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Western Medicine 502 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

The compact ball of capillaries in a nephron is called?

A

the glomerulus

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2
Q

Which of these is the most abundant nitrogenous waste in the blood? uric acid, urea, ammonia, creatinine, albumin

A

urea

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3
Q

Which of these lies closest to the renal cortex? the parietal peritoneum, the renal facia, the fibrous capsule, the perirenal fat capsule, the renal pelvis

A

the fibrous capsule

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4
Q

Most sodium is reabsorbed from the glomerular filtrate by

A

the proximal convoluted tubule

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5
Q

A glomerulus and glomerular capsule

A

renal corpuscle

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6
Q

The kidney has more _____ than any of the other structures listed. (arcuate arteries, minor calyces, medullary pyramids, afferent arterioles, collecting ducts)

A

afferent arterioles

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7
Q

The renal clearance of ______ is normally zero.

A

amino acids

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8
Q

Beavers have relatively little need to conserve water and could therefore be expected to have _______ than humans do.

A

shorter nephron loops

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9
Q

Increased ADH secretion should cause the urine to have

A

a higher specific gravity

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10
Q

________ is the ability of a nephron to adjust its GFR independently of nervous or hormonal influences.

A

renal autoregulation

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11
Q

The two ureters and the urethra form the boundaries of a smooth area called the ____ on the floor of the urinary bladder.

A

trigone

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12
Q

The _____ is a group of epithelial cells of the nephron loop that monitors the flow or composition of the tubular fluid.

A

macula densa

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13
Q

To enter the capsular space, filtrate must pass between foot processes of the ____, cells that form the visceral layer of the glomerular capsule.

A

podocytes

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14
Q

Glycosuria occurs if the rate of glomerular filtration of the glucose exceeds the _____ of the proximal convoluted tubule.

A

transport maximum

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15
Q

______ is a hormone that regulates the amount of water reabsorbed by the collecting duct.

A

ADH

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16
Q

The _____ sphincter is under involuntary control and relaxes during the micturition reflex.

A

internal urethral

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17
Q

Very little _____ is found in the glomerular filtrate because it is negatively charged and is repelled by the basement membrane of the glomerulus.

A

protein

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18
Q

Blood flows through the _______ arteries just before entering the interlobular arteries.

A

arcuate

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19
Q

The 6 organs of the urinary system

A

2 kidneys, 2 ureters, urinary bladder and urethra

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20
Q

The smooth muscle of the internal urethral sphincter is under _____ control, and the skeletal muscle of the external urethral sphincter is under _____ control.

A

involuntary, voluntary

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21
Q

The 3 regions of the male urethra

A

prostatic urethra, membranous urethra and spongy (penile) urethra

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22
Q

The kidneys filters _____ _____, separates waste from useful chemicals, returns useful substances to blood, and eliminates _____.

A

blood plasma, wastes

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23
Q

The kidneys regulate _____ volume and pressure by eliminating or conserving _____

A

blood, water

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24
Q

The kidneys regulate the _____ of the body fluids by controlling the relative amounts of water and _____ eliminated

A

osmolarity, solutes

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25
Q

The kidneys secrete the enzyme _____ which activates horomonal mechanisms that control _____ pressure and _____ balance.

A

renin, blood, electrolyte

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26
Q

The kidneys secrete the hormone _____ which stimulates the production of red blood cells.

A

Erythropoietin

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27
Q

The kidneys collaborate with the lungs to regulate the _____ and _____ _____ balance of body fluids.

A

PCO2, acid-base

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28
Q

The kidneys perform the final step in synthesizing the hormone _____ which contributes to calcium homeostasis.

A

calcitrol

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29
Q

The kidneys engage in _____ from amino acids in extreme starvation.

A

gluconeogenesis

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30
Q

These four systems carry out excretion

A

respiratory, integumentary, digestive and urinary

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31
Q

The _____ system excretes CO2 and small amount of other gases and water.

A

respiratory

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32
Q

The _____ system excretes water, inorganic salts, lactic acid, and urea via sweating.

