads away from the glomerular capsule and ends at the tip of the medullary pyramid

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30
Q

Collecting duct

A

receives fluid from many nephrons

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31
Q

Collecting duct vs Papillary duct

A

-receives fluid from the DCTs of several nephrons as it passes back into the medulla

-merger of several collecting ducts
30 papillary ducts end in the tip of each papilla
Collecting and papillary ducts lined with simple cuboidal epithelium

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32
Q

Nephron Loop

A

long U-shaped portion of renal tubule
-Descending limb
-Ascending limb
Thick segments -active transport of salts
many mitochondria
Thin segment - very permeable to water

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33
Q

flow of fluids

A

glomerular capsule - glomerular filtrate
pct - tubular fluid
nephron loop - tubular fluid
dct - tubular fluid
collecting duct - urine all below
papillary duct
minor calyx
major calyx
renal pelvis
ureter
urinary bladder
urethra

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34
Q

4 processes of urine production

A

1.Glomerular filtration
plasma-like filtrate
2. Tubular reabsorption
returns solutes to the bloodstream
3. Tubular secretion
removes additional wastes from the blood
4. Water conservation
returns water to the bloodstream

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35
Q

How much of the glomerular filtrate is reabsorbed back into the blood?

A

99%

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36
Q

Mechanism of glomerular filtration

A

capillary fluid exchange process
water and some solutes in the blood pass from the capillaries of the glomerulus into the capsular space of the nephron ( pass thru are water, electrolytes, glucose, fatty acids, amino acids, nitrogenous wastes, and vitamins)

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37
Q

Filtration membrane

A

-fenestrated endothelium - small enough to exclude blood cells
-Basement membrane - proteoglycan gel
a few large particles may penetrate, but most are held back
negatively charged
blood plasma 7% protein, glomerular filtrate 0.03%
-Filtration slits
podocyte arms have pedicels with negatively charged filtration slits to exclude large anions

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38
Q

pass through filtration membrane

A

Water
Electrolytes
Glucose
Amino acids
Fatty acids
Vitamins
Urea
Uric acid
Creatinine

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39
Q

can’t pass the filtration membrane

A

Blood cells
Plasma proteins
Large anions
Protein-bound
minerals and
hormones
Most molecules
>8nmin
diameter

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40
Q

Proteinuria (albuminuria)

A

protein in urine

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41
Q

Hematuria

A

blood in the urine

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42
Q

why would protein be found in the urine

A

Distance runners and swimmers often experience temporary proteinuria or hematuria
prolonged, strenuous exercise greatly reduces perfusion of the kidney
glomerulus deteriorates under prolonged hypoxia

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43
Q

Blood hydrostatic pressure (BHP)

A

Much higher in glomerular capillaries
60 mm Hg compared to 10-15 in most other capillaries
An afferent arteriole is larger than efferent arteriole
larger inlet and smaller outlet

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44
Q

Hydrostatic pressure (CP)

A

in capsular space
18 mm Hg due to high filtration rate and continual accumulation of fluid in the capsule

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45
Q

Colloid osmotic pressure (COP) of blood

A
  • 32 mm Hg
    filtrate is almost protein-free  no significant COP
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46
Q

Net filtration pressure:

A

60out – 18in – 32in = 10 mm Hg out

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47
Q

effect of high glomerulus blood pressure

A

hypertension
rupture of glomerular capillaries
scarring of the kidneys (nephrosclerosis)
atherosclerosis of renal blood vessels
renal failure

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48
Q

Avg. glomerular filtration rate in males and females

A

males: 180 L/day
females: 150 L/day

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49
Q

how many liters of urine are excreted daily?

A

1-2 Liters of urine a day

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50
Q

If the glomerular filtration rate is too high what happens?

A

-Fluid flows through the renal tubules too rapidly for them to reabsorb the usual amount of water and solutes
-Urine output rises
dehydration and electrolyte depletion

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51
Q

If the glomerular filtration rate is too low what happens?

A

-Too much waste is reabsorbed
azotemia may occur

52
Q

the glomerular filtration rate is controlled by ….

A

adjusting glomerular blood pressure

53
Q

the glomerular filtration rate is controlled by what three mechanisms?

