lecture 19: urinary system Flashcards

1
Q

what are the 4 structures of the urinnary systm

A

kidneys (2)
ureters (2)
urinary bladder
urethra

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2
Q

true or false: since we only have 1 bladder, we only have 1 ureter

A

false, we haev 2

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3
Q

true or false: the kidney is the only retroperitoneal organ

A

false, the pancrease is also

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4
Q

what is the location of the kidney

A

Found between T12 and L3 vertebrae (partially

protected by 11th and 12th rib)

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5
Q

what kidney is lower and rwhy

A

R. kidney is slightly lower than the L. kidney because the liver takes up alot of space

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6
Q

what structures pass thru the renal hilus

A

ureter, renal artery and vein,
lymphatic vessels and nerves enter and/or leave the
kidney

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7
Q

what are the 3 layers covering the kidney deep to superficial

A

renal capsule
adipose capsule
renal facisca

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8
Q

put these layers of the kidney in orger from deep to superficial
adipose capsule, renal capsule, renal fascia

A

renal capsule
adipose capsule
renal fascia

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9
Q

true or false: adipose capsule is the deepest layer covereing the kidney

A

false, it is the intermediate layer

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10
Q

what is the function of the renal capsule (deep)

A
  • Forms a barrier against trauma

* Helps maintain the shape of the kidney

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11
Q

what is the adipose capsule (internemdiate) and its function

A
  • Mass of fatty tissue surrounding the renal capsule
  • Protects against trauma
  • Helps hold the kidney in place within the abdominal cavity
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12
Q

what is the function of the renal fascia (superficial)

A
  • Anchors kidney to surrounding structrues

* Deep to peritoneum (on anterior surface

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13
Q

the renal fascia is deep to what

A

deep to peritoneum on anterior surface

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14
Q

what is nephroptosis

A

Inferior displacement of the kidney (dropping of kidney)

  • Kidney slips due to a deficient adipose capsule or renal fascia
  • Occurs most often in very thin people
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15
Q

nephroptosis occurs most often in what types of people

A

very thin people

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16
Q

what happens in serious cases of nephroptosis

A

In serious cases, the ureter may kink and block the flow of urine

  • Back-up of urine causes pressure on the kidney, damaging the tissue
  • Pain results from the twisting ureter
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17
Q

true or false, the renal cortex is deep

A

false although it is part of the internal structures of the kidney, it is superfiecial

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18
Q

explain where the renal cortex is located

A

(extends from the renal capsule to the base of the

pyramids and spaces between the pyramids (Renal columns)

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19
Q

what are the spcaces b/w the pyrmadids called

A

renal columns

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20
Q

what is the renal medulla

A

Consists of 8-18 cone-shaped renal pyramids

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21
Q

what is the base and apex of the renal medulla

A

Base: faces the renal cortex

• Apex: Renal papilla – points towards the center of the kidney

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22
Q

what is a reneal lobe

A

Area consisting of 1 renal pyramid and its overlying renal cortex

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23
Q

what are renal lobes divideed into

A

Divided into an outer cortical zone and an inner juxtamedullary
zone

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24
Q

the number of pyramids = the number of blank

A

minor calyces

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25
Q

what is the functuonal portion of the kidney

A

parenchyma

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26
Q

wat dies the parenchyma constain

A

nephrons

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27
Q

what is the functional unit of the kindey

A

nephron

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28
Q

where does the urinne formed by the nephrons drain

A

into the large papillary ducts

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29
Q

exxplain the passage of urine

A
Urine formed by the nephrons drains into large papillary ducts
• Papillary ducts drain into minor calyces (8-18) which in turn drain into
major calyces (2-3)
• One minor calyx receives urine from renal papilla and delivers it to a
major calyx
• Urine then drains from the major calyces into the renal pelvis and then
out through the ureter into the urinary bladde
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30
Q

• One minor calyx receives urine from renal papilla and delivers it to whatn

A

major calyx

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31
Q

urine drains from thee major calyces to where

A

the reenal pelvis then out thru the ureter to the bkaldder

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32
Q

what is the renal sinus

A

Expanded area of the renal hilus

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33
Q

what does the renal sinus cotnrain

A

Contains the calyces, part of the renal pelvis, renal

blood vessels and nerves

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34
Q

what is the space occupied by the calyces and pelvis called

A

renal sinus

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35
Q

what are the 3 major fucntions of the kindye

A

Regulation of blood volume and composition

reg of blood pressure

contribution of metabolism

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36
Q

true or fale: the kidney removes waste

A

true

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37
Q

formation of the urine is done by what

A

nephron

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38
Q

how does the kindeey help control blood pH

A

by excreting selected ampunts of H+

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39
Q

explain hoe the kidney regulates blood pressure

A

• Secretion of the enzyme RENIN

Activates the renin-angiotensin pathway which results in an
increase in blood pressure