A

integumentary

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33
Q

The _____ system excretes water, salts, CO2, lipids, bile pigments, cholesterol, other metabolic waste and food residue.

A

digestive

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34
Q

The _____ system excretes many metabolic wastes, toxins, drugs, hormones, salts, H+ and water.

A

urinary

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35
Q

Urea formation occurs in the breakdown of _____ to amino acids. Then, _____ is removed to form ammonia, which the _____ converts to urea.

A

proteins, NH2, liver

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36
Q

_____ _____ is a product of nucleic acid catabolism

A

uric acid

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37
Q

_____ is a product of creatine phosphate catabolism

A

creatinine

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38
Q

_____ _____ _____ is an expression of the level of nitrogenous waste in the blood. Normal concentration is 10-20 mg/dl.

A

blood urea nitrogen (BUN)

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39
Q

_____ is elevated BUN and indicates renal insufficiency.

A

azotemia

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40
Q

_____ is a syndrome of diarrhea, vomiting, dyspnea, and cardiac arrhythmia stemming from the toxicity of nitrogenous waste. Treatment is hemodialysis or organ transplant.

A

uremia

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41
Q

The kidneys lie against the posterior _____ _____ at the level of T12 to L3. The _____ kidney is slightly lower due to large lobe of liver. Rib 12 crosses the middle of the _____ kidney. The kidneys are _____ along with the ureters, urinary bladder, renal artery and vein and adrenal glands.

A

abdominal wall, right, left, retroperitoneal

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42
Q

The kidneys receive ___% of cardiac output known as the _____ fraction.

A

21, renal

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43
Q

Kidneys account for only ___% of body weight.

A

0.4

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44
Q

Each kidney is supplied by a _____ _____ arising from the aorta. Each one divides into segmental arteries that give rise to interlobar arteries, arcuate arteries, interlobular arteries, afferent arterioles and balls of capillaries.

A

renal artery

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45
Q

_____ arteries penetrate each renal column and travels between the pyramids toward the corticomedullary junction, the boundary between the cortex and the medulla.

A

interlobar

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46
Q

Interlobar arteries form _____ arteries, which make a sharp 90 degree bend and travel along the base of each pyramid.

A

arcuate

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47
Q

Each arcuate artery gives rise to several _____ arteries, which pass upward into the cortex.

A

interlobular

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48
Q

As an interlobular artery ascends through the cortex, a series of _____ _____ arise from it at nearly right angles like limbs arising from the trunk of a tree. Each one supplies one functional unit of the kidney called a _____.

A

afferent arterioles, nephron

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49
Q

The afferent arteriole leads to a ball of capillaries called a _____, enclosed in a nephron structure called the glomerular capsule.

A

glomerulus

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50
Q

Blood leaves the glomerulus by way of an _____ _____

A

efferent arteriole

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51
Q

The efferent arteriole usually leads to a plexus of _____ capillaries which form a network around another part of the nephron, the _____ _____

A

peritubular, renal tubule

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52
Q

The renal tubule reabsorbs most of the _____ and _____ that filtered out of the blood at the _____ and returns these to the bloodstream by way of _____ capillaries.

A

water, solutes, glomerulus, peritubular

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53
Q

The peritubular cavities carry away the reabsorbed water and solutes to the _____ veins, _____ veins _____ veins and the ____vein, which then leaves the hilum and drain into the _____ _____ _____.

A

interlobular (cortical radiate), arcuate, interlobar, renal, inferior vena cava

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54
Q

The _____ is the functional unit of the kidney.

A

nephron

55
Q

Each kidney has ___ million nephrons

A

1.2

56
Q

Each nephron is composed of two principle parts: the renal _____ and the renal _____.

A

corpuscle, tubule

57
Q

The renal _____ filters the blood plasma.

A

corpuscle

58
Q

The renal _____ is a long coiled tube that converts the filtrate into urine.

A

tubule

59
Q

The renal corpuscle consists of the _____ and a two-layered glomerular (_____) capsule that encloses the _____.

