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Anatomy & Physiology III > Urinary System: Part Two > Flashcards

Urinary System: Part Two Flashcards

1
Q

Early Filtrate Processing
Tubular Reabsorption

Describe:

A

A transepithelial process whereby most tubule content are returned to the blood

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2
Q

Early Filtrate Processing
Tubular Reabsorption

Related membranes:

A

Transported substances move through three membranes:

Luminal membranes of tubule cells
Basolateral membranes of tubule cells
Endothelium of peritubular capillaries

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3
Q

Early Filtrate Processing
Sodium Reabsorption- Primary Active Transport

Describe:

A

Na+ ions are the most abundant ion in filtrate; sodium reabsorption is almost always by active transport

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4
Q

Early Filtrate Processing
Sodium Reabsorption- Primary Active Transport

Active transport process

Describe:

A

Sodium reabsorption is almost always by active transport:

Actively transported out of tubules by a Na+/K+ ATP pump

Na+ passively enters the tubule cells at the luminal membrane (PCT)

From there is moves to the peritubular capillaries due to low hydrostatic pressure and high osmatic pressure of the blood

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5
Q

Early Filtrate Processing
Reabsorption by PCT Cells

Describe:

A

Active pumping of Na+ drives reabsorption of:

Water by osmosis, aided by water-filled pores called aquaporins

Cations and fat soluble substances by diffusion

Organic nutrients and selected cations by secondary active transport

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6
Q

Early Filtrate Processing
Reabsorbed Substances

Transport Maximum

Describe:

A

Reflects the number of carriers in the renal tubules available

Exists for nearly every substance that is actively absorbed

When the carriers are saturated, excess of that substance is excreted

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7
Q

Early Filtrate Processing
Reabsorbed Substances

Substances are not reabsorbed…

Describe:

A

Substances are not reabsorbed if they…

Lack carriers

Are not lipid soluble

Are too large to pass through the membrane pores

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8
Q

Early Filtrate Processing
Reabsorbed Substances

Key Non-reabsorbed Substances

Describe:

A

Creatine and uric acid (not the same as urea) are the most important non-reabsorbed substances

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9
Q

Secondary Active Transport

Describe:

A

No direct coupling of ATP

Instead the electrochemical potential difference created by pumping Na+ ions out of the cells

Three main forms of this are uniport, counter-transport (antiport), and co-transport (symport)

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10
Q

Early Filtrate Processing
Absorptive Capabilities of Renal Tubules and Collecting Ducts

Substances Reabsorbed in PCT Include

Describe:

A

Sodium, all nutrients, cations, anions, and water

Urea and lipid soluble solutes

Small proteins

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11
Q

Early Filtrate Processing
Absorptive Capabilities of Renal Tubules and Collecting Ducts

Loop of Henle Reabsorbs

Describe:

A

H2O in the descending limb (but not solutes)

Solutes in the ascending limb (but not H2O)

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12
Q

Early Filtrate Processing
Absorptive Capabilities of Renal Tubules and Collecting Ducts

DCT (Distal Convoluted Tubule) Reabsorbs

Describe:

A

Ca, Na, H, K, and water

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13
Q

Early Filtrate Processing
Absorptive Capabilities of Renal Tubules and Collecting Ducts

Collecting Duct Reabsorbs

Describe:

A

Water, urea, and sodium

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14
Q

Early Filtrate Processing
Na+ Entry into Tubule Cells

Passive Entry

Describe:

A

Na+ down concentration gradient

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15
Q

Early Filtrate Processing
Na+ Entry into Tubule Cells

In the PCT (Proximal Convoluted Tubule)

Describe:

A

Facilitated diffusion using symport and antiport carriers

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16
Q

Early Filtrate Processing
Na+ Entry into Tubule Cells

Ascending Loop of Henle

Describe:

A

Facilitated diffusion via Na+ K+ and 2Cl- symport system

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17
Q

Early Filtrate Processing
Na+ Entry into Tubule Cells

In the DCT (Distal Convoluted Tubule)

Describe:

A

Na+ Cl- symporter

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18
Q

Early Filtrate Processing
Na+ Entry into Tubule Cells

In the collecting tubules

Describe:

A

Diffusion through the membrane pores

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19
Q

Early Filtrate Processing
Atrial Natriuretic Peptide Activity

ANP reduces blood Na+ which…

Describe:

A

ANP reduces blood Na+ which:

Decreases blood volume
Lowers blood pressure

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20
Q

Early Filtrate Processing
Atrial Natriuretic Peptide Activity

ANP lowers blood Na+ by…

Describe:

A

ANP lowers blood Na+ by:

Acting directly on medullary ducts to inhibit Na+ reabsorption

Counteracting the effects of angiotensin II

Indirectly stimulating an increase in GFR reducing water reabsorption

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21
Q

Early Filtrate Processing
Tubular Secretion

Describe:

A

Essentially reabsorption in reverse, where substances move from peritubular capillaries or tubule cells back into filtrate

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22
Q

Early Filtrate Processing
Tubular Secretion

Tubular secretion is important for…

Describe:

