Urinary System Flashcards
Barbara Herlihy. (2020). The Human Body in Health and Illness (7th Edition) [Texidium version]. Retrieved from http://texidium.com (175 cards)
1
Q
Which organs remove waste and constantly adjusts the amount of water and electrolyte concentrations?
(Herlihy, 2020, p. 459)
A
Kidneys
(Herlihy, 2020, p. 459)
2
Q
What are the most important excretory organs?
(Herlihy, 2020, p. 459)
A
Kidneys
(Herlihy, 2020, p. 459)
3
Q
What eliminates nitrogenous waste, water, electrolytes, toxins, and drugs?
(Herlihy, 2020, p. 459)
A
Kidneys
(Herlihy, 2020, p. 459)
4
Q
Other organs perform excretory functions; the ___ ___ secrete small amounts of nitrogen compounds, water, and electrolytes; the ___ eliminate carbon dioxide and water; and the ___ excrete digestive wastes, bile pigments, and other minerals.
(Herlihy, 2020, p. 459)
A
sweat glands
lungs
intestines
(Herlihy, 2020, p. 459)
5
Q
Whereas the skin, lungs, and intestines eliminate waste, only the ___ can fine-tune the excretion of water and electrolytes to maintain the normal volume and composition of body fluids.
(Herlihy, 2020, p. 459)
A
kidneys
(Herlihy, 2020, p. 459)
6
Q
Which system makes, temporarily stores, and finally eliminates urine from the body?
(Herlihy, 2020, p. 459)
A
Urinary
(Herlihy, 2020, p. 459)
7
Q
The major organs of the urinary system include the following:
- Two ___
- Two ___
- One ___ ___
- One ___
(Herlihy, 2020, pp. 459. 460)
A
kidneys
ureters
urinary bladder
urethra
(Herlihy, 2020, pp. 459. 460)
8
Q
Which organs forms urine from the blood?
(Herlihy, 2020, pp. 459. 460)
A
Kidneys
(Herlihy, 2020, pp. 459. 460)
9
Q
What are the tubes that conduct urine from the kidneys to the urinary bladder?
(Herlihy, 2020, p. 460)
A
Ureters
(Herlihy, 2020, p. 460)
10
Q
What acts as a temporary reservoir; receiving urine from the ureters and storing it until it can be eliminated?
(Herlihy, 2020, p. 460)
A
Urinary Bladder
(Herlihy, 2020, p. 460)
11
Q
What is the tube that conducts urine from the bladder to the outside for elimination?
(Herlihy, 2020, p. 460)
A
Urethra
(Herlihy, 2020, p. 460)
12
Q
(Herlihy, 2020, p. 460)
A
(Herlihy, 2020, p. 460)
13
Q
What is the word that refers to the kidneys?
(Herlihy, 2020, p. 460)
A
Renal
(Herlihy, 2020, p. 460)
14
Q
What refers to the study of kidney function?
(Herlihy, 2020, pp. 460, 461)
A
Renal Physiology
(Herlihy, 2020, pp. 460, 461)
15
Q
What is the term that refers to the study of kidney function, derived from the unit in the kidney that makes urine?
(Herlihy, 2020, p. 461)
A
Nephrology
(Herlihy, 2020, p. 461)
16
Q
What is the unit in the kidney that makes urine?
(Herlihy, 2020, p. 461)
A
Nephron Unit
(Herlihy, 2020, p. 461)
17
Q
What is the study of the urinary system?
(Herlihy, 2020, p. 461)
A
Urology
(Herlihy, 2020, p. 461)
18
Q
What are located high on the posterior wall of the abdominal cavity, behind the parietal peritoneum (retroperitoneal)?
(Herlihy, 2020, p. 461)
A
Kidneys
(Herlihy, 2020, p. 461)
19
Q
What are cushioned and protected by the renal fascia, adipose tissue pads, and lower rib cages?
(Herlihy, 2020, p. 461)
A
Kidneys
(Herlihy, 2020, p. 461)
20
Q
What are the reddish-brown, beanlike structures enclosed in tough fibrous capsules?
(Herlihy, 2020, p. 461)
A
Kidneys
(Herlihy, 2020, p. 461)
21
Q
Each ___ is about 4 inches (10 cm) long, 2 inches (5 cm) wide, and 1 inch (2.5 cm) thick.
(Herlihy, 2020, p. 461)
A
kidney
(Herlihy, 2020, p. 461)
22
Q
What is the indentation of the bean-shaped kidney called?
(Herlihy, 2020, p. 461)
A
Hilus
(Herlihy, 2020, p. 461)
23
Q
What is the point at which the blood vessels, ureter, and nerves enter and exit the kidney?
(Herlihy, 2020, p. 461)
A
Hilus
(Herlihy, 2020, p. 461)
24
Q
What are the three distinct kidney regions?
(Herlihy, 2020, p. 461)
A
Cortex
Medulla
Pelvis
(Herlihy, 2020, p. 461)
25
What is the light, outer region?
## Footnote
(Herlihy, 2020, p. 461)
Cortex
## Footnote
(Herlihy, 2020, p. 461)
26
What is the dark triangular structure located deep within the kidney?
## Footnote
(Herlihy, 2020, p. 461)
Medulla
## Footnote
(Herlihy, 2020, p. 461)
27
What are the striped, cone-shaped regions formed by the renal medulla?
## Footnote
(Herlihy, 2020, p. 461)
Pyramids
## Footnote
(Herlihy, 2020, p. 461)
28
Each pyramid is separated by a renal ___, an extension of the outer renal cortex.
## Footnote
(Herlihy, 2020, p. 461)
column
## Footnote
(Herlihy, 2020, p. 461)
29
The lower ends of the pyramids point toward the renal ___, a basin that collects the urine made by the kidney and helps form the upper end of the ureter.
