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Urinary System Flashcards

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1
Q

What is the urinary system’s function?

A

rids the body of waste
products

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2
Q

What do kidneys also do? (general)

A

play important roles in blood
volume, pressure, and composition

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3
Q

What does the urinary system consist of?

A

six organs: two kidneys, two ureters,
urinary bladder, and urethra

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4
Q

What are the urinary functions of the kidneys?

A

Filter blood plasma, excrete toxic wastes
* Regulate blood volume, pressure, and
osmolarity
* Regulate electrolytes and acid-base balance
* Secrete erythropoietin, which stimulates the
production of red blood cells
* Help regulate calcium levels by participating in
calcitriol synthesis
* Clear hormones from blood
* Detoxify free radicals
* In starvation, they synthesize glucose from
amino acids

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5
Q

What 4 body systems carry out excretion? What do they excrete?

A

– Respiratory system
* CO2, small amounts of other gases, and water
– Integumentary system
* Water, inorganic salts, lactic acid, urea in sweat
– Digestive system
* Water, salts, CO2, lipids, bile pigments, cholesterol, and
other metabolic waste
– Urinary system
* Many metabolic wastes, toxins, drugs, hormones, salts,
H+, and water

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6
Q

What are the nitrogenous wastes?

A

ammonia, urea, uric acid, protein

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7
Q

How do you measure level of nitrogenous waste in the blood?

A

blood urea nitrogen

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8
Q

What is azotemia?

A

elevated BUN

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9
Q

What is uremia?

A

syndrome of diarrhea,
vomiting, dyspnea, and cardiac
arrhythmia stemming from the
toxicity of nitrogenous waste
* Treatment—hemodialysis or
organ transplant

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10
Q

What is the positioning of the kidneys?

A

Lie against posterior abdominal wall at level of T12
to L3
– Right kidney is slightly lower due to large right lobe of
liver
– Rib 12 crosses the middle of the left kidney
– Retroperitoneal along with ureters, urinary bladder,
renal artery and vein, and adrenal glands

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11
Q

What is the peritoneum?

A

serous membrane surrounding digestive system

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12
Q

What is the shape and size of the kidney?

A

– About the size of a bar of bath soap
– Lateral surface is convex, and medial is concave with a slit,
called the hilum
* Receives renal nerves, blood vessels, lymphatics, and ureter

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13
Q

What are the 3 connective tissue coverings?

A

Renal fascia immediately deep to parietal peritoneum
* Binds it to abdominal wall
– Perirenal fat capsule: cushions kidney and holds it into place
– Fibrous capsule encloses kidney protecting it from trauma
and infection
* Collagen fibers extend from fibrous capsule to renal fascia
* Still drop about 3 cm when going from lying down to standing up

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14
Q

What is the renal parenchyma?

A

glandular tissue that forms
urine

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15
Q

What is the renal sinus?

A

cavity that contains blood and lymphatic
vessels, nerves, and urine-collecting structures
* Adipose fills the remaining cavity and holds
structures in place

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16
Q

What are the two zones of the renal perenchyma?

A

– Outer renal cortex
– Inner renal medulla

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17
Q

What is the inner renal medulla made up of?

A
  • Renal columns—extensions of the cortex that project inward
    toward sinus
  • Renal pyramids—6 to 10 with broad base facing cortex and renal
    papilla facing sinus
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18
Q

Define the lobe, minor calyx, major calyx, renal pelvis, and ureter

A

– Lobe of kidney: one pyramid and its overlying cortex
– Minor calyx: cup that nestles the papilla of each pyramid;
collects its urine
– Major calyces: formed by convergence of 2 or 3 minor calyces
– Renal pelvis: formed by convergence of 2 or 3 major calyces
– Ureter: a tubular continuation of the pelvis that drains urine
down to the urinary bladder

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19
Q

What does the renal pelvis do?

A

collects urine

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20
Q

What is the renal fraction?

A

kidneys are 0.4% body weight but recieve 21% of CO

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21
Q

What is the order of renal circulation?

A

renal a, cortical radiate a, afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries, vasa recta

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22
Q

What do the peritubular capillaries and vasa recta supply?

A

n the cortex, peritubular
capillaries branch off of
the efferent arterioles
supplying the tissue near
the glomerulus, the
proximal and distal
convoluted tubules
* In the medulla, the
efferent arterioles give
rise to the vasa recta,
supplying the nephron
loop portion of the
nephron

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23
Q

What is the nephron composed of?

