GU 19.1 Flashcards

(201 cards)

1
Q

What are the components of the urinary system?

A

two kidneys
two ureters
one urinary bladder
one urethra

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2
Q

After kidneys filter the blood they return most of the water and many solutes where?

A

the bloodstream

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3
Q

What is the scientific study of the anatomy, physiology, and disorders of the kidney?

A

Nephrology

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4
Q

What is the branch of medicine that deals with the male and female urinary system and the male reproductive system?

A

Urology

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5
Q

What are the 5 functions of the kidneys?

A

Regulation of ion levels in the blood
Regulation of blood volume and blood pressure
Regulation of blood pH
Production of hormones
Excretion of wastes

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6
Q

What ions are most importantly regulated by the kidneys?

A

Sodium ions (Na+)
Potassium ions (K+)
Calcium ions (Ca^2+)
Chloride ions (Cl-)
Phosphate ions (HPO4^2)

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7
Q

How do the kidneys adjust blood volume?

A

returning water to the blood or eliminating it in the urine

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8
Q

Blood pressure is regulated by what?

A

Secreation of enzyme renin

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9
Q

Enzyme renin does what?

A

activates the renin-angiotensin-aldosterone pathway by adjusting blood flow into and out of the kidneys, and by adjusting blood volume

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10
Q

How do the kidneys regulate the concentration of H+ in the body?

A

Excreting a variable amount of H+ in the urine

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11
Q

The kidneys conserve what important buffer of H+ to regulate pH?

A

HCO3-

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12
Q

What hormones do the kidneys produce?

A

Calcitriol
Erythropoietin

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12
Q

Calcitriol is the active form of vitamin D and does what?

A

Helps regulate calcium homeostasis

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13
Q

What does erythropoietin do?

A

stimulates production of red blood cells

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14
Q

What wastes or substances do the kidneys excrete?

A

Ammonia and urea
Bilirubin
Creatinine
Uric acid
Drugs and enviromental toxins

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15
Q

Ammonia and urea are from the breakdown of what?

A

Amino acids

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16
Q

Bilirubin is from the breakdown of what?

A

hemoglobin

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17
Q

Creatinine is the breakdown from what?

A

Creatine phospate in muscle fibers

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18
Q

Uric acid is the breakdown from what?

A

nucleic acids

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19
Q

Where do kidneys lie in the body?

A

Either side of the vertebral column between the peritoneum and the back wall of the abdominal cavity

between T-12 and L-3

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20
Q

What provides protection for the superior aspect of the kidneys?

A

11-12th pairs of ribs

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21
Q

What is the indentation near the center of the medial border of the kidney called?

A

Renal hilum

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22
Q

What enters and exits at the renal hilum?

A

Enters/Exit
-blood vessels
-lymphatic vessels
-nerves

Exit
-Ureters

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23
Q

What surrounds each kidney that is smooth, transparent, connective tissue sheath that gives shape and serves as a barrier against trauma?

