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Anatomy and Physiology > Urinary System > Flashcards

Urinary System Flashcards

1
Q

what is the function of the kidney?

A

produces urine

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2
Q

what is the function of the ureter?

A

transports urine toward the urinary bladder

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3
Q

what is the function of the urinary bladder?

A

temporarily stores urine prior to elimination

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4
Q

what is the function of the urethra?

A

conducts urine to exterior; in males, transports semen as well

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5
Q

what is renal ptosis?

A

kidneys drop

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6
Q

where is the left kidney located?

A

just below the spleen

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7
Q

where is the right kidney located?

A

just below the liver

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8
Q

what is lower, the right or left kidney?

A

right kidney

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9
Q

what is the function of connective tissue around the kidney?

A

anchors the kidney and surrounding adipose to abdominal wall

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10
Q

what is it called if you are born with 1 kidney?

A

unilateral renal agenesis

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11
Q

why do we have two kidneys when we only need 1?

A

serious health problems if get down to only 25% function. kidney disease has no symptoms until just before the kidney fails

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12
Q

what are the two most common causes of kidney failure?

A

high BP and diabetes

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12
Q

what are the two most common causes of kidney failure?

A

high BP and diabetes

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13
Q

order the major parts of the kidney from superficial to deep

A

fibrous capsule, renal cortex, renal medulla, renal pyramid, papillary duct, renal papilla, minor calyx, major calyx, renal pelvis, ureter

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13
Q

order the major parts of the kidney from superficial to deep

A

fibrous capsule, renal cortex, renal medulla, renal pyramid, papillary duct, renal papilla, minor calyx, major calyx, renal pelvis, ureter

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14
Q

describe the path of blood flow through the renal blood vessels beginning with the aorta?

A

aorta, renal artery, segmental artery, interlobar artery, arcuate artery, cortical radiate artery, afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries/vasa recta, cortical radiate vein, arcuate vein, interlobar vein, renal vein, inferior vena cava

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15
Q

what are the two types of nephrons?

A

cortical or juxtamedullary

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16
Q

what is the function of the renal corpuscle?

A

filters the blood (filtration); produces filtrate

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17
Q

what are the two parts of the renal corpuscle?

A

glomerulus and bowman’s capsule

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18
Q

what is the function of the proximal convoluted tubule?

A

returns filtered substances to the blood (reabsorption)

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19
Q

what is the function of the loop of henle?

A

helps conserve water and solutes (reabsorption of water)

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20
Q

what is the function of the distal convoluted tubule?

A

rids the body of additional wastes (secretion)

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21
Q

what is the function of the collecting duct?

A

carries urine from cortex toward renal papilla; water balance, can reabsorb water as needed

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22
Q

what is the function of the collecting duct?

A

carries urine from cortex toward renal papilla; water balance, can reabsorb water as needed

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23
Q

what is the distinction between cortical and juxtamedullary nephrons?

A

cortical nephrons have loops of henle that do not extend into the medulla while juxtamedullary nephrones HAVE loops of henle that extend deep into the medulla

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24
Q

what is the blood vasculature that surrounds cortical nephrons?

A

peritubular capillaries

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25
Q

what do peritubular capillaries/vasa recta drain into?

A

venules to cortical radiate veins

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26
Q

what is the blood vasculature that surrounds juxtamedullary nephrons?

A

vasa recta

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27
Q

what is the parietal layer of the nephron made of?

A

simple squamous epithelium

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28
Q

what is the visceral layer of the nephron made up of?

A

podocytes, wrap around glomerular capillaries

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29
Q

what is the structural difference between the distal and proximal convoluted tubule?

A

distal convoluted tubule lack microvilli while proximal convoluted tubule HAS microvilli

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30
Q

what is the function of mesangial cells?

A

supporting cells containing actin filaments. Can contract, respond to AngII, ADH

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31
Q

what is the function of the afferent arteriole?

A

delivers unfiltered blood

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32
Q

what is the function of the efferent arteriole?

A

transports filtered blood away

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33
Q

what are the three components of the glomerular filtration membrane?

A
  1. glomerular capillary endothelium with fenestrae
  2. basement membrane
  3. podocytes
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34
Q

true of false, the kidney capillaries are fenestrated?

A

true

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35
Q

what is the glomerular filtration rate?

A

the volume of filtrate formed by both kidneys per minute

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36
Q

what percentage of filtrate is returned to circulation by reabsorption in healthy kidneys?

A

99%

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37
Q

what is the average daily urine output in liters?

A

1-2 liters

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38
Q

what is the function of foot podocytes?

A

confer size selectivity and filtration surface; slits contain many cell-surface proteins which ensure that large proteins remain in the bloodstream

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39
Q

what is the ultrafiltrate?

