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A&P Lecture Final > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Renal ptosis

A

kidneys drop

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2
Q

Floating kidney

A

suspensory collagen fibers break (Connective tissue
anchors the kidney and surrounding adipose to abdominal wall)

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3
Q

unilateral renal agenesis

A

some people (1 in 5000) born with only 1 kidney

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4
Q

Things that can cause kidney failure from kidney disease (unexpectedly…no before kidney failure):

A

 High BP; damage small blood vessels in kidney
 Diabetes; excess blood glucose leads to kidney vascular damage and micro and macroalbuminuria
 Aspirin / acetaminophen / ibuprofen
 Congenital problems; polycystic renal disease

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5
Q

Renal corpuscle

A

(glomerulus and Bowman’s capsule;
comprised of parietal and visceral layer) – filters the
blood (filtration); produces filtrate

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6
Q

Proximal convoluted tubule

A

returns good filtered substances to the blood (reabsorption)

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7
Q

Loop of Henle

A

helps conserve water and solutes (reabsorption of water)

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8
Q

Distal convoluted tubule

A

rids the body of additional wastes (secretion)

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9
Q

Collecting duct

A

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

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10
Q

parietal layer of the bowman’s capsule:

A

simple squamous epithelium on exterior of the capsule

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11
Q

Visceral layer of the bowman’s capsule:

A

podocytes, wrap around glomerular capillaries

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12
Q

Afferent arteriole

A

delivers unfiltered blood to the glomerulus. wider diameter vessel that leads into the glomerulus

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13
Q

Efferent arteriole

A

transports filtered blood away. blood that’s been filtered out through the glomerulus goes back into the bloodstream (stuff that needs to be reabsorbed from filtrate will happen later in the proximal convoluted tubule)

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14
Q

Mesangial Cells:

A

Supporting cells in the glomerulus (stationed between podocytes)
-specialized cells derived from smooth muscle
-Can phagocytize things
-Contain actin filaments: Can contract
-Respond to AngII, ADH
(May make renin?)

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15
Q

Glomerular capillary endothelium contains _____
basement membrane

A

fenestrated

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16
Q

Anuria

A

Low urine output

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17
Q

glomerular filtration rate (GFR)

A

The volume of filtrate formed by both kidneys per minute

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18
Q

Glomerular Filtration Membrane consists of:

A
  1. Glomerular capillary endothelium with fenestrae (deepest)
  2. Basement membrane
  3. Podocytes (visceral membrane of
    Bowmans capsule)
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19
Q

glomerular hydrostatic pressure (GHP)

A

Forces water and dissolved solutes/ small particles
out into the glomerular capsule into the pericapsular
space (all but most plasma proteins, blood cells and
platelets; lose about 1% of albumin)

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20
Q

blood colloid osmotic pressure (BCOP)

A

tends to draw water out of the filtrate and into
the plasma; it thus opposes filtration

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21
Q

The net filtration pressure (NFP)

A

the net pressure acting across the glomerular
capillaries. It represents the sum of the
hydrostatic pressures and the colloid osmotic
pressures. Under normal circumstances, the
net filtration pressure is approximately 10 mm
Hg. This is the average pressure forcing water
and dissolved materials out of the glomerular
capillaries and into the capsular space.

GHP – (CHP + BCOP) = 55 – (15+30) = 10 mm Hg

(even small decreases in blood pressure at glomeruli can decrease GFR, if drops to 40 filtration stops and can cause acute renal failure)

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22
Q

Capsular hydrostatic pressure (CsHP)

A

force of filtrate fluid
against the wall of the capsule (= 15 mm Hg)

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23
Q

Melanuria

A

dark urine

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24
Q

Peritubular fluid

A

filtrate that has been reabsorbed into space around peritubular capillaries

Most tubular fluid is reabsorbed into peritubular space and referred to as peritubular fluid

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25
Q

Apical (luminal) membrane

A

faces tubule lumen

26
Q

Basolateral membrane

A

often is
anchored to underlying
tissue/fascia; BUT in tubular
organs or structures in the
body this faces the interstitial
space / body cavity

27
Q

Reabsorption

A

the process of
moving a substance from the
filtrate in the tubule lumen into
the peritubular fluid into the
peritubular capillary

28
Q

Filtration

A

occurs in the glomerulus. Does NOT require energy. Driven by the differences in pressure
Afferent arteriole to glomerulus across podocyte into capsular fluid exits into tubule lumen