A

renal capsule

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24
What surrounds the renal capsule and cushions the kidney as well as anchors the kidney to the posterior abdominal wall with dense irregular connective tissue?
Adipose tissue
25
What are the two main regions inside the kidney?
Renal cortex Renal medulla
26
Which region of the internal kidney is the outer light-red region?
Renal cortex
27
Which region of the internal kidney is the inner, darker red-brown region?
Renal medulla
28
Cone-shaped renal pyramids are within what structures?
Renal medulla
29
What structures fill the spaces between renal pyramids and are extensions of the renal cortex?
Renal columns
30
What cuplike structures does urine that is formed in the kidney pass from papillary ducts into?
minor calyces
31
How many minor calyces are in each kidney?
8-12
32
Urines flows from the minor calyces to what?
Major calyces
33
How many major calyces are in a kidney?
2-3
34
Urine travels from the major calyces to the single large cavity called?
renal pelvis
35
The renal pelvis drains urine into the ureter that transports urine to where? and then where?
urinary bladder urethra
36
How much of the resting cardiac output flows into the kidneys through the right and left renal arteries?
20-25% 1200 mL of blood per min
37
What smaller vessels do renal artery divide into? (all)
segmental interlobar arcuate Cortical radiate
38
Vessels that branch from the renal artery ultimately deliver blood to what structure?
afferent arterioles
39
afferent arteriole divide into a tangled capillary network called the?
glomerulus
40
The capillaries of the glomerulus reunite to form what structure?
Efferent arteriole
41
What capillaries do efferent arterioles divide into?
peritubular capillaries
42
Where do the veins from the peritubular capillaries ultimately drain into after leaving the glomerulus?
Renal vein
43
What is the functional unit of the kidney?
Nephron
44
How many nephrons are in each kidney?
About a million
45
What are the two parts of the nephron?
Renal corpuscle Renal tubule
46
Where is blood plasma filtered in the nephron?
Renal corpuscle
47
Filtered fluid, called glomerular filtrate passes through what structure of the nephron?
Renal tubule
48
What is added to fluid as it moves through the renal tubles?
Waste excessive substances
49
What are the two parts that make up a renal corpuscle?
glomerulus glomerular capsule (Bowman's)
50
Glomerular filtrate enters the glomerular capsule and then pass into the?
renal tubule
51
What are the three main sections of the renal tubule?
proximal convoluted tubule loop of Henle distal convoluted tubule
52
What lies within the renal cortex?
Renal corpuscle Convoluted tubules
53
What structure of the renal tubule extends into the renal medulla?
loop of Henle
54
What does a papillary duct lead into?
minor calyx major calyx renal pelvis ureter
55
What are the basic functions performed by a nephron?
Glomerular filtration tubular reabsorption tubular secretion
56
What is the first step of urine production?
Glomerular filtration
57
What forces water and blood plasma solutes across the glomerular capillaries?
Blood pressure
58
How much of the filtered water and useful solutes to the blood during tubular reabsorption?
99%
59
The filtered fluid is called urine after tubular reabsorption and secretion and it enters what structures?
minor and major calyx
60
Nephrons perform glomerular filtration, tubular reabsorption and tubular secretion to maintain what?
Homeostasis of blood volume and composition
61
What two layers of cells compose the capsule that surrounds the glomerular capillaries?
podocytes simple squamous epithelial cells
62
Why do blood cells and most plasma proteins remain in the blood during filtration?
Too large to pass through membrane
63
What are two pressures that oppose glomerular filtration?
Blood colloid osmotic pressure Glomerular capsule pressure
64
When osmotic or capsule pressure increases what happens to glomerular filtration?
decreases
65
What is the normal net filtration pressure when blood pressure is greater than osmotic and capsule pressures?
10 mm Hg
66
How much volume does net filtration pressure force into the capsular space for men and women?
M- 180 L F- 150 L
67
What is the formula for net filtration pressure?
Blood colloid osmotic pressure + Glomerular capsular pressure minus Glomerular capillary blood pressure equals Net Filtration pressure
68
Which arteriole assists with raising blood pressure and has a smaller diameter?
Efferent
69
The amount of filtrate that travels through the kidneys every minute is called?
Glomerular filtration rate
70
What is the GFR for men and women?
M- 125mL/min F- 105mL/min
71
What happens to substances if the GFR is too high?
pass out of the body in urine due to inability to reabsorb
72
What would cause all filtrate being reabsorbed and waste not be excreted in the urine?
Low GFR
73
What hormone promotes loss of sodium ions and water in urine partly due to increase glomerular filtration rate and involves the stretching of the atria?
Atrial Natriuretic Peptide (ANP)
74
ANP acts on what organ to increase loss of sodium ions and water in urine to reduce blood volume?
Kidneys
75
What would be seen when vessels are constricted, i.e. exercise or hemorrhage, in the kidneys?
blood flow to glomerular capillaries is decreased NFP drops GFR drops
76
What is the second basic function of nephrons and collecting ducts?
Tubular reabsorption
77
What percentage of water in glomerular filtrate leaves the body in urine?
1%
78
Where does the 1% of the water in filtrate leave the kidney?
Renal pelvis
79
What makes up the largest contribution to reabsorption?
Proximal convoluted tubules
