exam 4 Flashcards
(86 cards)
1
Q
- Other organs function in urine transport, storage, or elimination
- Kidneys, ureters, and urinary bladder considered retroperitoneal
Urinary system:
kidneys and the urinary tract
A
Urinary system:
kidneys and the urinary tract
2
Q
process of eliminating urine from the body
A
Urination (micturition)
3
Q
- Excretion – separate wastes from body fluids
- Elimination from body
- Homeostatic regulation
* Blood volume and pressure
* Electrolyte balance
* Acid-base balance
* Erythropoietin (EPO)
* Clear hormones, drugs, free radicals
* Make glucose from amino acids
A
What are the functions of the urinary system?
4
Q
- most nerve fibers associated with the sympathetic division
- adjust rate urine formation by changing blood flow
- stimulate release of renin
A
Renal nerves innervate the kidneys and ureters
5
Q
-Renal artery arises at aorta
-Kidneys receive a large volume of blood for waste removal (~1-1.2 liters/min)
Efferent arteriole
Should know:
* Renal artery
* Renal vein
A
Blood supply to the kidneys
6
Q
Hydronephrosis is a common issue in newborns in which the renal pelvis is enlarged. While this often resolves itself, in some cases it is indicative of a blockage that is causing urine to accumulate in the renal pelvis. If you
were a doctor, where would you look for a blockage and why?
A
first and most likely location to investigate in newborns is the ureteropelvic junction, due to its high incidence and direct relationship with urine drainage from the kidney.
7
Q
Kidney stones are caused by high levels of certain substances in the urine (for e.g., calcium, oxalate, phosphorus, uric acid, etc). Individuals with large kidney stones may experience pain in their lower back or lower abdomen. How would you explain to a patient why these are the locations they are feeling pain?
A
the pain follows the path of the stone — from the kidney (lower back) down through the ureter (abdomen/groin) — which is why those are the spots where you feel it.
8
Q
Renal pelvis, ureters, and urinary bladder are lined by _____ _______
A
transitional epithelium (urothelium)
9
Q
- Peristaltic waves move urine towards urinary bladder
- No sphincters
- Ureter wall has 3 layers
A
Ureters function in urine transport
10
Q
Urinary bladder functions in temporary storage of _____
A
urine
11
Q
Urethra conducts urine to the _____
A
exterior
12
Q
_____ have shorter urethra,
putting them at higher risk of urinary tract infections
A
females
13
Q
urethra is longer and subdivided into
regions: prostatic, membranous, and spongy urethra (spongy urethra passes through the penis)
A
males
14
Q
Detrusor underactivity is a dysfunction associated with incomplete bladder emptying and/or the failure to completely empty the bladder within a normal timeframe.
How do you explain the clinical signs of this dysfunction based on what you know?
A
detrusor underactivity leads to signs of inefficient urination, with symptoms tied to a weak or insufficient contraction of the bladder muscle during the voiding phase.
15
Q
fluid/solutes moved from blood into capsular space (filtration)
* Glomerular capsule (Bowman’s capsule)
* Glomerulus
A
Renal corpuscle
16
Q
solutes reabsorbed (taken back into
body) or secreted into tubular fluid
A
renal tubule
17
Q
Cortical nephrons are associated with _____ _____
A
peritubular capillaries
18
Q
Juxtamedullary nephrons are associated with the ____ ____ → runs countercurrent to nephron loop, important for maintaining medullary osmotic a gradient (discussed later)
A
vasa recta
19
Q
- Multiple nephrons empty into a collecting duct
- Multiple collecting ducts can empty into a papillary duct
A
Collecting system
20
Q
- Filtration
- Reabsorption
- Secretion
Note variable reabsorption and secretion is often tied to:
* Hormonesignalsrelatedtowater, electrolyte balance
* Maintaining acid-base balance
A
Processes associated with urine formation
21
Q
Blood flow through the ____ _____ is opposite filtrate flow -> maintains gradient by taking away reabsorbed H2O and solutes
A
vasa recta
22
Q
Variable reabsorption and secretion due to hormonal regulation
A
Distal convoluted tubule and collecting duct:
23
Q
Collecting ducts use the gradient to adjust urine _____
A
osmolarity
24
Q
- Which BEST explains why it is important that the vasa recta runs countercurrent to and along the nephron loop (of juxtamedullary nephrons)?
a.The vasa recta is the countercurrent multiplier.
b.It ensures the tubular fluid is isosmotic to blood at all times. c.It determines whether the urine produced is a pale or dark
yellow.
d.It enables both solutes and water to be carried away as they
are reabsorbed.
e.It creates an osmotic gradient in the renal cortex.