## Footnote
(Herlihy, 2020, p. 461)
pelvis
## Footnote
(Herlihy, 2020, p. 461)
30
What are the cuplike edges of the renal pelvis, closest to the pyramids?
## Footnote
(Herlihy, 2020, p. 461)
Calyx
## Footnote
(Herlihy, 2020, p. 461)
31
What collects the urine formed in the kidney?
## Footnote
(Herlihy, 2020, p. 461)
Calyx
## Footnote
(Herlihy, 2020, p. 461)
32
Blood is brought to the kidney by the ___ ___, which arises from the abdominal aorta.
## Footnote
(Herlihy, 2020, p. 461)
renal artery
## Footnote
(Herlihy, 2020, p. 461)
33
The renal arteries deliver a large amount of blood to the kidneys, averaging about ___% to ___% of the cardiac output.
## Footnote
(Herlihy, 2020, p. 461)
20
25
## Footnote
(Herlihy, 2020, p. 461)
34
After entering the kidney, the renal artery branches into a series of smaller and smaller arteries, which deliver blood to the ___ ___, the urine-making structures of the kidney.
## Footnote
(Herlihy, 2020, p. 461)
nephron units
## Footnote
(Herlihy, 2020, p. 461)
35
Blood leaves the kidney through a series of veins that finally merge to form the ___ ___.
## Footnote
(Herlihy, 2020, p. 461)
renal vein
## Footnote
(Herlihy, 2020, p. 461)
36
Where does the renal vein empty?
## Footnote
(Herlihy, 2020, p. 461)
Inferior Vena Cava
## Footnote
(Herlihy, 2020, p. 461)
37
A) Organs of the Urinary System
B) Internal Structure of a Kidney
## Footnote
(Herlihy, 2020, p. 461)
## Footnote
(Herlihy, 2020, p. 461)
38
What travels with the renal blood vessels to the kidney?
## Footnote
(Herlihy, 2020, p. 461)
Renal Nerves
## Footnote
(Herlihy, 2020, p. 461)
39
Renal nerves are primarily ___ nerves that help control blood flow to the kidney and regulate the release of a blood pressure–regulating enzyme.
## Footnote
(Herlihy, 2020, p. 461)
sympathetic
## Footnote
(Herlihy, 2020, p. 461)
40
What cleanses the blood of waste products, helps regulate the volume and composition of body fluids, and helps regulate the pH of body fluids?
Kidneys
41
Specifically, the kidneys perform the following tasks:
* Excretes nitrogenous waste such as ___, ___ ___, ___, and ___
* Regulates ___ ___ by determining the amount of water excreted
* Helps regulate the ___ content of the blood
* Plays a major role in the regulation of ___-___ ___ (___ ___) by controlling the excretion of hydrogen ions (H+)
* Plays a role in the long-term regulation of ___ ___
* Plays a role in the regulation of red blood cell production through the secretion of ___
## Footnote
(Herlihy, 2020, p. 461)
urea, uric acid, ammonia, creatinine
blood volume
electrolyte
acid–base balance (**blood pH**)
blood pressure
erythropoietin
## Footnote
(Herlihy, 2020, p. 461)
42
What is the functional unit, or urine-making unit, of the kidney?
## Footnote
(Herlihy, 2020, p. 461)
Nephron Unit
## Footnote
(Herlihy, 2020, p. 461)
43
Each kidney contains about 1 million ___ ___.
The number of ___ ___ does not increase after birth, and they cannot be replaced if damaged.
## Footnote
(Herlihy, 2020, p. 461)
nephron units
nephron units
## Footnote
(Herlihy, 2020, p. 461)
44
Each nephron unit has two parts: a tubular component (___ ___) and a vascular component (___ ___).
## Footnote
(Herlihy, 2020, p. 461)
renal tubules
blood vessels
## Footnote
(Herlihy, 2020, p. 461)
45
# Renal Tubules
The ___ ___, called Bowman capsule, is a C-shaped structure that partially surrounds a cluster of filtering capillaries called a ___.
## Footnote
(Herlihy, 2020, p. 461)
glomerular capsule
glomerulus
## Footnote
(Herlihy, 2020, p. 461)
46
# Renal Tubules
Bowman capsule extends from the glomerulus as a highly coiled tubule called the ___ ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
proximal convoluted tubule
## Footnote
(Herlihy, 2020, p. 463)
47
# Renal Tubules
The proximal convoluted tubule dips toward the renal pelvis to form a hairpin-shaped structure called the ___ of ___.
## Footnote
(Herlihy, 2020, p. 463)
**loop** of **Henle**
## Footnote
(Herlihy, 2020, p. 463)
48
# Renal Tubules
What contains a descending and ascending limb?
## Footnote
(Herlihy, 2020, p. 463)
loop of Henle
## Footnote
(Herlihy, 2020, p. 463)
49
# Renal Tubules
The ascending limb becomes the ___ ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
distal convoluted tubule
## Footnote
(Herlihy, 2020, p. 463)
50
# Renal Tubules
The distal convoluted tubules of several nephron units empty into a ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
collecting duct
## Footnote
(Herlihy, 2020, p. 463)
51
# Renal Tubules
The ___ ___ run through the renal medulla to the calyx of the renal pelvis.
Urine is formed and modified in these tubules.
## Footnote
(Herlihy, 2020, p. 463)
collecting ducts
## Footnote
(Herlihy, 2020, p. 463)
52
# Renal Blood Vessels (Vascular Structures)
How does the kidney receive blood?
## Footnote
(Herlihy, 2020, p. 463)
Renal Artery
## Footnote
(Herlihy, 2020, p. 463)
53
# Renal Blood Vessels (Vascular Structures)
The renal artery branches into smaller blood vessels that eventually form the ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
afferent arteriole
## Footnote
(Herlihy, 2020, p. 463)
54
# Renal Blood Vessels (Vascular Structures)
The afferent arteriole branches into a cluster, or tuft, of capillaries called a ___.
