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ABPI Unit Three > Unit 3.4 The Urinary System > Flashcards

Unit 3.4 The Urinary System Flashcards

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1
Q

What does the urinary system consist of?

A

Two kidneys, two ureters, one urinary bladder and one urethra.

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2
Q

What is urine produced by?

A

The kidneys which filter out harmful and unwanted waste products from the blood and balance the water and salt content from the body.

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3
Q

What do healthy kidneys filter the blood to remove?

A

Waste products (mainly urea from the breakdown of protein and other nitrogen rich compounds) and excess water and salts.

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4
Q

Proteins are essential for growth and repair but have to be used almost immediately as excess protein that has been eaten cannot be stored - where are the amino acids that make up proteins broken down and what do they produce?

A

They are broken down in the liver producing urea as a toxic waste product which must be removed from the body mostly through the kidneys.

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5
Q

As well as filtering blood what can the kindney’s help control and produce?

A

They help control blood pressure and produce hormones and chemicals which help the production of RBCs and maintain healthy bone.

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6
Q

Before blood returns to the heart what does it pass through?

A

The kidneys.

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7
Q

The kidneys are very important in homeostasis - what is this?

A

Maintaining a constant internal environment in the body.

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8
Q

Each day, how many litre of blood do the kidneys process, and through what system?

A

About 190 litres of blood through 225km of tubes and millions of tiny filtering systems called nephrons.

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9
Q

Where are the kidneys located?

A

High in the abdomen, towards the back of the abdominal cavity either side of the spine.

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10
Q

What protects the kidneys?

A

They receive some protection from the lower rib cage. They are encased in fat which also helps to protect them from damage.

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11
Q

Each kidney functions as a blood filter, how?

A

Retaining useful chemicals and removing the harmful or unneeded ones.

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12
Q

In addition, it regulates the loss of water and salts from the body and maintains the pH of the blood, how?

A

By adjusting the acid-base balance as well as regulating blood volume and pressure.

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13
Q

What hormones do the kidneys produce and what do these do?

A

Calcitrol is the active form of vitamin D and helps to regulate calcium in the body.

Erythropoietin stimulates the production of red blood cells.

The enzyme renin is also produced by the kidneys and helps to regulate the blood pressure.

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14
Q

Each kidney has 3 main functioning areas, what are these?

A

Cortex - the outer part of the kidney, it contains the functional units of the kidney called nephrons

Medulla - this is the region of the kidney which contains the loops of henle, where water and salts are reabsorbed back into the blood.

Pelvis - this is where all the collecting ducts combine into the ureter which carries urine down into the bladder.

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15
Q

What is the size of the kidney?

A

Each adult kidney is about 12cm long, 6cm wide and 3cm thick.

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16
Q

The kidneys have plentiful blood supply - what is the renal blood slow?

A

Approximately 1200cm3 per minute (about 25% of all the blood in the body)

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17
Q

Each kidney contains about one million microscopic filtration structures, what are these called?

A

nephrons

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18
Q

What do the kidneys bear the major responsibility for eliminating?

A

Nitrogenous wastes (urea) toxins (from the breakdown of many different substances in the liver) and drugs from the blood.

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19
Q

What is the tiny nephron?

A

The functional unit of the kidney and the site of urine production.

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20
Q

What does the blood supply to each nephron consist of?

A

An afferent arteriole coming in from the renal artery and an efferent arteriole going out of the renal vein.

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21
Q

What is the ball of delicate capillaries called in between the arterioles?

A

Golmerulus.

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22
Q

What does the golmerulus sit in and what are the two structures called together?

A

The golmerulus sits in the bowmans capsule and the 2 structures together are called the Malpighian body.

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23
Q

which tubule leaves the Bowmans capsule?

A

The renal tubule.

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24
Q

What are the three separate regions of the renal tubule?