A

– Renal corpuscle: filters the blood plasma
– Renal tubule: long, coiled tube that converts the filtrate into urine

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24
Q

What is the renal corpuscle composed of?

A

consists of the glomerulus and a
two-layered glomerular capsule that encloses
glomerulus
– Parietal (outer) layer of glomerular capsule is simple squamous
epithelium
– Visceral (inner) layer of glomerular capsule consists of elaborate
cells called podocytes that wrap around the capillaries of the
glomerulus

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25
What separates the two layers of the glomerular capsule?
capsular space
26
What are the two poles of the renal corpuscle?
* Vascular pole—the side of the corpuscle where the afferent arterial enters the corpuscle and the efferent arteriole leaves * Urinary pole—the opposite side of the corpuscle where the renal tubule begins 23-24
27
What is the renal tubule?
duct leading away from the glomerular capsule and ending at the tip of the medullary pyramid
28
What are the 4 regions of the renal tubule?
– Proximal convoluted tubule, nephron loop (loop of Henle), distal convoluted tubule: parts of one nephron – Collecting duct receives fluid from many nephrons
29
What are the features of the PCT?
arises from glomerular capsule – Longest and most coiled region – Simple cuboidal epithelium with prominent microvilli for majority of absorption 23-25
30
What are the features of the nephron loop?
long U-shaped portion of renal tubule – Descending limb and ascending limb – Thick segments have simple cuboidal epithelium * Initial part of descending limb and part or all of ascending limb * Heavily engaged in the active transport of salts and have many mitochondria – Thin segment has simple squamous epithelium * Forms lower part of descending limb * Cells very permeable to water
31
What are the features of the DCT?
begins shortly after the ascending limb reenters the cortex – Shorter and less coiled than PCT – Cuboidal epithelium without microvilli – DCT is the end of the nephron 23-26
32
What are the features of the collecting duct?
receives fluid from the DCTs of several nephrons as it passes back into the medulla – Numerous collecting ducts converge toward the tip of the medullary pyramid – Papillary duct: formed by merger of several collecting ducts * 30 papillary ducts end in the tip of each papilla * Collecting and papillary ducts lined with simple cuboidal epithelium
33
What is the flow of fluid from where the glomerular filtrate is formed?
glomerular capsule → proximal convoluted tubule → nephron loop → distal convoluted tubule → collecting duct → papillary duct → minor calyx → major calyx → renal pelvis → ureter → urinary bladder → urethra
34
What are cortical nephrons?
– 85% of all nephrons – Short nephron loops – Efferent arterioles branch into peritubular capillaries around PCT and DCT
35
What are juxtamedullary nephrons?
– 15% of all nephrons – Very long nephron loops, maintain salinity gradient in the medulla and help conserve water – Efferent arterioles branch into vasa recta around long nephron loop
36
What is the important function of the renal plexus?
Carries sympathetic innervation from the abdominal aortic plexus (for RAAS)
37
What are the basic stages of urine formation?
Glomerular filtration Creates a plasmalike filtrate of the blood Tubular secretion Removes additional wastes from the blood, adds them to the filtrate Tubular reabsorption Removes useful solutes from the filtrate, returns them to the blood Water conservation Removes water from the urine and returns it to blood; concentrates wastes
38
What is glomerular filtrate?
the fluid in the capsular space – Similar to blood plasma except that it has almost no protein
39
What is tubular fluid?
—fluid from the proximal convoluted tubule through the distal convoluted tubule – Substances have been removed or added by tubular cells
40
What is urine?
fluid that enters the collecting duct – Undergoes little alteration beyond this point except for changes in water content
41
What are the 3 parts of the filtration membrane?
– Fenestrated endothelium of glomerular capillaries * 70 to 90 nm filtration pores – small enough to exclude blood cells * Highly permeable – Basement membrane * Proteoglycan gel, negative charge, excludes molecules greater than 8 nm * Albumin repelled by negative charge * Blood plasma is 7% protein, the filtrate is only 0.03% protein – Filtration slits * Podocyte cell extensions (pedicels) wrap around the capillaries to form a barrier layer with 30 nm filtration slits * Negatively charged which is an additional obstacle for large anions