## Footnote
(Herlihy, 2020, p. 463)
glomerulus
## Footnote
(Herlihy, 2020, p. 463)
55
# Renal Blood Vessels (Vascular Structures)
The glomerulus sits in Bowman capsule and exits from Bowman capsule as the ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
efferent arteriole
## Footnote
(Herlihy, 2020, p. 463)
56
# Renal Blood Vessels (Vascular Structures)
The efferent arteriole forms a second capillary network called the ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
peritubular capillaries
## Footnote
(Herlihy, 2020, p. 463)
57
# Renal Blood Vessels (Vascular Structures)
The peritubular capillaries surround the renal tubules and empty blood into the venules, larger veins and, finally, into the ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
renal vein
## Footnote
(Herlihy, 2020, p. 463)
58
The Nephron Unit: Tubular and Vascular Structures
## Footnote
(Herlihy, 2020, p. 462)
## Footnote
(Herlihy, 2020, p. 462)
59
What is formed in the nephron units as water and dissolved substances move between the vascular and tubular structures?
## Footnote
(Herlihy, 2020, p. 463)
Urine
## Footnote
(Herlihy, 2020, p. 463)
60
Three processes are involved in the formation of urine: ___ ___, tubular ___, and tubular ___.
## Footnote
(Herlihy, 2020, p. 463)
glomerular filtration
reabsorption
secretion
## Footnote
(Herlihy, 2020, p. 463)
61
Urine formation begins in the ___ and ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
glomerulus
Bowman capsule
## Footnote
(Herlihy, 2020, p. 463)
62
What causes water and dissolved substances to move from the glomerulus into Bowman capsule?
## Footnote
(Herlihy, 2020, p. 463)
Glomerular Filtration
## Footnote
(Herlihy, 2020, p. 463)
63
About ___% of the blood that flows through the glomeruli is filtered into the tubules; the remaining ___% of the blood leaves the glomeruli by the efferent arterioles and continues into the peritubular capillaries.
## Footnote
(Herlihy, 2020, p. 463)
20
80
## Footnote
(Herlihy, 2020, p. 463)
64
What occurs when the pressure on one side of a membrane is greater than the pressure on the opposite side?
## Footnote
(Herlihy, 2020, p. 463)
Filtration
## Footnote
(Herlihy, 2020, p. 463)
65
Blood pressure in the glomerulus is higher than the pressure in Bowman capsule.
This pressure difference provides the driving force for ___.
This pressure difference is called the ___ ___ ___.
## Footnote
(Herlihy, 2020, p. 463)
filtration
glomerular filtration pressure
## Footnote
(Herlihy, 2020, p. 463)
66
If blood pressure suddenly declines, as in shock, ___ ___ ___ decreases, thereby reducing urinary output.
## Footnote
(Herlihy, 2020, p. 463)
glomerular filtration pressure
## Footnote
(Herlihy, 2020, p. 463)
67
The wall of the glomerulus contains ___ and acts like a sieve or a strainer.
The size of the ___ determines which substances can move across the wall from the glomerulus into Bowman capsule.
## Footnote
(Herlihy, 2020, p. 463)
pores
pores
## Footnote
(Herlihy, 2020, p. 463)
68
Small substances such as water, sodium, potassium, chloride, glucose, uric acid, and creatinine move through the pores very easily.
These substances are filtered in proportion to ___ concentration.
In other words, if the concentration of a particular substance in the ___ is high, much of that substance is filtered.
## Footnote
(Herlihy, 2020, p. 463)
plasma
plasma
## Footnote
(Herlihy, 2020, p. 463)
69
Large molecules such as ___ ___ ___ and large ___ cannot fit through the pores and therefore remain within the glomerulus.
## Footnote
(Herlihy, 2020, p. 463)
red blood cells
proteins
## Footnote
(Herlihy, 2020, p. 463)
70
What refers to the water and dissolved substances that have been filtered into Bowman capsule?
## Footnote
(Herlihy, 2020, p. 463)
Glomerular Filtrate
## Footnote
(Herlihy, 2020, p. 463)
71
Glomerular filtrate is protein-free and is thus called an ___.
## Footnote
(Herlihy, 2020, p. 463)
ultrafiltrate
## Footnote
(Herlihy, 2020, p. 463)
72
Presence of ___ (___) in the urine indicates abnormally large holes in the glomerulus.
## Footnote
(Herlihy, 2020, p. 463)
protein (**proteinuria**)
## Footnote
(Herlihy, 2020, p. 463)
73
The protein that is most often found in urine is ___ (___).
## Footnote
(Herlihy, 2020, p. 463)
albumin (**albuminuria**)
## Footnote
(Herlihy, 2020, p. 463)
74
What refers to the rate at which glomerular filtration occurs?
## Footnote
(Herlihy, 2020, p. 463)
Glomerular Filtration Rate (GFR)
## Footnote
(Herlihy, 2020, p. 463)
75
The amount of filtrate formed is ___ mL/min, or ___ L (45 gallons) in 24 hours.
## Footnote
(Herlihy, 2020, p. 463)
125
180
180
## Footnote
(Herlihy, 2020, p. 463)
76
Most filtrate, approximately ___ L, is reabsorbed in the kidney and returned to circulation.
## Footnote
(Herlihy, 2020, p. 464)
178.5
## Footnote
(Herlihy, 2020, p. 464)
77
What is the process whereby water and dissolved substances (glomerular filtrate) move from the tubules into the blood of the peritubular capillaries?
