Urinary Lecture Exam #4 Flashcards
(113 cards)
1
Q
- ____________ and _____________ are known as the renal corpuscle.
A. Bowman’s Capsule and Renal Cortex
B. Glomerulus and Bowman’s Capsule
C. Loop of Henle and Renal Medulla
D. Proximal Convoluted Duct and Distal Convoluted Duct
A
Glomerulus and Bowman’s Capsule
2
Q
- Blood flows out of the glomerulus via the:
A. Afferent arteriole
B. Peritubular capillaries
C. Vasa Recta
D. Efferent arteriole
A
Efferent arteriole
3
Q
- The glomerulus filters all the following substances EXCEPT: (SELECT-ALL-THAT-APPLY)
A. Blood cells
B. Water
C. Urea
D. Proteins
E. Amino acids
F. Creatinine
G. Sodium and Chloride
H. Calcium
I. Bicarbonate
A
A. Blood cells
D. Proteins
4
Q
- Which parts of the nephron are found in the renal medulla of the kidney?
A. Proximal Convoluted Tubule and Distal Convoluted Tubule
B. Loop of Henle and Distal Convoluted Tubule
C. Loop of Henle and Collecting Tubule/Duct
D. Loop of Henle (except the descending limb) and Distal Convoluted Tubule
A
C. Loop of Henle and Collecting Tubule/Duct
5
Q
- Which part of the Loop of Henle is ONLY permeable to water?
A. Descending Limb
B. Transverse Limb
C. Ascending Limb
D. Proximal Limb
A
A. Descending Limb
6
Q
- The _______________________ is responsible for reabsorbing MOST of the substances found in the filtrate which includes nearly 100% of glucose and amino acids along with approximately 90% bicarbonate and 60-70% of water, sodium and chloride.*
A. Distal Convoluted Tubule
B. Collecting Tubule
C. Loop of Henle
D. Proximal Convoluted Tubule
A
D. Proximal Convoluted Tubule
7
Q
- The main role of the Loop of Henle is to?
A. Maintain an isotonic environment in the renal medulla
B. Concentrate the urine by allowing reabsorption of water and sodium chloride from the filtrate
C. Dilute the urine by secreting water and sodium chloride into the filtrate
D. Assist the Proximal Convoluted Tubule with hydrogen ion secretion to maintain normal blood pH
A
B. Concentrate the urine by allowing reabsorption of water and sodium chloride from the filtrate
8
Q
- Which part of the kidney is very vital in helping the Loop of Henle with performing its role with filtrate reabsorption?*
A. Renal Medulla
B. Renal Cortex
C. Renal Papilla
D. Minor and Major Calyx
A
A. Renal Medulla
9
Q
- Which substance found in the filtrate is only filtered from the bloodstream by the glomerulus and is not reabsorbed or secreted into the renal tubule? (Hint: this substance’s rate of excretion from the bloodstream allows us to determine the efficiency of the kidneys)*
A. Urea
B. Creatinine
C. Hydrogen ions
D. Nitrogen
A
B. Creatinine
10
Q
- In the Distal Convoluted Tubule, which hormone plays a role in sodium reabsorption which causes water to be reabsorbed as well?
A. Anti-diuretic hormone (ADH)
B. Parathyroid Hormone (PTH)
C. Aldosterone
D. Cortisol
A
C. Aldosterone
11
Q
- True or False: Calcium is reabsorbed in the loop of Henle under the influence of the parathyroid hormone.*
True
False
A
False
12
Q
- Which part of the renal tubule performs the “final touches” on the filtrate before it leaves the kidney as urine?*
A. Collecting Tubule/Duct
B. Renal Papilla
C. Loop of Henle
D. Distal Convoluted Tubule
A
A. Collecting Tubule/Duct
13
Q
- Which hormone plays a role in water reabsorption in the collecting duct/tubule?*
A. Aldosterone
B. Thyroxine
C. Anti-diuretic hormone
D. Corticotropin-releasing hormone
A
C. Anti-diuretic hormone
14
Q
- The final components of urine do NOT include? Select-ALL-that apply:*
A. Glucose
B. Urea
C. Creatinine
D. Lipids
E. Proteins
A
A,D,E
Glucose, lipids, proteins
15
Q
The functional part of the kidney is known as the ________
A. Renal Pyramid
B. Renal Pelvis
C. Nephron
D. Collecting ducts
A
C. Nephron
16
Q
Which statement below is true regarding the Loop of Henle?