A

glomerulus, Bowman, glomerulus

60
Q

The _____ layer of the Bowman capsule is made of simple squamous epitherlium.

A

parietal (outer)

61
Q

The _____ layer of the Bowman capsule consists of elaborate cells called _____ that wrap around the capillaries of the glomerulus.

A

visceral (inner), podocytes

62
Q

_____ space separates the two layers of the Bowman capsule.

A

capsular

63
Q

The 4 parts of the renale tubule

A

proximal convoluted tubule
loop of Henle
distal convoluted tubule
collecting duct

64
Q

The _____ _____ tubule arises from the glomerular capsule. It is the longest and most coiled region. It is made up of simple cuboidal epithelium with prominent _____ for a majority of absorption.

A

Proximal convoluted, microvilli

65
Q

The _____ loop or loop of _____ is a long U-shaped portion of the renal tubule. It has a descending limb and an ascending limb. It is heavily engaged in the active transport of _____ and has many _____. The cells are very permeable to _____.

A

nephron, Henle, salts, mitochondria, water

66
Q

The _____ _____ _____ begins shortly after the ascending limb reenters the cortex.

A

distal convoluted tubule (DCT)

67
Q

The _____ _____ receives fluid from the DCTs of several nephrons as it passes back into the medulla.

A

collecting duct

68
Q

Glomerular filtrate collects in the _____ _____and then flows into the _____ _____ _____.

A

capsular space, proximal convoluted tubule

69
Q

The afferent arteriole is _____ than the efferent arteriole.

A

larger

70
Q

Most molecules that are smaller than ___ nm do not filtrate into the kidneys.

A

8

71
Q

Almost any molecule smaller than ___ nm can pass freely through the filtration membrane. They include water, electrolytes, glucose, fatty acids, amino acids, nitrogenous wastes and vitamins.

A

3

72
Q

Some substances of low molecular weight are bound to the _____ _____ and cannot get through the membrane. These include most calcium, iron, and thyroid hormone.

A

plasma proteins

73
Q

Kidney infections and trauma can damage the filtration membrane and allow _____ or _____ _____ to filter.

A

albumin, blood cells

74
Q

_____ is the presence of protein in the urine.

A

Proteinuria (albuminuria)

75
Q

_____ is the presence of blood in the urine

A

hematuria

76
Q

Distrance runner and swimmers often experience temporary proteinuria or hematuria. Prolonged, strenuous exercise greatly reduces _____ of the kidneys. The _____ deteriorates under prolonged hypoxia.

A

profusion, glomerulus

77
Q

_____ _____ is the fluid in the capsular space. It is similar to blood plasma except that it has almost no _____.

A

glomerular filtrate, protein

78
Q

_____ _____ is fluid from the proximal convoluted tubule through the distal convoluted tubule. Substances have been removed or added by _____ _____.

A

Tubular fluid, tubular cells

79
Q

_____ is fluid that enters the collecting duct. It undergoes little alteration beyond this point except for changes in _____ content.

A

Urine, water

80
Q

The 3 stages in urine formation

A

glomerular filtration
tubular reabsorption and secretion
water conservation

81
Q

glomerular filtration rate (GFR) is driven by _____ _____

A

blood pressure

82
Q

The _____ _____ _____ is the amount of filtrate formed per minute by the 2 kidneys combined. It equals 180 L/day in _____ and 150 L/day in _____

A

glomerular filtration rate (GFR), males, females

83
Q

The total amount of filtrate produced equals 50-60 times the amount of _____ in the body.

A

blood

84
Q

___% of filtrate is reabsorbed since only 1-2 liters of urine are excreted/day.

A

99

85
Q

If GFR rises above normal (high blood pressure), the flow of tubular fluid _____ and more _____ is reabsorbed. The macula densa stimulates the _____ _____ cells with a paracrine messenger. These cells contract, which constricts the _____ _____, thus reducing GFR to normal.

A

increases, NaCl, juxtaglomerular apparatus (JA), afferent arteriole

86
Q

If GFR falls below normal, the macula densa _____ the afferent arterioles and mesangial cells. Blood flow _____ and GFR rises back to normal.

