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Module 8 > Renal > Flashcards

Renal Flashcards

1
Q

what four things does the urinary system consist of?

A

kidney
ureters
urniary bladder
urethra

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2
Q

what is the four functions of the urinary system?

A
  1. regulate blood volume and composition, regulate blood pressure, pH, and glucose levels and excretes waste
  2. ureters transport urine from the kidneys to urinary bladder
  3. urinary bladder stores urine and expels it into urethra
  4. urethra discharges urine from blood
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3
Q

what are the eight kidney functions?

A

regulation of blood ionic composition
regulation of blood pH
regulate blood volume
regulate blood pressure
maintenance of blood osmolarity
regulation of blood glue levels
production of hormones
excretion of waste

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4
Q

where is the kidney located?

A

between the levels of the last thoracic and third lumbar vertebrae

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5
Q

is the left or right kidney higher?

A

left

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6
Q

what is the difference between an adult kidney and a child’s kidney?

A

the adult kidney is 4-5 inches (bar of soap)
Childs kidney is smaller

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7
Q

what is the renal hilum?

A

an indent where ureters emerges from the kidney along with blood vessels, lymphatic vessels and nerves

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8
Q

what are the three layers of the kidney?

A

renal capsule
adipose capsule
renal fascia

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9
Q

what layer of the kidney is the deepest and gives the kidney its shape?

A

renal capsule

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10
Q

what layer of the kidney is the middle layer which helps protect the kidney from trauma?

A

adipose capsule

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11
Q

which kidney layer is most superficial and anchors the kidney in place?

A

renal fascia

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12
Q

what is the renal cortex?

A

superficial region
extends from Renal capsules to bas of renal pyramids

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13
Q

what is the inner most region of the kidneys that consist of pyramids?

A

renal medulla

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14
Q

what are the cone-shaped structures that are found in the medulla?

A

renal pyramids

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15
Q

what are the renal papillas?

A

the apex of the renal pyramids

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16
Q

what are the portions of the renal cortex that extend between the renal pyramids?

A

renal columns

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17
Q

what is the renal lobe?

A

consist of a renal pyramid, it overlying area of the renal cortex and one half of each adjacent column

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18
Q

what is the most functional portion of the kidney?

A

parenchyma

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19
Q

what is the functional unit of the kidney?

A

nephrons

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20
Q

what are the papillary ducts?

A

extend through the papilla of the pyramids
filtrate formed by the nephrons and drains into there’s large dicts

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21
Q

what are the cup like strictures that the papillary ducts drain into?

A

minor and major calyces

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22
Q

how many minor calyces do we have?

A

8-18

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23
Q

how many major calyces do we have?

A

2-3

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24
Q

what is the renal pelvis?

A

single large cavity that the major calyces drain into

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25
Q

what is the renal sinus?

A

a cavity within the kidneys that the hilum expands into

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26
Q

what is the order of drainage starting with the nephron?

A

nephrons
papillary ducts
minor calyces
major calyces
ureters
urinary bladder

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27
Q

what percentage of resting cardiac output is received by the kidneys ?

A

20-25%

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28
Q

how much blood flow does an average adult receive through the kidneys?

A

1200mL per minute

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29
Q

what two parts make up the nephrons?

A

renal corpuscle
renal tubules

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30
Q

what part of the nephron is used to filter blood plasma?

A

renal corpuscle

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31
Q

what part of the nephrons receives filtered fluid?

A

renal tubule

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32
Q

what is the Bowmans capsule?

A

double walled cup surrounded by the glomerulus

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33
Q

where would you find the loop of henle?

A

within the renal tubule extending to the medulla

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34
Q

what kind if turn does the loop of henle make?

A

hair pinned

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35
Q

what makes up 80-85% of nephrons?

A

cortical nephrons

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36
Q

what males up 15-20% of nephrons?

A

juxtamedullary nephrons

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37
Q

based on the glomerular capsule, what are the two locations in which they can be found (glomerular capsule)?

A

visceral layer
parietal layer

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38
Q

what are podocytes?

A

modified simple squamous epithelial cells

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39
Q

what is the function of the globular capsule?

A

forms inner wall of capsule (v) and outer wall (p)

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40
Q

where are the locations of the renal tubule and collecting ducts?