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40
Q

what does RENIN do

A

Activates the renin-angiotensin pathway which results in an

increase in blood pressure

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41
Q

true or falsee: the kidney can particpate in synthesis of vit D

A

true

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42
Q

explain how tje kidney contributes to metabolism

A
  • Synthesis of new glucose molecules during periods of fasting or starvation
  • Secretion of erythropoeitin

Synthesis of vitamin D

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43
Q

true or false: kidneys recieve very little of cardiac output

A

false, they reecive 20-25% of the cardiac output

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44
Q

within each kidney, the renal artery dives into what

A

lobar/segmental

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45
Q

the segmental arterie branch into what

A

interlobar

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46
Q

at the base of the pyramids, the interlobar arch b./w the medualla amd the cortex form what

A

the arcurate a

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47
Q

what do arcuate artriese bracinh into

A

interlobular

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48
Q

what do interlobular artries branch off into

A

afferent arterials (entering the glomerulus)

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49
Q

afferent artries enter what

A

the glomerulus

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50
Q

the renal artery branches off what

A

abdominal aorta

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51
Q

what artery is fpound between the lobes

A

interlobar

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52
Q

each nephron recives one affterent arteris which dives to form what

A

to form a glomerulus (small

tangled capillary network)

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53
Q

the capilarries that divided to form the glomeerulus reunite to form what

A

sn efferent arterial

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54
Q

the efferent arterilees drains or brings blood into thee glom

A

drains

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55
Q

what can vasodilation/constriction of the afferent or effeerent arterioles of the nephron do

A

Vasodilation and vasoconstriction of afferent / efferent
can produce large changes in the renal blood flow and
vascular resistance affecting the entire systemic
circulation

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56
Q

what is the flow of fluid thru a nephron

A
bowmans capsule
prox conv tubule
descneding limb of loop of henle
ascending limb of loop of hele
distal conv tibule (into colleected duct)
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57
Q

efferent arteries of the nephon divide to form wht

A

Divide to form a network of capillaries called

peritubular capillaries

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58
Q

where do peritubular caps surrond

A

Surround tubular portions of the nephron in the renal

cortex

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59
Q

the peritubular capillaries reuine to form what

A

Reunite to form peritubular venules and then
interlobular veins (also receive blood from the vasa
recta)

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60
Q

what does the vasa recta supply

A

the meudulla

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61
Q

blood leaves the kidneys how

A

thru renal vein

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62
Q

where do vasa recta extend and what do they supply

A

Extend from some efferent arteries and supply the

tubular portions of the nephrons in the renal medulla

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63
Q

where do the nerves of the kidney originate from

A

Originate from the celiac ganglia (sympathetic division

of the ANS)

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64
Q

where do the nerves of the kidney pass thr u

A

the renal plexus

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65
Q

what are the most common nerves in the kidney and what do they do

A

• Most are vasomotor nerves and regulate blood flow and

renal resistance by altering the diameter of arterioles

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66
Q

EXPLAIN THE ENTIRE PATHWAY OF BLOOD THRY THE KIDNEY

A
renal artery
segmental/lobar
interlobar
arcurate
interlobular
affereten arterioles 
glom capillaries
efferent arterioles
vasa recta 
peritubular venules
interlobular v
arcurate v
interlobar v
renal v
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67
Q

how many segmental/lobar arteries are there per kidney

A

5

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68
Q

true or false: the number of nephrons remain constant after birth

A

true

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69
Q

what does the increase of kindye size result from

A

growth of the nephonrs

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70
Q

what are the 3 basic functions of the nephron

A
  1. Filter blood
  2. Return useful substances to the blood so that they are
    not lost from the body
  3. Remove substances that are not needed by the body
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71
Q

