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KNES 260 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Name the functions of the kidney

A
  • Excretion of wastes
    -H20 balance (plasma volume)
    -Blood pressure control (renin)
  • acid-base balance
  • blood cell production (erythropoietin)
  • vitamin d activation
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2
Q

What does the urinary system consist of?

A
  • Kidneys
  • blood supply (20%)
  • transport vessels
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3
Q

What are the 3 transport vessels in the urinary system?

A
  • Ureters
    -Urinary bladder
  • urethra
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4
Q

What are the 2 types of nephrons?

A
  • Cortical
    -juxtamedullary
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5
Q

Which type of nephron is shorter?

A

Cortical

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6
Q

Which type of nephron controls the osmotic gradient?

A

Juxtamedullary

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7
Q

What type of nephrons are there more of?

A

Cortical

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8
Q

What are the vascular components of the nephron?

A
  • Renal artery
  • efferent arteriole
    -Glomerulus
    -Efferent arterial
  • peritubular capillaries
  • renal vein
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9
Q

What are the parts of the tubule? (In order)

A
  1. Bowman’s capsule
  2. Proximal tubule
  3. Loop of henle (ascending, descending)
  4. Distal tubule
  5. Collecting duct
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10
Q

What are the 3 renal processes?

A
  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion
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11
Q

Where does filtration occur?

A

Bowman’s capsule

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12
Q

Where does reabsorption occur?

A

Loop of henle, proximal tubule, distal tubule, collecting ducts

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13
Q

Where is the osmotic gradient created?

A

Loop of henle

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14
Q

In what part of the tubule is reabsorption hormone controlled?

A

Distal tubule

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15
Q

What is filtered in the glomerulus?

A

Everything but RBC’s and proteins (too big)

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16
Q

What is reabsorbed?

A

Na, cl, ca, PO4, water, glucose

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17
Q

What is secreted?

A

K,H, large organic

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18
Q

What is the glomerulus?

A

Fenestrated tuft of capillaries surrounded by bowman’s capsule

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19
Q

What are the 3 layers of the glomerular membrane?

A
  • glomerular capillary wall
  • basement membrane (acellular gelatinous layer, collagen and glycoproteins)
    Inner layer of bowman’s capsule (consists of podocytes that encircle the glomerulus tuft)
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20
Q

How much is filtered a day in the glomerulus?

A

160 -180L/day ( 125ml/min)

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21
Q

What moves into tubules in glomerular filtration?

A

Electrolytes, water, glucose (RBC’s and most proteins are too big to be filtered)

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22
Q

True/false: podocytes can change shape

A

True

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23
Q

What do podocytes do?

A

Control filtration

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24
Q

What happens during renal failure in relation to podocytes?

A

Large slits form allowing proteins and rbc’s in

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25
Q

What are the 3 main forces involved in glomerular filtration?

A
  1. Glomerular capillary blood pressure
  2. Plasma - colloid osmotic pressure
    3.bowman’s capsule hydrostatic pressure (hydrostatic wants to more water out)

Bowman’s capsule osmotic pressure has small effect

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26
Q

Which forces favour glomerulus filtration?

A

Glomerular blood pressure

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27
Q

Which forces opposes filtration?

A

-Plasma-colloid osmotic pressure
- bowman’s capsule hydrostatic pressure

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28
Q

What is the glomerular filtration rate dependant on?

A
  • Net filtration pressure
  • glomerular surface area available for penetration
  • permeability of the glandular membrane (podocytesslit size can change with infection)
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29
Q

True/false: GFR won’t change if the blood hydrostatic pressure changes

A

False (will change)

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30
Q

How is GFR auto-regulated?

A

-tubuloglomerular feedback ( local (paracrine) control)
- hormones/autonomic (Change arteriole resistance)

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31
Q

Afferent arteriole __________ will lower GFR

A

Constriction

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32
Q

Afferent arteriole __________ will increase GFR

A

Dilation

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33
Q

Efferent arteriole __________ will lower GFR

A

Dilation

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34
Q

Efferent arteriole __________ will higher GFR

A

Constriction

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35
Q

What controls long-term regulation of arterial BP?

A

Sympathetic control (input to afferent arterioles, baroreceptor reflex)

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36
Q

Does lower blood pressure mean higher or lower GFR?

A

Lower GFR (and retention of fluids)

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37
Q

How do you measure GFR?

A

Use inulin (No reabsorption or secretion so excretion = filtration)

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38
Q

True/false: trans-cellular transport can be active or passive

A

True

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39
Q

How are Na and glucose moved?

A

Trans-cellular transport

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40
Q

What is paracellular transport?

A

Passive only (diffusion of water, ions)

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41
Q

What are the 2 ways things are reabsorbed in tubular reabsorption?

A
  • Passive and active reabsorption
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42
Q

What is passive reabsorption?

A

No energy, down electrochemical or osmotic gradients

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43
Q

What is active reabsorption?

