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Integrated Systems 4 > Urinary System Reading > Flashcards

Urinary System Reading Flashcards

1
Q

Outer Renal cortex contains

A
  • Capillary tufts
  • Convoluted tubules
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2
Q

Inner Renal Medulla contains

A
  • Renal pyramids seperated by renal columns
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3
Q

Acute renal failure

A

Sudden loss of kidney function

Associated with shock or intense renal vasoconstriction that lasts from a few days to weeks

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4
Q

Cystitis

A

Inflammation of bladder

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5
Q

Hematuria

A

Blood in urine

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6
Q

Hemodialysis

A

Method of clearing waste products from blood

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7
Q

Nocturia

A

Night urination while asleep

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8
Q

Oliguria

A

Urinary volumes of less than 500 ml/day

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9
Q

Uremia

A

Retention of urinary constituents in the blood, owing to kidney dysfunction

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10
Q

Nephron consists of

A
  • Glomerulus
  • Bowmans capsule
  • Proximal convoluted tubule
  • Loop of Henle
  • Distal convoluted tubule
  • Collecting duct (1 collecting duct serves several nephrons)
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11
Q

Glomerulus

A
  • Network of 50 capillaries
  • Endothelial lining has circular fenestrations
  • Highly permeable
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12
Q

Bowmans capsule

A
  • Double walled
  • Composed of squamous epithelium
  • Outer layer is continous with epithelium of proximal tubule
  • Inner layer is composed of podocytes that are closely associated with glomerular capillaries
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13
Q

Proximal convoluted tubule

A
  • Continous with epithelium of bowmans capsule
  • Consists of a single layer of cuboidal cells containing microvilli
  • Many mitochondria, energy for active transport
  • Terminates at descending limb of loop
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14
Q

Loop of Henle

A
  • Has descending ascending thin limbs and thick ascending portion
  • Thin segments- flat squamous cells that lack microvilli
  • Thick- cuboidal cells lack microvilli, runs between the afferent and efferent arterioles
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15
Q

Distal convoluted tubule

A
  • Begins at macula densa, a amss of specialized epithelial cells of tubule wall, next to afferent arteriole
  • Shorter than proximal
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16
Q

Glomerular filtration

Filtrate passes through

A
  • Filtrate must pass through
    • Capillary endothelium
      • Fenestrations
    • Basement membrane
      • Unusually thick with type 4 collagen
    • Podocytes
      • Primary and secondary extensions (pedicles)
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17
Q

Glomerular filtration membrane regulates prevents and permits

A
  • Prevents passage of blood cells and most plasma proteins
  • Permits movement of water, metabolic wastes, ions, glucose, fatty acids, vitamins other solutes out of blood
  • Valuable solutes reabsorbed by PCT
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18
Q

3 major functions of nephrons

A
  • Glomerular filtration
    • Creates plasma like filtrate of blood
  • Tubular Reabsorption
    • Removes useful solutes from filtrate, return to blood
  • Tubular secretion
    • Removes additional waste from blood and adds to filtrate
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19
Q

Glomerular Filtrate

A
  • Fluid and solute in blood plasma of glomerulus pass in glomerular capsule
    • Called Glomerular Filtrate
    • Normal GF output 180L/day
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20
Q

Mechanisms that cause glomerular filtration

A
  • High hydrostatic pressure of blood in glomerulus
  • Large number and size of pores
21
Q

Glomerular filtrate contains

A
  • Contains water, elctrolytes and glucose
  • Excludes RBC WBC, plasma proteins, platelets bc too large
    • If protein and RBC are present then its a sign of hydrostatic pressure being too high and a defect in glomerular membrane
22
Q

Glomerular Filtration Rate (GFR) normal

Regulation

A
  • Total amt of filtrate formed per min by kidney
  • Healthy 125 ml/ min
  • Regulated by vaso dilation or constriction of Afferent arteriole due to
    • Extrinsic (sympathetic)
    • Intrinsic (locally produced chemicals)
23
Q

