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Mam Physiology > Urinary system > Flashcards

Urinary system Flashcards

1
Q

Function of urinary system

A 
Regulate blood volume and
blood pressure
• Regulate plasma ions, such as
sodium, potassium, chloride,
and calcium
• Aid in stabilization of plasma
pH
• Conserve valuable nutrients
like glucose and amino acids
• Eliminate wastes like urea and
uric acid,creating,drugs, toxins
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2
Q

Where kidneys are found

A

In retroperitoneal space, outside the peritoneum cavity

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3
Q

What does supply kidneys with blood

A

Renal arteries

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4
Q

How much blood do kidney have at any time

A

20-25% of the cardiac output

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5
Q

What is part of urinary system

A

Urinary bladder
Kidney
ureter (connecting kidneys and bladder)
Urethra

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6
Q

What is blood osmolarity

A

290 OsM

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7
Q

The body’s integrated
responses to increased
blood volume and blood
pressure

A

Increased blood volume-“ increased blood pressure

Increased BP-“volume receptors in atria,endocrine cells in atria and carotid and aortic baroreceprtors trigger homeostatic reflexes: causing heart to decrease output and to vasodilate

And kidneys to excrete salts and H2O in urine-> decreased ECF and ICF volume->decreased BP

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8
Q

How body responses to decreased blood volume and decreased blood pressure

A

In heart the opposite of increased BP

Behavior: increased thirst->incresed water intake->increased ECF and ICF, kidneys conserve H2O

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9
Q

Functional unit of kidney is

A

Nephron

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10
Q

Parts of kidney

A

Renal cortex, renal medula, renal pyramid,renal pelvis, calyx which are connected to renal pelvis

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11
Q

distribution of nephrons between cortex and medulla

A 
80% of the nephrons in the
kidney are almost completely
contained within the cortex
and the other 20 % dip down
into the medulla
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12
Q

What part of the nephron is in the medulla and cortex

A

Cortex- corpsule, some tubules

Medulla-collecting duct,nephron loop

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13
Q

What blood vessels lead into the glomerous

A

cortical radiate arteries

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14
Q

2 components of nephron

A

Vascular component

Tubular component

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15
Q

Vascular route in nephron

A

1.On entering the kidney the renal artery –afferent
arteriole, brings blood to the afferent arterioles
which deliver blood to the…
2. glomerulus to be filtered. Efferent arteriole
transports blood from glomerulus
3.Efferent arteriole breaks down into peritubular
capillaries which surround tubular part of
nephron and supply the blood for the exchange
with the fluid in the tubular lumen
4.Peritubular capillaries join into venules which
transport blood into the renal vein which is the
way by which blood leaves the kidneys

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16
Q

The nephron tubular component begins with ball-like structure known as
___

A

Bowman’s capsule

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17
Q

Histology/structure of glomerulus and bowman’s capsule

A

The endothelium of the glomerulus is fused to the epithelium of the
capsule allowing the fluid being filtered to pass directly in ot the lumen of
the tubule.

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18
Q

structure of the nephron

A

Glomerulus+bowman’s capsule
Proximal tubule
Helenie’s loop or nephron loop: descending,henle’s loop and ascending limb
Distal convoluted tubule leading to collecting tubule

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19
Q

What plays a role in controlling the pooling activity in the kidney

A

The osmolaric gradient in medulla

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20
Q

How much plasma that enters glomerulus is not filtered

A

extracts from the 80% unfiltered in

the peritubular capillary->venous system

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21
Q

Urine results from 3 processes

A 
1. Glomerular filtration- non
discriminant, except blood cells and
plasma proteins all constituents
within the blood are filtered
2. Tubular reabsorption- highly
selective movement of filtered
substances from the tubular lumen
into the peritubular capillariesconserved
for body of value kept
3. Tubular secretion: selective
movement of non-filtered
substances from the peritubular
capillaries into the tubular
lumen- for excretion
-This provides a second route for
substances to enter the tubules
for excretion in addition to the
GF
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22
Q

What is done to favor the filtration in glomerulus

A

afferent Arterial diameter is bigger efferent one-> blood pressure

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23
Q

solutes are transported in/out tubular fluid via

A

transport proteins

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24
Q

What cell layers the liquid need to pass in order to get through glomerulus

A

1) the pores between the endothelial cells of the glomerular capillary
2) an acellular basement membrane
3) the filtration slits between the foot processes of the podocytes of the inner layer if bowman’s capsule

