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A&P3 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Effects of angiotensin II includes:

a. Increases GFR
b. Decreases sodium absorption
c. Vasoconstriction of afferent arterioles
d. All of the above

A

Angiotensin II causes vasoconstriction of afferent arterioles - hence decreases glomerular filtration rate. It increases sodium and water reabsorption directly and via aldosterone.

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2
Q

Renin is secreted by the kidneys when the blood pressure is ___________

A

Renin is secreted by the kidneys when the blood pressure is decreased. The juxtaglomerular cells secrete renin which converts angiotensinogen to angiotensin I. Angiotensin I is converted to angiotensin II in the presence of angiotensin converting enzyme.

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3
Q

Juxta glomerular cells secrete RENIN or ANGIOTENSIN 1?

A

Juxtaglomerular cells secrete RENIN when the walls of the afferent arterioles are stretched less

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4
Q

Conversion of angiotensinogen to angiotensin I is catalysed by ________

A

Renin. The juxtaglomerular cells secrete renin which converts angiotensinogen to angiotensin I. Angiotensin I is converted to angiotensin II in the presence of angiotensin converting enzyme.

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5
Q

Which of the following structures assist in producing more concentrated urine?

A

Under the influence of ADH the renal tubules and collecting ducts conserve water producing a concentrated urine. Minor, major calyces, ureters and urinary bladder merely act as conduit for urine. Filtration of plasma happens in glomerula capsule.

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6
Q

What is antidiuretic hormone (ADH) also known as?

A

ADH (antidiuretic hormone) is also known as vasopressin. ADH is one of the hormones that regulates tubular reabsorption and secretion.

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7
Q

Where is ADH produced? And where is it released?

A

ADH is produced in the hypothalamus and release by the posterior pituitary (part of endocrine system).

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8
Q

How does ADH work?

A

ADH is a hormone that helps regulate tubular reabsorption and secretion. ADH moves water from the tubules, back into the blood stream (reabsorption).
ADH stimulates the insertion of a water channel protein (called aquaporin-2) in the last part of the distal convoluted tubule and throughout the collecting duct.

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9
Q

What would happen if there was a lack of ADH?

A

If there was lack of the hormone, ADH, then urine output would be high (up to 20L). If someone has diabetes they excrete a lot of urine – they have ADH however they don’t have insulin and they thus have high glucose. Glucose draws water. A glucose in urine test can determine if excessive urination is due to a lack of insulin, or due to a lack of ADH. If sugary, there is a lack of insulin. Different types of diabetes…

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10
Q

Would a decrease in blood volume stimulate the release of AHD?

A

Yes, a decrease in blood volume would in fact stimulate the release of AHD.

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11
Q

What is aquaporrn-2?

A

Aquapoin-2 is a water channel protein that is stimulated by the release of ADH (which regulate reabsorption of water from distal convoluting tubules and collecting ducts, back into the blood stream).

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12
Q

AHD is released by the________

A

The posterior pituitary secretes ADH and oxytocin which are produced by the hypothalamus. Kidneys produce renin. Anterior pituitary secretes growth hormone, prolactin, gonadotropins, ACTH and TSH.

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13
Q

When ADH level is low the kidneys produce________

A

When ADH level is low the kidneys produce a high volume of dilute urine.
ADH released by the posterior pituitary is responsible for facultative water reabsorption by increasing the permeability of distal tubules and collecting ducts. In the absence or low levels of ADH the kidneys will produce large volume of dilute urine.

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14
Q

ADH increases water reabsorption in the _____________

A

ADH increases water reabsorption in the distal convoluting tubules.
ADH released by the posterior pituitary is responsible for facultative water reabsorption by increasing the permeability of distal tubules and collecting ducts.