A

The first coiled tubule (or proximal convoluted tuuble), the loop of Henle and the second coiled tubule (distil convoluted tuble)

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25
What does the renal tubule finally join into?
The collecting duct.
26
What does the efferent arteriole which exits the glomerulus divide to form?
A second set of capillaries which surround the renal tubule - this is where substances are reabsorbed into the blood.
27
Which 4 processes are involved in the filtration of blood and the production of urine?
Filtration, secretion, re absorption and synthesis
28
In filtration why do small molecules move from the capillary into the bowmans capsule?
Blood in the afferent arteriole is under high pressure having come from the abdominal aorta and the renal artery. As a result small molecules such as water, glucose, amino acids and salts and waste products such as urea pass through the capillary wall into the Bowmans capsule.
29
In filtration why do larger plasma proteins and blood cells no appear in healthy urine?
Large molecules such as larger plasma proteins and blood cells do not pass through in healthy individuals and so protein and blood cells are not found in normal healthy urine
30
What is the liquid that arrives in the Bowmans capsule known as?
The glomerular filtrate and has the same concentration of most substances as blood plasma.
31
How many litres of fluid are filtered into the kidney tubles every day?
About 150-190 litres.
32
What is the process of secretion in the production of urine?
If the concentration of some substances in the efferent arteriole is too high even after filtration, they can be actively secreted into the renal tubule and removed form the body in the urine - In this way waste products such as urea, uric acid and creatinine can be excreted.
33
What occurs in the process of reabsorption?
As the glomerular filtrate passes through the tubules about 99% of the water, all glucose and most of he mineral ions (salts) are reabsorbed into the blood by processes which include diffusion and active uptake (which requires energy) This is a highly selective process and the actual quantity of substances reabsorbed is dependent on the body's needs at any one time - most of the 150-190 glomerular filtrate is reabsorbed back into the blood which is why you produce only between 1-2 litres of urine per day.
34
What is the synthesis process of the filtration of blood and the production of urine?
Kidney tissue can also support the activity of the liver by making substances which inactivate some toxic chemicals, making them inactive and safe. In this way the kidney contributes to the detoxification process.
35
Which part of the kidney collects urine from the collecting ducts of the nephrons?
The pelvis.
36
Where does the urine drain from the pelvis into?
The two ureters.
37
What are the ureters?
They are muscular walled, narrow tubes each about 30cm long and 6mm in diameter. They connect the kidney with the bladder.
38
What is the lining of the ureter continuous with?
the lining of the bladder.
39
How does urine pass from the kidney to the bladder?
By the peristaltic action of smooth muscle in the wall of the uterus.
40
How often do peristaltic waves occur?
About one to five times each minute depending on how fast the kidneys are producing urine.
41
What is the urinary bladder, what does it act as?
It is a smooth, collapsible, muscular organ which acts as a temporary reservoir for urine.
42
What is the size of the bladder what can it hold?
The size and position varies according to the amount of urine stored at any one time - it is capable of storing around half a litre of urine comfortably and a maximum of about a litre in adult men or around 700-800cm3 in women.
43
How does urine enter and exit the bladder?
Urine enters the bladder via he ureter and exits the bladder via the urethra.
44
What is the process of urination known as and how does it occur?
It is known as micturition and it occurs due to a combination of voluntarty and involuntary muscle contractions.
45
What happens as the volume of urine in the bladder increased?
Stretch receptors in the bladder walls transmit nerve impulses to the spinal cord, these eventually trigger a spinal reflex called the micturition reflex - during childhood we learn how to control the micturition reflex so we only pass urine when we choose to do so.
46
What closes the bladders exit to the urethra?
Two sphincters. There is an internal sphincter made of smooth muscle which is under autonomic control and an external sphincter made of skeletal muscle which is under voluntary control. Meaning although babies urinate involuntary, children and adults can usually control when they urinate.
47