A
It enables both solutes and water to be carried away as they
are reabsorbed.
25
- affects bp and volume
-can vary intake of water or water loss
- water loss in urine is tied to transport of ions (especially Na+) + aquaporins in membrane
water balance
26
* Can eliminate excess acids in urine
* Can create/regenerate buffering molecules
* Acid-base balance
27
Balance water gain versus water loss → imbalance associated with a change in osmolarity of extracellular fluids → affects cells, blood volume and _____ ____
BP
28
* Stimulate thirst
* Release antidiuretic hormone
(ADH)
* Renin-angiotensin-aldosterone
system (RAAS)
Too much water loss:
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* Inhibit thirst
* Natriuretic peptides secreted –
especially atrial natriuretic peptide (also called atrial natriuretic hormone/ANH)
Too much water gain:
30
promotes water reabsorption → cells respond to ____ by putting more aquaporins in the apical membrane
ADH
31
1. decrease osmolarity of extracellular fluids
2. decrease ADH release from posterior pituitary
3. decrease number of aquaporins in collecting duct
4. decrease H20 reabsorption from collecting duct
5. large volume of dilute urine
if we were so over hydrated we had no ADH
32
1. increase osmolarity of extracellular fluids
2. increase ADH release from posterior pituitary
3. increase number of aquaporins in collecting duct
4. increase H20 reabsorption from collecting duct
5. small volume of dilute urine
if we were so over dehydrated we had maximal ADH
33
____+ ion balance also
affects ADH secretion
Na
34
either a loss of water or an excess of sodium
Hypernatremia
35
It’s usually due to an excess of water relative to sodium, not always a sodium deficiency
Hyponatremia
36
Diabetes insipidis is characterized by an inability of the body to balance fluid levels due to problems related to antidiuretic hormone (ADH). Patients experience extreme thirst, the frequent need to urinate, and produce large quantities of pale urine.
a) This condition can be acquired later in life for example if there is damage to the hypothalamus or pituitary gland. Why would this cause the clinical signs given above?
Damage to the hypothalamus or pituitary disrupts ADH production, leading to impaired water retention, which causes excessive urination and extreme thirst—the hallmark signs of diabetes insipidus.
37
Diabetes insipidis is characterized by an inability of the body to balance fluid levels due to problems related to antidiuretic hormone (ADH). Patients experience extreme thirst, the frequent need to urinate, and produce large quantities of pale urine.
This condition can also be caused by genetic mutations that prevent the kidneys from responding to ADH. Can you explain the mechanism by which this causes the clinical signs given above?
Genetic mutations disrupt the kidney's ability to respond to ADH, so water can't be reabsorbed, leading to excessive urination and thirst, just like in central diabetes insipidus — but due to a receptor/channel problem, not a hormone deficiency.
38
1. decrease in BP at glomerulus
2. stimulation of juxtaglomerular cells by sympathetic innervation
3. decrease of tubular fluid osmolarity at macula densa
Renin release triggered by:
39
1. angiotensin 2 secreted
2. constricts afferent and especially efferent arterioles
3. maintains glomerular BP and glomerular filtration
4. reduced BP in peritubular capillary
5. reduces resistance to tubular reabsorption
6. tubular reabsorption
7. urine volume is less but concentration is high
Renin-angiotensin-aldosterone system (RAAS)
40
Aldosterone promotes water reabsorption at the ____ convoluted tubule and ____ portion of the collecting duct
distal; proximal
41
- Stimulates synthesis and incorporation of Na+ channels and Na+/K+ pumps into membranes
* Activity of aldosterone affects K+ ion balance
Aldosterone
42
Increased plasma potassium can also directly stimulate _____ secretion
aldosterone
43
Addison’s disease, otherwise called adrenal insufficiency, is a condition where the body does not make enough adrenal hormones, including aldosterone.
a.Clinical signs of this disease can include fluid loss and low blood pressure. How do you explain this based on what you know from class?
