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Anatomy & Physiology 019 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

What are the fluid compartments of the body

A

Intracellular fluid compartment (2/3) and extracellular fluid compartment (1/3)

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2
Q

What is intracellular fluid compartment?

A

All fluid within the body’s cells

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3
Q

What is extra cellular fluid compartment?

A

Plasma, interstitial fluid, lymph, cerebrospinal fluid, synovial fluid, aqueous and vitreous humors, water (solvent)

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4
Q

Describe movement of solutes and water in body

A

Fluid movement between compartments is constant and depends on osmotic and hydrostatic pressures

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5
Q

Major function of the kidneys (6)

A

Regulate total volume of water in the body and the total concentration of solutes
Regulate concentration of ions in the extra cellular fluids
Regulate long term acid base balance
Excrete metabolic wastes and foreign substances
Producing hormones
Converting vitamin D to its active form

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6
Q

What is the gross anatomy of kidney

A

Renal cortex and renal medulla

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7
Q

What is renal cortex?

A

Superficial layer with granular appearance

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8
Q

Sections of renal medulla (3)

A

Medullary (renal) pyramids
Renal columns
Lobes

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9
Q

Medullary (renal) pyramids

A

Cone shaped tissue that appear striped due to parallel bundles of urine collecting tubules and capillaries

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10
Q

Renal columns

A

Inward extensions of cortex separating pyramids

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11
Q

Lobes

A

Pyramid surrounded by cortical tissue

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12
Q

Parts of the nephron (2)

A

Renal corpuscle and renal tubule

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13
Q

Renal corpuscle function

A

Responsible for filtering the blood and forming pre urine

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14
Q

Renal Tubule Function (3)

A

Adjusts contents of pre urine to form urine. It’s long length increases processing capability
Removes 99% of water from pre urine and returns it to the blood (concentrates urine)
Adjusts ion levels and ph

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15
Q

How much total cardiac output does the kidney receive

A

1/4 total cardiac output (blood)

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16
Q

Blood supply through kidney

A

Abdominal aorta
Renal artery
Every lobe
Cortex
Afferent arterielle
Nephron
Renal vein
Inferior vena cava

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17
Q

Parts of the urinary system which urine flows after leaving kidney

A

Ureters
Urinary bladder
Urethra

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18
Q

Subdivisions of renal corpuscle (2)

A

Glomerulus and glomerular capsule

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19
Q

Glomerulus

A

Capillary bed

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20
Q

Glomerular capsule

A

Cup surrounding glomerulus

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21
Q

Subdivisions of renal tubule (3)

A

Proximal convoluted tubule
Nephron loop (loop of henle)
Distal convoluted tubule

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22
Q

Proximal convoluted tubule

A

Leads out of glomerular capsule

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23
Q

Nephron loop (loop of henle)

A

Descending limb into medulla
Ascending limb back to cortex

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24
Q

Distal convoluted tubule

A

Leads to collecting duct

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25
Q

Collecting duct (nephron)

A

Collects from many nephrons and completes modification of urine

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26
Q

What are 3 major renal processes responsible for urine formation

A

Glomerular filtration
Tubular reabsorotiom
Tubular secretion

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27
Q

Glomerular filtration

A

Dumps cell free and protein free blood Filtrate into the container (glomerular capsule or bowman’s capsule)

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28
Q

Tubular reabsorption

A

Reclaims what the body needs to keep (from tubule to blood)

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29
Q

Tubular secretion

A

Selectively adds to the filtrate (from blood to tubule)

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30
Q

Excretion

A

Term used to describe the elimination of finished urine from body

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31
Q

Describe the structure of filtration membrane (3 layers)

A

fenestrated endothelium
Basement membrane
Filtration slits between the foot processes of podocytes

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32
Q

Fenestrated endothelium (of glomerular capillary)

A

Allows passage of everything but blood cells

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33
Q

Basement membrane

A

Repels negatively charged macromolecules (plasma proteins)

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34
Q

Filtration slits between the foot processes of podocytes (visceral layer of glomerular capsule)

A

Slit diaphragm cover filtration slits adding a final barrier to macromolecules
Glomerular mesangial cells phagocytize debris caught between layers

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35
Q

“Ultrafiltrate of blood plasma”

A

In healthy nephrons, filtrate contains anything that is in blood plasma except cells and proteins

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36
Q

What forces promote or oppose glomerular filtration (2)

A

Hydrostatic pressure
Osmotic pressure

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37
Q

Hydrostatic pressure

A

Pressure of fluid against walls of vessel

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38
Q

Osmotic pressure

A

Pressure exerted by particles in the blood which tend to “pull” water into the vessel l or space