A. The Loop of Henle is found in both the renal cortex and renal medulla.
B. The Loop of Henle is the largest part of the nephron.
C. The Loop of Henle is responsible for ultrafiltration.
D. The Loop of Henle is found in the renal medulla of the kidney.
A
D. The Loop of Henle is found in the renal medulla of the kidney.
17
Q
What represents the outer layer of the kidney that gives the kidney its shape and provides protection to the kidney from infection that may occur from surrounding organs?
A
The cortex
18
Q
Which option below represents the correct order in how filtrate flows through the nephron?
A. Bowman’s Capsule, glomerulus, proximal convoluted duct, loop of Henle, distal convoluted duct, collecting ducts
B. Glomerulus, Bowman’s Capsule, distal convoluted duct, proximal convoluted duct, loop of Henle, collecting ducts
C. Glomerulus, Bowman’s Capsule, proximal convoluted duct, loop of Henle, distal convoluted duct, collecting ducts
D. Glomerulus, Bowman’s Capsule, distal convoluted duct, loop of Henle, proximal convoluted duct, collecting ducts
A
C. Glomerulus, Bowman’s Capsule, proximal convoluted duct, loop of Henle, distal convoluted duct, collecting ducts
19
Q
Which parts of the nephron play a role in tubule reabsorption and secretion? SELECT-ALL-THAT-APPLY:
A. Glomerulus
B. Afferent arteriole
C. Loop of Henle
D. Distal Convoluted Duct
E. Efferent arteriole
F. Proximal Convoluted Duct
G. Collecting Ducts
H. Vasa Recta
A
C,D,F,G
C. Loop of Henle
D. Distal Convoluted Duct
F. Proximal Convoluted Duct
G. Collecting Ducts
20
Q
Select the option below that represents the correct order in how the urine flows out of the kidney once it leaves the nephron (collecting duct)?
A. Renal papilla, minor calyx, major calyx, renal pelvis, ureter, bladder, urethra
B. Minor calyx, major calyx, renal papilla, renal pelvis, ureter, bladder, urethra
C. Renal papilla, renal pelvis, minor calyx, major calyx, ureter, bladder, urethra
D. Renal papilla, major calyx, minor calyx, renal pelvis, ureter, bladder, urethra
A
A. Renal papilla, minor calyx, major calyx, renal pelvis, ureter, bladder, urethra
21
Q
The renal medulla’s environment is ___________ which plays a vital role (with the help of the nephron) in maintaining the water and salt balance in the body.
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Hyper/hypotonic
A
C. Hypertonic
22
Q
__________ is the process where water and solutes are removed from the filtrate and enter back into the circulation via peritubular capillaries.*
A. Tubular reabsorption
B. Renal secretion
C. Renal resorption
D. Tubular secretion
A
A. Tubular reabsorption
23
Q
________ is the process where substances enter from the peritubular capillaries to the renal tubules (hence the filtrate).*
A. Renal reabsorption
B. Tubular secretion
C. Tubular filtration
D. Tubular excretion
A
B. Tubular secretion
24
Q
The structure that takes blood flow to the glomerulus for filtration is known as the ______________.
A. Efferent arteriole
B. Renal vein
C. Peritubular capillaries
D. Afferent arteriole
A
D. Afferent arteriole
25
Describe the general anatomical characteristics of the Kidneys, Ureters, Urinary bladder, and Urethra
Kidneys:
-Paired structures
-depression- hilum
-Have a renal vein; clean blood goes out
-Renal artery; dirty blood comes in and where blood vessels and ureters are connected.
-Ureters exit the kidney (the dirty stuff/urine empties out through the ureters)
Ureters:
-Tubes that carry urine to the Urinary bladder
-Connect the kidneys to the bladder and have two layers of muscle
-Peristalsis is the cause of movement. IT uses smooth muscle; Two layers, circular and longitudinal that pushes urine to urinary bladder
Urinary Bladder:
-Stores Urine
-Expandable (surrounded by smooth muscle)
-Has transitional epithelium tissue
-Has mucosal valves that prevent back flow of urine into kidneys
-Sphincters- circular muscle that contracts
-internal- smooth muscle; no control
-external- skeletal muscle; control
- triggered to open by urethra
Urethra:
-You'll find transitional epithelium tissue
-removes urine from the body
-short in females 4cm
separate from reproductive, digestive, & urinary for females
-Longer in males 20cm
shares with reproductive tract & urinary; some opening
prostate gland (produces secretions that go into semen)
Male swelling causes pain in urinating
Females have higher risk to UTIs then men
26
Kidneys take care of acid-base balance. What do the kidneys secrete and reabsorb when too acidic?
If too acidic the Kidneys will secret hydrogen ion (H+)
and reabsorb bicarbonate (HCO3-) if too acidic.
