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aa Orgo > zzz Watson Urinary > Flashcards

zzz Watson Urinary Flashcards

1
Q

filter blood to remove metabolic waste products

A

Kidneys

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2
Q

modify resulting for- Fluid and electrolyte homeostasis AND Acid-base and blood pressure homeostasis

A

Kidneys

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3
Q

Both kidneys are found

A

Retroperitoneal

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4
Q

Right kidney is found in a slightly ___ position due to liver

A

Inferior

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5
Q

3 layers of urinary tract

A

Adventitia, muscularis, mucosa

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6
Q

Urinary bladder held in place by ___ ____

A

parietal peritoneum

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7
Q

muscularis layer of the bladder

A

Detrusor muscle

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8
Q

A second sphincter that allows for voluntary control of urination: the ____ urethral sphincter

A

external

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9
Q

A second external urethral sphincter is formed by ___ ___ muscle

A

levator ani

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10
Q

Micturition reflex – reflex arc mediated by ___ nervous system

A

Parasympathetic

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11
Q

Micturition center – found in

A

Pons

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12
Q

Kidney layer; dense irregular connective tissue; anchors each kidney to peritoneum and musculature of posterior abdominal wall

A

Renal fascia

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13
Q

Kidney layer; thickest layer; wedges each kidney in place and shields them from physical shock

A

Adipose capsule

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14
Q

Kidney layer; thin layer of dense irregular connective tissue; covers exterior of each kidney; protects it from infection and physical trauma

A

Renal capsule

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15
Q

opening on medial surface of kidney

A

Hilum

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16
Q

Hilum opens into renal ___

A

renal sinus

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17
Q

Three distinct regions of kidney: renal cortex, middle renal medulla,
and innermost renal ___

A

pelvis

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18
Q

Renal ___ and the renal ___ make up

urine-forming portion of kidney

A

Cortex, medulla

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19
Q

Renal ___ and its associated structures drain urine formed in cortex and medulla

A

Pelvis

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20
Q

extensions of renal cortex; pass through

renal medulla toward renal pelvis

A

Renal columns

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21
Q

Globe-shaped renal ___ found in renal cortex

A

Corpuscle

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22
Q

renal ___ are found within renal medulla separated by renal columns on either side

A

pyramids

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23
Q

Each renal pyramid tapers into a slender

A

papilla

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24
Q

Each papilla borders on a cup-shaped tube (__ calyx); first urine-draining structure

A

Minor

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25
Q

Three to four minor calyces drain into a larger urine-draining structure (___ calyx)

A

major

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26
Q

Two to three major calyces drain into a large urine collecting chamber (renal ___) which leads to ureter

A

Pelvis

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27
Q

Calyces and renal pelvis are found in renal

A

sinus

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28
Q

Left and right renal arteries are branches of abdominal

A

aorta

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29
Q

ball-shaped capillary bed

A

glomerulus

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30
Q

Efferent arteriole feeds into a second capillary bed

A

peritubular capillaries

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31
Q

Venous blood exits kidney parallel to arterial pathway beginning with peritubular venules that drain ___ ___ beds

A

peritubular capillary beds

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32
Q

Nephron – two main divisions; renal corpuscle and renal

A

Tubule

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33
Q

group of looping fenestrated capillaries; extremely “leaky”, or permeable

A

Glomerulus

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34
Q

double-layered outer sheath of epithelial tissue; consists of outer parietal and inner visceral layer

A

Glomerular capsule (Bowman’s capsule)

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35
Q

composed of both macula densa and juxtaglomerular (JG) cells

A

Juxtaglomerular apparatus (JGA)

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36
Q

a group of cells in contact with modified smooth muscle cells (juxtaglomerular (JG) cells) found in walls of both afferent and efferent arterioles

