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BRS - U&R > Genitourinary System > Flashcards

Genitourinary System Flashcards

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1
Q

Name the main parts of the kidneys.

A 
→ renal artery
→ renal vein
→ cortex
→ medulla
→ major + minor calyx
→ ureter
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2
Q

What are the 5 main functions of the kidneys?

A

→ Excretion of metabolic products (e.g. urea, uric acid, creatinine)
→ Excretion of foreign substances (e.g. drugs)
→ Regulation of body fluids, electrolytes & acid-base balance
→ Control of blood pressure
→ Secretes hormones (e.g., erythropoietin, renin)

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3
Q

What is the organisation of vessels from the renal artery to renal vein?

A 
→ renal artery
→ segmental artery
→ interlobar artery
→ arcuate artery
→ interlobular artery
→ afferent arteriole
→ glomerular capillaries
→ efferent arteriole
→ peritubular capillaries
→ interlobular vein
→ arcuate vein
→ interlobar vein
→ renal vein
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4
Q

What is the purpose of the detrusor muscle + where is it found?

A

Contracts to build pressure in the urinary bladder to support urination - surrounds the bladder

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5
Q

What is the purpose of the trigone + where is it found?

A

Stretching of this triangular region to its limit signals the
brain about the need for urination - at the bottom near internal sphincter, has the ureteric openings

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6
Q

What is the purpose of the bulbourethral gland + where is it found?

A

Produces thick lubricant which is added to watery semen to promote sperm survival - found only in men

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7
Q

What is the purpose of the internal scphincter + where is it found?

A

Involuntary control to prevent urination - at the bottom of the bladder after the trigone

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8
Q

What is the purpose of the external scphincter + where is it found?

A

Voluntary control to prevent urination - external to the urethra

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9
Q

What is the nephron?

A

structural + functional unit of the kidneys - kidneys are made up of millions + millions of these filtering units

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10
Q

What is the glomerulus?

A

network of blood capillaries that act as microscopic filter to constantly filter blood

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11
Q

What is the Bowman’s capsule?

A

sac that contains glomerulus + starts filtration into PCT

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12
Q

What is the proximal convoluted tube (PCT)?

A

tube of nephron between Bowman’s capsule + loop of Henle, functions by reabsorbing solutes + Na + Cl ions + H2O from glomerular filtrate

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13
Q

What is the Loop of Henle?

A

long U-shaped portion of tubule that conducts urine within nephron, involved in hormonal control and reabsorption of H2O + Na+ and K+ excretion + acid/base balance through H+ secretion

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14
Q

What is the distal convoluted tubule?

A

between loop of Henle + collecting tubule, partially responsible for regulation of K+ Na+ Ca+ Cl- and pH balance

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15
Q

What is the collecting duct?

A

passages that connects to multiple nephrons to collect tubular fluid, which then undergoes changes in the collecting ducts

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16
Q

What parts of the nephron are RICH in mitochondria?

A
  • PCT
  • thin descending Loop of Henle
  • DCT
  • intercalated cells of the Collecting Duct
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17
Q

What parts of the nephron are LOW in mitochondria?

A
  • thin ascending Loop of Henle

* principal cells in the Collecting Ducts

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18
Q

What are the two types of nephron?

A
  • superficial

* juxtamedullary

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19
Q

What is the ration for the two types of nephrons?

A

10 : 1

superficial : juxtamedullary

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20
Q

What is a juxtaglomerular apparatus?

A
  • GFR regulation through tubulo-glomerular feedback mechanism
  • renin secretion for regulating blood pressure
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21
Q

What are the 3 constituents of the juxtaglomerular apparatus?

A
  • macula densa (DCT) (GFR regulation)
  • extraglomerular mesangial cells
  • juxtaglomerular cells (afferent arteriole) (renin secretion)
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22
Q

What processes occur after glomerular filtration?

A
  • reabsorption
  • secretion
  • excretion
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23
Q

What kind of process is glomerular filtration?

A

passive process - fluid is driven through semi-permeable glomerular capillaries into Bowman’s capsule by hydrostatic pressure of heart

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24
Q

How permeable is the filtration barrier?