A

Tubular secretion is important for:

Disposing of substances not already in the filtrate

Eliminating undesirable substances such as urea and uric acid

Ridding the body of excess potassium ions

Controlling blood pH

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23
Q

Early Filtrate Processing
Regulation of Urine Concentration and Volume

Osmolarity

Describe:

A

Measure of the osmoles of solute per liter of solution. Reflects the solution’s ability to cause osmosis

Typically number of solute particles dissolved in 1L of water

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24
Q

Early Filtrate Processing
Regulation of Urine Concentration and Volume

Osmolality

Describe:

A

Measure of osmoles of solute per kilogram of solvent . If the concentration is very low, osmolarity and osmolality are considered equivalent

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25
Q

Early Filtrate Processing
Countercurrent Mechanism

Describe:

A

Medullary osmotic gradient is created by the loops of Henle in the juxtamedullary nephrons.

Dissipation of the medullary osmotic gradient is prevented because the blood in the vasa recta equilibrates with the interstitial fluid

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26
Q

Early Filtrate Processing
Loop of Henle: Countercurrent Multiplier

The descending loop of Henle

Describe:

A

Is relatively impermeable to solutes

Is permeable to water

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27
Q

Early Filtrate Processing
Loop of Henle: Countercurrent Multiplier

The ascending loop of Henle

Describe:

A

Is permeable to solutes

Is impermeable to water

28
Q

Late Filtrate Processing
Formation of Dilute Urine (Closed State)

Describe:

A

Filtrate is diluted in the ascending Loop of Henle.

Dilute Urine is created by allowing this filtrate to continue into the renal pelvis.

Collecting ducts remain impermeable to water; no further water reabsorption occurs.

Sodium and select ions can be removed by active and passive mecahisms.

29
Q

Late Filtrate Processing
Formation of Concentrated Urine (Duct has Opened Up)

Describe:

A

Antidiuretic hormone (ADH) inhibits diuresis. This equalizes the osmolarity of the filtrate and interstitial fluid.

In the presence of ADH, 99% of the water in the filtrate is reabsorbed.

The kidney’s ability to respond depends on the high medullary osmotic gradient.

ADH increases the permeability of the collecting duct and water is reabsorbed and urine is concentrated.

30
Q

Late Filtrate Processing
Diuretics

Describe:

A

Chemicals that enhance the urinary output. These include:

Any substances not reabsorbed

Substances that exceed the ability of the renal tubules to reabsorb it.

Substances that inhibit Na+ reabsorption

31
Q

Late Filtrate Processing
Diuretics

Osmotic Diuretics

Describe:

A

High glucose levels- carries water out with glucose.

Alcohol- inhibits the release of ADH.

Caffeine and most diuretic drugs- inhibits sodium ion reabsorption.

32
Q

Late Filtrate Processing
Dehydration

Describe:

A

Lack of adequate body fluids needed for the body to carry on normal functions at an optimal level.

Caused by fluid loss, inadequate intake, or a combination of both

33
Q

Late Filtrate Processing
Dehydration

Mild

Describe:

A

Thirst
Dry lips
Slightly dry mouth membranes

34
Q

Late Filtrate Processing
Dehydration

Moderate

Describe:

A

Very dry mouth membranes
Sunken eyes
Sunken fontanel on infant’s head
Skin doesn’t bounce back quickly when lightly pinched or released (more chronic than acute)

35
Q

Late Filtrate Processing
Dehydration

Severe

Describe:

A 
All signs of moderate dehydration
Rapid, weak pulse (more than 100 at rest)
Cold hands and feet
Rapid breathing
Blue lips
Confusion, lethargy, difficult to arouse
36
Q

Late Filtrate Processing
Hyponatremia

Describe:

A

Plasma Na+ levels too low (i.e. from water intoxication)

Usually caused by high ADH levels; requires treatment with intravenous isotonic/hypertonic saline.

37
Q

Late Filtrate Processing
Renal Clearance

Describe:

A

The volume of plasma that is cleared of a particular substance in a given time

38
Q

Late Filtrate Processing
Renal Clearance

Importance

Describe:

A

Used to determine GFR (Glomerular Filtration Rate), detect glomerular damage, and follow-up on the progress of diagnosed renal disease

39
Q

Late Filtrate Processing
Renal Clearance

Equation

Describe:

A

RC = UV / P

RC = Renal Clearance

U= Concentration (mg/ml) of the substance in urine

V = Flow rate of urine formation (ml/min)

P = Concentration of the same substance of plasma

40
Q

Late Filtrate Processing
Creatinine Clearance

Equation

Describe:

A

RCcr = Ucr * V / Pcr

Relatively constant level in the blood, freely filtered but neither reabsorbed nor secreted by the kidneys

41
Q

Late Filtrate Processing
Renal Clearance

Normal GFR Range

Describe:

A

Males: 97 to 137 ml/min

Females: 88 to 128 ml/min

42
Q

Late Filtrate Processing
Physical Characteristics of Urine

Color and Transparency

Describe:

A

Clear, pale to deep yellow; concentrated urine has a deeper yellow color

43
Q

Late Filtrate Processing
Physical Characteristics of Urine

Odor

Describe:

A

Fresh urine is slightly aromatic; standing urine develops an ammonia odor

44
Q

Late Filtrate Processing
Physical Characteristics of Urine

pH

Describe:

A

Slightly acidic (pH 6) with a range of 4.0 to 8.0

45
Q

Late Filtrate Processing
Physical Characteristics of Urine

Specific Gravity

Describe:

A

Ranges from 1.001 to 1.035. It is dependent on the solute concentration.