A

relaxes, increases

87
Q

The renin-angiotensin-aldosterone mechanism is stimulated by _____ and the _____ nervous system.

A

hypotension, sympathetic

88
Q

If blood pressure drops dramatically, _____ is secreted by juxtaglomerular cells.

A

renin

89
Q

Renin converts _____, a blood protein, into _____.

A

angiotensinogen, angiotensin I

90
Q

In the lungs and kidneys, _____ _____ _____ converts angiotensin I to angiotensin II, the active hormone in the renin-angiotension-aldosterone mechanism that works in several ways to restore fluid volume and blood pressure.

A

angiotensin-converting enzyme (ACE)

91
Q

_____ is secreted by the adrenal cortex. Its primary function is to increase blood pressure. It acts on the _____ _____ _____. It functions to control blood fluid volume by conserving sodium, retaining water, and excreting potassium.

A

Aldosterone, distal convoluted tubule

92
Q

_____ mimics aldosterone effects.

A

Estrogen

93
Q

In tubular _____ water and solutes move from the tubule to peritubular capillaries, which means it returns to the _____.

A

reabsorption, bloodstream

94
Q

In tubular _____ water and solutes move from peritubular capillaries back to the tubules to create _____.

A

secretion, urine

95
Q

The 3 factors that promote osmosis into the peritubular capillaries

A

high colloid osmotic pressure (COP) in the blood
low blood hydrostatic pressure (BHP) in the capillaries
high hydrostatic pressure in the tissue fluid

96
Q

_____ _____ is the process in which the renal tubule extracts chemical from the capillary blood and secretes them into tubular fluid.

A

tubular secretion

97
Q

In ____ _____, urea, uric acid, bile acids, ammonia, catecholamines, protaglandins and a little creatine are secreted into the tubule. Secretion of _____ _____ compensates for its reabsorption earlier in the proximal convoluted tubule (PCT). This clears the blood of pollutants, morphone, penicillin, aspirin and other drugs. This explain the need to take prescriptions 3-4 times a day to keep pace with the rate of clearance.

A

waste removal, uric acid

98
Q

The acid-base balance involves the secretion of _____ and _____ _____ to help regulate the _____ of the body fluids.

A

hydrogen, bicarbonate ions, pH

99
Q

3 stages by which the kidneys convert blood plasma into urine

A

glomerular filtration, tubular reabsorption and secretion, and water conservation

100
Q

_____ _____ is the fluid in the capsular space. It is blood plasma without protein.

A

glomerular filtrate

101
Q

_____ _____ is fluid in the renal tubule. It is similar to glomerular filtrate except tubular cells have removed and added substances.

A

tubular fluid

102
Q

Tubular fluid becomes _____ once it enters the collecting duct. The only remaining change is in the _____ content.

A

urine, water

103
Q

PCT reabsorbs ___% of glomerular filtrate and returns it to _____ _____. Much reabsorption by osmosis and cotransport mechanisms are linked to the active transport of _____.

A

65, peritubular capillaries, sodium

104
Q

The nephron loop reabsorbs ___% of glomerular filtrate.

A

25

105
Q

DCT reabsorbs Na+, Cl- and water under hormonal control, especially _____ and _____.

A

aldosterone, ANP

106
Q

The tubules also extract drugs, wastes, and some solutes from the blood and secrete them into the _____ _____.

A

tubular fluid

107
Q

DCT completes the process of determining the _____ _____ of urine.

A

chemical composition

108
Q

The _____ _____ conserves water.

A

collecting duct

109
Q

PCT reabsorbs about 65% of _____ _____, removes some substances from the _____, and secretes them into the _____ _____ for disposal in urine. 2/3 of _____ in filtrate is reabsorbed by the PCT.

A

glomerular filtrate, blood, tubular fluid, water

110
Q

The kidneys reduce 180 L of glomerular filtrate to _____ L of urine each day.

A

1-2

111
Q

Reabsorptionof all the salt and organic solutes makes the tubule cells and tissue fluid _____. Water follows the solutes by osmosis through both paracellular and transcellular routes through water channels called _____. In PCT, water is reabsorbed at a constant rate called _____ _____ _____.