What are these sphincters sometimes referred to as?
The urethral sphincters because they are found at the site where the urethra joins the bladder.
48
How long is the urethra in males?
About 20cm long and serves s dual purpose in the transportation of semen as well as excreting urine.
49
How long is the urethra in women?
About 3cm long and only carries urine.
50
Why can UTIs relatively common in women?
The female urinary opening is very close to the anal opening and faeces contain many bacteria which can easily find a way into the urethra.
51
The urinary system makes a major contribution to homeostasis - how does it contribute to all body systems?
Kidneys regulate the volume, composition and pH of body fluids by removing waste and excess substances from the blood and secretin them in urine.
52
What does the kidney and skin both contribute to the synthesis of?
Calcitriol - the active form of vitamin D.
53
How do the kidneys contribute to the homeostasis of the skeletal system?
The kidneys help to adjust levels of blood calcium and phosphates.
54
How do the kidneys contribute to homeostasis of the muscular system?
Kidneys help to adjust the level of calcium in the blood, needed for muscle contraction
55
How do the kidneys contribute to homeostasis of the endocrine system?
Kidneys participate in the synthesis of calcitriol and release erythropoietin, the hormone that stimulates the production of RBCs
56
How does the urinary system contribute to homeostasis of the cardiovascular system?
By increasing or decreasing the re absorption of water filtered from the blood, the kidneys help to adjust blood volume and pressure. Renin, an enzyme release by the juxtaglomerular cells raises blood pressure in a complex interaction with the hormones angiotensin and aldosterone.
57
How do the kidneys contribute to the homeostasis of the respiratory system?
The kidneys and lungs work together in adjusting the pH of body fluids.
58
How do the kidneys contribute to the homeostasis of the digestive system?
Kidneys are involved in the synthesis of calcitriol which is needed for the absorption of dietary calcium from the gut.
59
Maintaining the correct acidity/alkalinity of the blood is an important role of the kidney, for cells of the body to function properly what must the pH of the blood be maintained at?
Between 7.35 - 7.45
60
What do pH above 7.45 and below 7.35 indicate?
A pH above 7.45 indicates alkalosis while a pH below 7.35 results in acidosis.
61
What do alkalosis and acidosis f blood affect?
Both these conditions affect how the body works by affecting enzyme activity and other reactions.
62
How does the kidney balance the pH of the blood?
The kidney helps to balance the pH of the blood by reabsorbing bicarbonate ions.
63
As the needs of the body vary and the intake of both water and electrolyte changes from meal to meal, what regulates the balance of these?
The kidney.
64
What detects the osmotic concentration of the blood?
Osmoreceptors in the hypothalamus
65
What happens then the blood is too concentrated??
The hypothalamus stimulates the posterior lobe of the pituitary gland to release a hormone called anti-diuretic hormone (ADH). this travels in the blood to the kidney where it acts upon the cells of the distal convoluted tubule and collecting ducts and increases their permeability to water. More water is then reabsorbed back into the bloodstream and results in only a small volume of concentrated dark coloured urine.
66
What happens if a person drinks large volumes of liquid?
The osmotic concentration of the blood will fall. The release of ADH is reduced, the tubules become less permeable to water so a larger volume of dilute pale coloured urine is produced.
67
If there is a reduction in body fluid what can happen to the blood pressure?
If there is a reduction in body fluid volume, this may be reflected in a reduction in blood volume which could lead to a reduction in blood pressure.
68
What does reduced blood pressure cause the kidney to release?
Reduced blood pressure is detected by receptors in the kidney which release an enzyme called renin into the blood.
69
What does renin result in the production of?
Renin sets off a series of reactions which end up in the production of angiotensin II
70
What is angiotensin II? What does it stimulate?
Angiotensin II is a powerful vasoconstrictior, it narrows the blood vessels which causes an immediate and local increase in blood pressure - it also stimulates the release of aldosterone from the adrenal cortex.
71
What does aldosterone increase?
The permeability of the renal tubules to sodium which is actively reabsorbed.
72
What does the re absorption of sodium mean?
More water is reabsorbed from the kidney tubules meaning the net result is an increase in blood volume and therefore an increase in blood pressure.