-bicarbonate acts as a buffer
27
Kidneys take care of acid-base balance. What do the kidneys secrete and reabsorb when in Alkalosis?
The kidneys will secrete HCO3- and reabsorb H+
Secretion and reabsorption help maintain homeostasis
28
Describe the internal structure of the kidneys
-Has a Fibrous capsule with dense irregular connective tissue
-Renal cortex that is the outer most layer (where urine formation takes place)
-Renal medulla that has, renal columns, renal pyramids, renal papilla (collecting ducts)
-Renal sinus- minor calyx (collects urine), major calyx, &
renal pelvis
Arteries;
Renal artery
Segmental arteries
Interlobar arteries also know as (Cortical radiate artery)
Acuate arteries; separate cortex from medulla
Interlobular arteries; run up parallel
Then, blood goes into nephron and comes back out into the veins.
Veins;
Interlobular veins
Arcuate Veins
Interlobar Veins (Cortical radiate veins)
Segmental veins (renal veins branching out)
Renal vein
29
Map of blood flow through the kidneys
Filtration- small molecules pass through the glomerulus into the Bowmans capsule. 180L/day
Reabsorption- the majority of the filtrate is reabsorbed back into blood stream. 178.5L/day
Secretion- (active transport) additional waste lose penicillin, caffeine, excess vitamin C. Material is secreted from the blood into the filtrate by active transport
-not all blood that gets to glamorous is filtered
Excretion- collection duct/renal
The filtrate leaves the kidney here. 1.5L/day
30
How many Liters of filtration occurs in the body per day?
180Liters/day
-amino acids, glucose, ions, urea, water
31
How many liters are reabsorbed in a day?
178.5L/day
32
What is the formula for amount filtered?
Amount filtered (everything small 180) - amount reabsorbed (everything useful 178.5) + amount secreted (anything additional) = amount excreted
33
In Glomerular filtration, what fraction percentage is only filtered? And what percentage is not affected?
Only 20% of the plasma that passes through the glomerulus is filtered and 80% is not affected.
34
What are the 3 Filtration barriers?
Has to get through these 3 barriers:
-Capillary Endothelium- Filtration barriers allow for small molecules to pass and holds back large proteins and cells. Has Mesengial cells that are associated w/ filtration through capillary.
-Basal Lamina- acts as a course seive
-Epithelium of Bowman's capsule- contains podocytes who's foot processes form filtration slits. Influence rate of filtration.
There are cells lining these structures that can change size, move, expand, or contract to control the movement of material out of glomerulus & into the Bowmans capsule.
35
Where are Nephrons mostly located?
Cortex
36
Vascular elements of Nephron
-Afferent arterioles go towards Glomerulus
-Efferent arterioles (blood coming out/ leaving glomerulus)
-Then go to Peritubular capillary network
-Vasa recta
37
Tubular components of Nephron
-Bowmans capsule (renal capsule)- simple squamous
when material is filtered out of capillaries it goes into the Bowmans capsule. (in cortex)
-Proximal convoluted tubule- simple cuboidal w/ many microvilli (extensions of cell membrane) absorbs nutrients. Designed to reabsorb material out that we don't want to loose like glucose. (in cortex)
-Loop of Henle- segments that ascend (thick) & descend (thin). Located in medulla.
-Distal convoluted tubule- simple cuboidal w/ few microvilli. Mainly secrete additional wastes into the urine. (In cortex)
-Collecting ducts- carry urine to the renal pelvis. Lots of nephrons can use the same collecting duct. (In medulla)
-
38
Between the proximal tubule and distal tubule we have what?
Loop of Henle
39
Urinary system is used to excrete metabolic waste from the blood. It uses molecules like Urea, which is what? Where does it come from?
-Is a nitrogenous end product made from proteins metabolism, NH3 (ammonia)
-Comes from breaking down proteins
40
Uric acid is another molecule used for metabolism that is a nitrogenous end product produced by breaking down nucleic acids. What do they form?
Gout- formed crystals; affect arthritis
41
Removal of metallic waste by kidneys is different from what?
Defecation- fecal material was never used by the body
42
In excretion of foreign material, drugs and toxins are detoxified by _______ and removed/filtered by ______
Liver and kidneys
43
Urinary System also maintains salt-water balance (osmolarity) in kidneys. What is the main type of salt that is reabsorbed?
NaCl
44
High salt increases what it in the kidneys?
-water retention
-blood pressure
-blood volume
45
Kidneys secrete their own hormones. What are the three hormones?
Renin- helps regulate BP.