Result on GFR from vasodilaltion and constriction

A
  • Afferent vasodilation increases blood flow into glomerulus
    • Increases glomerulus capillary BP
    • Increases net filtration
    • Increases GFR
  • Afferent vasoconstriction decreases blood flow
    • Dcreases BP in glom cap
    • Dec Net filtration
    • Dec GFR
24
Q

Equation for GFR

A

GFR (ml/min)= Urine vol(rate of urine form) (ml/min) X Inulin concentration in urine (mg/ml) / Inulin concentration in plasma (mg/ml)

25
Q

What would happen if filtration was too high or too low, what influences it?

A
  • Too high
    • 250 ml/min
    • frequent urination
    • Increase in protein and glucose bc cant be reabsorbed
  • Too low
    • Dilute urine
    • Reabsorb too much
  • Influenced
    • diameter of blood vessels that feed system
26
Q

Tubular reabsorption def

A
  • Transfer of fluid and solutes out of lumen of nephron through interstitial space and into peritubular capillaries
27
Q

How much filtrate is actually secreted

A

180 L/day of filtrate is made and only 1-2 L secreted

99% of filtrate i reabsorbed from renal tubules

28
Q

Tubules reabsorption capacity

A

Tubules have high reabsorptive capacity for essential substances and little to non for those of no value

Only excess amounts of valuable substances are excreted

29
Q

Where does tubular reabsorption take place

A
  • Throughout renal tubules
  • Primarily in Proximal Convoluted Tubule
30
Q

Sodiums reabsorption

A
  • Majority of sodium is reabsorbed Actively
    • Most in PCT (needed for glucose and AA reabsorption)
    • Loop of henle (role in kidneys ability to make dilute or concentrated urine)
    • Distal tubule (subject to hormonal control, aldosterone)
31
Q

Aldosterone and sodium reabsorption

A
  • Aldosterone regulate reabsorption of sodium in Distal and collecting duct
  • Renin-angiotensin aldosterone system
32
Q

Glucose reabsorption

A
  • 100% of glucose filteres is reabsorbed in Proximal tubule
  • Carrier-mediated transport of glucose displays the property of saturation
  • Concentration of transported molecules needed to saturate the carriers and achieve maximal transport rate is called Transport Maximum
  • Tm for glucose is 375 mg/min filtered
    • Normal glocose concentration in plasma is 100mg/100ml of plasma
  • Glucose levels above Tm will not be reabsorbed and will appear in urine–> diabetes
33
Q

Reabsorption of glucose normal and diabetic

A
  • 1 mg/ml glucose in blood
    • 1 mg.ml X 125 ml/min=125 mg/min
    • Tm is 375 mg/min so no glu in urine
  • 3.5 mg/ml glucose in blood
    • TL: 3.5 X 125= 438 mg/min
    • Law of kidney= filtration-Reabsorption + secretion=Excretion
    • 438 mg/min - 375 mg/min= 63 mg/min in urine
34
Q

Tubular Secretion

A
  • Active transport secretion of substances from
    • Peritubular capillarie–> Kidney tubules–> excretion in urine
  • Involves trans-epithelial transport (reverse of reabsorption)
35
Q

What are the most imp substances secreted by tubules

A
  • Hydrogen ions, potassium ions, penicillin, organic anions
    • H+ secretion important for acid-base balance and can be secreted in all tubular regions
    • Potassium is reabsorbed in PCT and actively secreted in DCT
      • K secretion is coupled to Na reabsorption and stimulated by Aldosterone
36
Q

Acidosis

A
  • Ratio of CO2 and HCO3 in extracellular fluid is increased
  • Net result is H ions are excreted and Na and HCO3 ions retained
37
Q

Alkalosis

A
  • Ratio of HCO3 increases as pH rises
  • Net result is H ions are retained and bicarbonate ions are excreted
  • Kidneys help regulate the pH of fluids between 7.37-7.45
38
Q