29
Q

Reabsorption

A

substances in the lumen of the nephron can then be
reabsorbed across the apical membrane of the tubules – through the
cytosol – across the basolateral membrane into the interstitial fluid
and then into the peritubular capillaries to re-enter blood
Tubular fluid to peritubular fluid (interstitial fluid) into peritubular capillary

30
Q

Secretion

A

The body can get rid of substances that are too large to be filtered by secreting them from the blood into the tubule lumen to be lost from the body in urine

Peritubular capillary into peritubular fluid into the tubule lumen

31
Q

Excretion

A

Elimination of wastes from the body

Tubule fluid into collecting duct, into ureters, into bladder, into urethra, out the body

32
Q

Glucose is absorbed in the PCT by a ____

A

sodium-glucose co-transporter

33
Q

pyel

A

trough or pelvis

34
Q

What cells are found in the collecting duct?

A

Principal cell: main sodium reabsorbing cells (influenced by hormones–ADH)

Intercalated cell: cells that mediate secretion and bicarbonate reabsorption

35
Q

What cells are found in the papillary duct (duct from collecting ducts to minor calyces)?

A

columnar cells (Hormones influence permeability of papillary duct)

36
Q

Facultative (optional) water reabsorption (10-15% of water reabsorption) – occurs
in ____ and ___.

Without ____ epithelium is impermeable to water.
With ____ epithelium is permeable to water, make ____ urine and ____ water.

A

DCT and collecting tubules; ADH
ADH; concentrated; conserve

37
Q

Three metabolic wastes:

A

 Urea (most abundant organic waste, most from
breakdown of amino acids, produce ~21 g/d)
 Creatinine (from breakdown of creatine phosphate in
skeletal muscle, make ~1.8 g/d, all excreted in urine)
 Uric acid (from recycling of nitrogenous bases from
RNA, make ~480 mg/d)

38
Q

Juxtaglomerular Apparatus (JGA) components:

A

Juxtaglomerular (JG) cells, macula densa, and (extraglomerular) mesangial cells

39
Q

Juxtaglomerular (JG) cells

A

 Enlarged, smooth muscle cells in walls of afferent arteriole
 Act as mechanoreceptors

40
Q

Macula densa

A

 Tall, closely packed distal tubule cells
 Lie adjacent to JG cells
 Function as chemoreceptors / osmoreceptors

41
Q

Mesangial cells (extraglomerular, part of the JGA):

A

 Have phagocytic and contractile properties
 Influence capillary filtration
 Vasopressin / Angiotensin II affect mesangial cell contraction

42
Q

RAAS

A

renin-angiotensin-aldosterone-system

43
Q

JG cells surrounding afferent arterioles make
____ (enzyme) –
 _____ converts ______ into
________ (inactive precursor)
 _______ is then converted into
________ (hormone) by _______ (ACE)
 ACE is richly expressed in the capillaries
of the lungs and is found in the kidney

A

Renin

Renin; angiotensinogen; Angiotensin I

Angiotensin I; Angiotensin II; angiotensin
converting enzyme

44
Q

Angiotensin II

A

systemic vasoconstriction, stimulates aldosterone (salt) and ADH (water) production. Works on proximal convoluted tubule.

most vasoactive
 Has a direct effect on the PCT to increase Na reabsorption
Increases GFR by increasing renal perfusion pressure
 Constricts systemic blood vessels (arteriolar vasoconstriction)
 Stimulates aldosterone production from adrenal glands
 Stimulates posterior pituitary to make ADH (water reabsorption from collecting tubule)
 More Na and Cl reabsorption from nephron, more K+ secretion into nephron tubule
 Stimulates sympathetic activity
 Blood volume increases, BP goes up, GFR goes up

45
Q

Aldosterone

A

salt retention in distal tubule and collecting duct (principle cells). produced by adrenal cortex. stimulated by angiotensin II and stretch receptors in heart and low sodium.