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15
Q

Stimuli for release of ADH include all the following, EXCEPT

     a. increase in plasma osmolarity  	
 b. increase in blood pressure 	
 c. dehydration 	
 d. hemorrhage
A

Stimuli for release of ADH include all the following, EXCEPT FOR
- an increase in blood pressure.
Stimuli for release of ADH include increase in plasma osmotic pressure, decrease in blood volume due to dehydration or haemorrhage. A low blood pressure due to a low blood volume can cause release of ADH.

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16
Q

ADH is responsible for:

 a. water reabsorption by the kidneys
 b. tubular secretion of solutes  	
 c. regulating the renal blood flow  	
 d. Causing glomerular filtration
A

ADH is responsible for water reabsorption by the kidneys.
ADH released by the posterior pituitary is responsible for facultative water reabsorption by increasing the permeability of distal tubules and collecting ducts.

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17
Q

Effects of the parathyroid hormone include:

 a. reabsorption of calcium from the tubules into blood 	
 b. increased excretion of sodium into the tubules  	
 c. reabsorption of potassium from the tubules into blood  	
 d. increased excretion of hydrogen into the tubules
A

Reabsorption of calcium from the tubules into blood.
Low blood calcium stimulates the parathyroid glands to release parathyroid hormone. PTH stimulates the distal convoluted tubule cells to reabsorb more calcium in the blood. It also inhibits phosphate reabsorption in proximal convoluted tubules thus enhancing its excretion.

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18
Q

A low blood calcium can stimulate the release of:

     a. calcitonin 	
 b. vitamin D 	
 c. parathyroid hormone  	
 d. all of the above
A

A low blood calcium can stimulate the release of the parathyroid hormone. Low blood calcium stimulates the parathyroid glands to release parathyroid hormone. An increase in blood calcium stimulates release of calcitonin from thyroid gland.

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19
Q

Effects of atrial natriuretic peptide can include all the following, EXCEPT

 a. increase sodium excretion  	
 b. increase urine output 	
 c. decrease blood volume 	
 d. increase blood pressure 	Correct, ANP inhibits reabsorption of sodium and water in the proximal convoluted tubule thus increases sodium and water loss in urine. These effects result in decrease in blood volume and blood pressure.
A

Effects of atrial natriuretic peptide can include all the following:
a. increase sodium excretion
b. increase urine output
c. decrease blood volume
ANP can not cause an increase blood pressure.

ANP inhibits reabsorption of sodium and water in the proximal convoluted tubule thus increases sodium and water loss in urine. These effects result in decrease in blood volume and blood pressure.

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20
Q

Atrial natriuretic peptide can

 a. increase sodium excretion  	
 b. increase potassium excretion  	
 c. decrease sodium excretion  	
 d. increase potassium excretion
A

Atrial natriuretic peptide can increase sodium excretion.
ANP inhibits reabsorption of sodium and water in the proximal convoluted tubule thus increases sodium and water loss in urine. It does not affect potassium ion.

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21
Q

Atrial natriuretic peptide is produced by

A

Atrial natriuretic peptide is produced by the heart

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22
Q

What is the functional portion of the kidney called?

A

The parenchyma consists of the renal cortex and renal pyramids. The parenchyma contains 1 million functional units called nephrons.

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23
Q

The parenchyma contains 1 million functional units called ____________.

A

The parenchyma contains 1 million functional units called nephrons. Nephrons lines by simple epithelium

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24
Q

Kidney functions include:

A
  • excretion of nitrogen waste (urea, ammonia, uric acid)
  • regulates blood volume (controls water volume, whats excreted or conserved - if water excreted in urine, blood volume decreases, blood pressure decreases)
  • blood pressure
  • regulates electrolyte content in blood - chloride, sodium, calcium, potassium.
  • regulates blood pH as kidneys excrete hydrogen ions into urine (blood becomes more alkaline), kidneys also conserve bicarbonate ions (an important buffer for H+)
  • production of hormones - vitamin D, and erythropoietin (used for RBC production)
  • blood glucose levels regulated as kidneys ise amin acod glutamine for glucogenesis (synthesis of new glucose molecules). Kidneys can also release blood into the blood.
  • blood osmolarity maintained through regulating loss of water and solutes in water
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25
Q

What are the organs of the urinary system?