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39
Q

Proximal Convoluted tubule histology

A

simple cuboidal epithelium with microvilli

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40
Q

Nephron Loop - thin descending limb Histology

A

simple squamous cells

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41
Q

Nephron Loop - thick ascending limb histology

A

simple cuboidal cells

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42
Q

Distal Convoluted tubule histology

A

simple cuboidal epithelium with very few microvilli

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43
Q

peritubular capillaries

A

efferent arteriole gives rise to peritubular capillary bed
surround PCT and DCT in cortex and will reclaim/reabsorb most of the solutes and water from the filtrate

44
Q

Vasa recta

A

Efferent arteriole gives rise to vasa recta - long straight capillaries
follow nephron loop deep into medulla - maintain osmotic gradient that makes it possible to concentrate urine

45
Q

transport maximum

A

number of transport proteins available in tubule cell membrane

46
Q

Secondary active transport

A

as Na+ diffuses across the membrane through a membrane cotransporter protein, it drives glucose against its concentration gradient into the cell

47
Q

Where are secondary active transport proteins located?

A

Apical surface of the cuboidal cells of the proximal convoluted tubule (PCT)

48
Q

Where are sodium potassium pumps located

A

Basal Surface of the cuboidal cells of the proximal convoluted tubule (PCT)

49
Q

Proximal is always in ____

A

osmotic equilibrium with surrounding interstitial fluid and blood in peritubular capillaries

50
Q

Proximal convoluted tubule function

A

65-70% of the filterest Na+, K+ os reabsorbed, plus many other electrolytes
100% of the filtered glucose is reabsorbed
100% of the filtered amino acids are reabsorbed
water follows by osmosis
some secretion occurs

51
Q

Proximal Convoluted tubule functions happen ____?

A

automatically and are not regulated

52
Q

Tubular reabsorption

A

reclaims what the body needs to keep (from tubule to blood) which is almost everything

53
Q

Tubular secretion

A

selectively adds to the waste container (from blood to tubule)

54
Q

Medullary Osmotic gradient

A

created by an increasing osmotic gradient extending through whole renal medulla

55
Q

Glomerular filtration rate

A

volume of filtrate/min formed by all glomeruli in the kidneys

56
Q

3 factors that modify glomerular filtration rate (GFR)

A

Net filtration pressure
surface area of all glomeruli
filtration membrane permeability

57
Q

Net filtration rate

A

main controllable factor
glomerular hydrostatic pressure biggest influence - change diameter of arterioles

58
Q

renal autoregulation

A

act locally within the kidney to maintain GFR despite changes in systemic blood pressure

59
Q

Myogenic mechanism

A

smooth muscle reflex contracts when stretched and relaxes when not stretched, an inherent property of smooth muscle

60
Q

Tubuloglomerular feedback mechanism

A

directed by the macula densa cells in the juxtaglomerular apparatus macula densa cells are sensitive to filtrate NaCl goes down and the concentration of NaCl in the ascending limb of loop goes up

61
Q

what are the neural and hormonal controls of glomerular filtration

A

nervous regulation (sympathetic nervous system)
Hormonal regulation (renin-angiotensin-aldosterone mechanism)

62
Q

What are the effects of angiotensin II?

A

vasoconstriction
stimulation of aldosterone release
stimulates Na/Cl absorption at PCT
Stimulates thirst

63
Q

What are 3 hormones affecting BP and volume

A

aldosterone
antidiuretic hormone
atrial natriuretic peptide (ANP)

64
Q

How does aldosterone regulate water and sodium levels?

A

it reabsorbs Na so it increases blood volume and BP

65
Q

How does antidiuretic hormone regulate water and sodium levels?

A

it reabsorbs water so decrease extracellular fluid osmolality

66
Q

how does atrial natriuretic peptide regulate water and sodium levels?

A

It decreases BP and blood volume
suppress the release of ADH, aldosterone and renin

67
Q

What are the mechanisms that regulate water and sodium levels in the body?

A

No receptors
sodium-water balance is linked to BP and blood volume control mechanism
Changes in BP or volume trigger neural and hormonal controls to regulate Na+ content

68
Q

why is the medullary osmotic gradient important?

A

without osmotic gradient, we would never be able to concentrate urine over 300 mOsm

69
Q

What is the role of ADH in the medullary osmotic gradient?

A

ADH determines whether water can be reabsorbed by inserting aquaporins in the collecting duct cells

70
Q

What is the role of urea in medullary osmotic gradient?

A

waste product, but is solute that aids in formation of osmotic gradient
urea “cycles” between collecting ducts, interstitium and ascending loop

71
Q

What is the role of diuretics in the medullary osmotic gradient?

A

increase urine output

72
Q

how does alcohol affect urinary system?