-associated w/ aldosterone
Erythropoietin- stimulates/increases production of RBC
-effected by vasopressin & aldosterone (Kidneys)
46
Hydrostatic pressure comes from BP, and forces fluid into the _______
Bowman's capsule
47
What is colloid pressures function?
- Larger proteins are pulling fluid back into capillaries and working against filtration
48
Hydrostatic fluid pressure function?
Resistance of fluid already in the Bowmans capsule
49
Net filtration pressure equation?
PH (hydrostatic ) - π (colloid osmotic) - P fluid (static) =
NFR
50
What is GFR? (Glomerular filtration rate)
How fast material is moving from the glomerulus into the Bowman's capsule. How fast are we filtering.
51
Stats for filtration as the entire volume per day?
60 times a day
52
Net filtration is determined by ______________
renal blood flow
53
Intrinsic regulates GFR directly in what two forms?
Myogenic response- happening @level of blood vessels/ afferent & efferent arterioles.
-arterioles undergo vasoconstriction decrease and vasodilation increase to maintain BP
(generated by smooth myogenic muscle only)
Tubulogolmerar feedback- paracrine signaling through feedback from the distal convoluted tubule
-chemical messenger that travels a short distance.
-not a hormone
-Has Mascula dense cells that are reacting
and detect levels of NaCl in distal convoluted tubule
-secrete paracrines
54
Mascula dense cells secrete what and detect levels of?
Paracrines and NaCl
55
Overview of Feedback: Paracrines released are going to cause vasoconstriction that is going to decreases ant of blood & slow down GFR & give proximal convoluted tubule cells more chance to pick up Na.
So if we detect that material is passing to slowly or fast we can affect the afferent arteriole & decrease or increase GFR.
56
Extrinsic regulation deals with systemic BP. It involves what two systems?
Sympathetic NS
- a drop in BP triggers vasoconstriction (baroreceptors)
Hormonal control
-Renin- angiotensin II pathway
- triggers aldosterone release which increases Na+ reabsorption which increases water reabsorbed & increase BP/BV
57
What is key to Tubular reabsorption?
Active transcrit of Na+
58
What is the primary driving force for most of renal absorption?
Active transport of Na+
59
Macula densa cells detect what in the distal convoluted tubules? What do they release as a result?
solutes, and release paracrines
that cause vasoconstriction and vasodilation
60
What is linked with secondary active transport?
Na
- deals w/ amino acids. ions, various organic metabolites
61
Reabsorption begins with what?
Active transport of Na then everything else falls by various mechanisms of transport. Some passive and some active.
62
What happens in diffusion of Urea?
as other solutes are reabsorbed a concentration gradient is created
63
Receptor-mediated uptake of small proteins is?
small proteins in the filtrate are too large to pass through the barriers
64
What happens in Saturation?
-All transports are occupied
- Transport has reached transport maximum
-substances begin to show up in the urine when the renal threshold is reached
This is the Max kidneys can pull out then hits renal threshold & shows in urine.
65
Filtrate in the descending limb becomes progressively more _____________ as it ____________.
Concentrated, and loses water
66
Is water permeable or impermeable in the descending limb?
Permeable to water
67
What is the concentration level of osmolarity in in the CORTEX?
300 mOsM
-water can pass back and forth
68
Filtrate in the ascending limb becomes ________
less concentrated
As it ascends because ions are being pulled out, it becomes less concentrated.
69
Is the ascending limb permeable to water or impermeable? What does it pump out?
Impermeable 100 Osmo & pumps put salt
70
The ascending limb pumps out Na, K, and Cl and filtrate becomes what?
Hyposmotic/ 100 mosm
71
In the countercurrent exchange in the loop of henle, blood removes water leaving. Where is this blood located?
Vasa recta
72
What is the concentrated volume in the medulla
1200 msom
73
Water is passed from the descending limb to the ascending limb of the what?
Vasa recta
-water gets reabsorbed back into the blood
74
More water is pulled out at what osmotic?
-100
-1200
-300
1200 osmo in medulla
75
Removal of solute in the thick ascending limb creates what fluid?
Hyposomotic fluid
76
__________ fluid leaving the proximal tubule becomes progressively more concentrated in the _____________ limb.
Isosmotic fluid, descending limb
77
Permeability to water and solutes is regulated by?
Hormones
78
Urine osmolarity depends on _____________ in the collecting duct.
reabsorption
79
The cortex is __________ to plasma
Isosmotic
80
Water only leaves the filtrate through________
Osmosis
81
The high concentration in the renal medulla creates the _____________ to draw water out & reach ________________
Osmotic pressure, equilibrium
82
Ions become more _____________ when coming out in the Distal Tubule.