A

-Renal autoregulation
-Sympathetic nervous system control
-Hormonal control

54
Q

renal autoregulation

A

the ability of the nephrons to adjust their own blood flow and GFR without external (nervous or hormonal) control

55
Q

Contrast the myogenic mechanism and tubuloglomerular feedback

A

Myogenic mechanism—based on the tendency of smooth muscle to contract when stretched
Tubuloglomerular feedback—the mechanism by which the glomerulus receives feedback on the status of the downstream tubular fluid and adjusts filtration

56
Q

Juxtaglomerular apparatus

A

complex structure found at the very end of the nephron loop where it has just reentered the renal cortex
Loop comes into contact with the afferent and efferent arterioles at the vascular pole of the renal corpuscle

57
Q

3 kinds of cells occur in the juxtaglomerular apparatus

A

Macula densa— Senses variations in flow or fluid composition and secretes a paracrine that stimulates JG cells
Juxtaglomerular (JG) cells:
dilate or constrict arterioles when stimulated by the macula
secrete renin in response to a drop in blood pressure
Mesangial cells:
constrict or relax glomerular capillaries to regulate the flow

58
Q

sympathetic control of glomerular filtration rate

A

-Reduces GFR and urine output
-Redirects blood from the kidneys to the heart, brain, and skeletal muscles
-GFR may be as low as a few milliliters per minute

59
Q

hormones that regulate GFR and describe the functions

A

1.Renin is secreted by the kidneys when they sense a drop in blood pressure
first step in pathway to angiotensin II
2.Angiotensin II
Potent vasoconstrictor raising BP throughout body
Constricts efferent arteriole raising GFR despite low BP
-Angiotensin II stimulates adrenal cortex to secrete aldosterone promoting Na+ and H2O reabsorption in DCT and collecting duct
-Stimulates posterior pituitary to secrete ADH which promotes water reabsorption by collecting duct
-Stimulates thirst and H2O intake

60
Q

How much glomerular filtrate becomes urine?

A

1%

61
Q

Tubular secretion

A

wastes from the blood to the tubular fluid

62
Q

Tubular reabsorption

A

-useful substances from tubular fluid back to the blood
reabsorbs 65% of GF to peritubular capillaries!

63
Q

Structure of proximal convoluted tubule

A

-Great length, prominent microvilli, and abundant mitochondria for active transport
-Reabsorbs a greater variety of chemicals than other parts of the nephron

64
Q

Two routes of reabsorption

A

1.Transcellular route
Substances pass through the cytoplasm of the PCT epithelial cells
2.Paracellular route
Substances pass between PCT cells
Junctions between epithelial cells are quite leaky and allow significant amounts of water to pass through
Solvent drag—water carries with it a variety of dissolved solutes
3.Taken up by peritubular capillaries

65
Q

Why is there a solute transport maximum?

A

Limited by # of TRANSPORT PROTEINS ; If all transporters are occupied as solute molecules pass, then excess solutes appear in urine

66
Q

Tubular secretion

A

Extracts additional chemicals/wastes from capillary blood and secretes them into tubular fluid

1.Waste removal
Urea, uric acid, bile acids, ammonia, catecholamines, prostaglandins, and a little creatinine
Secretion of uric acid compensates for its reabsorption earlier in PCT
Clears blood of pollutants, morphine, penicillin, aspirin and other drugs
explains need to take prescriptions multiple times/day to keep pace with the rate of clearance
2. Acid-base balance
Secretion of hydrogen and bicarbonate ions help regulate pH of body fluids

67
Q

structure of nephron loop

A

-Only the thin segment is permeable to water
Electrolyte reabsorption from filtrate
-Thick segment reabsorbs 25% of Na+, K+, and Cl−
Ions leave cells by active transport and diffusion
-NaCl remains in the tissue fluid of renal medulla
Water cannot follow since thick segment is impermeable

68
Q

tubular fluid is very dilute as it enters the

A

distal convuloted tubule

69
Q

tubular fluid in the dct

A

DCT still contains about 20% of the water and 7% of the salts from the glomerular filtrate

70
Q

Hormones that act of the DCT

A

1.Aldosterone acts on thick segments and cause absorb of Na+ and excretion of K+
2.Atrial Natriuretic Peptide- reduces blood vol and pressure; causes excretion of salt and water in urine
3.ADH-collecting duct more permeable to water so that it can enter the tissues
4.Parathyroid hormone- dct increase calcium concentration and pct excrete phosphate