In Addison’s disease, aldosterone deficiency leads to loss of sodium and water through the urine. This causes a drop in blood volume, which results in low blood pressure and dehydration — two hallmark signs of the condition.
44
Addison’s disease, otherwise called adrenal insufficiency, is a condition where the body does not make enough adrenal hormones, including aldosterone.
b.If a physician suspects Addison’s disease, they may perform a blood test to check sodium and potassium levels. What would you expect the individual to have high or low levels of potassium? Of sodium?
Electrolyte Expected Level in Addison’s Disease
Sodium (Na⁺) Low (Hyponatremia)
Potassium (K⁺) High (Hyperkalemia)
45
Less K+ is lost when pH is low because Na+ is instead exchanged for H+ ions
Potassium homeostasis
46
Why is potassium ion imbalance so dangerous?
Potassium imbalance is dangerous because it disrupts the electrical balance of cells, especially in the heart, which can result in fatal arrhythmias, muscle dysfunction, and neurological symptoms.
47
If blood pressure is too high, natriuretic peptides promote increased ____ _____ in urine
water loss
48
Maintaining the pH of ECF within the optimal physiological range (7.35- 7.45)
* The term acidosis and alkalosis are used with respect to this physiological pH optimal range:
Acid-base balance:
49
less than 7.35
acidosis
50
greater than 7.45
alkalosis
51
Only removes volatile acids (i.e., carbonic acid → water and carbon dioxide)
Respiratory compensation
52
Need to also buffer against pH changes in tubular fluid
Mechanisms to counter acidosis can affect balance of other ions
Renal compensation
53
help minimize pH changes as acids or bases are added
* Buffer present → smaller change in pH → less likely to impact on function
* Buffer systems have a limited buffering capacity
Buffers
54
Do not dissociate completely -->
Adding an acid or base shifts the equilibrium -->
Less dramatic change in pH
Buffer systems involve a weak acid and weak base combination
55
1. Production of gametes
2. Bringing male and female gametes together
3. Fertilization to form a zygote
4. Supporting fetal development (gestation) and birth (parturition)
Reproductive system functions humans
56
* Homologous structures
* Endocrine and neural regulation
* Neural regulation of sexual function involves the ANS
Common features male and female reproductive systems
57
elevates testes
cremaster muscle
58
wrinkles scrotal skin
Dartos muscle
59
. When individuals visit fertility specialists, they are often asked to fill out a questionnaire. One of the questions commonly included on male fertility
questionnaires is “Do you take hot baths, saunas, or whirlpools?” Why is this information relevant to male fertility?
Testicular temperature regulation is crucial for healthy sperm development (spermatogenesis).
The testes are located outside the body in the scrotum to maintain a temperature about 2–4°C cooler than core body temperature—ideal for sperm production.
When a man frequently takes hot baths or uses saunas/whirlpools, testicular temperature rises, which can:
Reduce sperm count
Impair motility (sperm movement)
Cause abnormal morphology (shape and structure)
Studies show that prolonged exposure to elevated temperatures can temporarily lower fertility, though the effects may be reversible after stopping heat exposure.
60
Each testis is divided into lobules containing seminiferous tubules that produce _____
sperm
61
_______ is the maturation of a spermatid into a functional sperm
seprmiogenesis
62
Seminiferous tubules → rete testis → efferent ductule → epididymis
Pathway sperm travel:
63
Pathway sperm travel:
Seminiferous tubules → rete testis → efferent ductule → epididymis
64
* Monitor and adjust fluid compositions
* Recycle/remove damaged sperm
* Store and protect sperm
* Facilitate functional maturation sperm
* Fluid movements and peristaltic contractions move sperm (sperm arealso
ejaculated from the epididymis, not testis; at this stage they are not motile/fully functional → need to undergo capacitation)
Epididymis is a comma-shaped organ associated with the testes
64
65
* Activate sperm
* Provide nutrients * Buffers
* Propel sperm and fluids
Accessory glands: seminal glands, prostate, bulbo- urethral glands
66
Contraction of smooth muscle in walls of accessory glands pushes secretions out of gland into the ______ system
duct
67
- sperm count, morphology (shape), and motility
- semen pH
- time it takes for semen to liquify
- indicators of infection (for ex. bacteria, WBCs)
Semen analysis commonly involves looking at:
68
Prostate cancer is one of the most common cancers among males. If detected early, the prognosis is often good. In some cases, surgery is required to treat prostate cancer. Typically, the surgery will involve removal of the entire prostate, the seminal glands, and some pelvic lymph nodes.