A

small molecules (water, glucose, ions) that pass through

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40
Q

how do podocytes regulate the glomerular filtration rate?

A

when podocytes contract, they reduce the size of the filtration slits

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41
Q

what can the destruction of the filtration membrane lead to?

A

proteinuria, excess protein in urine

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42
Q

which way does the glomerular hydrostatic pressure push water and solute?

A

out of the plasma and into the filtrate

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43
Q

what is the significance of the efferent arteriole being smaller in diameter than the afferent arteriole?

A

the GHP is significantly higher than capillary pressures elsewhere in the systemic circuit

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44
Q

what does the blood colloid osmotic pressure do?

A

draws water out of the filtrate and into the plasma, opposing filtration.

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45
Q

what does the capsular hydrostatic pressure do?

A

pushes water and solutes out of the filtrate and into the plasma, opposing GHP

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46
Q

what is capsular hydrostatic pressure the result of?

A

resistance of filtrate already present in the nephron that must be pushed toward the renal pelvis.

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47
Q

What is the average pressure of the glomerular hydrostatic pressure?

A

55 mm Hg

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48
Q

What is the average pressure of the blood colloid osmotic pressure?

A

30 mm Hg

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49
Q

What is the average pressure of the capsular hydrostatic pressure?

A

15 mm Hg

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50
Q

what is the net filtration pressure?

A

10 mm Hg, pushing water and dissolved materials out of glomerular capillaries and into the capsular space

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51
Q

what is peritubular fluid?

A

filtrate that has been reabsorbed into space around peritubular capillaries

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51
Q

what is peritubular fluid?

A

filtrate that has been reabsorbed into space around peritubular capillaries

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52
Q

does filtration at the glomerulus require energy?

A

No, driven by the differences in pressure

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53
Q

what is facilitated diffusion?

A

carrier transport; no ATP; follows concentration gradient

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54
Q

what is active transport?

A

uses ATP; moves against gradient

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55
Q

what is co-transport?

A

carrier protein not linked to ATP hydrolysis; 2 substrates follow gradient. movement follows gradient of at least 1 of the transported substances

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56
Q

what is counter transport?

A

like co-transport but ions move in opposite directions

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57
Q

how is glucose reabsorbed in the PCT?

A

a sodium-glucose co-transported

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58
Q

what influences the amount of glucose absorbed?

A

the number of carriers in the tubules

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59
Q

what happens when the carriers are saturated?

A

excess substance cannot be reabosrbed and is excreted - start spilling into urine = glycosuria

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60
Q

what epithelia cell type is found in the PCT and DCT?

A

cuboidal cells

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61
Q

what is citamin D-DBP bound to as it is reabsorbed in PCT?

A

megalin/cubulin

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62
Q

where is most calcium reabsorbed?

A

PCT

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63
Q

what is found in the PCT that synthesizes the active form of vitamin D?

A

1-alpha hydroxylase

64
Q

what is primarily absorbed in the loop of Henle?

A

water and salt reabsorption

65
Q

what is primarily absorbed in the descending limb of the loop of Henle?

A

water

66
Q

what is primarily absorbed in the ascending limb of the loop of Henle?

A

ions such as sodium

67
Q

what is osmolarity?

A

number of solute particles in 1 kg of water

68
Q

what is the function of the high osmolarity in the renal medulla?

A

driving force for water reabsorbtion and urinary concentration

69
Q

why is distinct about the ascending loop of Henle?

A

impermeable to water; active solute transport of Na+ and Cl-

70
Q

what is the results of the transport of NaCL along the ascending limb?

A

movement of water from the descending limb

71
Q

what is the exchange of ions at the ascending loop of Henle?

A

sodium and chloride are reabsorbed in exchange for potassium

72
Q

what substances are reabsorbed at the DCT?

A

water, sodium ions, and calcium ions (under hormonal control)

73
Q

what is reabsorbed at the collecting duct?

A

water

74
Q

what is secreted at collecting duct?

A

sodium, potassium, hydrogen and bicarbonate ions

75
Q

what is the function of the papillary duct?

A

delivery of urine to minor calyx

76
Q

what are the two cells of the collecting duct?

A

intercalated cell, principal cell

77
Q

what is the function of the principal cell in the collecting duct?

A

main sodium reabsorbing cells

78
Q

what is the function of the intercalated cells in the collecting duct?

A

mediate secrete and bicarbonate reabsorption

79
Q

what cells are found in the papillary duct?

A

columnar cells

80
Q

where is obligatory water reabsorption occur?

A

PCT and descending loop of Henle

81
Q

what causes obligatory water reabsorption?

A

water follows reabsorbed solutes due to osmotic gradients

82
Q

where does facultative water reabsorption take place?