## Footnote
(Herlihy, 2020, p. 464)
Tubular Reabsorption
## Footnote
(Herlihy, 2020, p. 464)
78
Although reabsorption occurs throughout the entire length of the renal tubule, most occurs across the ___ ___ ___.
## Footnote
(Herlihy, 2020, p. 464)
proximal convoluted tubule
## Footnote
(Herlihy, 2020, p. 464)
79
The kidney chooses the type and quantity of substances it reabsorbs.
Some substances, such as ___, are completely reabsorbed.
For example, the amount of ___ filtered is the same as the amount reabsorbed, so ___ normally does not appear in the urine.
Some substances are incompletely reabsorbed.
For example, over 99% of ___ and ___ is reabsorbed, whereas only 50% of ___ is reabsorbed.
Some waste products such as ___ are not reabsorbed at all.
Those substances that are not reabsorbed remain in the tubules and become part of the urine.
## Footnote
(Herlihy, 2020, p. 464)
glucose
glucose
glucose
water, sodium, urea
creatinine
## Footnote
(Herlihy, 2020, p. 464)
80
In hyperglycemic conditions, usually caused by uncontrolled diabetes mellitus, excess glucose is filtered.
The amount of filtered glucose exceeds the reabsorptive capacity of the tubules.
The excess glucose therefore “spills” into the urine (___).
## Footnote
(Herlihy, 2020, p. 464)
glucosuria
## Footnote
(Herlihy, 2020, p. 464)
81
If a person or pet ingests the sweet-tasting ethylene glycol in antifreeze, the chemical is ___ in that it forms precipitates within the tubular structures and severely impairs urine formation.
## Footnote
(Herlihy, 2020, p. 464)
nephrotoxic
## Footnote
(Herlihy, 2020, p. 464)
82
Reabsorption of substances by the kidney also varies with transport mechanisms of reabsorption.
Absorption occurs through active or passive transport.
For example, ___ is actively transported from the tubules into the peritubular capillaries.
___ and ___ passively follow the movement of ___ from the tubules into the peritubular capillaries.
## Footnote
(Herlihy, 2020, p. 464)
sodium
Water, chloride, sodium
## Footnote
(Herlihy, 2020, p. 464)
83
In general, when sodium is pumped from one location to another, water and chloride follow passively.
This response is the basis for the action of most ___, drugs that increase the production of urine.
Most ___ block the tubular reabsorption of sodium and therefore also block the reabsorption of water.
The excess sodium and water remain in the tubules and are eliminated as urine.
The excess secretion of urine is called ___.
## Footnote
(Herlihy, 2020, p. 464)
diuretics
diuretics
diuresis
## Footnote
(Herlihy, 2020, p. 464)
84
Although most of the water and dissolved substances enter the tubules because of filtration across the glomerulus, a second process moves very small amounts of select substances from the blood into the tubules.
This process is ___ ___.
## Footnote
(Herlihy, 2020, p. 464)
tubular secretion
## Footnote
(Herlihy, 2020, p. 464)
85
What involves the active transport of potassium ions (K+), hydrogen ions (H+), uric acid, ammonium ions (NH4 +), and drugs from the peritubular capillaries into the tubules?
## Footnote
(Herlihy, 2020, p. 464)
Tubular Secretion
## Footnote
(Herlihy, 2020, p. 464)
86
Which secretion is of particular interest because it is through this mechanism that the kidneys play a crucial role in acid-base regulation?
## Footnote
(Herlihy, 2020, p. 464)
Hydrogen Ion (H+)
## Footnote
(Herlihy, 2020, p. 464)
87
Several ___ act on the kidney to regulate water and electrolyte excretion.
Thus, these ___ play an important role in the regulation of blood volume, blood pressure, and electrolyte composition of body fluids.
## Footnote
(Herlihy, 2020, pp. 464, 465)
hormones
hormones
## Footnote
(Herlihy, 2020, pp. 464, 465)
88
Which hormone is secreted by the adrenal cortex?
## Footnote
(Herlihy, 2020, p. 465)
Aldosterone
## Footnote
(Herlihy, 2020, p. 465)
89
Which hormone is a mineralocorticoid that acts primarily on the distal tubule and upper collecting duct of the nephron unit?
## Footnote
(Herlihy, 2020, p. 465)
Aldosterone
## Footnote
(Herlihy, 2020, p. 465)
90
Which hormone stimulates reabsorption of sodium and water and the excretion of potassium?
## Footnote
(Herlihy, 2020, p. 465)
Aldosterone
## Footnote
(Herlihy, 2020, p. 465)
91
What is called the “salt-retaining” (NaCl) hormone because of its effect on sodium (Na+)?
## Footnote
(Herlihy, 2020, p. 465)
Aldosterone
## Footnote
(Herlihy, 2020, p. 465)
92
Because ___ increases sodium (Na+) and water reabsorption, it expands or increases blood volume.
The expanded blood volume, in turn, increases blood pressure.
## Footnote
(Herlihy, 2020, p. 465)
aldosterone
## Footnote
(Herlihy, 2020, p. 465)
93
A deficiency of ___ causes severely diminished blood volume, decline in blood pressure, and shock.
## Footnote
(Herlihy, 2020, p. 465)
aldosterone
## Footnote
(Herlihy, 2020, p. 465)
94
What is one of the most important stimuli for the release of aldosterone?
## Footnote
(Herlihy, 2020, p. 465)
Renin
## Footnote
(Herlihy, 2020, p. 465)
95
Renin is an enzyme that activates the ___-___-___ ___.
## Footnote
(Herlihy, 2020, p. 465)
renin–angiotensin–aldosterone system
## Footnote
(Herlihy, 2020, p. 465)
96
Renin is secreted by a specialized collection of cells called the ___ ___, located in the afferent arterioles of the kidney.