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25
Q

Fluid filtered from the glomerulus
into Bowman’s capsule must pass
through three layers of the
glomerular membrane

A
  1. Glomerular capillary wall
  2. Basement membrane
  3. Inner layer of Bowman’s capsule
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26
Q

Glomerulus pressure vs filtration pressure

A

g: 55 mm HG
filtration: 10 mm

Fluid moves from high
presssure to low presssure
area which in the glom is
further facilitated by the high
permeability partially
mediated by the filtration
slits and thinness of the
capillary wall in the glom.
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27
Q

what other pressure is created by the plasma in glomerulus

A 
Plasma-colloid osmotic pressure
Oppositional force
• larger plasma proteins can not be
filtered across the glomerulus
membrane and enter into BC
• unfiltered proteins exert a colloid
osmotic pressure on the filtered fluid
in the BC
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28
Q

3rd pressure in the kidney during the filtration

A 
Fluid pressure in
Bowmans capsule
opposes filtration
• This opposing pressure
can increase in the case
of a blockage
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29
Q

What is GHP,BCOP,NFP,CsHP

A

GHP-glomerular hydrostatic pressure
BCOP-blood colloid osmotic pressure
NFP=net filtration pressure
CsHP-capsular hydrostatic pressure

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30
Q

What drives the solutes out of the nephron

A

in the nephron loop this is increasing osmolaric pressure

in collecting duct - it is hormones and reabsotprion in collecting duct

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31
Q

what is absorbed at each step of the kidney reabsorption

A

Proximal tubule-some solutes are actively transported back into the blood:nutrients, NaCl
Passively:HCO3-,H2O,K

Inside the proximal tubule: actively-H+, passively-NH3

Descending limb of loop of Henie is permeable only to water-> water out to medulla-> increased osmolaric pressure inside the limb

Thin segment of ascending limb (right after the turn)->passive transport out of NaCl, not water
Thick sigment->active transport of NaCl

In distal tubule:active transport in:K,H, out-NaCl,HCo3-
Passively out H2O

In the collecting duct by osmosis, allowing salty urine to exit . H2O passively out, urea passively out

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32
Q

Histology of descending and ascending limb

A

Ascending is much thicker and limits the diffusion of most molecules

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33
Q

What is the difference between collecting duct and the loop of henlie if the have the same osmotic pressure

A 
The collecting
duct is the
structure that
makes
concentrated
urine; the loop
of Henle just
maintains the
osmotic
gradient.
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34
Q

How the level of urine is adjusted in the nephron

A 
Water permeability of
collecting duct is adjustable.
-More permeability means
more water reabsorption;
saltier urine.
- Permeability is adjusted by
adding or removing
aquaporins-This is how ADH
acts on kidney
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35
Q

What is glomerular filtration rate

A

Amount of filtrate produced by
kidneys/minute
– Average is 125 mL/min or 180 L/day
– 99 percent reabsorbed in renal tubules

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36
Q

GFR is dependent on

A

– Maintaining adequate blood flow to kidney

– Maintaining adequate net filtration pressures

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37
Q

What is key to maintain kidney function

A

Maintaining net filtration pressure and
consistent GFR is necessary for normal
kidney function

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38
Q

GFR is regulated by

A
  1. Autoregulation (or local regulation)
  2. Hormonal regulation
  3. Autonomic regulation
    • Through sympathetic division of ANS
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39
Q

Factors affecting vasopressin release

A

Osmolarity greater than 280 mOsM (hypothalamic osmoreceptors)
Decreased atrial stretch due to low blood volume (atrial stretch receptor)
Decreased blood pressure (carotid and aortic baroreceptors)

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40
Q

Vasopressin is released from

A

posterior pituitary

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41
Q

Action of vasopressin

A

Insertion of water pores in apical membrane in collecting duct epethilium-> increased water reabsorption to conserve water

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42
Q

Vasopressin acts through what biochemical signalling

A

cAMP

43
Q

How autoregulation of renal blood flow happens

A

1.Myogenic regulation.