A

Macula densa

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37
Q

regulates blood pressure and glomerular filtration rate

A

JGA

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38
Q

Several medullary collecting ducts merge to form a ___ duct

A

Papillary duct

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39
Q

Once filtrate enters papillary duct it is known as ___, not filtrate

A

Urine

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40
Q

Urine exits papillary duct
at papilla of renal pyramid
into a ___ ___

A

minor calyx

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41
Q

___ nephrons make up about 80% of nephrons in kidneys

A

Cortical

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42
Q

Cortical portion of nephron is surrounded by ____ capillary branches from neighboring cortical nephrons; nephron loop is surrounded by a ladder-like network of capillaries called the ___ ___

A

Peritubular, vasa recta

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43
Q

Unique capillary structural arrangement allows juxtamedullary nephrons to

A

control volume and concentration of urine

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44
Q

Reabsorption in distal tubule and collecting duct is more

A

Precise

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45
Q

Tubular ___ – process where substances are added into filtrate from peritubular capillaries for excretion from body

A

Secretion

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46
Q

Includes fenestrated glomerular capillary endothelial cells, basal lamina, and podocytes

A

Filtration membrane

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47
Q

thin layer of extracellular matrix gel; makes up second layer that separates glomerular endothelial cells from podocytes

A

Basal lamina

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48
Q

group of small substances that are readily filtered; include:

A

urea, ammonia, creatine kinase

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49
Q

Amount of filtrate formed by both kidneys in __ minute is known as glomerular filtration rate (GFR)

A

1

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50
Q

Pressure (not colloid osmotic pressure) that opposes filtration

A

Capsular hydrostatic pressure

51
Q

internal kidney mechanisms that work together to maintain GFR within normal range

A

Autoregulation

52
Q

similar to constriction of smooth muscle in blood vessel walls in response to increases in blood pressure

A

Myogenic mechanism

53
Q

Myogenic mechanism: ___ systemic blood pressure stretches afferent arteriole less, reducing GFR; triggers smooth muscle ____, increasing blood flow through glomerulus, causing an increase in GFR back toward normal range

A

Decreased, relaxation

54
Q

Mechanism works best for systemic blood pressure changes between __ and __ mm Hg to rapidly restore GFR back to normal

A

80 and 180

55
Q

Tubuloglomerular feedback – second autoregulation mechanism; involves __ __

A

macula densa

56
Q

macula densa are in the ___ renal tubule

A

distal renal tubule

57
Q

Tubuloglomerular feedback – negative feedback loop controls pressure in glomerulus in response to __ concentration of filtrate

A

NaCl

58
Q

As GFR increases, volume of filtrate flowing through renal tubule ___, and more sodium and chloride ions are absorbed into macula densa

A

Increases

59
Q

Macula densa responds to increases in ___ concentration by releasing chemicals that cause afferent arteriole to constrict

A

NaCl

60
Q

Tubuloglomerular feedback (continued): Macula densa also signals JG cell causing a reduction in release of hormones, ___ and ____, when reduced allow efferent arteriole to dilate causing a decrease in GFR towards normal

A

renin and angiotensin-II

61
Q

Decreases in GFR reduces sodium and chloride ions absorbed by macula densa, which triggers ___ of afferent arteriole and constriction of efferent arteriole, which increase glomerular hydrostatic pressure to restore GFR

A

Dilation

62
Q

RAAS responds to combination of three conditions: stimulation by sympathetic nervous system, low glomerular hydrostatic pressure, and stimulation from ___ ___

A

macula densa

63
Q

Neural regulation of GFR primarily involves sympathetic division of autonomic nervous system and its hormone ____

A

norepinephrine

64
Q

Increased sympathetic activity causes ____ of afferent arterioles like most systemic blood vessels; increases systemic blood pressure

A

Constriction

65
Q

Low levels of sympathetic stimulation trigger JG cells to release ____, ultimately leading to formation of angiotensin-II; raises systemic blood pressure and increases GFR

A

Renin

66
Q

High levels of sympathetic stimulation leads to high levels of ____; constricts both afferent and efferent arterioles, decreasing GFR to minimize fluid loss, preserve blood volume, and maintain blood pressure

A

angiotensin-II

67
Q

Transcellular route – substances such as ___ and amino acids must move through tubule cells

A

Glucose

68
Q

Most substances either reabsorbed or secreted via transcellular route do so by ___-___ transport in one of the following processes: Facilitated diffusion or Active transport