## Footnote
(Herlihy, 2020, p. 465)
juxtaglomerular apparatus
## Footnote
(Herlihy, 2020, p. 465)
97
Which cells are stimulated when blood pressure or blood volume declines?
## Footnote
(Herlihy, 2020, p. 465)
Renin-Secreting
## Footnote
(Herlihy, 2020, p. 465)
98
Renin sets off the following series of events:
* Renin activates ___ to form angiotensin I.
* An enzyme called ___ ___ changes angiotensin I to angiotensin II.
* Angiotensin II stimulates the adrenal cortex to release ___.
The ___, in turn, stimulates the distal tubule of the nephron unit to reabsorb ___ and ___ and to excrete ___.
The increased blood volume increases blood pressure.
* In addition to stimulating the release of aldosterone, ___ is also a potent vasopressor, a blood pressure–elevating agent.
* Thus, the activation of the ___-___-___ ___ helps regulate blood volume and blood pressure.
## Footnote
(Herlihy, 2020, p. 465)
angiotensinogen
converting enzyme
aldosterone
aldosterone
sodium, water, potassium
angiotensin II
renin–angiotensin–aldosterone system
## Footnote
(Herlihy, 2020, p. 465)
99
What is secreted by the liver and circulates within the blood (inactive)?
## Footnote
(Herlihy, 2020, p. 465)
Angiotensinogen
## Footnote
(Herlihy, 2020, p. 465)
100
Which converting enzyme is found in blood throughout the body and particularly high concentrations in the lungs?
## Footnote
(Herlihy, 2020, p. 465)
Angiotensin II
## Footnote
(Herlihy, 2020, p. 465)
101
A class of drugs called ___ ___ ___ (___) ___ is used to lower blood pressure.
## Footnote
(Herlihy, 2020, p. 465)
angiotensin-converting enzyme (**ACE**) inhibitors
## Footnote
(Herlihy, 2020, p. 465)
102
Which drugs prevent the production of angiotensin II and aldosterone, both of which increase blood pressure?
## Footnote
(Herlihy, 2020, p. 465)
Angiotensin-Converting Enzyme (ACE) Inhibitors
## Footnote
(Herlihy, 2020, p. 465)
103
Which drugs include the -pril drugs, such as lisinopril and captopril?
## Footnote
(Herlihy, 2020, p. 465)
Angiotensin-Converting Enzyme (ACE) Inhibitors
## Footnote
(Herlihy, 2020, p. 465)
104
A second hormone affecting water reabsorption is ___ ___ (___).
Its action allows the kidneys to concentrate urine.
## Footnote
(Herlihy, 2020, p. 465)
antidiuretic hormone (**ADH**)
## Footnote
(Herlihy, 2020, p. 465)
105
What literally means “against diuresis?”
## Footnote
(Herlihy, 2020, pp. 465, 466)
Antidiuretic
## Footnote
(Herlihy, 2020, pp. 465, 466)
106
The ___ ___ ___ (___) secretes antidiuretic hormone (ADH).
## Footnote
(Herlihy, 2020, p. 466)
posterior pituitary gland (**neurohypophysis**)
## Footnote
(Herlihy, 2020, p. 466)
107
What works primarily on the collecting duct of the nephron unit by determining its permeability to water?
## Footnote
(Herlihy, 2020, p. 466)
Antidiuretic Hormone (ADH)
## Footnote
(Herlihy, 2020, p. 466)
108
In the presence of ___ ___ (___), the collecting duct becomes permeable to water.
Water is reabsorbed from the collecting duct into the ___ ___.
## Footnote
(Herlihy, 2020, p. 466)
antidiuretic hormone (**ADH**)
peritubular capillaries
## Footnote
(Herlihy, 2020, p. 466)
109
What decreases the urinary excretion of water and causes excretion of a concentrated urine?
## Footnote
(Herlihy, 2020, p. 466)
Antidiuretic Hormone (ADH)
## Footnote
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110
In the absence of antidiuretic hormone (ADH), the membrane permeability of the ___ ___ decreases and water cannot be reabsorbed; the result is excretion of a large volume of dilute urine.
## Footnote
(Herlihy, 2020, p. 466)
collecting duct
## Footnote
(Herlihy, 2020, p. 466)
111
What plays an important role in the determination of blood volume and blood pressure because it affects the amount of water excreted by the kidneys?
## Footnote
(Herlihy, 2020, p. 466)
Antidiuretic Hormone (ADH)
## Footnote
(Herlihy, 2020, p. 466)
112
Excess antidiuretic hormone (ADH) (diminishes/expands) blood volume, whereas a deficiency of antidiuretic hormone (ADH) (diminishes/expands) blood volume.
## Footnote
(Herlihy, 2020, p. 466)
expands
diminishes
## Footnote
(Herlihy, 2020, p. 466)
113
The stimulus for the release of antidiuretic hormone (ADH) is decreased ___ ___ and a concentrated ___.
## Footnote
(Herlihy, 2020, p. 466)
blood volume
plasma
## Footnote
(Herlihy, 2020, p. 466)
114
Consider a person who becomes dehydrated by vomiting.
The person loses large amounts of water and electrolytes.
When the volume of blood decreases and the concentration of the blood increases, ___ ___ (___) is released.
___ ___ (___) increases the reabsorption of water by the kidneys, expanding blood volume and diluting the blood.
The increased blood volume eventually stops the stimulus for the release of ___ ___ (___).
## Footnote
(Herlihy, 2020, p. 466)
antidiuretic hormone (**ADH**)
antidiuretic hormone (**ADH**)
antidiuretic hormone (**ADH**)
## Footnote
(Herlihy, 2020, p. 466)
115
What determines the membrane permeability to water but does not affect sodium (Na+) reabsorption as does aldosterone?