When arterial pressure increases the renal afferent arteriole is
stretched. Vascular smooth muscle responds by contracting
thus increasing resistance-> decreased urinary flow

44
Q

What are granular cells, macula densa and regulation of tubuloglomerular feedback

A 
•At the fork (made by afferent and
efferent arterioles) there are
specialized smooth muscle cells in
the wall of the afferent arteriole, these
are called granular cells.
•There are also specialized tubular
cells in this region are called the
macula densa. The macula densa
act to detect changes in salt level in
the fluid passing by them.( ascending limb of loop of henle, connecting to the distal tubule)
• If more fluid is passing through the
tubule-more salt is detected and the
Macula densa release adenosine.
•Adenosine acts as a Paracrine
regulator causes vasoconstriction at
adjacent granular cells
45
Q

Autoregulation: tubuloglomerular feedback summary

A

GFR increases->Flow through tubule increases->NaCl flow past macula densa increases->paracrine factor adenosine from macula densa to afferent arterioles->afferent arteriole constricts->resistance in afferent arteriole increases->hydrostatic pressure in glomerulus decreases->GFR decreases

46
Q

What part of the nephron forms
the juxtaglomerular apparatus?

  1. Bowman’s capsule
  2. Where the collecting duct joins the ureter
  3. Where the ascending limb of henle joins the distal
    tubule
  4. Where the proximal tubule joins the descending limb
  5. Where the descending limb joins the ascending limb
A

3

47
Q

What happens to GFR when the

afferent arteriole dilates?

A

It increases

48
Q

The plasma is most similar in chemical
composition to the fluid in the _______.

  1. proximal tubule
  2. collecting duct
  3. distal tubule
  4. Bowman’s capsule
  5. ascending limb of the loop of Henle
A

4

49
Q

What does it mean filtration, reabsorption, secretion and excretion in regards to nephron

A

Filtration: blood to lumen (in glomerulus)
re-absorption: lumen to blood
Secretion: from blood to lumen
Excretion: lumen to external environment ( out of collecting duct to the bladder)

50
Q

“Secretion” in a nephron
always refers to transport of
________.

  1. water into the nephron lumen
  2. water out of the nephron lumen
  3. a solute into the nephron lumen
  4. a solute out of the nephron lumen
A

3 or water as well

51
Q

How ADH influences the collecting duct

A

It increases the reabsorption of water because of extra waterporins inserted->small volume of concentrated urine

52
Q

What will happen if you ingest high salty meal?

A

No change in volume, but increased osmolarity-> vasopressin secreted-> increased water reabsorption->kindneys conserve water

Increased osmolarity->thirst->increased water intake-> increased ECF-> increased blood pressure

Increased ECF->Kidneys excrete salt and water (slow response)

Increased BP->CV reflexes lower blood pressure (rapid response)

53
Q

What happens when the body needs salt?

A

Aldosterone combines with a cytoplasmic receptor in P cell of distal nephron

  1. Nephron-receptor complex initiates transcription
  2. Translation and protein synthesis-> new protein channels and pumps, increase Na and K channels open time
  3. Na ATPase pump speeds up
  4. Result is increased Na reabsorption and K secretion
54
Q

Aldosterone produced in ___, acts on ___

A

adrenal

Principal cells in the distal tubule

55
Q

What is RAAS

A

The renin-angiotensin-aldosterone system

In response to the blood pressure

56
Q

What is renin and when it is secretedd

A

In response to decreased BP granular cells in kidney release renin that converts angiotensinogen in the plasma to ANGI

57
Q

What will happen to ANGI in plasma

A

ACE enzyme that is in blood vessel endothelium cells in the lungs will convert ANGI to ANGII

58
Q

What is the role of ANGII

A

To vasoconstrict arterioles

To increase CV response influencing medulla oblongata

To increase vasopressin and thirst acting on hypothalamus

Increase aldosterone by influencing adrenal cortex

59
Q

What is ANP

A

Atrial Natriuretic Peptide (ANP)
• Antagonist to aldosterone
• Increases water loss. This is regulatory system of
Blood pressure. Would be produced in the case of
high blood pressure

60
Q

How ANP works

A

ANP Inhibits Na+ reabsorption
• Secreted by atria in response to being stretched by Na+
retention, expansion of ECF volume, and increase in
arterial pressure
• Release inhibits Na+ reabsorption in the distal tubule
which increases Na+ output in urine
• Increase GFR-more water loss
• Inhibits renin secretion by the kidneys.
• hypotensive effects to help correct the original stimulus
that brought about release of ANP

61
Q

What is one target for decreasing high blood pressure

A

inhibit angiotensin converting enzyme

62
Q

Target of ANP

A

decrease Na reabsorption by kidney tubules

decreasevSalt-conserving renin-angiotensin aldosterone system

Smooth muscle of afferent arterioles-> afferent arteriolar vasodilation

Decrease sympathetic nervous system-> decreased arterial blood pressure

63
Q

How coffee influences kidney

A

Coffee blocks ADH->decreased water reabsorption to conserve water-> increased peeing with dilute urine