Why would males be considered infertile after this surgery even though they are still able to produce sperm?
removal of the prostate and seminal vesicles disrupts the ejaculation pathway, preventing sperm from being released—hence, the individual is considered infertile.
69
blood flow
restricted (vasoconstriction associated with sympathetic activity)
Resting state
70
facilitated by parasympathetic reflex that leads to nitric oxide release → leads to vasodilation, chambers fill with blood
Erection
71
*Originally investigated as a medication for treating angina and hypertension → later repurposed as an erectile dysfunction drug
* Target of the drug found to be highly expressed in the corpora cavernosa and its vasculature, but poorly expressed in the myocardium
Viagra
72
Increases parasympathetic activity --> erection
Nitric oxide release leads to vasodilation and filling of the vascular channels with blood
Sexual arousal
73
Sensory receptors in glans penis --> Lubrication of spongy urethra and glans penis
Alkaline mucus secretion from bulbo- urethral glands
Sexual stimulation
74
Sympathetic activity, somatic motor neurons
Movement sperm and fluids
Associated with the male orgasm, systemic changes including increased heart rate, and blood pressure
Ductus deferens, seminal glands, and prostate contract
Internal urethral sphincter constricts to prevent flow of urine
Muscles associated with penis undergo rapid series of contractions to propel semen
Emission and ejaculation
75
Sympathetic activity
Heart rate and blood pressure decrease, erection is lost
Blood leaves erectile tissue, followed by a refractory period
Resolution and detumescence
76
For ligaments and mesenteries, the emphasis is on ______ function rather than identifying individual ligaments/mesenteries
collective
77
Untreated sexually transmitted infections (STI) can have numerous, negative impacts on female health.
a. STI infections in females can more easily spread from the reproductive system to the peritoneal (abdominopelvic) cavity. Why do you think this is?
STIs can more easily spread to the peritoneal cavity in females because the female reproductive tract is open to the abdominal cavity through the fallopian tubes. This allows bacteria to travel from the vagina through the uterus and fallopian tubes into the peritoneal cavity, increasing the risk of complications like pelvic inflammatory disease.
78
STI’s in females may impact fertility, especially if the infection spreads to the uterine tubes where it can cause inflammation and scar tissue formation. Why would this impact fertility?
STIs can cause inflammation and scar tissue in the uterine (fallopian) tubes, which can block or narrow them. This prevents sperm from reaching the egg or the fertilized egg from reaching the uterus, making fertilization or implantation difficult and reducing fertility.
79
are sites of gamete and hormone (estrogen, progesterone) production in females
Ovaries
80
Fertilization usually occurs near where the ampulla and isthmus meet
* Uterine tubes open into peritoneal cavity, not directly connected to ovaries → individuals at risk of ectopic pregnancies, pelvic inflammatory disease associated with STIs
Uterine tubes (fallopian tubes) transport the secondary oocyte and are where fertilization occurs
81
helps move oocytes, nourish gametes, and complete capacitation of sperm
Uterine tube
82
receives, retains, and nourishes fertilized ovum
uterus
83
* *
cervical glands also secrete mucus that covers external os, helps lubricate vagina Three layers to uterine wall: perimetrium, myometrium, endometrium
uterus
84
- results from strong myometrial contractions due to high prostaglandin secretion
- NSAID drugs are often effective for cramps because they inhibit prostaglandins biosynthesis
- excessive pain during menstruation may be due to other conditions
Functional layer of the endometrium undergoes cyclical changes in response to ovarian hormones, is shed during menstruation
Note on menstrual cramps:
85
* Rugae
* Stratified squamous
epithelium
* No specialized glands
* In healthy individuals has an acidic pH due to bacterial activity
The vagina is the female organ of copulation, serves as a passageway for menstrual flow and delivery of an infant