A

size + charge dependent:
• highly permeable to fluids + small solutes
• impermeable to cells + proteins

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25
What features of the filtration barrier determine its permeability?
* fenestrae - gaps of 70,, diameter, allows passage of water + ions + small proteins * slit diaphragm - thin + porous, allows passage of water + small solutes
26
What are the 2 participating pressures in glomerular filtration?
* hydrostatic pressure (pushing) | * oncotic pressure (pulling)
27
What is hydrostatic pressure?
* fluid exerted pressure | * solutes + fluid molecules shoved out
28
What is oncotic pressure?
* solute exerted pressure | * fluid molecules drawn in across semipermeable membrane
29
What is net ultrafiltration pressure?
Puf, represents the interaction between hydrostatic + osmotic pressure
30
What is HPgc?
hydrostatic pressure in glomerular capillaries
31
What is HPbw?
hydrostatic pressure in Bowman's capsule
32
What is πgc ?
oncotic pressure of plasma proteins in glomerular capillaries
33
What is the equation for Puf?
Puf = HPgc - (HPbw + πgc)
34
What is GFR (glomerular filtration rate) ?
amount of fluid filtered into the Bowman's Capsule per unit time (mL/min) - sum of filtration rate of all functioning nephrons
35
What is the equation for GFR?
GFR = Puf x Kf | where Kf is an ultrafiltration coefficient - membrane permeability + surface area available for filtration
36
What would cause GFR imbalances?
changes in filtration forces + Kf
37
What is a fall in GFR an indication of?
cardinal feature of renal disease
38
What is the healthy range for male GFR?
90-140 mL/min
39
What is the healthy range for female GFR?
80-125 mL/min
40
What two mechanisms are used to regulate GFR?
* myogenic mechanism | * tubulo-glomerular feedback mechanism
41
What is the myogenic mechanism?
* arterial pressure increase * afferent arteriole stretches * arteriole contracts * vessel resistance rises * blood flow reduces * GFR stays the same
42
What is the tubulo-glomerular feedback mechanism?
* increase/decrease in GFR * increased/decreased NaCl in Loop of Henle * change detected by macula densa (their osmolarity changes) * increased/decreased ATP & adenosine discharged, leads to production of renin * afferent arteriole constricts / dilates, retaining water * GFR stabilises
43
What is renal clearance (C)?
the no. of litres of plasma that are completely cleared of the substance
44
How can the value of renal clearance (C) be used?
* calculating GFR * calculating RPF (renal plasma flow) * understand the excretory route of a substance
45
What is the equation for renal clearance?
C = (U X V) / P (mL/min) • U = concentration of substance in urine • V = rate of urine production • P = concentration of substance in plasma
46
What happens when a molecule is freely filtered and neither reabsorbed nor secreted?
* amount filtered = amount excreted | * GFR = renal clearance
47
What is the ideal molecule for measuring GFR?
inulin
48
Why is inulin the ideal molecule for practical determination of GFR?
* Plant polysaccharide * Freely filtered and neither reabsorbed nor secreted * Not toxic * Measurable in urine and plasma
49
Why is inulin not used very often?
not found in mammals so needs to be infused
50
What is commonly used in renal clearance tests instead of inulin?
creatinine
51
What is creatinine?
waste product from creatine in muscle metabolism
52
What is the advantage of using creatinine?
amount of creatinine released is fairly constant
53
Why is creatinine not the ideal molecule?
freely filtered + not | reabsorbed BUT small amount is secreted into the nephron - therefore not perfect
54
What does low creatine clearance or high plasma creatine mean?
indicates renal failure
55
How do we overcome the shortcomings of creatinine?
accounted for when estimating creatinine in blood + urine to allow for GFR calculations
56
What is renal plasma flow?
volume of plasma that reaches the kidneys per unit of time
57
When does renal clearance = renal plasma flow?
total amount of substance entering kidney = amount excreted
58
What is PAH?
para-aminohippuric
59
Why is PAH used?
completely removed from the plasma passing through filtration + secretion
60
What is the filtration fraction (FF)?
ratio of the amount of plasma which is filtered, and which arrives via the afferent arteriole
61
What is the equation for FF?