71
Q

_____ completes the process of determining the chemical composition of urine

A

distal convuloted tubule

72
Q

water absorption by collecting duct

A

starts in the cortex and receives fluid from many nephrons
As CD passes through the medulla, it reabsorbs water & concentrates urine up to 4X
The medullary portion of CD is more permeable to water than to NaCl

73
Q

Water diuresis

A

drinking large volumes of water will produce a large volume of hypotonic urine

-Cortical portion of CD reabsorbs NaCl, but it is impermeable to water
Urine concentration may be as low as 50 mOsm/L

74
Q

hypertonic urine

A

-Dehydration causes the urine to become scanty and more concentrated
-High blood osmolarity stimulates release of ADH and then an increase in synthesis of aquaporin channels by renal tubule cells
-More water is reabsorbed by collecting duct
-Urine is more concentrated

75
Q

If BP is ____, GFR will be ____

A

low, low (more salt removed and more water reabsorbed; less urine produced)

76
Q

The Countercurrent Multiplier

A

-The ability of the kidney to concentrate urine depends on the salinity gradient in the renal medulla
-Four times as salty in the renal medulla than the cortex

77
Q

how does the nephron loop act as a countercurrent multiplier?

A

Multiplier: continually recaptures salt and returns it to extracellular fluid of medulla which multiplies the salinity in adrenal medulla
Countercurrent : because of fluid flowing in opposite directions in adjacent tubules of nephron loop

78
Q

recycling of urea

A

-lower end of CD permeable to urea
Urea contributes to the osmolarity of deep medullary tissue
-Continually cycled from collecting duct to the nephron loop and back
-Urea remains concentrated in the collecting duct and some of it always diffuses out into the medulla adding to osmolarity

79
Q

Contrast countercurrent multiplier and countercurrent exchange

A

Countercurrent multiplication is something the tubule does to create the high interstitial osmolality, and a large osmolality gradient between the renal medulla and the renal cortex. The countercurrent exchange mechanism is something the vasa recta do to maintain this gradient.

80
Q

the function of the countercurrent multiplier

A

reabsorb water from the tubular fluid and produce concentrated urine.

81
Q

beavers have little need to conserve water so they would have ____nephron loops

A

shorter

82
Q

appearance of urine

A

Clear to deep amber is normal

Urochrome - yellow pigment produced from breakdown of hemoglobin of dead RBCs

Pink, green, brown, black
-food, vitamins, drugs, metabolic disease

Cloudy
– bacterial growth

83
Q

pyuria

A

pus present due to kidney/bladder infection

84
Q

hematuria

A

blood present
-caused by infection, trauma, kidney stones

85
Q

odor of urine

A

-Should normally have little odor
Pungent odor – bacteria
bacteria convert urea to ammonia

Foods may cause odor
ie. asparagus

Sweet, fruity odor – glucose present
diabetes
Foul odor - infection

86
Q

specific gravity of urine

A

1.001-1.035

87
Q

chemical composition of urine

A

95% water, 5% solutes

Normal solutes
urea, NaCl, createnine, uric acid, phosphates, sulfates calcium, magnesium, bicarbonate, H+
Abnormal solutes
Glucose
Free hemoglobin or whole RBCs
Albumin
Ketones (ok during pregnancy)
Bile pigments

88
Q

normal urine volume

A

1-2 liters a day

89
Q

polyuria

A

excess of 2L/day
disease long term (ie. Diabetes)
drugs - temporary

90
Q

Oliguria

A

less than 500 mL/day

91
Q

Anuria

A
  • 0 to 100 mL
    disease
    dehydration
    circulatory shock
    enlarged prostate gland (males only)
92
Q

pH of urine

A

range: 4.5-8.2
usually 6.0, which is slightly acidic

93
Q

diuretics

A

any chemical that increases urine volume

94
Q

caffeine effect

A

dilate the afferent arteriole

95
Q

alcohol inhibits ____

A

adh

96
Q

what is diuretics used for

A

treat hypertension & congestive heart failure by reducing the body’s fluid volume and blood pressure

97
Q

diuretics’ effect on urine volume

A

increase GFR, reduce tubular reabsorption of water, act on nephron loop Impairs countercurrent multiplier reducing the osmotic gradient in the renal medulla

98
Q

ureters

A

-Muscular tube from renal pelvis of kidney to bladder
-passes dorsal to bladder and enters it from below
-about 25 cm long