## Footnote
(Herlihy, 2020, p. 466)
Antidiuretic Hormone (ADH)
## Footnote
(Herlihy, 2020, p. 466)
116
Place before ADH
Renin–Angiotensin–Aldosterone System
## Footnote
(Herlihy, 2020, p. 466)
## Footnote
(Herlihy, 2020, p. 466)
117
## Footnote
(Herlihy, 2020, p. 469)
## Footnote
(Herlihy, 2020, p. 469)
118
Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) cause excretion of sodium (Na+), a process called ___.
## Footnote
(Herlihy, 2020, p. 467)
natriuresis
## Footnote
(Herlihy, 2020, p. 467)
119
What is secreted by the walls of the atria of the heart in response to an increase in blood volume?
## Footnote
(Herlihy, 2020, p. 467)
Atrial Natriuretic Peptide (ANP)
## Footnote
(Herlihy, 2020, p. 467)
120
What is secreted by the walls of the ventricles in response to elevated ventricular volume?
## Footnote
(Herlihy, 2020, p. 467)
Brain Natriuretic Peptide (BNP)
## Footnote
(Herlihy, 2020, p. 467)
121
The effects of the natriuretic peptides are opposite of the effects of ___ and ___ ___ (___).
## Footnote
(Herlihy, 2020, p. 467)
aldosterone
antidiuretic hormone (ADH)
## Footnote
(Herlihy, 2020, p. 467)
122
What is used diagnostically in the assessment of heart failure because ventricular blood volume increases in the failing heart?
## Footnote
(Herlihy, 2020, p. 467)
Brain Natriuretic Peptide (BNP)
## Footnote
(Herlihy, 2020, p. 467)
123
What is secreted by the parathyroid glands?
## Footnote
(Herlihy, 2020, p. 467)
Parathyroid Hormone (PTH)
## Footnote
(Herlihy, 2020, p. 467)
124
Parathyroid hormone (PTH) does not affect water balance but plays an important role in the regulation of two electrolytes: ___ and ___.
## Footnote
(Herlihy, 2020, p. 467)
calcium
phosphate
## Footnote
(Herlihy, 2020, p. 467)
125
What stimulates the renal tubules to reabsorb calcium and excrete phosphate?
## Footnote
(Herlihy, 2020, p. 467)
Parathyroid Hormone (PTH)
## Footnote
(Herlihy, 2020, p. 467)
126
The excretion of phosphate is called the ___ effect of parathyroid hormone (PTH).
## Footnote
(Herlihy, 2020, p. 467)
phosphaturic
## Footnote
(Herlihy, 2020, p. 467)
127
The primary stimulus for the release of parathyroid hormone (PTH) is a low plasma level of ___.
Also responding to plasma ___ levels is ___, secreted by the thyroid gland.
## Footnote
(Herlihy, 2020, p. 467)
calcium
calcium
calcitonin
## Footnote
(Herlihy, 2020, p. 467)
128
What is released in response to increased plasma calcium and causes the kidneys to excrete calcium and phosphate?
## Footnote
(Herlihy, 2020, p. 467)
Calcitonin
## Footnote
(Herlihy, 2020, p. 467)
129
## Footnote
(Herlihy, 2020, p. 466)
## Footnote
(Herlihy, 2020, p. 466)
130
Urine is a fluid composed mostly of water (___%), nitrogen-containing waste, and electrolytes.
Important nitrogenous waste includes ___, ___ ___, ___, and ___.
## Footnote
(Herlihy, 2020, p. 467)
95
urea, uric acid, ammonia, creatinine
## Footnote
(Herlihy, 2020, p. 467)
131
The light-yellow colour of urine is caused by a pigment called ___, formed from the breakdown of hemoglobin in the liver.
## Footnote
(Herlihy, 2020, p. 467)
urochrome
## Footnote
(Herlihy, 2020, p. 467)
132
The average output of urine is ___ mL/day.
## Footnote
(Herlihy, 2020, p. 467)
1500
## Footnote
(Herlihy, 2020, p. 467)
133
The term oliguria (oligo- means “scanty”) refers to a urine output of less than ___ mL/day.
## Footnote
(Herlihy, 2020, p. 467)
400
## Footnote
(Herlihy, 2020, p. 467)
134
What refers to the ratio of the amount of solute to volume?
## Footnote
(Herlihy, 2020, p. 467)
Specific Gravity
## Footnote
(Herlihy, 2020, p. 467)
135
The ___ ___ of urine ranges from 1.001 to 1.035, depending on the amount of solute [substances such as sodium (Na+) and creatinine] in the urine.
The more solute, the higher is the ___ ___.
If a patient is dehydrated, the kidneys filter less water; as a result, the volume of urine decreases.
The ratio of solute to volume in the urine therefore increases.
Thus, dehydration is characterized by an increase in urinary ___ ___.
## Footnote
(Herlihy, 2020, p. 467)
specific gravity
specific gravity
specific gravity
## Footnote
(Herlihy, 2020, p. 467)
136
Very dilute urine, as in blood volume expansion, has a low ___ ___.
## Footnote
(Herlihy, 2020, p. 467)
specific gravity
## Footnote
(Herlihy, 2020, p. 467)
137
Regarding urine odor—it is not too bad if fresh.
However, over time, bacteria degrade the urea to ___.
That explains the “diaper pail” odor.
Similarly, a bladder infection can often be detected by the rotten odor of the urine.
## Footnote
(Herlihy, 2020, p. 467)
ammonia
## Footnote
(Herlihy, 2020, p. 467)
138
There are many reasons why the kidneys fail.
___ drugs, such as aminoglycosides, nonsteroidal anti-inflammatory drugs (NSAID), and many more, and poisons such as antifreeze (ethylene glycol) damage or destroy the kidneys.