73
A small amount of which hormone circulates at all times in the blood stream, causing a steady production of RBCs which carry oxygen in the blood?
Erythropoietin
74
What happens to the release of erythropoietin when blood levels of oxygen decline for any reason (hypoxia)
The kidney increase their release of erythropoietin
75
What does release of erythropoietin cause to help declining oxygen levels in blood??
Erythropoietin targets bone marrow and causes the production of increased numbers of erythrocytes to carry more oxygen in the blood.
76
What can be the problem with erythropoietin and sport?
This hormone is sometimes used illegally by athletes in various sports to increase their number of RBCs - this increases the oxygen carrying capacity of their blood which can give them an edge in competition but because erythropoietin is a naturally occurring hormone it can be difficult to detect.
77
What is Golmerular filtration rate (GFR) a measure of?
The amount of filtrate formed in all the renal corpuscles of Kidneys per minute. Because of the key part the kidneys play in homeostasis, it is important that they maintain a constant GFR
78
What is the average GFR in males and females?
In adult males this averages 125cm3/min and in females 105cm3/min.
79
Which two hormones contribute to the regulation of the GFR?
Angiotensin II reduces GFR while atrial natiuretic peptide (ANP) increases it.
80
What is Glomerulonephritis?
An inflammation of the glomeruli in the nephron.
81
What is one of the most common causes of glomerulonephritis?
Allergic reaction to toxins produced by streptococcal bacteria that have infected another area of the body, especially the throat.
82
What glomerulonephritis cause??
The glomeruli become so swollen and engorged with blood that blood cells and plasma proteins are forced through the membrane into the filtrate - this causes urine to contain a lot of protein as well as red blood cells (haematuria) Acute conditions are reversible when the infection is cured. Chronic conditions can be fatal.
83
What is renal failure?
A decrease in or cessation of glomerular filtration - may be acute or chronic and can be unilateral or bilateral (one or two kidneys)
84
What are causes of kidney failure?
Low blood volume, decreased cardiac output, damaged renal tubules, kidney stones or a reaction to NSAIDs or certain antibiotics.
85
What is chronic renal failure??
Usually a progressive and irreversible decline in glomerular filtration rate.
86
What happens during the first phase of chronic renal failure?
Around 75% of nephrons are lost, but the patient may have no symptoms because other nephrons have taken up the workload. Once 75% of nephons are lost the patient is termed renally insufficient.
87
What happens at end stage renal failure?
When 90% of nephrons have been lost and regular dialysis therapy or a kidney transplant operation is required.
88
What are UTIs?
Either an infection of part of the urinary system or the presence of large numbers of microbes in the urine. Most caused by gram negative bacteria, most commonly e.coli. UTIs include urethritis (inflammation of the urethra) cystitis (inflammation of the urinary bladder) and pyelonephritis (inflammation of the kidneys) more commen in women due to short urethra.
89
What is Polycystic kidney disease?
One of the most common inherited disordered. In PKD the kidneys become riddled with thousands of cysts. Many cells die in the kidney tubules leading to progressive renal failure and eventually end stage renal failure.
90
What are widely used to treat UTIs?
Antibiotics and the choice to antibiotics will depend on the invective pathogen and the area of the urinary tract affected.
91
What can be used to treat kidney infections such as glomerulonephritis?
Antibiotics to try and overcome the infection before permanent damage is done to the kidneys.
92
High blood pressure is often a factor in the development of kidney disease - what is sued to treat this?
Hypertension medication is widely used to help prevent further damage to the kidneys. Examples of medicines used include beta blockers and ACE inhibitors angiotensin receptor blockers.
93
Severe kidney disease is almost impossible to treat? what are the main options?
Dialysis - where the blood is removed from the body and circulated through a machine where the urea is removed and the salt and water balance of the blood is restored. Transplants - a kidney from a dead of living donor is transplanted into the patient, these can work extremely well but the patient has to take immunosupressant drugs for the rest of their life to prevent the body rejecting the new kidney.

ABPI Unit Three (8 decks)

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