What are the 2 mechanisms the Kidneys reg urine concentration

A
  • Producing an osmotic gradient between tubular lumen and surrounding interstitial fluid
  • By amount of ADH secreted from posterior pituitary
39
Q

Why does osmolarity increase deep to medulla (5)

A
  • This Ascending limb actively transports neg Cl- OUT of tubular fluid into medullary interstium, Na follows bc of charge
  • Ascending limb impermeable to H2O
  • Fluid in ascending becomes more dilute (100 mosm/L) as it passes–> cortex
  • Ions (Na, Cl) are actively transported into interstium from collecting duct, urea passively diffuses out of collecting duct into interstium
  • Peritubular capillaries contain 1-2% of renal blood flow, as result carries only a min amuont of medullary interstitial solutes are carried away from renal medulla
  • Net result- high osmolarity in medulla 1200-1400 osmos/L
40
Q

Low ADH

A
  • Distal tubules and collecting ducts become impermeable to water
    • No water reabsorbed, excess water eliminated
  • NaCl is still being pulled out and despite the high osmotic gradient, little H2O is pulled out into medulla
  • Producing Large vol of DiLUTE urine (100 mosm/L)
41
Q

High ADH

A
  • ADH increases permeabi;ity of distal and collecting duct
    • More water is reabsorbed, less water lost in urine more water returned to blood
  • H2O is pulled out bc of high osmotic gradient in interstium
  • Producing small vol of CONCENTRATED urine (1200 mosm/L)
42
Q

Juxtaglomerular Apparatus

A
  • Kidney plays imp role in BP regulation
    • Renin-Angiotensin-Aldosterone-System
  • Renin is made and secreted from Juxta App
    • Where distal CT contacts affernt arteriole near Bowmans capsule
43
Q

Decrease in BP in afferent arteriole…

or

Increased Na, Cl concentration of fluid in Distal CT

A
  • Dec in BP in affernt is sensed by
    • J cells
  • Inc in NaCl in DCT is sensed by
    • Macula densa
  • Both result in release of renin from J cells
44
Q

Macula densa histo

A
  • Tall densely packed cells
  • Contain Osmoreceptors which sense drop in blood osmotic pressure, change in [Na}
45
Q

Renin secreting Juxta cells histo

A
  • Modified smooth muscle cells
  • Mechanoreceptors line wall of afferent arteriole
    • Sense pressure changes due to tension in arterial wall
46
Q

Renal function step 1. glomerulus, 2. PCT

A
  • Glomerulus
    • Filtrate produced at renal corpuscle
    • Same comp as blood plasma minus plasma proteins
  • PCT
    • Active removal of ions and organic substrates
      • Produces osmotic water flow out of tubular fluid
      • Reduces vol of filtrate
      • Keeps solutions inside and outside tubule isotonic
47
Q

Renal function 3. PCT and Descending 4. Thick ascending

A
  • PCT and Descending Limb
    • Water moves into peritubular fluids leaving highly concentrated tubular fluid
    • Reduction in volume occurs by obligatory water reabsorption
  • Thick Ascending Limb
    • Tubular cells actively transport Na and Cl out of tubule
    • Urea accounts for higher proportion of total osmotic concentration
48
Q

Renal function 5. DCT and Collecting ducts

A
  • DCT and collecting ducts
    • Final adjustments in composition of tubular fluid
    • Osmotic concentration is adjusted thru active transport (reabsorption or secretion based on ADH)
  • Urine production ends wehn fluid enters renal pelvis
49
Q

Urination Signaling

A
  • Stretch receptors in bladder send impulses to sacral spinal cord
  • Sensory neurons snd impulse to brain
  • Parasympathetic nerve impulses stimulates detrusor muscle and the internal urethral sphincter
  • Dertrusor muscle contracts and internal sphincter relaxes–> have to pee really bad now!
  • To preevent use voluntary contraction of external urethral sphincter
  • To urinate, external urethral sphincter is relaxed, detrusor contracts

Integrated Systems 4 (7 decks)

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