A

DCT and collecting tubules

83
Q

what is the driving factor behind facultative water reabsorption?

A

ADH making epithelium water permeable

84
Q

what is key to making concentrated urine and conserving water?

A

ADH

85
Q

what substance is not reabsorbed at all?

A

creatinine

86
Q

what are the three types of metabolic waste?

A

urea, creatinine, uric acid

87
Q

what does urea come from?

A

breakdown of amino acids

88
Q

what does creatinine come from?

A

breakdown of creatine phosphate in skeletal muscle

89
Q

what does uric acid come from?

A

recycling of nitrogenous bases from RNA

90
Q

where is the juxtaglomerular complex located?

A

found between the afferent arteriole and distal convoluted tubule of the same nephron

91
Q

what are the three cell types of the juxtaglomerular apparatus?

A

juxtaglomerular cells, macula densa, mesangial cells

92
Q

where are juxtaglomerular cells found?

A

enlarged, smooth muscle cells in walls of afferent arteriole

93
Q

what is the function of juxtaglomerular cells?

A

act as mechanoreceptors

94
Q

where are macula densa cells located?

A

tall, closely packed distal tubule cells that lie adjacent to JG cells

95
Q

what is the function of macula densa cells?

A

function as chemoreceptors/osmoreceptors

96
Q

what is the function of mesangial cells?

A

have phagocytic and contractile properties, influence capillary filtration

97
Q

what influences mesangial cell contraction?

A

vasopressin, angiotensin II

98
Q

what are the three control mechanisms of glomerular filtration rate?

A

autoregulation, neural regulation, hormonal regulation

99
Q

describe the autoregulation mechanism when homeostasis is disturbed?

A
  1. decreased GFR resulting in decreased filtrate and urine production
  2. dilation of afferent arterioles, contraction of mesangial cells, constriction of efferent arterioles
  3. increased glomerular blood pressure
  4. homeostasis restored = normal GFR
100
Q

what are myogenic mechanisms?

A

smooth muscle cells strech wall of afferent arteriole

101
Q

what are tubular mechanisms?

A

macula densa detects solute level in filtrate

102
Q

if there is a decrease in BP what occurs to increase GFR?

A

dilate afferent artery, relax supporting cells and dilate capillaries, constrict efferent arteriole

103
Q

if there is an increase in BP what occurs to decrease GFR?

A

constrict afferent, decrease GFR

104
Q

when is neural regulation activated?

A

under stress or during physical activity; reduces GFR

105
Q

what happens during neural regulation?

A

sympathetic fibers innervate kidneys, constrict afferent arteriole

106
Q

what else besides fall in BP can stimulate JG cells?

A

sympathetic innervation

107
Q

what do macula densa cells sense?

A

low fluid or low NA

108
Q

what do JG cells surrounding afferent arterioles make?

A

renin

109
Q

what does renin convert angiotensinogen into?

A

angiotensin I

110
Q

what converts angiotensin I into angiotensin II?

A

angiotensin-converting enzyme

111
Q

what is the effect of angiotensin II on the PCT?

A

direct effect to increase Na reabsorption

112
Q

what does angiotensin II do to GFR?

A

increases GFR by increasing renal perfusion pressure

113
Q

what is the effect of angiotensin II on systemic blood vessels?

A

widespread vasoconstriction

114
Q

how does angiotensin II regulate water reabsorption?

A

stimulates the posterior pituitary to make ADH which causes aquaporins to move to the collecting duct which increases water reabsorption

115
Q

how does angiotensin II regulate Na+ uptake?

A

stimulates the adrenal cortex to secrete aldosterone which stimulates Na+ uptake on the apical cell membrane in the DCT and collecting ducts

116
Q

true of false, angiotensin II stimulates sympathetic activity?

A

true

117
Q

describe how angiotensin II increases GFR?

A

blood volume increases, BP goes up, GFR goes up

118
Q

what zone of the adrenal cortex secretes aldosterone?

A

zona glomerulosa

119
Q

what is aldosterone?

A

a steroid hormone; mineralocorticoid

120
Q

what is another name for the posterior pituitary?

A

neurohypophysis

121
Q

what type of tissue is the posterior pituitary?

A

neural tissue

122
Q

why is the posterior pituitary not a true endocrine gland?

A

it does not synthesize hormones, it stores/releases neurohormones

123
Q

what are the two hormones released by the posterior pituitary?

A

oxytocin and antidiuretic hormone (ADH) known as vasopressin

124
Q

what is the role of ADH?

A

to increase BP by conserving water and constricting vessels?

125
Q

what does ADH do to the collecting duct and DCT?

A

induces aquaporin translocation

126
Q

how does alcohol affect ADH release?