 Synthesis from adrenal cortex (mineralocorticoid from zona glomerulosa)
 Increases Na and Cl reabsorption and K excretion; leads to water retention
 Works on distal kidney tubules, principal cells of collecting duct

 Steroid hormone
 Synthesized by adrenal cortex; acts on the kidney
 Is a mineralocorticoid
 Role is to increase BP - by conserving sodium, secreting potassium and increases blood pressure
 Synthesis stimulated by angiotensin II, ACTH and potassium levels (all of these increase when sodium deficient) and by plasma acidosis
 Stretch receptors in the heart also sense decreased BP and stimulate adrenal gland to release aldosterone
 Acts on distal tubule and collecting duct -principal cells

46
Q

Antidiuretic Hormone (ADH) = Vasopressin

A

water reabsorption, posterior pituitary, in response to angiotensin II or high osmolality (solute content in blood)

Increases water reabsorption in collecting duct and DCT – by stimulating aquaporin production in apical membrane

 Released by posterior pituitary in response to increased osmolality of plasma or stimulation by Angiotensin II
 Is a neurohypophyseal hormone
 Role is to increase BP - by conserving water and constricting blood vessels
nInduces aquaporin translocation into apical membranes in collecting duct and distal convoluted tubule

47
Q

Erythropoietin (EPO)–

A

 Synthesized by the JG cells in response to Hypoxia
 Increases RBC production in the bone marrow
 More RBC more capacity to transport oxygen

48
Q

Calcitriol (1,25(OH)2D)

A

 Synthesized in the PCT
 25(OH)D-DBP taken into PCT cell by megalin / cubulin receptor(receptor mediated endocytosis)
 25(OH)D can be used inside the cell to make calcitriol because 1-alpha hydroxylase enzyme (CYP27B1 gene) is present in the PCT
 If calcitriol is not needed, 25(OH)D can by hydroxylated at the 24-position by 24-hydroxylase in the PCT (CYP24A1 gene)

49
Q

Atrial natriuretic peptide and brain
natriuretic peptide

A

 Synthesized by cardiac cells in
response to increased blood volume or increased blood pressure
 Work to reduce fluid volume by inhibiting ADH (lose more fluid, reduce plasma volume, less concentrated urine)
 Reduce thirst so not taking in fluid
 Cause peripheral vasodilation (lower BP, reduce GFR)

50
Q

What are the 2 most common health
problems that lead to CKD?

A

Hypertension
Diabetes

51
Q

Less than 2% of older patients with CKD
require renal replacement therapy – why?

A

Die from cardiovascular disease

52
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
flow to kidneys so their ability to
function decreases

53
Q

List 3 biochemical findings that could be
used to provide evidence of altered renal
function in those with CKD?

A
  • Proteinuria
  • Micro and macroalbuminuria
  • Elevated serum creatinine
  • Reduced glomerular filtration rate (rate at
    which the kidney filters the blood)
  • Alterations in serum metabolites
  • Elevated cystatin C – newer test
54
Q

elevated Cystatin C blood test may be a good marker of GFR bc

A

-filtered only by glomerulus
-not secreted by renal tubules
-generated at a consistent rate by all cells in the body

55
Q

What 2 hormones can the body use to regulate P homeostasis and where are
these made?

A

FGF23 - osteocyte / PTH – parathyroid glands

56
Q

What does high P do to increase risk of cardiac disease?

A

High serum P associated with vascular calcification, get arterial stiffness, can narrow the lumen of the arteries. High P stimulates vascular smooth muscle cells to undergo osteochondrogenic differentiation and calcify
Link between vascular calcification and osteogenesis; regulators of bone formation in vascular plaques

57
Q

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

What are some of the non-hormonal
reasons for this anemia?

A

Erythropoietin (EPO) – made in kidney
Hepcidin – made in liver from inflammation caused by CKD

Fe deficiency anemia
Blood loss from dialysis
Decreased RBC half-life

58
Q

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

A

Intravenous iron, bypass the gut
Average dose of Fe 914 mg a month IV
Typically absorb 1-2 mg Fe/d = 30-60 mg per month

59
Q

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

What tissues are most at risk?

A

NTBI: non-transferrin bound iron (free floating serum iron); taken up by ZIP14

pancreas and liver

60
Q

FGF23 from osteocyte:

A

*Increases from high P
*Inhibits P absorption from gut
*Inhibits P reabsorption from kidney
*Inhibits PTH release
*Inhibits 1-alpha hydroxylase in kidney

61
Q

Calcitriol from kidney:

A

*Increased by PTH- low Ca
*Decreased by high P
*Increases bone resorption
*Inc Ca/P absorption gut
*Inhibit PTH secretion
*Stimulate FGF23 production

62
Q

PTH from 4 PTH glands:

A

*Increases from low Ca/ high P
*Increases calcitriol production kidney
*Inhibits P reabsorption from kidney
*Increases Ca reabsorption from kidney
*Increases Ca/P release from bone

A&P Lecture Final (5 decks)

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