Infections, such as those caused by escherichia coli (E. coli), found in contaminated beef can destroy the kidneys and are capable of causing a lethal ___ ___ ___ (___).
Finally chronic diseases such as hypertension, diabetes mellitus, and gout are capable of destroying the kidneys.
## Footnote
(Herlihy, 2020, p. 469)
Nephrotoxic
hemolytic uremic syndrome (**HUS**)
## Footnote
(Herlihy, 2020, p. 469)
139
When the kidneys fail, they no longer make urine (___ ___).
The blood is not cleansed of its waste, and substances that should have been excreted in the urine remain in the blood.
This condition is called ___, which literally means urine in the blood.
## Footnote
(Herlihy, 2020, p. 469)
renal suppression
uremia
## Footnote
(Herlihy, 2020, p. 469)
140
What may be prevented and treated with the use of an artificial kidney, a form of dialysis?
## Footnote
(Herlihy, 2020, p. 469)
Uremia
## Footnote
(Herlihy, 2020, p. 469)
141
The artificial kidney consists of a cylinder filled with a plasma-like solution called the ___.
The patient’s blood is passed through a series of tiny tubes immersed in the ___.
Waste products in the blood, such as potassium, creatinine, uric acid, and excess water diffuse out of the tubes into the ___.
The blood is thereby cleansed of these waste products and returned to the patient.
Because this procedure cleanses blood like a kidney, it is called an artificial kidney.
## Footnote
(Herlihy, 2020, p. 469)
dialysate
dialysate
dialysate
## Footnote
(Herlihy, 2020, p. 469)
142
A second form of dialysis is ___ ___.
With this procedure, the ___ ___ of the patient is used as the cylinder of an artificial kidney, and dialysate is infused into the ___ ___.
Waste products diffuse from the patient’s blood into the dialysate.
The dialysate eventually drains out of the ___ ___ and is discarded.
## Footnote
(Herlihy, 2020, p. 469)
peritoneal dialysis
peritoneal cavity x 2
peritoneal cavity
## Footnote
(Herlihy, 2020, p. 469)
143
Types of Dialysis
## Footnote
(Herlihy, 2020, p. 469)
## Footnote
(Herlihy, 2020, p. 469)
144
Whereas the kidneys form urine, the remaining structures of the urinary system (ureters, urinary bladder, and urethra) function as ___ and form the ___ ___.
They do not modify the urine in any way; instead, they temporarily store and then conduct urine to the outside of the body for elimination.
## Footnote
(Herlihy, 2020, p. 469)
plumbing
urinary tract
## Footnote
(Herlihy, 2020, p. 469)
145
The urinary tract has an outer layer of ___ ___ and a middle layer of ___ ___.
The tract is lined with ___ ___.
## Footnote
(Herlihy, 2020, p. 469)
connective tissue, smooth muscle
mucous membrane
## Footnote
(Herlihy, 2020, p. 469)
146
Two ___ connect the kidneys with the bladder.
## Footnote
(Herlihy, 2020, p. 469)
ureters
## Footnote
(Herlihy, 2020, p. 469)
147
The ___ originate in the renal pelvis of the kidneys and terminate in the bladder.
## Footnote
(Herlihy, 2020, p. 469)
ureters
## Footnote
(Herlihy, 2020, p. 469)
148
What are the long (10 to 13 inches [25 to 33 cm]), slender, muscular tubes capable of peristalsis?
## Footnote
(Herlihy, 2020, p. 469)
Ureters
## Footnote
(Herlihy, 2020, p. 469)
149
What moves along the ureters from the kidneys to the bladder in response to gravity and peristalsis?
## Footnote
(Herlihy, 2020, p. 469)
Urine
## Footnote
(Herlihy, 2020, p. 469)
150
Sometimes, a kidney stone (___ ___ or ___) lodges in the slender ureter, and the urine backs up behind the stone, increasing pressure within the renal pelvis (___).
The increased pressure causes severe pain and renal colic and can adversely affect the kidney, causing a severe decline in ___ ___ ___ (__) and irreversible kidney damage.
The stone must be removed.
Most stones simply wash out with the urine.
Some must be extracted with an instrument inserted into the ureters via the bladder.
Other methods include lithotripsy (crushing by ultrasound) and surgical removal.
## Footnote
(Herlihy, 2020, pp. 469, 470)
renal calculus, nephrolithiasis, hydronephrosis
glomerular filtration rate (**GFR**)
## Footnote
(Herlihy, 2020, pp. 469, 470)
151
What functions as a temporary reservoir for the storage of urine?
## Footnote
(Herlihy, 2020, p. 471)
Urinary Bladder
## Footnote
(Herlihy, 2020, p. 471)
152
When empty, the bladder is located below the ___ ___ and behind the symphysis pubis.
When full, the bladder rises into the ___ ___.
A distended bladder is felt when a hand is placed over the lower abdomen.
## Footnote
(Herlihy, 2020, p. 471)
peritoneal membrane
abdominal cavity
## Footnote
(Herlihy, 2020, p. 471)
153
Four layers make up the wall of the bladder.
The innermost layer is the ___ ___ and contains several thicknesses of transitional epithelium.
The ___ ___ is continuous with the ___ ___ of the ureters and urethra.
The second layer is the ___ and consists of connective tissue and contains many elastic fibers.
The third layer is composed of muscle.
This involuntary smooth muscle is the ___ muscle.
The outermost layer of the upper part of the bladder is the ___.
## Footnote
(Herlihy, 2020, p. 471)
mucous membrane
mucous membrane x 2
submucosa
detrusor
serosa
## Footnote
(Herlihy, 2020, p. 471)
154
The bladder wall is arranged in folds called ___ that allow the bladder to stretch as it fills.
