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_Physiology Exam 5 > 4/8: II - Urinary System > Flashcards

4/8: II - Urinary System Flashcards

1
Q

What does the renal system regulate?

A
  • water and electrolyte balance
    (output = input)
  • arterial pressure
    Vascular resistance, circulating volume
    Renin-gniotensin-aldosterone, AVP/ADH
  • solute concentrations (osmolarity)
  • acid base balance
    active vitamin D (calcitriol) production:
    Calcium homeostasis
    Dynamic bone structure
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2
Q

What does the renal system excrete?

A

Metabolic waste products and foreign chemicals
- urea, uric acid, creatinine, bilirubin
- drugs, pesticides, food additives
Gluconeogenesis

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3
Q

How does the kidnet match input?

A

Increasing or decreasing excretion rate of a substance
Ex: 10x increase of Na+ intake leads to compensatory 10x increase in Na+ excretion
- Small period of time between disturbance and balance
- Excretion rate lags behind the intake rate by about 2-3 days, which leads to a small increase in volume that will be maintained

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4
Q

What is the gross anatomy of the kidneys?

A

Two kidneys - retroperitoneal
Size of clenched fist

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5
Q

What are the two major regions of the kidney?

A

Cortex
Medulla

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6
Q

What is the medulla composed of?

A

Renal pyramids
Renal columns

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7
Q

What do renal pyramids contain?

A

Nephrons (functional unit)

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8
Q

What does the nephron produce?

A

Urine

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9
Q

What are renal pyramids border of?

A

Cortex/medulla

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10
Q

Describe the flow of urine

A

nephron dumps urine contents into minor calyx -> major calyx -> renal pelvis -> ureter -> urinary bladder -> released from the body via micturition reflex

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11
Q

What are ureters?

A

Tubes with smooth muscle walls that exhibit peristalsis

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12
Q

What happens during peristalsis?

A
  • Calyces stretched by urine
  • Initiates peristaltic wave that
    flows through pelvis, along
    ureter to bladder
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13
Q

What can alter peristalsis?

A

Autonomic nerves

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14
Q

What does parasympathetic and sympathetic do to peristalsis?

A
  • Parasympathetic enhances
    peristalsis
  • Sympathetic decreases
    peristalsis
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15
Q

Where do the ureters enter the bladder through?

A

Detruser muscle (smooth muscle)

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16
Q

What does muscle tone do to the ureters?

A

Muscle tone compresses ureter and prevents black
flow of urine during micturition

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17
Q

What does peristaltic wave do within the ureter?

A

Peristaltic wave increase pressure within ureter,
opening ureter lumen, allowing urine to flow into
bladder

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18
Q

What is trigone?

A

Trigone: triangular region of the bladder where ureters pass through the wall of the bladder

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19
Q

What is the vesicouteral reflux?

A

condition of backflow of urine into ureter that causes enlarged ureters and back flow of pressure into the kidneys and can damage renal pelvis and nephrons in the kidney
o Ureters have increased pain innervation, causing this condition to be painful

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20
Q

What is ureterorenal reflex?

A

reflex that occurs when the ureters are blocked. Protective reflex that functions to slow down kidney function and renal blood flow
i.e. kidney stone

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21
Q

What is the detrusor muscle?

A

forms the body of the bladder
Single unit smooth muscle connected by gap junctions and function together
They can rapidly transmit electrical signals

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22
Q

What is the trigone?

A

triangular region of the bladder where ureters pass through the wall of the bladder

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23
Q

What is the internal urethral sphincter?

A

forms the neck of the bladder
Is a smooth muscle sphincter with intrinsic tone that prevents bladder emptying until pressure increases to threshold
- Under involuntary control

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24
Q

What is the external urethral sphincter?

A

part of the urogenital diaphragm. Made up of skeletal muscle. When maturation reflex is initiated, it will cause internal urethral sphincter to relax
- Under voluntary control. Learned to control this during our 2-3rd year of life

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25
Q

What is the urethra?

A

once the external urethral sphincter relaxes it causes urethra to relax and urine will flow

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26
Q

What is the urinary bladder innervation?

A

Via pelvic nerves (forms sacral nerves)

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27
Q

What do visceral snesory neurons detect?

A

Degree of bladder stretch
- As urine starts to fill up bladder, the wall is stretched, and sensory information is sent into spinal cord

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28
Q

What do parasympathetic neurons stimulate?

A

contraction of the detrusor muscle and relaxation of internal sphincter (Involuntary)

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29
Q

What are pudendal nerves?

A

Somatic motor neurons controlling external sphincter (voluntary)

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30
Q

What do sympathetic neurons control?

A

Bladder blood vessels (not bladder)
**has no influence on micturition reflex

31
Q

Describe the micturition reflex

A
32
Q

What is receptive relaxation?