A

carrier-mediated

69
Q

a concentration gradient set up by a primary active transport pump is used to drive the transport of a second substance against its concentration gradient via another carrier protein:

A

Secondary active transport

70
Q

bring sodium ions into cell from filtrate and secrete hydrogen ions into filtrate

A

Na+/H+ antiporters

71
Q

steroid hormone made by and released from adrenal cortex; increases reabsorption of sodium ions from filtrate and secretion of potassium ions into filtrate

A

Aldosterone

72
Q

made by hypothalamus and secreted by posterior pituitary; causes water reabsorption; reduces urine output

A

ADH

73
Q

stimulates urinary excretion of sodium ions while it also inhibits release of both aldosterone and ADH; results in more water and sodium excretion

A

ANP

74
Q

last chance for regulation of fluid, electrolyte, and acid-base balance before filtrate becomes urine

A

Medullary collecting system

75
Q

Medullary collecting system is impermeable to water in absence of

A

ADH

76
Q

Medullary collecting system is permeable to ___; allows it to be reabsorbed passively into interstitial fluid

A

Urea

77
Q

If blood pH increases, tubule cells reabsorb less ___ ions from filtrate; lowers blood pH as these ions are excreted in urine

A

Bicarbonate

78
Q

Reabsorption of organic solutes and ions occurs in __ half of proximal tubule

A

First

79
Q

Na+/glucose symporters use the sodium ion gradient to move both sodium ions and glucose molecules, by secondary ___ transport, into tubule cell

A

Active

80
Q

Amino acids, lactic acid, sulfate ions, and phosphate ions are also transported by ___ ___ transport in this fashion

A

secondary active

81
Q

Bicarbonate ion reabsorption occurs as result of ___ antiporter activity and a reversible chemical reaction: CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3−

A

Na+/H+

82
Q

Hydrogen ions secreted into filtrate combine with bicarbonate ions forming

A

carbonic acid

83
Q

Carbonic acid is converted to CO2 and H2O by enzyme

A

carbonic anhydrase

84
Q

Bicarbonate ion reabsorption is ___ as hydrogen ions are again secreted back into tubular lumen

A

Continual

85
Q

Obligatory water reabsorption Occurs in ___ half of proximal tubule where sodium ions, glucose, and other organic molecules have already been reabsorbed; water is “obliged” to follow reabsorbed substances

A

Second

86
Q

passive movement of water out of filtrate happens by osmosis through ____ and ___ routes

A

paracellular and transcellular

87
Q

___ in proximal tubule includes hydrogen ions (discussed previously), many drugs, and various nitrogenous wastes

A

Secretion

88
Q

In first half of proximal tubule, most of __ acid in filtrate is reabsorbed; nearly all of it is secreted back into filtrate in second half of the tubule

A

Uric

89
Q

last chance for regulation of fluid, electrolyte, and acid-base balance before filtrate becomes urine: ___ ___ __

A

Medullary collecting system

90
Q

Medullary collecting system is ___ to water in absence of ADH

A

Impermeable

91
Q

Medullary collecting system is ___ to urea; allows urea to be reabsorbed passively into interstitial fluid

A

Permeable

92
Q

Local ___ cells secrete hydrogen ions into filtrate against a steep concentration gradient, increasing H+ concentration in filtrate by as much as 900 times

A

Intercalated

93
Q

Cells of proximal tubule secrete ___ ions as a mechanism for reabsorbing bicarbonate ions while cells of distal tubule secrete hydrogen ions under direction of ___

A

Hydrogen, aldosterone

94
Q

Production of Dilute Urine: Facultative water reabsorption is turned off as ADH hormone release is

A

Suppressed

95
Q

creates and maintains medullary osmotic gradient: ___ mechanism

A

Countercurrent mechanism

96
Q

Countercurrent mechanism creates and maintains medullary osmotic gradient by exchanging materials in opposite directions between ___ and ___ fluids