A

proximal convoluted tubule
loop of henle
most of distal convoluted tubule
The last part of the distal convoluted title and all of collecting ducts

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41
Q

what cells are found in the ascending limbs?

A

macula ducts

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42
Q

what is the function of primary cells?

A

receptors for antidiuretic hormones and aldosterone

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43
Q

what is the function of intercalated cells?

A

plays a role in blood pH balance

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44
Q

what does the juxtaglomerular apparatus do?

A

regulates blood pressure in kidneys

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45
Q

what two things does the juxtaglomerular have?

A

macula dense juxtaglomerular cells

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46
Q

what is retropertioneal?

A

pertaining to organs closely attached to the posterior abdominal wall and partly covered by peritoneum

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47
Q

what structures are in the renal cortex?

A

renal capsule
renal pyramids

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48
Q

what are the three processes of the nephron and collecting ducts to produce urine?

A

glomerular filtration
tubular reabsorption
tubular secretion

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49
Q

how much water is reabsorbed by tubule cells?

A

99%

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50
Q

where would reabsorption take place during tubular reabsorption?

A

from the renal tubules to the Blood stream

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51
Q

what things are removed from the blood plasma into the renal tubule?

A

waste
drugs
excess ions

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52
Q

what is the name of the fluid that drains from the minor and major calyces and then into the renal pelvis?

A

urine

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53
Q

what is the calculation for rate of solution of urine?

A

rate of solute = rate of glomerular + rate of secretion - rate of reabsorption

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54
Q

what is glomerular filtrate?

A

fluid that enters capsular space

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55
Q

what is the daily volume of glomerular filtrate?

A

150-180 liters

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56
Q

how much urine do humans excrete daily?

A

1-2 liters

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57
Q

what is the leaky barrier called?

A

filtration membrane

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58
Q

what are the three filtration barriers that substances will pass?

A

glomerular endothelial cells
basement membrane
pedicels

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59
Q

what are the large pores found in the glomerular endothelial cells?

A

fenestrations

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60
Q

what are mesangial cells?

A

help regulate fluid and are found in the cleft of afferent and efferent arteroles

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61
Q

what are your foot like processes?

A

pedals

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62
Q

what is created in the space between pedals?

A

filtration slits or membranes

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63
Q

what things make the renal capsule high in full filtered?

A

large surface area
filtration membrane
glomerular capillary blood pressure is higher

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64
Q

what is the total pressure promoted by filtration?

A

net filtration pressure

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65
Q

what are the three pressures controlling glomerular filtration?

A

glomerular blood hydrostatic pressure
capsular hydrostatic pressure
blood colloid osmotic pressure

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66
Q

what pressures influences / increased net filtration pressure?

A

capsular hydrostatic pressure
blood colloid osmotic pressure

67
Q

what is the amount of filtrate formed in all the renal corpuscles of both kidneys each minute?

A

glomerular filtration rate

68
Q

what is the average GFR in male adults? female adults?

A

125mL men
105mL women

69
Q

what happens when too much GFR is present?

A

substances pass too quickly and are not reabsorbed

70
Q

what happen when too little GFR is present?

A

nearly all reabsorbed and some waste products not adequately excreted

71
Q

what things control the GFR?

A

renal auto regulation
neural regulation
hormonal regulation

72
Q

when does the myogenic mechanism occur?

A

stretching triggers the contraction of smooth muscle cells in afferent arterioles
increase BP and GFR

73
Q

when does the tubuloglomerular mechanism occur?

A

when macula dense in the renal tubules provide feedback
BP increases will trigger this

74
Q

what hormones contribute to hormonal regulation of GFR?

A

angiotensin II (reduce GFR)
atrial natriuretic peptides (increases GFR)

75
Q

is reabsorption passive or active?

A

both

76
Q

what solutes are actively and passively reabsorbed?

A

glucose
amino acids
urea
ions

77
Q

what things are more fine tuned for reabsorption and help balance water and selected ions?

A

small proteins
peptides

78
Q

what is secretion?

A

transfer of material from blood into glomerular filtrate

79
Q

what is reabsorption?