42
What molecules can pass freely through the filtration membrane?
any small molecule
43
What molecules cannot pass freely through the filtration membrane?
low MW, Ca, Fe, thyroid
44
What is proteinuria?
protein in urine (albuminuria)
45
What is hematuria?
blood in urine
46
Why do athletes get protein/hematuria
– Prolonged, strenuous exercise reduces profusion of kidney – Glomerulus deteriorates under prolonged hypoxia
47
What does filtration pressure depend on?
hydrostatic and osmotic pressures on each side of the filtration membrane
48
What is BHP?
– High in glomerular capillaries (60 mm Hg compared to 10 to 15 in most other capillaries) * Because afferent arteriole is larger than efferent arteriole: a large inlet and small outlet
49
What does BHP dictate?
GFR, because an increase will favor filtration since the afferent is larger
50
What is the GFR?
amount of filtrate formed per minute by the two kidneys combined – GFR = NFP x Kf  125 mL/min. or 180 L/day (male) – GFR = NFP x Kf  105 mL/min. or 150 L/day (female)
51
What happens if GFR is too high?
– Fluid flows through renal tubules too rapidly for them to reabsorb the usual amount of water and solutes – Urine output rises – Chance of dehydration and electrolyte depletionW
52
What happens if GFR is too low?
– Wastes are reabsorbed – Azotemia may occur
53
How is GFR controlled?
by adjusting glomerular blood pressure from moment to moment
54
What are the 3 GFR control mechanisms?
– Renal autoregulation: too high – Sympathetic control: too low – Hormonal control: either
55
What are the features of renal autoregulation? What are the methods?
the ability of the nephrons to adjust their own blood flow and GFR without external (nervous or hormonal) control myogenic mechanism and tubuloglomerular feedback
56
What is the myogenic mechanism?
based on the tendency of smooth muscle to contract when stretched – If arterial blood pressure increases * Afferent arteriole is stretched * Afferent arteriole constricts and prevents blood flow into the glomerulus from changing – If arterial blood pressure falls * Afferent arteriole relaxes * Afferent arteriole dilates and allows blood to flow more easily into glomerulus, so that flow rate remains similar and filtration remains stableW
57
What is tubuloglomerular feedback??
glomerulus receives feedback on the status of downstream tubular fluid and adjusts filtration rate accordingly – Regulates filtrate composition, stabilizes kidney performance, and compensates for fluctuations in blood pressure
58
What is the juxtaglomerular apparatus?
complex structure found at the end of the nephron loop where it has just reentered the renal cortex – Loop comes into contact with the afferent and efferent arterioles at the vascular pole of the renal corpuscle
59
What is the macula densa?
patch of slender, closely spaced sensory cells in nephron loop * When GFR is high, filtrate contains more NaCl * When macula densa absorbs more NaCl, it secretes ATP * ATP is metabolized by nearby mesangial cells into adenosine * Adenosine stimulates nearby granular cell
60
What are the granular cells?
modified smooth muscle cells wrapping around arterioles (close to macula densa) * Granular cells respond to adenosine by constricting afferent arterioles – Constriction reduces blood flow which corrects GFR
61
What are mesangial cells?
constricting capillaries and further limiting GFR
62
What do granular cells also contain?
renin
63
What does sympathetic control consist of?
Sympathetic nervous system and adrenal epinephrine constrict the afferent arterioles in strenuous exercise or acute conditions like circulatory shock – Reduces GFR and urine output – Redirects blood from the kidneys to the heart, brain, and skeletal muscles
64
What is the RAAS mechanism?
a drop in BP is sensed by the kidneys, who send renin to convert angiotensinogen into angiotensin 1, which is then converted into angiotensin 2 by ACE from the lungs angiotensin 2 stimulates ADH and aldosterone which promote water reabsorption and sodium reabsorption
65
What does the PCT reabsorb?
everything but salt
66
What is reabsorption mostly powered by?
Na K pump
67
How does diabetes result in glycosuria?
If all transporters are occupied, any excess solute passes by and appears in urine * Transport maximum is reached when transporters are saturated * Each solute has its own transport maximum
68
What is the primary function of the nephron loop?
o generate salinity gradient that enables collecting duct to concentrate the urine and conserve water * Electrolyte reabsorption from filtrate
69
What do the DCT and collecting duct reabsorb? What regulates them?