A

decreases ADH release

73
Q

How does caffeine affect urinary system

A

it increases GFR
decreases Na reabsorption

74
Q

How do loop diuretics affect the urinary system?

A

inhibit formation of osmotic gradient by inhibiting pumps in ascending limb

75
Q

what is the flow of urine after the kidneys

A

Ureter
urinary bladder
urethra

76
Q

What is the structure of the ureter

A

3 layers
mucosa
muscularis
adventitia

77
Q

what is the structure of the urinary bladder

A

3 layers
mucosa
muscularis
adventitia or serosa

78
Q

what is the structure of the urethra

A

internal urethral sphincter
external urethral sphincter

79
Q

where does tubular reabsorption happen?

A

Proximal convoluted tubule
descending limb of nephron loop
ascending loop of nephron
Distal convoluted tubule
collecting duct

80
Q

What substances are absorbed during tubular reabsorption

A

all nutrients
electrolytes
Na+
water
Solutes (Na+ K+ Cl-)
Antidiuretic hormone
aldosterone
atrial natriuretic peptide
parathyroid hormone

81
Q

Where does tubular secretion happen?

A

Proximal convoluted tubule
sometime distal tubule

82
Q

What are the main substances secreted during tubular secretion

A

Drugs and drug metabolites
urea, uric acid, nitrogenous wastes
creatine
excess K+
Excess H+ is secreted when blood is too acidic

83
Q

What is the normal PH of urine?

A

4.5-8 (average 6)

84
Q

What is the normal specific gravity of urine?

A

1.003-1.030

85
Q

What is the osmotic concentration of urine?

A

855-1335 mOsm/L

86
Q

What is the water content of urine

A

93-97%

87
Q

Average volume of urine?

A

700-2000 mL/day

88
Q

what is the normal color, clarity and odor of urine

A

pale yellow
clear
odor varies

89
Q

What is the bacterial content of urine

A

none

90
Q

What is renal clearance?

A

volume of plasma from which the kidneys clear a particular substance in one minute

91
Q

Why is inulin use to estimate GFR?

A

inulin is not secreted or absorbed which means that rate at which inulin shows up in urine is the same as glomerular filtration rate (GFR)

92
Q

Why is creatine used to estimate GFR?

A

produced at a constant rate, little is reabsorbed, a small amount is secreted

93
Q

If clearance value is equal to inulin…

A

substance is filtered but neither reabsorbed or secreted

94
Q

if clearance value is less than inulin…

A

substance is filtered but at least some is reabsorbed by tubule cells

95
Q

if clearance value is greater than inulin…

A

substance is filtered but also being secreted by subtle cells and added to the filtrate

96
Q

what are the 3 major chemical buffer systems?

A

carbonic acid-bicarbonate buffer system
phosphate buffer system
protein buffers

97
Q

what is the carbonic acid-bicarbonate system?

A

extracellular fluid compartment
carbon dioxide + water –> carbonic acid –> bicarbonate ion + hydrogen ion

98
Q

what is the phosphate buffer system

A

intracellular fluid compartment and urine
uses a strong acid (HCl) or a strong base (NaOH)

99
Q

what is the protein buffer system

A

both ICF and ECF
individual amino acids on a protein can donate or accept H+ allowing it to function as a weak acid or base as needed

100
Q

what is the relationship between PCO2 and bicarbonate ions to blood PH

A

the net effect is that strong acid is converted to a weak acid so that arterial PH goes down very little
buffering capacity is dependent on concentration of bicarbonate ions (alkaline reserve)

101
Q

how does the respiratory system make adjustments to pH

A

Central respiratory centers are most sensitive to CO2 levels
Buildup of CO2 or H+ in blood activates respiratory centers to increase respiratory rate and depth
CO2 is blown off so H+ concentration is reduced

102
Q

if blood PH rises what happens to the respiratory rate

A

the respiratory rate slows, CO2 accumulates, pushing equation to right so H+ concentration increases and blood PH is restored to normal

103
Q

How do the kidneys influence acid-base balance (PH)

A

H+ is secreted while HCO3- is reabsorbed
phosphate buffer in filtrate ensures excretion of H+
Glutamine metabolism and NH4+ secretion and excretion

104
Q

Respiratory acidosis

A

build up of H+ and CO2 retention (hypoventilation)

105
Q

Respiratory Alkalosis

A

reduce H+, CO2 elimination (hyperventilation)

106
Q

Metabolic acidosis

A

PH 7.35 (low) HCO3 levels 22 mEQ/L (low)

107
Q

metabolic alkalosis

A

PH 7.45 (high) HCO3 levels 26 mEq/L (high)

Anatomy & Physiology 019 (5 decks)

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