## Footnote
(Herlihy, 2020, p. 471)
rugae
## Footnote
(Herlihy, 2020, p. 471)
155
The urge to urinate usually begins when the bladder has accumulated about ___ mL of urine.
As the volume of urine increases to ___ mL, the urge to urinate becomes more intense.
A moderately full bladder contains about ___ mL, or ___ pint, of urine.
An overdistended bladder may contain more than ___ L of urine.
With overdistention, the urge to urinate may be lost.
## Footnote
(Herlihy, 2020, p. 471)
200
300
500, 1
1
## Footnote
(Herlihy, 2020, p. 471)
156
One specific area of the floor of the bladder is the ___.
It is a triangular area formed by three points: the entrance points of the two ureters and the exit point of the urethra.
## Footnote
(Herlihy, 2020, p. 471)
trigone
## Footnote
(Herlihy, 2020, p. 471)
157
The exit of the urinary bladder contains a sphincter muscle, called the ___ ___.
## Footnote
(Herlihy, 2020, p. 471)
internal sphincter
## Footnote
(Herlihy, 2020, p. 471)
158
What is composed of smooth muscle that contracts involuntarily to prevent emptying?
## Footnote
(Herlihy, 2020, p. 471)
Internal Sphincter
## Footnote
(Herlihy, 2020, p. 471)
159
Below the internal sphincter, surrounding the upper region of the urethra, is the ___ ___.
## Footnote
(Herlihy, 2020, p. 471)
external sphincter
## Footnote
(Herlihy, 2020, p. 471)
160
Which sphincter is composed of skeletal muscle and is controlled voluntarily?
## Footnote
(Herlihy, 2020, p. 471)
External Sphincter
## Footnote
(Herlihy, 2020, p. 471)
161
Contraction of the ___ ___ allows resistance against the urge to urinate.
## Footnote
(Herlihy, 2020, p. 471)
external sphincter
## Footnote
(Herlihy, 2020, p. 471)
162
Organs of the Urinary Tract
## Footnote
(Herlihy, 2020, p. 470)
## Footnote
(Herlihy, 2020, p. 470)
163
Urination, also called ___ or voiding, is the process of expelling urine from the bladder.
## Footnote
(Herlihy, 2020, p. 471)
micturition
## Footnote
(Herlihy, 2020, p. 471)
164
As the bladder fills with urine, stimulated ___ ___ send nerve impulses along sensory nerves to the spinal cord.
The spinal cord reflexively sends motor nerve impulses back to the bladder, causing the bladder wall to contract rhythmically and the internal sphincter muscle to relax.
This response is called the ___ reflex.
This reflex gives rise to a sense of urgency.
## Footnote
(Herlihy, 2020, p. 471)
stretch receptors
micturition
## Footnote
(Herlihy, 2020, p. 471)
165
Contraction of the ___ ___ prevents involuntary urination.
In an infant, the ___ reflex causes the bladder to empty involuntarily.
As infants mature, they learn to override this reflex by voluntarily controlling the ___ ___.
## Footnote
(Herlihy, 2020, p. 471)
external sphincter
micturition
external sphincter
## Footnote
(Herlihy, 2020, p. 471)
166
What is the tube that carries urine from the bladder to the outside?
## Footnote
(Herlihy, 2020, p. 472)
Urethra
## Footnote
(Herlihy, 2020, p. 472)
167
What is lined with mucous membrane that contains numerous mucus-secreting glands?
## Footnote
(Herlihy, 2020, p. 472)
Urethra
## Footnote
(Herlihy, 2020, p. 472)
168
The muscular layer of the ___ contracts and helps expel urine during micturition.
## Footnote
(Herlihy, 2020, p. 472)
urethra
## Footnote
(Herlihy, 2020, p. 472)
169
In the (female/male), the urethra is short (1.5 inches [3.8 cm]); it opens to the outside at the urethral meatus.
## Footnote
(Herlihy, 2020, p. 472)
female
## Footnote
(Herlihy, 2020, p. 472)
170
In the (female/male), the urethra is part of the urinary and the reproductive systems.
## Footnote
(Herlihy, 2020, p. 472)
male
## Footnote
(Herlihy, 2020, p. 472)
171
The female urethral ___ is located anterior to the vaginal opening.
## Footnote
(Herlihy, 2020, p. 472)
meatus
## Footnote
(Herlihy, 2020, p. 472)
172
The (female/male) urethra (8 inches [20 cm]) is much longer than the (female/male) urethra.
## Footnote
(Herlihy, 2020, p. 472)
male
female
## Footnote
(Herlihy, 2020, p. 472)
173
As the male urethra leaves the bladder, it passes through the ___ ___ and extends the length of the penis.
## Footnote
(Herlihy, 2020, p. 472)
prostate gland
## Footnote
(Herlihy, 2020, p. 472)
174
The ___ muscle of the urinary bladder and the internal sphincter have muscarinic receptors.
## Footnote
(Herlihy, 2020, p. 472)
detrusor
## Footnote
(Herlihy, 2020, p. 472)
175
Activation of the ___ ___ causes the detrusor muscle to contract and the sphincter to relax; this action causes the bladder to expel the urine.
This can lead to two pharmacology issues.
First, if a patient is experiencing urinary retention, they may be given a ___ ___ such as bethanechol (Urecholine).
The ___ ___ causes contraction of the detrusor muscle and relaxation of the urinary sphincter.
Second, if a person has been taking medications that have ___ side effects, they experience difficulty in urinating; the patient can neither contract the bladder nor relax the internal sphincter.
This often happens to persons who take preoperative drugs such as atropine and those who take antidepressants that cause anticholinergic side effects.
## Footnote
(Herlihy, 2020, p. 472)
muscarinic receptors
muscarinic agonist
muscarinic agonist
antimuscarinic
## Footnote
(Herlihy, 2020, p. 472)