eabsorb variable amounts of water and salt – Aldosterone, atrial natriuretic peptide, ADH, and parathyroid hormone
70
What are the kinds of cells in the DCT and collecting duct?
– Principal cells * Most numerous * Have receptors for hormones * Involved in salt and water balance – Intercalated cells * Involved in acid–base balance by secreting H+ into tubule lumen and reabsorbing K+
71
What is aldosterone? What are its functions?
the “salt-retaining hormone” – Steroid secreted by the adrenal cortex Acts on thick segment of nephron loop, DCT, and cortical portion of collecting duct * Stimulates reabsorption of Na+ and secretion of K+
72
What are natriuretic peptides?
secreted by atrial myocardium of the heart in response to high blood pressure * Four actions result in the excretion of more salt and water in the urine, thus reducing blood volume and pressure
73
What do naturietic peptides do?
– Dilates afferent arteriole, constricts efferent arteriole:  GFR – Inhibits renin and aldosterone secretion – Inhibits secretion of ADH – Inhibits NaCl reabsorption by collecting duct
74
What does ADH do?
– ADH makes collecting duct more permeable to water – Water in the tubular fluid reenters the tissue fluid and bloodstream rather than being lost in urine
75
What does parathyroid hormone do?
ncreases phosphate content and lowers calcium content in urine – Because phosphate is not retained, calcium ions stay in circulation rather than precipitating into bone tissue as calcium phosphate – PTH stimulates calcitriol synthesis by epithelial cells of the PCT
76
What are the features of the collecting duct?
* Collecting duct (CD) begins in the cortex where it receives tubular fluid from several nephrons * CD runs through medulla, and reabsorbs water, making urine up to four times more concentrated * Medullary portion of CD is more permeable to water than to NaCl * As urine passes through the increasingly salty medulla, water leaves by osmosis, concentrating urine
77
What is pyuria?
pus in urine
78
What is the pH of urine?
4.5-8.2, usually 6, mildly acidic
79
What should not be in urine?
glucose, free hemoglobin, albumin, ketones, bile pigments
80
What is the normal urine volume per day?
1-2 L
81
What is polyuria?
excess of 2 L a day
82
What is oliguria?
less than 500 mL a day`
83
What is anuria and what does it cause?
0 to 100 ml a day, uremia
84
What are the forms of diabetes?
– Diabetes mellitus type 1, type 2, and gestational diabetes * High concentration of glucose in renal tubule * Glucose opposes the osmotic reabsorption of water * More water passes in urine (osmotic diuresis) * Glycosuria—glucose in the urine – Diabetes insipidus * ADH hyposecretion causes not enough water to be reabsorbed in the collecting duct * More water passes in urine
85
What is a diuretic?
any chemical that increase urine volume, some increase GFR, some act on nephron loop
86
What are the anatomy of the ureters?
retroperitoneal, muscular tubes that extend from each kidney to the urinary bladder
87
What are the 3 layers of the bladder?
– Covered by parietal peritoneum, superiorly, and by fibrous adventitia elsewhere – Muscularis: detrusor: three layers of smooth muscle – Mucosa: transitional epithelium * Umbrella cells on surface of epithelium protect it from the hypertonic, acidic urine * Rugae—conspicuous wrinkles in empty bladder
88
What is a trigone?
smooth-surfaced triangular area on bladder floor that is marked with openings of ureters and urethra
89
What volume do you feel you need to pee?
at 200 ml, you contract muscles, at 400 you have to pee, max fullness is 800 ml
90
How long is the female urethra?
3 to 4 cm long
91
What are the 3 regions of the male urethra?
– Prostatic urethra (2.5 cm) * Passes through prostate gland – Membranous urethra (0.5 cm) * Passes through muscular floor of pelvic cavity – Spongy (penile) urethra (15 cm) * Passes through penis in corpus spongiosum
92
What is a UTI?
* Cystitis—infection of the urinary bladder – Especially common in females due to short urethra – Frequently triggered by sexual intercourse – Can spread up the ureter causing pyelitis * Pyelitis—infection of the renal pelvis * Pyelonephritis—infection that reaches the cortex and the nephrons – Can result from blood-borne bacteria
93
What causes renal failure?
Hypertension, chronic kidney infections, trauma, prolonged ischemia and hypoxia, poisoning by heavy metals or solvents, blockage of renal tubules in transfusion reaction, atherosclerosis, or glomerulonephritis
94
What is hemodialysis?
procedure for artificially clearing wastes from the blood

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