80
What does the PCT reabsorb?
65% of filtered water 100% of filtered glucose and amino acids large quants of ions (Na+, K+, Cl-, HCO3-, Ca^2+ & Mg^2+)
81
Water moves by what into peritubular capillaries?
osmosis
82
What is the third function of the nephrons?
tubular secretion
83
What is tubular secretion?
the transfer of materials from the blood through tubule cells into tubular fluid
84
Tubular absorptions occurs via what?
passive diffusion active transport processes
85
What secreted substances are seen in the tubular secretion phase?
Hydrogen ions (H+) Potassium (K+) ammonia (NH3) urea creatinine drugs (PCN)
86
What basic function of the nephrons helps eliminate substances from the body?
Tubular secretion
87
Urea and ammonia are secreted in sweat but mostly where?
Urine
88
What does tubular secretion help control?
blood pH
89
Urine is typically acidic due to what ion being secreted?
H+
90
What is the pH of urine?
Below 7
91
What are the most important hormonal regulators of ion reabsorption in the nephrons?
angiotensin II aldosterone
92
Angiotensin II enhances what to take place in the PCT?
Na+ and Cl- reabsorption
93
Angiotensin II stimulates what to release aldosterone?
adrenal cortex
94
Aldosterone stimulates the DCT to do what?
Reabsorb more Na+ and Cl- Secrete K+
95
What occurs when more Na+ and Cl- are absorbed?
More water is retained by osmosis
96
What is the major regulator of K+ in the blood?
Aldosterone-stimulated secretion
97
What plays a small role in the inhibition of Na+ and Cl- reabsorption and increases glomerular filtration rate?
ANP
98
What is the major hormone that regulates water reabsorption?
Antidiuretic hormone (ADH)
99
ADH operates via what?
Negative feedback
100
What stimulates ADH to be released from the posterior pituitary?
Water concentration in blood decreases by 1% Hemorrhage Severe dehydration
101
In the absence of ADH, renal tubes have what?
very low permeability
102
Water permeability of tubules is achieved when ADH causes what?
insertion of proteins to form channels in the plasma membrane
103
Low levels of Ca^2+ in the blood stimulates the parathyroid gland to release what?
Parathyroid hormone (PTH)
104
What part of the tubules does PTH act on to reabsorb more Ca^2+?
DCT
105
PTH also inhibits what ion reabsorption in the PCT promoting it's excretion?
HPO4^2- or phosphate
106
What is the normal volume of urine eliminated per day in a normal adult?
1-2 L
107
Water accounts for what percentage of total volume of urine?
95%
108
What solutes are typically present in urine? (long list...11 things)
urea creatinine potassium ammonia uric acid sodium chloride magnesium sulfate phosphate calcium`
109
What structures transport, store and eliminate urine?
Ureters Urinary Bladder Urethra
110
Ureters transport urine from what structure to the bladder?
Renal pelvis
111
What compresses the ureters to prevent backflow?
Bladder
112
What illness may arise if the urinary bladder physiological valve of the ureters is not functioning properly?
cystitis to kidney infection
113
The wall of the ureter consists of what layers?
Mucosa Middle layer of smooth outer layer of areolar connective tissue
114
What does the mucosa contain what allows the ureter to stretch to accommodate variable volume of fluid?
transitional epithelium
115
How do ureters transport urine from the renal pelvis to the bladder?
peristaltic contractions
116
What layer of the ureter houses the nerves, blood and lymph vessels?
outer layer
117
Where does the bladder sit in the pelvic cavity?
behind the pubic symphysis infront of the rectum (male) infront of the vagina, below uterus (female)
118
The shape of the bladder is determined by what?
the amount of urine it contains
119
What is the average capacity of urine held in the bladder?
700-800ml
120
What is the muscular layer or the bladder wall called?
detrusor muscle
121
What are the layers of the bladder?
Mucosa detrusor muscle peritoneum
122
Which urethral sphincter is composed of skeletal muscle and is under voluntary control?
External urethral sphincter
123
Urination is also known as what?
micturition
124
Stretch receptors are activated in the bladder when the pressure exceeds from urine volume above what?
200-400 ml
125
Where do bladder stretch receptors transmit nerve impulses to?
spinal cord
126
What is the reflux that occurs when the bladder stretch receptors are activated?
micturition reflex
127
Parasympathetic impulses from the spinal cord during post micturition reflex causes detrusor muscles and internal urethral sphincter muscle to do what?
Detrusor - contract Internal sphincter - relax
128
What is inhibited to cause relaxation of skeletal muscles in the external urethral spinchter?
somatic motor neurons
129
Body fluids make up what percentages of total body mass in a lean adult?
55-60%
130
Fluids in the body are present in what two main compartments?
inside and outside cells
131
What amount of fluid in the body are found within cells?
two-thirds
132
Fluids found in the cells are called what?
intracellular fluid or cytosol
133
Fluid outside the cells are called what?
Extracellular fluids
134
How much fluid in the body is found outside the cells?
one-third
135
What is the breakdown of fluids in extracellular fluid?
80% interstitial fluid 20% blood plasma
136
What are other examples of extracellular fluids that are grouped with interstitial fluid?
Lymph Cerebrospinal Synovial aqueous humor and vitreous endolymph and perilymph pleural, pericardial and peritoneal
137
What are the two barriers that separate intracellular fluid, interstitial fluid and blood plasma?
Plasma membrane Blood vessel walls
138
Which barrier separates intracellular fluid from the surrounding interstitial fluid?