what do all three functions of the nephron result in

A

homeostasis of the blood and urine production

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72
Q

what are the 2 parts of the nephron

A

renal corpuscle

renal tubule

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73
Q

renal corpuscle main function is what

A

plasma filtration

74
Q

each corpuscle has 2 components: what are hey

A

1) glomerulus

2) bowman capsule

75
Q

TTRUE OR FALSE: the glomerulus is a capilary network

A

true

76
Q

what is the bowmans capsule

A

epithelium cup

surrounding the glomerulus

77
Q

what is the main functiona of the renal tubule

A

passage of filtered fluid

78
Q

whar are the 3 sctions of the renal tubule

A

prox conv tubule
loop of henle
distal conv tubule

79
Q

what is the proximal conv tubule

A

portion attached to the

glomerular capsuleq

80
Q

what is the loop of henle

A

nephron loop

81
Q

what is the distal conv tubule

A

Distal convoluted tubule: tubule is tightly coiled,

furthest from the glomerular capsule

82
Q

what convulute tubule is attached to the glom capsule

A

proximal conv tubule

83
Q

the renal corpuscle and both convulutd tubules lie wheeree

A

in the renal corttex

84
Q

where does the long loop of henle lie

A

in the medulla

85
Q

several convultied tubules empty into what

A

a single collecting duct

86
Q

whatt is the last place for reabsorptions

A

colelctting duct

87
Q

collectting ducts converge to form what

A

papillary ducts which drain into the minor and jor calyces

88
Q

true or false: the glomerular capsule consttsis of only pariettal layers

A

false, also visceral

89
Q

what does the visceral layer of the glomerulus capsule consist of

A

consists of epithelial cells called

podocytes

90
Q

where do podocytets lie and what do theye form

A

Podocytes wrap around the glomerular capillaries and

form the inner wall of the capsule

91
Q

whatt does tthe parietal lyaer of thee glom capsule form

A

the outre wall of the capsule

92
Q

fluid filted from the glom capsule/filtered from the glomerulus enteres what

A

the bowmans space (the space between the two layes of thee capsule)

93
Q

80-85% of nephrons are what type

A

cortical nephrons

94
Q

renal corpuscloes of cortical nephrons lie where

A

in the superior portion of the cortex

95
Q

short loops of henle lie mosly where

A

Short loops of Henle lie mostly in the cortex and

penetrate only the superficial portion of the medulla

96
Q

where do cortical nephons reecive blood supply

A

Receive blood supply from the peritubular capillaries

arising from the efferent arterioles

97
Q

15-20% of nephrons are what type

A

juxtamedullary neprons

98
Q

renal corpuscles of the juxtamedullar nephrons like where

A

deep in the cortex, close to the

medulla

99
Q

explain thee long loops of henle and where they are located

A

Long loops of Henle – ascending limbs consist of a thin ascending limb and a thick ascending limb (lumen is the same only the epithelium thickness varies)

located in medualla

100
Q

where do juxtamedulalry nephons receivee their blood supply

A

Receive their blood supply from the peritubular

capillaries and the vasa recta

101
Q

In each nephron, the last part of the ascending
limb of the loop of Henle comes in contact with
what

A

the afferent arteriole serving the renal corpuscle

102
Q

tubule cells iin the area where the loop of henle comes in contact with the afferent arterial are known as what

A

macula densa

103
Q

the wall of the afferent arterial of the nephron contacts what fibers and cells

A

modified
smooth muscle fibers – juxtaglomerular cells (JG
cells)

104
Q

what make up the

juxtaglomerular apparatus

A

Both the macula densa and the JG cells

105
Q

Both the macula densa and the JG cells make up what

A

the

juxtaglomerular apparatus

106
Q

when doese the distal conv tubule begin

A

right after the macula densa

107
Q

what are the ttwo types of cells in the distal conv tubule and in the collecting ducts

A

principle cells

intercalated cells

108
Q

what are the principle cells in the tubules and collecting ducts for

A

Receptors for both ADH (anti-diuretic hormone) and
aldosterone (promote sodium & water reabsorption,
potassium excretion)

• Both regulate the function of the principle cells

109
Q

whatt is the function of the intercalted disks of the renal tubule and collecting duct

A

Play a key role in the homeostasis of blood pH

110
Q

renal tubules drain into what

A

colelcting ducts

111
Q

collecting ducts drain into what

A

the large papillary ducts

112
Q

what are the 3 functions of the nephrons

A

1) glomerular filtration
2) tubular reabsorption
3) tubular secretion

113
Q

what is the fluid entering the capsulate spacee called

A

glomerular filtrate

114
Q

more than 99% of the fluid entering the capsular space returns where

A

to the blood stream via tubular reabsorption

115
Q

Endothelial cells from the glomerular capillaries and podocytes form what

A

a leaky barrier called the filtration membrane

116
Q

what does the filtration membrane of the nephrons permit

A

Permits filtration of water and small solutes but prevent filtration of
most plasma proteins, blood cells and platelets