A

Kidneys - left & right. Right kidney slightly lower due to liver being atop it. Kidneys filter blood
Ureters - left & right, carries urine kidneys to bladder.
- Bladder - stores urine (temp)
- Urethra, connected to bladder & carries urine to be excreted

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26
Q

Outer and inner regions of kidneys are called

A

Renal cortex & renal medulla

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27
Q

Layers of kidney

A 
renal fascia (outer, connective tissue, anchors to surrounding structures)
adipose (middle) 
renal capsule (connective, inner, protective & gives shape)
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28
Q

Path of urine drainage is

A

Filtrate moves through:
Nephron
> Collecting duct
> Papillary duct in papilla of renal pyramid
> Minor calyces – cuplike structures
> Major calyces – cuplike structures, then
drains into
> Renal Pelvis – single large cavity, then Urine moves into
> Ureter
> Urinary bladder
> Urethra

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29
Q

Size and weight of kidney

A

150gr per kidney, 10-12cm x 5-7cm x 3cm

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30
Q

What are the afferent arterioles?

A

The afferent arterioles branch into the glomerular capillaries (glomerulus).

31
Q

What are the glomerular capillaries?

A

The glomerular capillaries lie between the afferent and efferent arterioles. Unique in the body (normally between arteriole and venule)

32
Q

What are the efferent arterioles?

A

The glomerular capillaries reunite to form an efferent arteriole that carries blood out of the glomerulus.

33
Q

Venous return through the kidneys…

A

The efferent arterioles carry blood out of the glomerulus. The efferent arterioles divide to form the peritubular capillaries which surround the tubules in the cortex of the nephron. Venous return occurs in the peritubular capillaries, they branch off to become the vasa recta and then reunite to become peritubular venules.
pertitubular capillaries > interlobular veins > arcuate veins > interlobar veins > renal veins

34
Q

Blood into the kidneys - how much? Renal blood flow - how much?

A

Kidneys remove waste from blood and regulate its volume and ionic composition - thus they receive 20-25% of resting cardiac output.
Blood flow through kidneys is 1200mL per minute.

35
Q

How many parts of the nephrons?

A

Two main parts.
Renal corpuscle: where blood is filtered - the glomerulus & bowmans tubule (surround glomeruluar capillaries)
Renal tubule: area into which the filtered fluid passes (proximal convoluted tubule, loop of henle, distal convoluted tubule).

36
Q

What foes the bowmans tubule do?

A

Part of the renal corpuscal in the nephron, the bowmans tubule collects filtrate from the glomerulus.

37
Q

What are the layers of the bowmans capsule?

A

The bowmans capsule (which cups the glomurulus) has an inner viseral layer (surrounds capillaries) and an outer parietal layer. In between is the bowmans space (fluid).

38
Q

What is the renal corpuscle, and what is it made up of?

A

The renal corpuscle is part of the nephron (alongside the renal tubule). The renal corpuscle is a blood plasma filtration site. The renal corpuscle is made up of the glomerulus and the bowmans capsule.

39
Q

what is the renal tubule, and what is it made up of?

A

The renal tubule is part of the nephron (alongside the renal corpuscle). The renal tubule is where the filtrated fluid passes into. The renal tubule is made up of the proximal convoluted tubule, the loop of henle (descending & ascending limbs) and the distal convoluted tubule.

40
Q

Where does the distal convoluted tubule part of the nephron end?

A

The distal convoluted tubule drains into the collecting ducts and then into the papillary duct.

41
Q

Where are the nephrons located?