Dilute
83
Things that the body doesn't need get transported into the filtrate in the ____________
Distal tubule
EX: Organic metabolites, xenobiotics, alcohol, caffeine
84
To remove water by osmosis the filtrate has to pass through an area of _________________________________
High solute concentration
85
Excreted fluid id very different from the _______________
original filtrate
86
Describe the factors that affect the variable reabsorption of water in the collecting duct.
-useful molecules have been reabsorbed
-metabolic wastes have been added (secreted)
- Passage of the filtrate through the collecting duct results in concentrated or dilute urine.
87
Renal clearance is
-How fast the body gets rid of unnecessary things.
-Rate of body removal from the body
88
Vasopressin increases ______
-blood osmolarity
-Dehdrated
-a hormone that is released by the post pitituary
89
Vasopressin responds to changes in?
What produces it?
-Osmolarity
-Osmoreceptors in the hypothalamus produce it.
90
Vasopressin
Origin:
Factors affecting release:
Target cells or tissues:
Tissue action:
Action at cellular molecular level:
-Origin in Hypothalamus; released by Post pitituary
-Increase in Osmolarity, decrease in BP/BV
-Target renal collecting ducts
-Induces the insertion of aquaporin-2 into the cells of the collecting ducts.
-Increases reabsorption of water by collecting ducts.
91
Urine is _________________ in the presence of vasopressin which causes ______________.
concentrated, dehydration
92
Urine _____________ by the absence of vasopressin
Dilutes/ 100 mOsm
93
Aldosterone responds to _____________________
increased extracellular K+ concentrations and low blood
94
Aldosterone
Origin:
Factors affecting release:
Target cells or tissues:
Action:
-Adrenal Cortex
-decrease in BP (via renin)
-increases K+
-Targets renal collecting ducts
-Increases Na+ reabsorption and K+ secretion
Induces the production of new ion channels in P-cells of the distal nephron
95
Similarities of Vasopressin and Aldosterone in collecting ducts:
-Both work on the collecting ducts
-Both stimulate the prod of pores on the apical surface of collecting ducts.
For aldosterone- its the aqua-Orin-2 (water directly is gonna be taking back up)
For Vasopressin- its the NA+ channels. Reabsorbs more Na.
But in both causes were gonna take in more water and bring up BV up.
96
If dehydrated do we want more Na?
No, therefore its Vasopressin
97
If osmolarity is low then we produce___________
Aldosterone
-decrease in osmolarity & BP
98
Low blood pressure triggers _____________ release in Aldosterone
angiotensin II
99
Increased BV causes increased _________ stretch
which leads to myocardial cells stretching and releasing
___________.
-Atrial
-ANP, Atrial Natriuretic Peptides
100
ANP Atrial Natriuretic peptides Target what?
kidney, brain, adrenal cortex
101
ANP influences many tissues by:
-increasing GFR through vasodilation of afferent arterioles
- decreases Na+ and water reabsorption in the nephron (stops kidneys from reabsorbing to much Na)
-Inhibits aldosterone secretion by the adrenal cortex
-inhibits vasopressin secretion by the hypothalamus
(which the last two bring up BP)
102
What happens in Micturition?
-Urine from the kidneys is transported to the urinary bladder
-Urine leaves the nephron/kidneys through the collecting ducts
-Flows into the renal pelvis
-Ureters connect the kidneys to the urinary bladder
-urine moves through the ureters by peristalsis
103
Where is urine stored?
Urinary bladder
104
The bladder has two sphincters. What are they?
Internal sphincter
-contracted smooth muscle
-pressure forms it to open
External sphincter
-contracted skeletal muscle ring
-muscle relax
potty training. We can control external
105
Micturition reflex inhibition is a _________
learned reflex
106
Micturition reflex inhibition sum up:
When stretch receptors respond to an increased amount of urine, that sends a simple spinal reflex to. the internal sphincter & opens up. Then it also sends a message to the external sphincter to open up but we can continuously keep that external closed since its skeletal muscle that we can control.
107
Urine leaves the urinary bladder through the __________
Urethra
108
Pyelonephritis is an infection in the _______
Kidneys; inflammation of the kidneys due to bacterial infection
109
Cystitis is an infection that causes inflammation in?
Who is more susceptible to it
Urinary bladder, and women
110
Two types of symptoms:
Dysuria- inflammation/ painful urination
Pyuria- white blood cells in urine
111
Kidney stones is a noninfectious disease that causes_____
granules in the renal pelvis
112
Bladder stones result from?
poor urine flow
-enlarged prostate
men more susceptible
113
Dialysis is _____
removal of blood solutes