A

filtrate and interstitial fluids

97
Q

Countercurrent mechanism involves three factors:
• ___ multiplier system in nephron loops of juxtamedullary nephrons
• Recycling of ___ in medullary collecting ducts
• Countercurrent exchanger in ___ ___

A

Countercurrent, urea, vasa recta

98
Q

Countercurrent multiplier proceeds in following steps: ___ is actively transported from thick ascending limb filtrate into interstitial fluid, raising NaCl concentration outside nephron

A

NaCl

99
Q

NaCl in interstitial fluid pulls water out of filtrate in thin ___ limb by osmosis

A

Descending

100
Q

As NaCl continues to be removed from filtrate, water continues to follow making filtrate more

A

Concentrated

101
Q

Last part of Countercurrent multiplier: High NaCl concentration in filtrate allows for continued NaCl reabsorption into

A

interstitial fluid

102
Q

Countercurrent mechanism (continued): Permeability of medullary collecting system to urea is another important factor in establishment of medullary osmotic gradient. As water is reabsorbed from filtrate, urea becomes more concentrated in remaining fluid. In medullary collecting ducts and papillary ducts, urea follows concentration gradient and passively diffuses out of filtrate and into interstitial fluid; further ___ medullary interstitial fluid

A

Concentrates

103
Q

Some urea enters thin descending limb, so ___ recycles

A

Continuously

104
Q

Note that urea diffusing out of collecting duct constitutes only a ___ amount of total urea; much of urea remains in filtrate and is excreted in urine

A

Small

105
Q

Medullary osmotic gradient created by countercurrent multiplier and urea recycling is maintained by vasa recta (vessels surrounding juxtamedullary loops) acting as

A

countercurrent exchanger

106
Q

Countercurrent exchanger (continued): By the time vasa recta exit renal medulla, blood has approximately __ concentration (about 300 mOsm) it had upon entering renal medulla

A

Same

107
Q

Countercurrent exchanger (continued): Return of blood to its initial osmolarity is critical; allows vasa recta to deliver oxygen and nutrients to cells of medulla without ___ medullary osmotic gradient necessary for water reabsorption and production of concentrated urine

A

Depleting

108
Q

Measurement of rate at which kidneys remove a substance from blood; can be used to estimate glomerular filtration rate; both measured in milliliters of plasma per minute

A

Renal clearance

109
Q

accurate assessment of GFR can be obtained using

A

inulin

110
Q

condition that can develop when GFR is less than 50% of normal

A

Uremia

111
Q

when GRF decreases, the macula densa releases chemicals to ___ the afferent arteriole

A

dilate

112
Q

The sympathetic nervous system ___ the blood vessels supplying the kidney to ___ the GFR

A

constricts; reduce

113
Q

The enzyme ___ is released by JG cells in response to a decrease in the GFR

A

renin

114
Q

The enzyme ___ converts angiotensin 1 to angiotensin 2

A

angiotensin-converting enzyme

115
Q

Generally, angiotensin 2 ___ systemic blood pressure while ___ the GFR

A

increases; maintaining

116
Q

the distal tubule reabsorbs sodium ions and secretes potassium and hydrogen ions in response to

A

aldosterone

117
Q

___ ion reabsorption creates a gradient that helps drive the reabsorption of water and many other solutes from the proximal tubule

A

sodium

118
Q

ADH triggers water reabsorption from the __ __ and the __ __

A

distal tubule

collecting duct

119
Q

___ water reabsorption occurs in the distal tubule and collecting duct

A

facultative

120
Q

Which of the following foes not contribute to the creation/maintenance of the medullary osmotic gradient

A

the countercurrent multiplier of the nephron loops of cortical nephrons

121
Q

the kidneys produce ___ urine when the osmolarity of the body’s fluids increases. The produce ___ urine when the osmolarity of the body’s fluids decreases

A

concentrated; dilute

122
Q

GFR can be estimated by measuring the rate at which certain substances are removed from the blood, which is known as ___ clearance

A

renal clearance

123
Q

the process by which urine is eliminated is called ____, and it is mediated by reflexes involving the ___ nervous system

A

micturition; parasympathetic

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