A

smooth muscle relaxes to try and keep tonic pressure relatively constant. This allows us to be able to put more urine into bladder before micturition reflex initiates
i.e. we can go from 100-250 mL with very little change in pressure

33
Q

Describe the pulsatile nature of the micturition reflex

A

positive feedback increases micturition reflex. After time, the reflex fatigues and ceases and the bladder relaxes. If the bladder was not emptied during that micturition reflex than the reflex will remain inhibited and then it will occur again due to increased pressure

34
Q

Describe voluntary urination

A

forced abdominal muscle contraction causes increase in bladder pressure that will activate micturition reflex and then voluntary voiding of urine can occur

35
Q

Describe kidney blood flow

A

very high, in the resting state it receives 20% of total cardiac output

36
Q

What is the kidney’s arterial system?

A

Renal artery (branch of the aorta) carries systemic blood to kidney and enters at hilum and branches into smaller and smaller arteries

37
Q

What are the arcuate arteries?

A

smallest branch that then starts microcirculation

38
Q

What is the kidney’s venous system?

A

small veins join together and eventually exit the kidney as the renal vein

39
Q

What is the kidney’s microcirculation?

A

Found around the nephron, comprised of two arterioles and two capillary beds

40
Q

Describe the flow of circulation in the kidneys

A

Afferent arteriole (from arcuate arteries) (towards the glomerulus) -> glomerular capillaries -> efferent arteriole (away from the glomerulus) -> peritubular capillaries -> venules

41
Q

Where does the regulation of blood flow occur?

A

on either side of the glomerulus
- Blood flowing into and out of glomerulus are through arterioles. Arterioles have the ability to change diameter, changing blood flow

42
Q

What are the pressures of glomerular and peritubular capillaries?

A

Glomerular - high pressure capillaries
Peritubular - low pressure capillaries

43
Q

What are the glomerular and peritubular capillaries site of?

A

Glomerular - site of filtration
Peritubular - site of secretion and reabsorption

44
Q

What do the glomerular and peritubular capillaries surround?

A

Glomerular - first capillary bed that surrounds the glomerulus
Peritubular - second capillary bed that surrounds nephron tubules

45
Q

What do afferent and efferent arteriole resistance alter in glomerular capillaries?

A

Afferent and efferent arteriole resistance can be altered to alter hydrostatic pressure in the capillaries (Pc) in glomerular capillaries via bulk flow

46
Q

What is the nephron?

A

functional unit of the kidney. Each segment of the nephron has different cell types with different functions. About 1 million nephrons per kidney

47
Q

Where is the proximal tubule located?

A

Cortex

48
Q

What does the proximal tubule divide into?

A
  • Proximal convoluted tubule (PCT): waved, early PT
  • Proximal straight tubule (PST): straight, late PT
49
Q

Where does the loop of henle extend to?

A

Medulla

50
Q

What is the loop of henle made up of?

A
  • Thin descending limb
  • Thin segment of ascending limb
  • Thick segment of ascending limb
51
Q

Where is the distal tubule located?

A

In the cortex

52
Q

What does the collecting duct further divide into?

A
  • Cortical collecting duct: found in cortex
  • Medullary collecting duct: found in medulla
53
Q

Where does the collecting duct (medullary) Connect with?

A

Papilla where it empties urine

54
Q

What are the two classes of nephrons?

A

Cortical
Juxtamedullary

55
Q

Compare the juxtamedullary and cortical nephrons

A
56
Q

What are the four renal processes of urine formation?

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Excretion
57
Q

What is the function of glomerular capillaries?

A

Filtration

58
Q

How does filtration occur?

A

Via bulk flow

59
Q

What is glomerular filtrate identical to?

A

Plasma except protein free

60
Q

What is glomerular filtration rate?

A

Rate of filtrate production

61
Q

What is the function of reabsorption?

A

removes wanted substances from glomerular filtrate and puts it back into blood via peritubular capillaries

62
Q

How does reabsorption occur?

A

Via passive and active transport processes across nephron epithelium

63
Q

What is secretion?

A

removal of unwanted substances still in plasma and secrete it into glomerular filtrate in nephron (“means of taking substances that didn’t get filtered into the nephrons and should have and secrete it into the filtrate”)

64
Q

How does secretion occur?

A

Via Passive and Active transport processes
across nephron epithelium

65
Q

What is excretion?

A

Removal of metabolic waste

66
Q

Where does urine exit and enter?

A

Exits collecting duct into minor calyx

67
Q

What is renal handling of substances defined as?

A

by the excretion rate of a substance should be equal to the filtration load minus the reabsorbed amount plus the secreted amount
EX= FX – RX + SX

68
Q

What is the renal handling with filtered only?

A
69
Q

What is the renal handling of filtered and partial reabsorption?

A
70
Q

What is the renal handling of filtered and complete reabsorption?

A
71
Q

What is the renal handling of filtered and secreted?

A
72
Q

Describe sodiums filtration and reabsorption work?

A

has extreme filtration and reabsorption work (25,560 Fx and 25,410 Rx)

73
Q

Why do we filter so much and then expend so much energy to return greater than 99% back into the ECF?

A

it can be the only way to get rid of some of the waste products. You want to filter a lot to capture the waste product that can only be removed via filtration

_Physiology Exam 5 (10 decks)

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