plasma membrane
139
Water is the largest single component of the body, making up what percentage of total body mass?
45-75%
140
Movement of water between intracellular and interstitial fluid is determined by what?
concentration of solutes
141
What is the utmost importance of the kidneys in the maintenance of homeostasis?
The ability of the kidneys to excrete dilute urine or concentrated urine
142
What are the two methods body can gain water?
Ingestion Metabolic reactions
143
About how much liquid is from ingested liquids?
1600 ml
144
What amount of water is gained by moist food?
about 700 ml
145
What is the total amount of water absorbed in the GI tract a day?
2300 ml
146
Metabolic water gains is usually what amount?
200 ml/day
147
Daily water gain totals what amount?
2500ml
148
Excretion values are: Kidneys- Evaporation- Exhale- Feces-
Kidneys- 1500ml Evaporation- 600ml Exhale- 300ml Feces- 100ml
149
What area is known as the thirst center?
hypothalamus
150
What amount of fluid must decrease for mild dehydration to exist?
2% of fluid loss
151
What are the two main solutes in extracellular fluids?
Sodium ions (Na+) Chloride ions (Cl-)
152
What are the three hormones that regulate the extent of renal Na+ and Cl- reabsorption?
Atrial natriuretic peptide Angiotensin II Aldosterone
153
What does atrial natriuretic peptide promote?
natriuresis (secretion of salt)
154
When blood volume increases renin is released more slowly effecting what hormone?
angiotensin II
155
What is the major hormone that regulates water loss?
antidiuretic hormone (ADH)
156
When intracellular and interstitial fluids are the same cells do what?
neither shrink nor swell
157
Cells shrink slightly when what is occuring?
increase osmotic pressure in interstitial fluid
158
A decrease in the osmotic pressure of interstitial fluids causes cells to do what?
swell
159
What is the most abundant extracellular ion?
Sodium ions (90% of extracellular cations)
160
What is the most prevalent anions in extracellular fluid?
Chloride ions
161
What is the most abundant cation in intracellular fluid?
Potassium
162
What is exchanged when K+ moves in or out of a cell?
H+
163
The level of K+ in blood plasma is controlled by what hormone?
Aldosterone
164
98% of calcium is located where in adults?
Skeleton and teeth
165
What are the main regulators of Ca^2+ in the blood plasma?
Parathyroid hormone (PTH) calcitriol
166
What are the functions of electrolytes?
Control the osmosis of water between fluid compartments Maintain acid-base balance Carry electrical current Serve as cofactors
167
How are ions formed?
when electrolytes break apart
168
What is the chief difference between the extracellular fluids?
blood plasma contains many protein anions interstitial fluids has very few
169
What is the major homeostatic challenge to keep pH in range?
maintaining appropriate H+ ions
170
North American diets generally do what to blood pH?
acidify the blood
171
What are the three major mechanisms to remove H+ from the body?
buffer systems exhalation of CO2 kidney excretion into urine
172
What are the three buffer systems?
Protein Carbonic Acid-Bicarbonate Phosphate
173
What is the most abundant buffer in intracellular fluid and plasma?
Protein buffer system
174
What are the functional groups of the protein buffer system?
carboxyl group amino group
175
Carboxyl groups does what when pH rises?
releases H+
176
What group in the protein buffer system combines with H+ when pH fails?
Amino
177
The protein buffer system can act on acids or bases?
both
178
The carbonic acid-bicarbonate buffer system can act as what?
a weak base (bicarb) a weak acid (carbonic)
179
What are the components of the phosphate buffer system?
dihydrogen phosphate mono-hydrogen phosphate
180
Which component of the phosphate buffer system can act as a weak acid?
dihydrogen phosphate ion
181
Which component of the phosphate buffer system can act as a weak base?
mono-hydrogen phosphate
182
Phosphate buffer system is an important regulator of pH in what?
cytosol
183
An increase in CO2 in body does what to H+ concentration?
increases H+
184
An increase in H+ in the blood makes the pH?
more acidic
185
A decrease in CO2 in body fluids raises the pH making it what?
more alkaline
186
Increased ventilation can cause what to happen IRT blood pH?
CO2 decreases H+ falls pH rises
187
If ventilation is slower or decreased what happens to blood pH?
Falls
188
What can stimulate the inspiratory area in the medulla oblongata?
chemoreceptors
189
Where are the chemoreceptors that stimulate the inspiratory area?
medulla oblongata aortic body carotid body
190
What is the slowest mechanism of removing acids?
Kidney excretion of H+
191
Kidneys synthesize and reabsorb what important buffer in the urine that contributes to the acid-base balance?
HCO3-
192
What is the condition when arterial blood pH is below 7.35?
Acidosis
193
What is the principal physiological effect of acidosis?
depression of the CNS, synaptic transmission
194
coma or death may occur if the pH falls below what?
7
195
What is the condition where blood pH is higher than 7.45?
alkalosis
196
What is the major physiological effect of alkalosis?
over-excitability of the CNS and peripheral nerves
197
What is the term for hypo or hyperventilation that can return blood pH to normal?
respiratory compensation
198
What is the compensation that occurs if the blood pH change is due to respiratory causes?
renal compensation
199
How quickly does respiratory compensation occur and reach its maximum effectiveness?
occurs within minutes maximum effect in hours
200
How quickly does renal compensation occur and reach its maximum effectiveness?
occurs within minutes takes days to reach max effect