A

80-85% are cortical nephrons lie mostly in the cortex, only a small portion of the loop of henle lie in the medulla (renal corpuscle starts at outer portion of cortex).
The remaining 15-20% are juxtamedullary nephrons, which have much longer loops of henle - deep into the medulla. The juxtamedullary nephrons renal corpuscle starts deep in the cortex.

42
Q

What is the juxtaglomerular apparatus

A

Macula dense & juxtaglomerular cells constitute the juxtaglomerular apparatus - regulating blood pressure within the kidneys.
Principle cells in the dct have receptors for hormones - ADH & Aldosterone (regulating blood pressure).

43
Q

Glomerular Net Filtration Pressure

A

Depends on 3 main pressures
One promotes filtration:
Glomerular Blood Hydrostatic Pressure (GBHP) - 55

Two oppose filtration
Capsular Hydrostatic Pressure (CHP) - 15
Blood Colloidal Osmotic Pressure (BCOP) - 30

55 - 15 - 30 = 10mmHg (that is the pressure required to allow filtration).

44
Q

What forms the primary urine?

A

Filtrate forms the primary urine. Filtrate enters the glomerular endothelial cells - a fenestrated wall which is very leaky so that water and solutes can pass through (from blood plasma) yet not the actual blood cells nor plasma.

45
Q

Urine production occurs with _____, _______, ______?

A

Urine production:

  • glomerular filtration
  • tubular reabsorption
  • tubular secretion
46
Q

Which hormones are involved n regulating glomerular filtration rate?

A

Angiotensin II and Antrial Natriuetic Peptide (ANP) are the hormones which regulate glomerular filtration rate.
Decreased BV/BP stimulates Angiotensin II > acting like a vasocontrictor of the afferent and efferent arterioles > reduces GFR.
Stretching of heart atria stimulates ANP > relaxes the mesangial cells in glomerulus, increasing capillary surface area available for filtration > increases GFR

47
Q

What is the tubuloglomerular feedback system for renal autoregulation of GFR?

A

Renal autoregulation maintains constant renal blood flow, despite changes in blood pressure.
When GFR is high, filtration is high / reabsorption is low. The macula densa & juxtaglomerular cells detect increased Na+, Cl, water, and the juxtaglomerular apparatus decreases NO secretion. The afferent arterioles constrict, decreasing blood flow through glomerulus.

48
Q

What are the 3 controls for glomerular filtration?

A

GFR is controlled by:

1) Renal autoregulation (kidneys regulate themselves)
- myogenic (smooth muscle activity of blood vessels. Change in blood pressure make smooth muscles dilate or constrict arterioles)
- tubuloglomerular (juxtaglomerular apparatus)
2) Neural regulation (blood vessels controlled by autonomic nervous system - sympathetic division, norepinephrine causes vasoconstriction / reduced urine output as greater blood flow to other organs eg skeletal muscles)
3) Hormonal (Angiotensin II & ANP)

49
Q

What role does Tubular Reabsorption play in urine production?

A

Tubular reabsorption is the return of the filtered water and solutes back into the blood stream. Occurs along renal tubule however mainly in the proximal convoluted tubule.
As the GFR is high (volume of fluid entering the PCT is higher than total blood plasma volume) some of this fluid needs to be returned back to the plasma.
Tubular reabsorption is the second basic function of the nephron and the collecting duct.

99% of filtered water is reabosorbed and the solutes include glucose, urea, small proteins and ions - Na+, K+, Ca2+, Cl-, HCO3-.

50
Q

Tubular Secretion

A

Happens when solutes are secreted from the blood and tubules into the filtrate (to become urine). Hydrogen secreted will regulate pH.
Ammonium, creatine, alcholol, certain drugs will be secreted for waste.