117
Q

filtered subsatncse in the kidney must pass thru 3 barriers,. what are theey

A

1) glomerular endothelial cells
2) basal lamina
3) a filtrattion slit formed by a podocytee

118
Q

the glomerular endothelial cells contain whatt and whatt does tthat allow for (in terms of filtration)

A

Contains large fenestration􀀁s
- Allows all solutes in the blood plasma to exit the capillary but
prevent filtration of blood cells and platelets

119
Q

What are the types of cells found in the endothelium of the glomerulus that help with filtration

A

Mesangial cells; contractile cells that help regulate glomerular
filtration

120
Q

what is the basal lamina of the filtration memebraee and what does it preveent

A
  • Layer of acellular material between the endothelium and
    podocyte
  • Prevents filtration of large plasma proteins
121
Q

whta are pedicels

A

Pedicels: 1000􀀁s of processes extending from each podocyte,

wrap around each glomerular capillary

122
Q

what do the spacese between the pedicels caleld

A

filttration slit

123
Q

what is the slit membrane formed by a podycte and what does it allow

A

Slit membrane: Extends across each filtration slit allowing the
passage of water, glucose, vitamins, amino-acids, very small
plasma proteins, ammonia, urea and ions.

124
Q

tubular reasorption returns what

A

Returns most of the filtered H20 and solutes into the

bloodstream

125
Q

tubular reabsorption mainly occurs where

A

Mainly occurs at the proximal convoluted cells

- Also carried out by other renal tubule cells and ducts

126
Q

what are some examples of reasborbed solutte in the nephon

A

Reabsorbed solute include glucose, a-a, urea, ions
(sodium, potassium, calcium, chloride, bicarbonate,
and phosphate)
- Most small proteins and peptides are reabsorbed

127
Q

what do diuretics do

A

Diuretics slow down renal re-absorption of water

and in turn cause diuresis – increased urination rate

128
Q

what are the 2 major outcomes of tubular secretion

A
  • H+ secretion helps control blood pH
  • Secretion of other substances help eliminate them from the
    body
129
Q

what is tubular secretion

A

Transfer of material from the blood and tubular cells

into the tubular fluid

130
Q

what are some secrete substances of the neprin

A

Secreted substances include H+, K+ and

ammonium, creatine and certain drugs

131
Q

know the basic functions of the nephoron picure

A

.

132
Q

what do the ureteers do

A

Transport urine from the renal pelvis to the urinary bladder

• Through peristaltic contractions (1-5 / minute) with contribution
from hydrostatic pressure and gravity.

133
Q

true or falsee: the ureeters are retroperitoneal

A

true

134
Q

what is backflow of urine prevented by

A

prevented by the pressure
within the bladder compressing the oblique
opening into the ureter

135
Q

what happens if the pressure witthin the pladder compressing the oblique opening into ureter is not functionning proprly

A

If not functioning properly, microbes can travel up the

ureter infecting one or both kidneys

136
Q

what are the.3 layers of the ureteeers

A

1) mucosa
2) muscularis
3) adventita

137
Q

what cells do the mucosa of the uretters contain and what does that allow

A

Contains transitional epithelial cells and a lamina propria

• Allows the ureter to accommodate various volumes of fluid

• Mucous secreted protects the cells and prevent them from coming in
contact with the urine

138
Q

what are the fibers of the muscularis layer of the ureters

A

Inner longitudinal fibers and outer circular fibers (opposite from
GI tract)

139
Q

trtue or false: the muscularis layer of the ureter only has an inner longitindal fibers

A

false Distal third of the tube also has an outer longitudinal layer

140
Q

what is the major function of the muscularis layere of the ureeters

A

peeristalsis

141
Q

whatt is the function of the adventitia layeer of the ureters

A

Contains blood vessels, lymph vessels and nerves

Anchors the ureters in place

142
Q

what is the urinary bladder and where is it located for everone

A

Hollow, distensible muscular organ located posterior to

the pubic symphysis

143
Q

in males where is the urinary bladder located

A

direectly anterior to rectum

144
Q

in femles, where is the bladdre locateed

A

anterior to vagina, infeerior to uterus

145
Q

how is the urinary bladder held in palce

A

by folds of peritoneum

146
Q

when empty, what happen to bladder

A

is collapsed

147
Q

whatt shape is the blader whenstretched

A

spherical
As the volume increases, it becomes pear-shaped and
rises in the abdominal cavity

148
Q

what is the trigone of the bladder

A

Small triangular area at the base of the bladder

149
Q

what are the openings in the trigone

A

2 ureteral openings (posterior corner)

• 1 internal urethral orifice (anterior corner)

150
Q

what are the layers of the wall of the bladder

A

1) mucosa
2) muscualris
3) adventitia

151
Q

what are the cells in the mucosa layer of the ueter

A

Transitional epithelium and lamina propria

152
Q

the folds in the mucous in the bladder are called..