A

return of most of the filtered water into bloodstream

80
Q

is paracellular reabsorption passive or active?

A

passive

81
Q

what is the filtered organic solutes that are 100% reabsorbed?

A

glucose
amino acids

82
Q

how much water is reabsorbed into the ascending loop of henle?

A

little to none

83
Q

what things get reabsorbed into the early distal convoluted tubule?

A

Na- cl

84
Q

what percentage of filtered solutes and fluids are returned tp the blood stream In the late distal tubule and collecting duct?

A

90-95%

85
Q

what is a major system for maintaining homeostasis of body fluid?

A

kidneys

86
Q

what is ADH responsible for?

A

controls weather dilute or concentrated urine is formed

87
Q

what happens with a low ADH level?

A

diluted urine

88
Q

what happens with a high level of ADH?

A

more concentrated urine

89
Q

what is osmolarity?

A

the concentration of a solution in terms of osmoses of solutes per litre of solution

90
Q

what things can lead to diluted urine?

A

osmolarity of fluid increases as it goes down the loop of Henle
osmolarity decreases as it goes up the ascending limbs
osmolarity decreases still more as it flows through nephrons

91
Q

what happens when the osmolarity of interstitial fluids of the renal medulla progressively increase?

A

water is absorbed more by the tubular fluid, the remaining fluid in lumen is greatly concentrated

92
Q

what things are absorbed in the supporting cells of the ascending limb of the loop ?

A

Na
K
Ci

93
Q

when is water permeability low in the pathway of tubular fluid movement?

A

in the thick ascending limb

94
Q

when fluid enters the DCT is it more concentrated or diluted?

A

diluted

95
Q

are DCT regulated by ADH hormones?

A

no

96
Q

is the concentration of tubular fluid high or low when it drains into the renal pelvis?

A

low

97
Q

what happens when water intake is low or water loss is high?

A

urine becomes highly concentrated

98
Q

how much more concentrated can urine be to the blood plasma?

A

1200 in urine
300 in blood plasma

99
Q

what solutes are highly osmolalic in the renal medulla?

A

Na
Cl
urea

100
Q

what does it mean when something is countercurrent flowing?

A

flow of fluid in the opposite direction

101
Q

what can urea recycling cause?

A

buildup of urea in the renal medulla

102
Q

what is an example in the body of countercurrent flow?

A

when solutes and water are passively exchanged between blood and fluid in the renal medulla

103
Q

what are the ureters responsible for?

A

transporting urine from the renal pelvis of the kidney to the bladder

104
Q

what things help move urine in the ureters?

A

gravity
contraction of muscle wall
hydrostatic pressure

105
Q

what is the frequency of peristaltic c waves which pass through the renal pelvis to the bladder?

A

1-5 per min

106
Q

how long are the ureters?

A

25-30 cm or 10-12 inch

107
Q

are ureters and kidneys retroperitoneal?

A

yes

108
Q

what are the three layers of the ureters?

A

mucose
muscular
adventia

109
Q

how does bladder infections occur?

A

when the bladder fills, it compresses the opening to prevent backflow and this can allow microbes to travel up in the ureters

110
Q

what is a hollow distensible muscular organ situated in the pelvic cavity?

A

bladder

111
Q

where is a male bladder located?

A

anterior to rectum

112
Q

where is a female bladder located ?

A

anterior to vagina and inferior to uterus

113
Q

What holds the bladder in position?

A

folds of peritoneum

114
Q

what is a trigone?

A

a small triangle area in the floor of the bladder

115
Q

what three layers makes up the urinary bladder?

A

muscose
muscularis
Adventita

116
Q

what is micturition reflex?

A

discharge of urine from bladder
combination of involuntary and voluntary muscle contraction in the bladder

117
Q

how much volume of urine can the bladder exceed?

A

200-400mL

118
Q

what sacral spinal cords are activated by the micturition reflex?

A

s2-s3

119
Q

what are the urethras?

A

small tubes leading leading the floor of the bladder

120
Q

where does male discharge occur?

A

same as semen

121
Q

what are the three anatomical regions of a male urethra?

A

prostatic urethra
intermediate urethra
spongy urethra

122
Q

how would you describe the female urethra?

A

short tube

123
Q

how long is the male urethra?