99
Q

3 tissues of the ureter

A

1.adventitia - CT
2.muscularis - 2 layers of smooth muscle
urine enters, it stretches & contracts in peristaltic wave
3.mucosa - transitional epithelium
lumen very narrow, easily obstructed

100
Q

urinary bladder

A

Muscular sac on floor of pelvic cavity
3 layers
Parietal peritoneum on flat superior surface
Fibrous adventitia everywhere else
Muscularis (detrusor muscle) - smooth muscle
Mucosa with rugae (wrinkles)
relaxed bladder in wrinkled – highly distensible

101
Q

Trigone

A

triangular area on floor where ureters enter and urethra exits

102
Q

male vs female urethra

A

female - 4 cm long, has an external urethral orifice (b/w vaginal orifice and clitoris)

male - 18 cm long

102
Q

male vs female urethra

A

female - 4 cm long , has a external urethral oriface (b/w vaginal orifice and clotris)

male - 18 cm long

103
Q

Micturition

A

voiding the bladder

104
Q

Micturition reflex in infants

A

1) 200 ml urine in bladder - stretch receptors send signal to spinal cord
2) parasympathetic reflex arc from spinal cord - stimulates contraction of detrusor muscle
3) relaxation of internal urethral sphincter
4) voids bladder

105
Q

Micturition in adults

A

If urination is appropriate, pons sends signal for stimulation of detrussor and relaxes internal urethral sphincter
If urination is inappropriate, impulses sent to external urethral sphincter keep it contracted
When urination becomes appropriate, the impulses are inhibited and the external urethral sphincter will relax

106
Q

Valsalva maneuver

A

Valsalva maneuver
aids in expulsion of urine by ↑ pressure on bladder
activates micturition reflex voluntarily when there is no urge to void bladder

107
Q

what are kidney stones made of ?

A

Renal Calculi
Calcium, phosphate, uric acid and protein crystallize
Form in the renal pelvis
Most are small, but some can be several centimeters
Causes blockages that destroy nephrons
Jagged  pain and hematuria

108
Q

causes of kidney stones

A

hypercalcemia
dehydration
pH imbalance
frequent urinary infections
enlarged prostate (males only)

109
Q

treatments of kidney stones

A

stone-dissolving drugs, surgery and/or lithotripsy (ultrasonic vibrations)

110
Q

UTI’s more common in females because

A

they have a shorter urethra

111
Q

Cystitis

A

infection of the urinary bladder

112
Q

Pyelitis

A

infection of the renal pelvis

113
Q

Pyelonephritis

A

infection that reaches the cortex and the nephrons

114
Q

Acute Glomerularnephritis

A

-destruction of glomeruli
autoimmune disease
may follow an infection
usually temporary – most recover

115
Q

Hydronephrosis

A

increased fluid pressure due to blockage in kidney

116
Q

Nephroptosis

A
  • floating kidney
    >too little body fat to hold kidney in place (ie anorexia)
    >prolonged vibration – truck drivers, jackhammer operators
117
Q

Nephrotic Syndrome

A
  • glomerular injury causes large amounts of protein to be excreted in urine

causes hypotension, edema, increased susceptibility to infection

118
Q

Acute Renal Failure

A

sudden onset traumatic damage to nephrons
great blood loss

119
Q

Chronic Renal Failure

A

slow, progressive
irreversible loss of nephrons
trauma
metal poisoning
glomeruli blocked by protein
atherosclerosis

120
Q

Urinary Incontinence

A

inability to control urination

causes :
Bladder irritation due to infection
Pressure during pregnancy
Incompetence of urethral sphincters
Obstruction

121
Q

Stress incontinence

A

uncontrollable urination due to brief surges in bladder pressure
laughter, coughing, sneezing

122
Q

With hyperglycemia and glycosuria (DIABETES)

A

1.diabetes mellitus I and II- insulin hyposecretion/insensitivity
2.gestational diabetes - 1 to 3% of pregnancies
3.pituitary diabetes - hypersecretion of GH
4.adrenal diabetes - hypersecretion of cortisol

123
Q

With glycosuria but no hyperglycemia

A

renal diabetes - hereditary deficiency of glucose transporters

124
Q

With no hyperglycemia or glycosuria

A

diabetes insipidus - ADH hyposecretion; CD ↓ water reabsorption

Lecture Exam 3 - Anatomy (2 decks)

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