51
Q

Reabsorption in Proximal Convoluted Tubule

A

Solutes are reabsorbed by passive and active transport proteins

  • 65% of water, Na, K
  • 100% glucose and amino acids
  • 50% of Cl, filtered urea
  • 80-90% of bicarbonate ions
52
Q

Hormonal Regulation of tubular reabsorption and secretion includes ______, _______, ________, _______

A 
Renin-Angiotensis-Aldosterone System (RAA)
Antidiuretic Hormone (ADH)
Atrial Natriuretic Peptide (ANP) 
Parathyroid Hormone (PTH)
53
Q

How do tubular reabsorption and secretion hormones regulate the blood flow in the kidneys, when blood pressure drops? HINT: RAA

A

When there is low blood volume / blood pressure the SNS causes the afferent arterioles to vasoconstrict, which means that they are stretched less than normal. The SNS does this by causing the juxtaglomerular cells to secrete renin. The renin then clips off a peptide called Angiotensin 1. The renin causes Angoteniogen (in the liver) to convert it to Angiotensin 1, then ACE (Angiotensin Converting Enzyme - from lungs) further converts to Angiotensin II.
Angiotensin II causes sodium & water to be reabsorption in the PCT and vasocontricts the afferent arteriole. Angiotensin II also stimulates the adrenal cortex to release aldosterone.
Aldosterone causes sodium and water reabsorption in the collecting ducts, which in turn increases blood volume and blood pressure. This will also result in increased potassium and hydrogen being excreted into urine.

54
Q

What does Angiotensin II do?

A

Angiotensin II causes vasoconstriction of afferent arterioles, decreasing GFR.
Angiotensin II enhances reabsorption of Na+, Cl- and water in the PCT > alters osmotic balance & encourages reabsorption of water.
Angiotensin II stimulates the adrenal cortex to release Aldosterone.

55
Q

What does Aldosterone do?

A

Aldosterone enhances reabsorption of Na+ and Cl- in the collecting ducts > more water is reabsorbed too > Less water is excreted > Blood volume & blood pressure increases.
Aldosterone occurs as part of the RAA system. Angiotensin II stimulates the adrenal cortex to secrete Aldosterone (after the enzyme, renin was secreted by the juxtaglomerular cells, and converted Agiotenisinogen to Angiotensin I, and then ACE converted Angiotensin I to Angiotensin II).

56
Q

What may dehydration, NA+ deficiency or a hemorrhage cause?

A

Dehydration, NA+ deficiency or a hemorrhage may cause a decrease in blood volume and blood pressure. RAA would then kick in (hormonal regulation of kidneys) to increase the BV/BP. RAA regulates the blood flow through the kidneys.

57
Q

Where does the Antidiuretic Hormone (ADH – Vasopressin) come from?

A

Vasopressin (ADH) is produced by the hypothalamus, yet stored and released by the posterior pituitary

58
Q

Where is the ACE (Angiotensin Converting Enzyme) from?

A

ACE is from the lungs

59
Q

Where is Renin secreted?

A

Renin is secreted from the juxtaglomerular cells in the afferent arteriole.

60
Q

Where is Aldosterone from?

A

Aldosterone is secreted by the adrenal cortex (stimulated by Angiotensin II).

61
Q

Does Angiotensin reduce or enhance GFR?

A

Angiotensin decrease the glomerular filtration rate by causing vasoconstruction of the afferent arteries.

62
Q

Where in the tubules does Angiotensin II enhance reabsorption?

A

Angiotensin enhances reabsorption of water, chloride and sodium n the proximal convoluted tubule.

63
Q

Where in the tubules does Aldosterone enhance reabsorption?

A

Aldosterone stimulates the principle cells in the collecting ducts to reabsorb more sodium, chloride and water. The osmotic consequence is that this increases blood volume and thus blood pressure.

64
Q

ADH - what does it do?

A

Plays an important role in faculative water absorption by increasing the water permeability of principle cells in erg last part of the distal convoluted tubule - and in the collecting duct.
ADH stimulates the insertion of Aquaporin-2 (a water channel present in the distal convoluted tubule / collecting ducts, when ADH is present). This happens via exocytosis, which increase water permeability - moving H2O from the tubules back into the blood stream.
The kidneys produce a large volume of dilute urine when ADH is low, and concentrated urines when ADH is high.