A

blocks the voltage gated calcium channels in nerve terminal so ADH not released leading to dehydration when drinking excess alcohol

127
Q

what is synthesized by the JG cells in response to hypoxia?

A

erythopoietin

128
Q

what does erythropoietin do to RBC production?

A

increases RBC production in the bone barrow allowing more capacity to transport oxygen

129
Q

what is synthesized by cardiac cells in response to increased blood volume or increased blood pressure?

A

atrial natriuretic peptide and brain natriuretic peptide

130
Q

what are the two most common health problems that lead to CKD?

A

hypertension and diabetes

131
Q

why do very few patients with CKD require renal replacement therapy?

A

they die from cardiovascular disease

132
Q

what is the name of the type of transport that is used to absorb glucose in the nephron and why does glucose appear in the urine?

A

co-transport with Na, these carrier proteins can become saturated

133
Q

where in the kidney are most substances reabsorbed?

A

PCT

134
Q

what changes that occur with CKD increase the risk of heart failure?

A

can’t maintain fluid balance- heart must pump larger amount of fluid that the kidneys cannot get rid of. As heart fails there is reduced blood blow to the kidneys so their ability to function decreases

135
Q

why is left ventricular hypertrophy often found in those with hypertension and CKD?

A

left ventricle pumps blood into the vasculature and CKD patients often have poor blood volume control so the heart pumps blood harder and the left ventricle hypertrophies to accommodate the increased work needed

136
Q

what are some biochemical findings that could be used to provided evidence of alternated renal function in those with CKD?

A

proteinuria, micro and macroalbuminuria, elevated serum creatinine, reduced glomerular filtration rate, alterations in serum metabolites, elevated cystatin C

137
Q

why is cystatin C blood test a good measure of GFR?

A

filtered solely by the glomerulus, not secreted by the renal tubules, completely reabsorbed by the tubules then catabolized, generated at a constant rate by all cells in the body

138
Q

what is creatinine clearance used for?

A

clinical estimation of GFR

139
Q

what are 2 hormones that the body can use to regulate Phosphorus homeostasis?

A

FGF23 and PTH

140
Q

where is FGF23 made?

A

osteocyte

141
Q

where is PTH made?

A

parathyroid hormone

142
Q

how does high P increase risk of cardiac disease?

A

high P associated with vascular calcification causing narrowing of lumen of the arteries. Vascular smooth muscle cells undergo osteochondrogenic differentiation and calcify

143
Q

what is FGF23 made in response to?

A

high levels of serum P

144
Q

what is the receptor for FGF 23 and where is it found?

A

FGFR 1 is found in the kidney

145
Q

what does FGF 23 do in the PCT?

A

decreases the expression of NaPi transporters needed to reabsorb Pi from tubular filtrate. decrease the expression of 1-a OHase - less 1,25(OH)2D

146
Q

what does FGF 23 do in the DCT?

A

increases the reabsorption of Ca and Na from the tubular filtrate

147
Q

in healthy kidneys, how does FGF23 work to reduce serum P?

A

decrease reabsorption by reducing the presence of P transporters in the nephron, less reabsorption, more P in tubule lumen, less P in peritubular fluid, less P in peritubular capillaries, more P in urine = increased renal P excretion

148
Q

what percentage of individuals with CKD is anemia found in?

A

50%

149
Q

what 2 hormones may explain the anemia that is found in those with CKD and where are those hormones produced?

A

erythropoietin- made in kidney
hepcidin - made in liver from inflammation caused by CKD

150
Q

how can anemia be treated according to the article issues of iron management in the hemodialysis patient?

A

intravenous iron, bypass the gut

151
Q

what are some risks associated with use of IV iron?

A

increases the risk of iron overload

152
Q

what form of Fe would be found in the blood in those with iron overload?

A

NTBI, taken up by ZIP 14

153
Q

what tissues are most at risk?

A

pancreas, liver

154
Q

what does CKD lead to chronically?

A

HIGH serum P

155
Q

what does high serum P cause?

A

HIGH serum FGF 23

156
Q

what does HIGH FGF 23 cause?

A

suppresses calcitriol in the kidney

157
Q

what does HIGH P cause specifically in the kidney?

A

inhibits 1-alpha hydroxylase which suppresses calcitriol in kidney

158
Q

what does suppressed calcitriol levels cause?

A

LOW serum Ca

159
Q

what does low serum Ca usually do?

A

normally, high PTH would increase Ca reabsorption and decrease P reabsorption

160
Q

in people with CKD, what do the kidneys fail to do?

A

do not respond to high PTH and make calcitriol or reduce urinary Ca? Hyperparathyroidism can develop which stimulates bone resorption

Anatomy and Physiology (7 decks)

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