64
Q

Causes of renal failure

A 
-Infectious organisms
– Toxic agents
– Inappropriate immune responses
– Obstruction of urine flow
– An insufficient renal blood supply
65
Q

After drinking a large volume of water, compensation is
primarily achieved by a decrease in the level of the
hormone ______.
1.aquaporin
2.aldosterone
3.vasopressin
4.atrial natriuretic peptide

A

Vasopressin

66
Q

hypertension and how it can influence the kidneys

A

persistent HBP->renal arteriosclerosis and atherosclerosis-> reduce blood flow through afferent arteria-> secretion of rennin->increased vasoconstriction-> increased thirst-> making the problem even worse

67
Q

Fred has chronic emphysema (type of chronic obstructive pulmonary disease. The air sacs in the lungs become damaged and stretched. Body is not able to get read of CO2). Blood tests show that his pH is low almost normal but his H2cO3 levels are elevated significantly-> respiratory acidosis. What is the problem

A

The kidneys try to compensate for acidosis-> kidney is getting rid of hydrogen ions

68
Q

Fred has chronic emphysema (type of chronic obstructive pulmonary disease. The air sacs in the lungs become damaged and stretched. Body is not able to get read of CO2). Blood tests show that his pH is low almost normal but his H2cO3 levels are elevated significantly-> respiratory acidosis. What is the problem

A

The kidneys try to compensate for acidosis-> kidney is getting rid of hydrogen ions-> urine is high hydrogen and low CO3

69
Q 
Aldosterone secretion will be \_\_\_\_\_
by an increase in plasma [K+].
1.increased
2.decreased
3.not changed
A

Increased

70
Q 
An 83–year–old woman with severe orthostatic hypotension is given Florinef,
a potent aldosterone agonist. In addition to following her blood pressure,
what parameter should also be monitored?
1.Heart rate
2.Serum potassium
3.Serum sodium
4.Serum chloride
5.Serum bicarbonate
A

Serum potassium -> decrease in potassium levels-> can check how the drug is working

71
Q 
The hormone that most directly
influences Na+ balance in the body is
\_\_\_\_\_\_.
1.vasopressin
2.angiotensin
3.renin
4.aldosterone
5.atrial natriuretic peptide
A

4

72
Q 
Eating salty dry food without drinking will
cause (before any response) a(n)
\_\_\_\_\_\_\_\_ in body fluid osmolarity and
\_\_\_\_\_\_\_\_ in the volume of the body fluids.
1.decrease; no change
2.decrease; an increase
3.decrease; a decrease
4.increase; no change
5.increase; an increase
A

4

73
Q

The vasa recta are the
_______.
1.peritubular capillaries associated with
the loop of Henle
2.osmoreceptors in the hypothalamus
3.kidney cells that produce renin
4.liver cells that produce angiotensinogen

A

1

74
Q

different stages of dehydration and symptoms: 2,5,10,12 % of body water loss

A 
2%
Thirst
Loss of Appetite
Fatigue or Weakness
Chills
Dry Skin
Skin Flushing
Dark Colored Urine
Dry Mouth
Head Rushes
5%
Increased heart rate
Increased respiration
Decreased sweating
Decreased urination
Increased body temperature
Extreme fatigue
Muscle cramps
Headaches
Nausea
Tingling of the limbs
10%
Muscle spasms
Vomiting
Racing pulse
Shriveled skin
Dim vision
Painful urination
Confusion
Difficulty breathing
Seizures
Chest and Abdominal pain
Unconsciousness

12%
Clinical shock, unconscious, depressed function of all organs

75
Q

What happens to Darlene during 14 days without water

A

Decreased blood volume as water is lost-> decreased blood pressure-> increase of heart rate at first (10% loss) , because the body tries to compensate for the loss

She is conscious but weak when found, weak pulse and low BP

76
Q

The first hing that rescuers have to Darlene was

A

Oxygen to save the brain

replenish fluids into the vein

77
Q

What is 60-40-20 rule

A

60% of our body mass is water
Extracellular fluid -20% pf body weight (lymph, fluid surrounding brain, plasma,etc.)
Intracellular fluid-40% (cells)
Solid matter- 40% of BW (bone,tissue matter)