65
Q

What is the urine like ADH is high?

A

The kidneys produce a concentrated urine when ADH is high (as little as 1/2L).

66
Q

How does ADH play a role in diabetes insipidus?

A

Diabetes insipidus is caused by insufficient vasopressin, a hormone produced by the brain that instructs the kidneys to retain water. Without enough vasopressin, too much water is lost from the body in urine, which prompts the affected person to drink large amounts of fluids in an attempt to maintain their fluid levels. In severe cases, a person may pass up to 30 litres of dilute urine per day. Without treatment, diabetes insipidus can cause dehydration and, eventually, coma due to concentration of salts in the blood, particularly sodium.

The name of this condition is a little misleading, since diabetes insipidus has nothing to do with diabetes mellitus (a condition characterised by high blood sugar levels), apart from the symptoms of thirst and passing large volumes of urine. The word diabetes means ‘to go through’ - describing the excessive urination. Insipidus means the urine is tasteless, whereas mellitus suggests it is sweet from its sugar content.

67
Q

Can a decrease in blood volume stimulate the release of ADH?

A

Yes - a decrease in blood volume stimulate the release of ADH. ADH is stimulated when osmolarity - or osmotic pressure of plasma and interstitial fluid - increases (i.e ADH is stimulated when water concentration decreases). ADH stimulates facultative water reabsorption, which brings plasma osmolarity back down to normal (negative feedback system regulates facultative water reabsorption by ADH).

68
Q

What is the function of the Atrial Natriuretic Peptide (ANP)?

A

ANP promotes water and sodium loss (as it inhibits reabsorption in the proximal convoluted tubule & collecting duct. It also suppresses the secretion of ADH and aldosterone.
This all decreases blood volume and blood pressure.

69
Q

When does ANP kick in?

A

ANP is stimulated when there is any large increase in blood volume. ANP is released by the atria of the heart (after a stretch) and it suppresses the release of aldosterone and ADH. ANP also inhibits the reabsorption of sodium and water in the proximal convoluted tubule and collecting duct.

70
Q

How do the regulating hormones affect urine output?

A

ADH prevents water loss > concentrate urine. Promotes water reabsorption. Water is retained in the body/blood stream as high reabsorption when ADH high.

Aldosterone prevents salt loss and water loss > concentrate urine. Aldosterone promotes water reabsorption.

ANP causes salt loss and water loss > dilute urine.

Parathyroid hormone

71
Q

What role does the parathyroid hormone play?

A

Lower than normal blood-calcium levels promote PTH to be released so to reabsorb more calcium in the DCT. PTH promotes phosphorus excretion.
PTH has effect in the bone, gut & kidneys.
PTH actions:
- Osteoclasts liberate calcium into the blood
- Increases vitamin D absorption in the gut
- Loss of calcium through kidneys is reduced

72
Q

Male urethra

A

Last part of urinary system - a tube that runs from the internal urethral orifice, to the exterior.

Male urethra (20 cm) transports urine and semen and has three regions:

  • Prostatic urethra (passes through prostate)
  • Membranous urethra (passes through deep muscles of the peritoneum, shortest portion)
  • Spongy urethra (passes through the penis)
73
Q

Vitamin D synthesis

A

Absorb vitamin D (inactive) from sun or gut. This then goes to the liver where it gets hydroxylated, then in the kidneys it gets further hydroxylated - to become calcitriol (the active form of vitamin D). Vitamin D promotes calcium deposition in the bone, which is why essential for calcium-blood homeostasis (as body pulls from bones in first instance, risking osteoporosis occurring).
PTH promotes osteoclasts to increase blood calcium levels, also effects on kidneys (to promote reabsorption) plus promotes gut absorption.

A&P3 (5 decks)

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