46
Q

Late Filtrate Processing
Chemical Composition of Urine

Describe:

A

Urine is 95% water and 5% solutes

Nitrogenous wastes include urea, uric acid, and creatinine

Other normal solutes include sodium, potassium, phosphate, and sulfate ions, calcium, magnesium, and bicarbonate ions

47
Q

Late Filtrate Processing
Urinalysis

Describe:

A

A description of color and appearance

48
Q

Late Filtrate Processing
Urinalysis

pH

Describe:

A

Reflects blood plasma pH

49
Q

Late Filtrate Processing
Urinalysis

Glucose

Describe:

A

DM (Diabetes Meticulitis)

50
Q

Late Filtrate Processing
Urinalysis

Ketones

Describe:

A

Up in starvation, DM, and alcoholics

51
Q

Late Filtrate Processing
Urinalysis

Protein

Describe:

A

Up in kidney disease

52
Q

Late Filtrate Processing
Urinalysis

RBC #

Describe:

A

Hematuria

53
Q

Late Filtrate Processing
Urinalysis

WBC *

Describe:

A

Infection

54
Q

Late Filtrate Processing
Urinalysis

hCG (Human Chorionic Gonadotropin)

Describe:

A

Pregnancy hormone

55
Q

Late Filtrate Processing
Urinalysis

Specific Gravity

Describe:

A

Amount of solute per solvent

Comparing the density of the liquid to water

High specific gravity means dehydration; low specific gravity means kidney disease, absent ADH, water intoxication

56
Q

Late Filtrate Processing
Ureters

Describe:

A

Slender tubes that convey urine from the kidneys to the bladder

Ureters enter the base of the bladder through the posterior wall

Ureters actively propel urine to the bladder via response to smooth muscle stretch (distension)

57
Q

Late Filtrate Processing
Ureters

Tri-layerd wall

Describe:

A

Ureters have a tri-layered wall: transitional epithelial mucosa, smooth muscle muscularis, fibrous connective tissue adventitia

58
Q

Late Filtrate Processing
Urinary Bladder

Describe:

A

Is it smooth, collapsable, muscular sac that temporarily stores urine

It is distensible and collapses when empty, forming rugae

As urine accumulates, the bladder expands without significant rise in internal pressuure

59
Q

Late Filtrate Processing
Urinary Bladder

Trigone

Describe:

A

Triangular area outlined by the openings for the ureters and the urethra

Clinically important because infections tend to persist in this region

60
Q

Late Filtrate Processing
Urinary Bladder

Tri-layered bladder wall

Describe:

A

A transitional epithelial mucosa

A thick muscular layer (detrusor muscle)

A fibrous adventitia

61
Q

Late Filtrate Processing
Urethra

Describe:

A

A muscular tube that drains urine from the bladder and conveys it out of the body

62
Q

Late Filtrate Processing
Urethra

Sphincters and the urethra…

Describe:

A

Sphincters keep the urethra closed when urine is not being passed:

Internal urethra sphincter- involuntary sphincter at the bladder-urethra junction

External urethral sphincter- voluntary sphincter surrounding the urethra as it passes through the urogenital diaphragm

Levator ani muscle- voluntary urethral sphincter

63
Q

Late Filtrate Processing
Urethra

Female Urethra

Describe:

A

The female urethra is tightly bound tot he anterior vaginal wall and has an external opening that lies anterior to the vaginal opening and posterior to the clitoris

64
Q

Late Filtrate Processing
Urethra

Male Urethra

Describe:

A

The male urethra has three named regions:

Prostatic urethra- runs with the prostate gland

Membranous urethra- runs through the urogenital diaphragm

Spongy (penile) urethra- passes through the penis and opens via the external urethral orifice

65
Q

Late Filtrate Processing
Micturation (Voiding or Urination)

Describe:

A

The act of emptying the bladder.

Distension of the bladder walls (at approximately 220ml) initiates spinal reflexes that stimulate contraction of the external urethral sphincter and inhibit the detrusor muscle and internal sphincter

66
Q

Late Filtrate Processing
Selected Pathology - Renal Calculi

Kidney Stones

Describe:

A

Most pass without concerns

Crystals of normally dissolved minerals (m/c = calcium oxalate CaC2O4)

67
Q

Late Filtrate Processing
Selected Pathology - Renal Calculi

Kidney Stones - Risk Factors

Describe:

A

Low water intake, high protein diet, high vitamin C intake, high Ca2 supplementation

Coffee intake is protective

Anatomy & Physiology III (3 decks)

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