78
Q

Extra cellular fluid components

A

Interstitial fluid and plasma

79
Q

What is transcellular compartment

A

the “third space”-the liquid that is not so easily accessible like spinal fluid, peritoneal, pleura, pericardial cavities, joints, GIT, ocular fluid

80
Q

Interstitial fluid provides medium for

A

Transport of gases, nutrients, wastes

81
Q

Which compartment will be compromised to sustain vascular fluid

A

IF for the periods of hemorrhage or loss of vascular fluid

82
Q

IF is supported by

A

Collagen fibers that opposes outflow of water from capillaries and prevent accumulation of free water

83
Q

IF is dominated by ___ ions

A

Na, Cl

84
Q

When transcellular fluid can be increased

A

conditions as ascites (large amounts of fluid in peritoneal cavity)

85
Q

What are the predominant ions inside the cells

A

K, HPO4, protein- a lot

Mg, Na HCO3-,Cl, So4- -> a little

86
Q

Plasma cations and anions concentration

A

Na and Cl - a lot

K,Ca, HCO3, HPO4, organic acid, proteins- a little

87
Q

Interstitial fluid - ion concentration

A

Na and Cl a lot

K,HCO3, HPO4, SO4 a little

88
Q

Where we lose moist

A

Water vapor lost at skin and lungs - 1.15 L
Water lost in feces
Water secreted by sweat glands
Water lost in urine-1.2 L

89
Q

Where we get fluid to ECF

A

from GI

Metabolic eater form cells

90
Q

How much water should we drink a day considering all the losses

A

2.2 L

91
Q

Does water moves freely across the cell membrane

A

Yes, it follows ion concentration

92
Q

How much water percent we get from food and drink

A

from food 40 percent

48 drink

93
Q

if 40 percent food and 48 drink, where is the rest 12 percent coming from

A

Metabolic generation

94
Q

Assuming that darlene did not have access to water during the entrapment , from what sources would her body begin to lose water

A

Urine
Skin
Gut
Respiratory tract

95
Q

Loss of electrolyte balance results in

A

Loss of water balance
Loss of cell function:
Ca and K imbalances affect cardiac muscle tissue
Na and K major contributors to osmolarity of ICF and ECF

96
Q

How might the body immediately begin to reduce water losses

A

Osmoreceptors in the hypothlamus detect increase in osmotic concentration and secrete ADH-> increased reabsorption of water from urine
Baroreceptors in the aortic and carotid bodies sense reduced blood pressure -> more firing of sympathetic NS-> more vasoconstriction->increased heart rate-> reduced blood flow to areas of potential water loss would decrease the rate of water loss somewhat
3)activation of RAAS-> increased water reabsorption

97
Q

Where the blood flow should be decreased in order to minimize water losses

A

Renal-> dercreased blood flow-> decreased water loss
Gut-> vasoconstriction-> less secretion, less loss In starvation gut function is reduced

Vasoconstriction in skin-> less sweating, but can increase body temperature

Hypometabolic state->reduction of muscle tone and decreased oxidative process->lowered evaporative water from respiratory tract. Less shivering during the night to conserve water

Nervous system blood flow should be maintained to preserve the ability to respond to physiological challenges, mental function becomes compromised

98
Q

Will the buried girl still pee

A

Yes, kidneys will work until kidney failure

99
Q

How the fact that the girl was buried under the building helped her

A

In a warm, humid environment darlene would have lower respiratory loss+ under the building constant environment-> protection from higher metabolic expenditures and decreased water loss form sweat and shivering

100
Q

Does age,weight or sex affect water loss requirements

A

Younger individuals usually weigh less than older ones-> lowered measured daily water loss as energy expenditure is lower

Females usually have higher water loss per unit of energy than males, but smaller bodies->less water loss
Young females can have an advantage of expanded plasma volume due to the influence of estrogen, and if Darlene were in mid-menstrual cycle, with estrogen levels at their peak, she would have has more extracellular blood volume , being capable of coping with prolonged dehydration than a similar sized male

101
Q

Does the fact that Darlene was born in Haiti matter

A

Probably because of her origin Darlene exhibited good heat acclimation to the environment. But heat acclimated people sweat more that non-ones, however Darlene’s sweat had less Na, which is important for plasma volume

102
Q

How darlene survived this prolonged period of starvation, will it use more water

A

Fat catabolism during starvation produces one gram of water per gram of fat metabolized

103
Q

what is thought to be the absolute minimum rate of water loss for humans

A

1.2 liters/day

Mam Physiology (16 decks)

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