FF = Quf / Qp • Quf = ultrafiltrate flow rate • Qp = plasma flow rate
62
What is the normal range for FF?
0.15-0.2 (i.e. 15% to 20% of plasma being filtered)
63
What is the other equation for FF including GFR?
FF = GFR / RPF
64
What forms of passive transport do the renal tubules use?
* Diffusion * Osmosis * Electrical Gradient Difference
65
What forms of active transport do the renal tubules use?
``` • Primary Active Transport e.g. Na+/K+ ATPase pump • Endocytosis • Secondary Active/Coupled Transport e.g. Na+/Glucose Symporter, Na+/H+ Antiporter ```
66
What is the paracellular pathway in the tubules?
movement between cells, usually water + ions move with water
67
What is the transcellular pathway for H2O?
aquaporins allow movement of water across cells
68
What is the mechanism for transcellular Na+ reabsorption?
* Na+/K+ pump on basolateral cell membrane creates Na+ gradient * Na+ moves in from tubular fluid
69
What gets reabsorbed in the early PCT?
* 100% Glucose * 100% amino acids * 90% HCO3- * 67% Na+ * 67% Cl- * 67% Water * 50% urea
70
How is Na+ reabsorption in the PCT regulated?
angiotensin II by increasing Na+/H+ antiporters
71
What substances are secreted by the early PCT?
* Drugs * Ammonia * Bile salts * Prostaglandins * Vitamins (folate & ascorbate)
72
What is the mechanism of Na+ and HCO3- reabsorption in the early PCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * CO2 enters cell through diffusion + combines w/ H2O = H+ + HCO3- * Na+ H+ antiporters transport Na+ into cell + H+ out of cell * Na+ HCO3- symporters pump Na+ + HCO3- out of cell into blood
73
What is the mechanism of glucose reabsorption in the early PCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * Na+ glucose symporter pumps Na+ + glucose into cell * GLUT2 transports glucose out of cell into blood
74
What substances are reabsorbed into Henle's Loop?
* 25% Na+ * 25% Cl- * 15% H2O
75
What is the thin descending limb permeable and impermeable to?
* H2O (passive) permeable | * Na+ and Cl- impermeable
76
What is the thin ascending limb permeable and impermeable to?
* Na+ and Cl- (passive) permeable | * H2O impermeable
77
What is the thick ascending limb permeable and impermeable to?
Na+ and Cl- actively pumped out
78
What is the mechanism of Na+ and Cl- reabsorption in the early PCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * Na+ K+ and 2 Cl- symporter pumps into cell * K+ Cl- symporter transports glucose out of cell into blood * K+ and Cl- are passively transported out
79
What is the mechanism of Na+ and Cl- reabsorption in the early DCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * Na+ Cl- symporter pumps into cell * K+ Cl- symporter transports glucose out of cell into blood * Cl- are passively transported out
80
What is the mechanism of active Ca2+ reabsorption in the early DCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * Na+ Ca2+ antiporter pumps Na+ into cell + Ca2+ out into blood * Ca2+ ATPase pump pumps out into blood
81
How is Na+ reabsorption regulated in the principal cell of the late DCT + collecting duct?
Aldosterone - increasing apical Na+ channels & basolateral Na+/K+ ATPase pumps
82
How is H2O reabsorption regulated in the principal cell of the late DCT + collecting duct?
ADH - increasing apical aquaporins
83
What is the mechanism of active Na+ K+ and H2O reabsorption in the early DCT?
* Na+/K+ ATPase pump creates low conc. of Na+ in cell * K+ passively diffuses out of cell + Na+ moves into cell * H2O osmotically moves in + out through aquaporins at membranes
84
What is the function of intercalated cells of the late DCT + collecting duct?
maintaining acid-balance
85
What is the function of ⍺-intercalated cells?
HCO3- reabsorption & H+ secretion
86
What is the function of β-intercalated cells?
HCO3- secretion & H+ reabsorption
87
What is the mechanism of active HCO3- reabsorption & H+ secretion in the early DCT?
* Cl- + HCO3- antiporter pumps Cl into cell and HCO3- out of cell into blood * H+ ATPase pump actively pumps H+ ions out of cell * Cl- passively moves out of cell into blood
88
What is the mechanism of active HCO3- secretion & H+ reabsorption in the early DCT?
* H+ ATPase pump actively pumps H+ ions out of cell into blood * Cl- + HCO3- antiporter pumps Cl into cell and HCO3- out of cell * Cl- passively moves out of cell into blood

BRS - U&R (2 decks)

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