A

20 cm

124
Q

how long is the female urethre?

A

4 cm

125
Q

what are the other tissue which contributes to wasting of materials?

A

body buffers
blood
liver
lungs
sweat glands
gastrointestinal tract

126
Q

what is diuretic drugs often prescribed for?
why?

A

hypertension
to lower blood volume and this reduces blood pressure

127
Q

what is a molecule that an release an H+?

A

acid

128
Q

what is a molecule that can accept or combine H+?

A

base

129
Q

what is the measure of concentration of H+ ions in a solution?

A

pH

130
Q

what does the pH scale run from?

A

0-14

131
Q

what does a low pH indicate?

A

high concentration of H+

132
Q

what does a high pH indicate?

A

low concentration of H+

133
Q

what is normal range of pH?

A

7.35-7.45

134
Q

what three things regulate pH in body fluid?

A

chemical buffers
lungs
kidneys

135
Q

what is metabolic acidosis?

A

decreased pH due to increase acid or decrease HCO3

136
Q

what does hyperventilation do for metabolic acidosis?

A

decrease PCO2

137
Q

what is metabolic alkalosis?

A

increased pH due t H+ loss or HCO3 gain which the kidney cannot excrete excess of

138
Q

what does hyppoventilate do for metabolic alkalosis?

A

retains PCO2

139
Q

what happens with hypercapnia?

A

increase PCO2

140
Q

what will happens in hypocapina?

A

decrease PCO2

141
Q

what things can cause metabolic acidosis?

A

excessive production of metabolic acid
impaired elation of metabolic acid

142
Q

what happens when the body has no insulin?

A

diabetic ketoacidosis

143
Q

what can lead to ketoacidosis?

A

fasting and starvation

144
Q

what things lead to excessive bicarbonate loss?

A

loss of intestinal secretion
increased renal loss

145
Q

what are some manifestations of metabolic acidosis?

A

increased extracellular H+ ion concentration
decrease pH
decrease in HCO3
decreased heart rate
increase rate and depth off respiration
increase ammonia

146
Q

what causes metabolic alkalosis?

A

an excessive gain in bicarbonate
excessive loss of hydrogen ions
increased bicarbonate retention
volume contraction

147
Q

what are some manifestations of metabolic alkalosis?

A

increased pH die to primary excess of plasma HCO3 ions

148
Q

what tings cause respiratory acidosis?

A

depression of respiratory center
lung disease
airway obstruction
breathing in high CO2 content

149
Q

what are some manifestations of respiratory acidosis?

A

pH decrease
increase PCO2
warm fleshed skin

150
Q

is cystic disease inherited?

A

yes

151
Q

is cystic diseases autosomal dominant?

A

yes

152
Q

what things can cause urinary tract obstruction?

A

development delays
stones
pregnancy
benign prostatic hyperplasia
scar tissue
tumors
spinal cord injuries

153
Q

what are the manifestations of urinary obstruction disease ?

A

pain
UTI symptoms
renal dysfunction

154
Q

what are kidney stones called?

A

nephrolithiasis

155
Q

what factors influence the formation of kidney stones?

A

the concentration of stone components in the urine
ability for stone to form
presence of substance that inhibits formation

156
Q

what are the types of kidney stones?

A

calcium
magnesium
uric acid
cystine

157
Q

what causes a UTI?

A

escherichia coli

158
Q

what things are obstructed with a UTI?

A

neurogenic bladder
infrequent voiding
detrusor muscles
constipation

159
Q

what are the manifestations of bladder infections?

A

frequency urination
lower abdominal pain
back discomfort
burning pain
cloudy or foul smell of urine
disappear after 48 hrs of treatment

160
Q

what is renal failure?

A

a condition in which the kidneys fail to remove metabolic end products from the blood and regulate the fluid etc

161
Q

what are the underlying causes of renal failure ?

A

renal disease
systemic disease
urologic defects

162
Q

what are the types of renal failure?

A

acute
chronic

163
Q

what are the stages of chronic kidney failure?

A

damage and increased GFR
mild reduction of GFR
moderate reduction of GFR
severe reduction of GFR
kidney failure need of replacement

Module 8 (12 decks)

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