A

Requires energy, moves against electrochemical gradient

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44
Q

How is Na reabsorbed?

A
  • Active process
    -na-k ATPase pump in absolute rail membrane
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45
Q

Where is 67% of Na reabsorbed?

A

Proximal tubule

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46
Q

What is the role of Na reabsorption?

A

Plays role in reabsorbing glucose, amino acids, water, chlorine, urea

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47
Q

Where is 25% of Na reabsorbed?

A

Ascending loop of henle

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48
Q

What is the role of Na reabsorption in the ascending loop of hence?

A

Plays critical role in kidneys ability to produce urine of varying concentrations

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49
Q

Where is 8% of Na reabsorbed?

A

Distal and collecting tubules

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50
Q

What is the role of Na reabsorption in the distal and collecting tubules?

A

Variable and subject to hormonal control; plays role in regulating ECF volume

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51
Q

How does the na/k pump facilitate Na reabsorption?

A

Creates Na gradient across membrane

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52
Q

How is water reabsorbed?

A

Via osmotic gradient created by Na reabsorption

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53
Q

How is Cl reabsorbed?

A

Via electrical gradient

54
Q

How is glucose reabsorbed?

A

By carriers (sodium linked glucose réabsorption in the proximal tubule)

55
Q

What is tubular maximum?

A

When all glucose carriers are full (excess glucose stays in tubules and is lost in the urine)

56
Q

What is renal threshold?

A

Blood glucose level where the carriers are full and glucose is seen in the urine

57
Q

What is a disease where we see renal threshold reached frequently?

A

Diabetes mellitus

58
Q

How is urea reabsorbed?

A

Through a passive process only till equilibrium is reached (50%)

59
Q

True/false: urea is small and diffusible

A

True

60
Q

How much glucose is reabsorbed?

A

100%

61
Q

How much urea is reabsorbed?

A

50%

62
Q

What does aldosterone control?

A

Na/k ATPase pumps

63
Q

When is aldosterone released?

A

If blood volume is low

64
Q

What does high aldosterone cause?

A
  • increased speed of pump
    -Inc Na reabsorption
    -Inc water reabsorption (decreased urine)
65
Q

True/false: aldosterone is decreased when dehydrated

A

False ( inc to inc water reabsorption)

66
Q

What does the renin-angiotensin-aldosterone system (raas) regulate?

A

Na and blood pressure/volume

67
Q

What is atrial natriuretic peptide (anp) antagonist to?

A

Aldosterone

68
Q

What does ANP do?

A

-Inactivates na/k pump
-Inhibits Na reabsorption

69
Q

When is ANP secreted by the atria?

A
  • Inc blood pressure
  • inc Na
  • inc stretch of atria (inc volume)
70
Q

What is secretion?

A

Transfer of molecules from extracellular fluid into tubule

71
Q

Is secretion a passive process?

A

No, active

72
Q

How is k+ secreted?

A

Na/k pump (later reabsorbed)

73
Q

How is h+ secreted?

A

Acid-base balance

74
Q

How are large organic secreted?

A

Biotransformed

75
Q

What is the main thing that happens in the collecting ducts?

A

Water reabsorption

76
Q

What is water reabsorption in the collecting ducts controlled by?

A

ADH

77
Q

What does water reabsorption in collecting ducts require?

A

Osmotic gradient from loop of hence

78
Q

True/false: descending loop of henle impermeable to water and permeable to salts

A

False, permeable to water, impermeable to salts

79
Q

Which part of the loop of henle does filtrate become more concentrated?

A

Descending

80
Q

Which part of the loop of henle does filtrate become less concentrated?

A

Ascending

81
Q

True/false: ascending loop of henle permeable salts and impermeable to water

A

True

82
Q

Which part of the loop of henle actively reabsorbs NaCl

A

Ascending

83
Q

What is the vessel following the loop of henle?

A

Vasa recta (has similar osmotic gradient in blood supply)

84
Q

What does the loop of henle do?

A

Creates a large vertical osmotic gradient in medulla (100 → 1200 mosm/ L)

85
Q

How is water reabsorbed?

A

ADH cause insertion of water pores into the apical membrane

86
Q

When is ADH (anti-diuretic hormore) released?

A

If blood osmolarity is high

87
Q

What does ADH control?

A

Permeability of collecting ducts

88
Q

What happens with low ADH?

A

Dilute, high volume of urine (water not reabsorbed

89
Q

What happens with high ADH?

A

Lower volume of concentrated unive (reabsorb more water)
Dehydrated

90
Q

What happens when you’re dehydrated?

A
  • Inc ADH
  • inc aldosterone
  • Dec ANP
  • inc water reabsorption → Dec urine (more concentrated)
91
Q

What are some behavioural mechanisms related to the kidneys?

A
  • Drinking replaces fluid loss
  • low sodium stimulates salt appetite
    Avoidance behautors help prevent dehydration (desert animals avoid the heat)
92
Q

What happens with water loading?