A

hypertonic, aquaporins, obligatory water reabsorption

112
Q

In the proximal convoluted tubule the amount of glucose is limited by the number of _____ _____ in the plasma membrane. If all the transporters are occupied as solute molecules pass, then _____ solutes appear in urine. Transport maximum is reached when transporters are _____. Each solute has its own transport maximum. Any blood glucose level above 220 mg/dL results in _____.

A

transport proteins, excess, saturated, glycosuria

113
Q

The primary function of the _____ _____ is to generate the salinity gradient that enables the collecting duct to concentrate the urine and conserve _____.

A

nephron loop, water

114
Q

The role of DCT is to concentrate _____ by reabsorbing water. Water then reenters the _____.

A

urine, bloodstream

115
Q

_____ _____ is secreted by the posterior lobe of the pituitary. It responds to dehydration and rising blood osmolarity. These stimulate the _____, which in turn stimulates the posterior pituitary. This secretion makes the _____ _____ more permeable to water. This way, water in the _____ _____ reenters the tissue fluid and bloodstream rather than being lost in urine.

A

Antidiuretic hormone (ADH), hypothalamus, collecting duct, tubular fluid

116
Q

Water _____ occurs upon drinking large volumes of water which produce a large volume of _____ urine.

A

diuresis, hypotonic

117
Q

_____ causes the urine to become scanty and more concentrated making it _____. High blood osmolarity stimulates the posterior pituitary to release _____ thereby concentrating the urine.

A

dehydration, hypertonic, ADH

118
Q

If blood pressure is low in a dehydrated person, _____ will be low. As the filtrate moves more slowly, there is more time for _____. In this way, more _____ is removed, more _____ is reabsorbed, and less urine is produced.

A

GFR, reabsoprtion, salt, water

119
Q

_____ is the examination of the physical and chemical properties of urine

A

urinalysis

120
Q

_____ is pus in the urine

A

pyuria

121
Q

_____ is blood in the urine due to a urinary tract infection, trauma, or kidney stones

A

hematuria

122
Q

_____ is an output of urine in excess of 2 L per day

A

polyuria

123
Q

_____ is a urinary output of less than 500 mL per day. The body cannot maintain a safe, low concentration of waste in the plasma.

A

oliguria

124
Q

_____ is a urinary output of 0 to 100 mL per day. Could be from kidney disease, dehydration, circulatory shock or prostate enlargement.

A

anuria

125
Q

_____ is any metabolic disorder resulting in chronic polyuria

A

diabetes

126
Q

In diabetes mellitus type 1, type 2, and gestational diabetes, there is a high concentration of _____ is the renal tubule. This opposes the osmotic reabsorption of _____ causing osmotic diuresis.

A

glucose, water

127
Q

_____ is the presence of glucose in the urine

A

glycosuria

128
Q

In diabetes _____ ADH hyposecretion causes insufficient water reabsorption in the collecting duct, so more water passes in the urine.

A

insipidus

129
Q

A _____ _____ is a hard granule of calcium phosphate, calcium oxalate, uric acid, or a magnesium salt called struvite. Causes include hypercalcemia, dehydration, pH imbalances, frequent UTIs, or enlarged prostate gland causing urine retention. Treatment includes stone dissolving drugs, often surgery, or _____, a non surgical technique that pulverizes stones with ultrasound.

A

renal calculus (kidney stone), lithotripsy

130
Q

_____ is infection of the urinary bladder. It is especially common in females due to short urethra.

A

cystitis

131
Q

_____ is infection of the renal pelvis. It can spread from cystitis.

A

pyelitis

132
Q

_____ is infection that reaches the cortex and nephrons. It can result from blood-born bacteria.

A

pyelonephritis

133
Q

_____ are any chemicals that increase urine volume. They are commonly used to treat hypertension and congestive heart failure by reducing the body’s fluid volume and blood pressure.

A

diuretics

Western Medicine 502 (10 decks)

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