A

rugae

153
Q

what is the msucularis of the ballder called

A

detrusor musclee

154
Q

what are the msucle fibers i nthe muscularis layer of the bladder

A

Consists of inner and outer longitudinal muscle with intermediate
circular muscle layer

155
Q

what is the itnernal urethral sphrincter formed by

A

circular fibers

156
Q

what is the external urethral sphincteer composed of

A

skeletal musclees

157
Q

true or false, we have control of both our internal and external urethral sphincter>

A

false, only external (made from skeletatl muscle)

158
Q

what is the adventia of the urinary bladder

A

Superficial coat of the posterior and inferior surface of the bladder – continuous with the ureter (superficial surface is covered with the serosa layer of viseral peritoneum

=allows bladder to stretch (move up in abdomen_

159
Q

what is another name for peeeign

A

mictruition

160
Q

what is mictruition and how does it occur

A

Discharge of urine from the urinary bladder
• Occurs through a combination of voluntary and
involuntary muscle contractions

161
Q

what makees you have to pee

A

When the volume > 200-400 ml, stretch receptors in the
wall transmit impulses into the spinal cord

• Propagate to micturition center in the spinal cord (at
the level of S2-S3) and trigger a micturition reflex

162
Q

from the mictrution center where to the parasympathtic impulses propogate and what does that cause

A

From the micturition center, parasympathetic impulses
propagate to the urinary bladder wall and internal
urethral sphincter
• Causes contractions of the detrusor muscle and
relaxation of the internal urethral spincter

• Simultaneously, innervation of the external urethral
sphincter is inhibited

163
Q

bladder filling causes what

A

Bladder filling causes a sense of fullness that initiates a conscious desire to urinate before the reflex actually
occurs

164
Q

what can initiate/delay the micturition relfex

A

Certain muscle of the pelvic floor., the cerebral cortex and
learned control of the external urethral sphincter can
initiate / delay the reflex for a limited period of time

165
Q

what is the urethtra

A

Small tube from the internal urethral orifice to the exterior
of the body
• Terminal portion of the urinary system

166
Q

what is the terminal portion of the urinary system

A

urethra

167
Q

where in the urethra located in females

A

Located posterior to the pubic symphysis

• Directed obliquely inferior and anterior

168
Q

where is the external urethral orifice located in females

A

b/w the clitoris and vagina orice

169
Q

epxlai nthe walls of the urethra in women

A

Wall consists of mucosa (epithelium and lamina propria)
and muscularis (circular smooth muscle continuous with
the urinary bladder)

170
Q

explain the passative of the urethra in males

A

Passes through the prostate gland, urogenital diaphragm

and penis

171
Q

explain nthe walls of the urethra in men

A

Wall consists of a deep mucosa and a superficial

muscularis

172
Q

what are the 3 divisions of the urethra in men

A

prostratic
membranous
spongy

173
Q

in the males, what are some glands/structures that deliver their contents to the urethra

A

Ducts from the prostate gland

• Ducts from the seminal vesicle and vas deferens

ducts from bulbourethral gland (into spongy)

urethral glands

174
Q

seecretionns from seminal vessicle and vas deferences do what

A

neutralize the acidity of
the female reproductive system

• Contribute to sperm motility and viability

175
Q

ducts from the bulbourethral gland (copwes) deleiver the contrents into what part of urethra

A

spongy

176
Q

what does the bulbourethral gland do

A

• Deliver an alkaline substance before ejaculation to neutralize the acidity of the urethra

• Also secrete mucous which lubricates the end of the
penis during sexual arousal

177
Q

where are the urethral glands found and what do they discharge

A

(mostly found in spongy urethra,
discharge mucous during sexual arousal and
ejaculation)

178
Q

as you get older, your kidneys get bigger or smaller

A

smaller

179
Q

as you age, does your kidneys filter more or less blood

A

less (there is less blood flow)

180
Q

as you get older, what happens to sense of thirst

A

diminshed

more prone to dehydration

181
Q

whatt are the common effects of aging on the urinary system

A
  • Polyuria
  • Nocturia
  • Increased frequency of urination
  • Hematuria