A
  • ADH decreases
  • aldosterone also decreases
  • ANP inc
    -dec water reabsorption
  • more urine, less concentrated
93
Q

How much Na, Cl and water is reabsorbed in the proximal tubule?

A

67%

94
Q

True/false: 100% of glucose and amino acids are reabsorbed in the proximal tubule

A

True

95
Q

What happens to k in the proximal tubule?

A

Small amount is secreted/ reabsorbed

96
Q

What happens to h+ in the proximal tubule?

A

Variable secretion

97
Q

T/f: organic ion secretion in proximal tubule is controlled

A

False, not controlled

98
Q

T/f: phosphate and electrolyte reabsorption in proximal tubule is controlled and variable

A

True

99
Q

Does urea reabsorption occur in the proximal tubule?

A

Yes

100
Q

What happens in the distal tubule?

A

-variable Na reabsorption (controlled by aldosterone and anp)

-variable water reabsorption (controlled by aldosterone and anp)

-variable K secretion/reabsorption (controlled by aldosterone)

-variable H secretion (depends on acid-base balance)

101
Q

What happens in the collecting ducts?

A

-variable water reabsorption (controlled by ADH)
-variable H secretion
-variable urea reabsorption (related to loop of henle)

102
Q

What does excretion =?

A

Filtration-reabsorption + secretion

103
Q

What is clearance?

A

Rate at which a solute disappears from the body
- non-invasive way to recastre GFR (inulin, creatinine)

104
Q

What does renal clearance equal?

A

RC =uv /p
-U= concentration of substance in urine
-V= flow rate of urine formation (GFR)
-P = concentration of same substance in plasma

105
Q

What is inulin clearance equal to?

A

GFR

106
Q

What is glucose clearance equal to?

A

Usually 0 (100% reabsorbed)

107
Q

What is micturition?

A

Urination reflex

108
Q

How does the urination reflex work?

A

Autonomic control of sphincters and detrusor muscle (CNS can override or initiate-stretch receptors)

109
Q

What occurs during filling of bladder?

A

Detrusor muscle relaxed, sphincters contracted

110
Q

What occurs during micturition?

A

Stretch receptors increase their firing
-sphincter relaxe, detrusor contracts, you pee

111
Q

What are causes of acute renal failure?

A

-Infections/toxic agents
-Innappropriate immune responses
- obstruction of urine flow
-Insufficient renal blood supply

112
Q

What are causes of chronic renal failure?

A
  • Hyper tension
  • diabetes (type 2)
  • chronic exposure to toxins/drugs
113
Q

What happens with renal failure?

A

-Build up of wastes to toxic levels
-Loss of calcium (osteoporosis)
- Na and k imbalance (affects nerve and muscle)
- loss of proteins -edema
- loss of rbc’s - anemia
- low BP (Dec renin)

114
Q

What are kidney stones?

A

Crystallization of minerals in either kidney, ureters or bladder
Calcium, oxalates (from veggies with rich colours), dehydration (binge drinking)

115
Q

What is the normal ph range?

A

7.38 - 7.42 (veins more acidic then arteries)

116
Q

What does absformal pt affect?

A

Can alter tertiary structure of proteins
Affects nervous system

117
Q

What happens with acidosis?

A

Neurons became less excitable (cns depression)

118
Q

What happens with altealosis?

A

Neurons are hyperexcitable

119
Q

When is pH disturbed?

A

When k+ is disturbed

120
Q

What is metabolic acidosis?

A

Metabolic organic acid production (lactic acid, ketoacids)

121
Q

What is respiratory acidosis?

A

Production of CO2 (acid production)

122
Q

What is metabolic alkalosis?

A

Dietary sources of bases (tums)
-vomiting
-pyloric stenosis

123
Q

What is respiratory alkalosis?

A

Hyperventilation (high altitude)

124
Q

How do we maintain pH homeostasis?

A

Buffers (fastest)
-combine with or release H
Ventilation
-75% of disturbances
Renal regulation (30 min, slowest)
-directly excreting or reabsorbing H

125
Q

What ave some examples of buffers?

A

_Phosphate
- protein (hemoglobin)
-Bicarbonate

126
Q

How does renal compensation work?

A

Either retains or eliminates h+ or HCO3 -

127
Q

How does the body correct for acidosis?

A

To raise pH:
- buffers bind to h+
- breathing increases (Dec CO2 and H+ via carbonic acid)
- kidney excerpts H+ and keep bicarbonate

128
Q

What type of interrelated cells function in acidosis?

A

Type A

129
Q

What do type an intercalated cells do?

A

Secrete h+, reabsorb bicarb

130
Q

What is the body’s correction for alkalosis?

A

To lower pH
-buffers release H+
-Breathing slows down (retains C02 and H+)
-Kidney retains H+ and secretes bicarbonate

131
Q

What type of intercalated cells function in alkalosis?

A

Type B

132
Q

What do type b intercalated cells do?

A
  • Secrete bicarb
    -Reabsorb h+

KNES 260 (9 decks)

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