Urinary system Flashcards
(168 cards)
1
Q
what are the five functions of the kidneys
A
- Regulate total water volume and total solute concentration
- Regulate electrolyte concentrations in the ECF
- ensure long term acid-base balance
- excreting metabolic waste, toxins, drugs
- Producing erythropoietin (RBCs) and Renin (BP)
2
Q
What transports urine from the kidneys to the urinary bladder
A
The ureters
3
Q
what is the urinary bladder
A
A temporary storage reservoir for urine
4
Q
What transports urine out of the body
A
Urethra
5
Q
Where are the kidneys located in anatomical terms
A
Retropertioneal, between the t12 and L 3 vertebra
6
Q
Which kidney is lower and why
A
The right kidney is lower because it is crowded by the liver
7
Q
what sits on top of each kidney
A
Adrenal gland
8
Q
Where is the renal hilum and what does it do
A
It is on the medial surface of the kidneys it is where the ureters, renal blood vessels, lymphatics and nerves enter and exit kidneys
9
Q
Which part of the kidney and which kidney is most susceptible to damage and why
A
The lower part of the right kidney is the most susceptible to damage because it is less covered by the thoracic cage due to it being lower
10
Q
What is it called when there is blood in your urine (need to know)
A
Hematuria
11
Q
What are the three regions of the internal kidney
A
Renal cortex
Renal Medulla
Renal pelvis
12
Q
What is the superficial surface of the internal kidney
A
The renal cortex
13
Q
What is deep to the renal cortex and is composed of cone shaped medullary (renal) pyramids
A
renal medulla
14
Q
What is continuous with ureter and contains minor calyces and major calyces
A
Renal pelvis
15
Q
What are cup shaped areas that collect urine draining from pyramids
A
Minor calyces
16
Q
What do major calyces do
A
collect urine from minor calyces and empty urine into pelvis
17
Q
What is the urine flow through the kidneys
A
Renal pyramid-> minor calyx->major calyx-> renal pelvis-> ureter
18
Q
What is inflammation of the kidney called, what can it cause, and what usually causes it and how do you treat it
A
pyelonephritis
It is usually in women caused by a uti of E.Coli
can cause puss buildup and blockage of renal pelvis
if left untreated can cause kidney damage
treated with antibiotics
19
Q
What is pyelonephritis(all info)
A
Inflammation of the kidney
usually caused by UTI in women when fecal matter enters urethra (E.Coli)
Severe cases can cause an abscess formation and pus blockage in renal pelvis
treated with antibiotics
20
Q
What do kidneys do in respect to blood
A
They filter blood and change its composition so it has a rich blood supply
21
Q
What delivers about one fourth of cardiac output to the kidneys each minute
A
Renal arteries
22
Q
What are the functional and structural units that form urine
A
Nephrons
23
Q
How many nephrons in each kidney
A
Over 1 million
24
Q
what are the two main parts of the nephron
A
Renal corpuscle and renal tubule
25
What are the two parts of the renal corpuscle
Glomerulus and glomerular capsule
26
What are important characteristics of the glomerulus
Tuft of highly porous capillaries which allows for efficient filtrate formation
27
What is filtrate
plasma-derived fluid that the renal tubules process to form urine
28
What is the bowmans capsule
The glomerular capsule
which is a cup shaped hollow structure surrounding the glomerulus
29
What is afferent arteriole
It is the terminal branch of the renal artery
This brings blood into the glomerulus for filtration
(afferent = bring to)
30
What does the efferent arteriole do and what are some examples of substances
It receives substances from blood that do not become filtrate
large macromolecules: RBCs, WBCs, Sugars, and proteins
31
What types of molecules shouldn't be in filtrate
Large macromolecules like Protein, WBCS, RBCS, and sugars
32
What brings the blood from efferent arterioles back into circulation
The peritubular capillaries and the renal vein
33
What are the 3 major parts of the renal tubule
Proximal convoluted tubule, Nephron loop, Distal convoluted tubule
34
Which part of the renal tubule is closest to the renal corpuscle
The proximal convoluted tubule
35
Which part of the renal tubule has ascending and descending limbs
The nephron loop
36
Which part of the renal tubule is farthest from the renal corpuscle
The distal convoluted tubule
37
What drains into the collecting duct
The distal convoluted tubule
38
Where are the decisions made on which substances to keep in filtrate or to put back into the blood stream
The Renal tubule
39
What is an important structure in the reabsorption of water and solutes into the blood stream, that are low pressure and highly porous
Peritubular capillaries
40
What does each nephron have one of
Juxtaglomerular apparatus
41
What contains Macula Densa
The modified distal convoluted tubule of the juxtaglomerular apparatus which controls NaCl content in urine
42
What produces renin
Juxtaglomerular cells in the modified portion of the afferent arteriole
43
What structure is important in regulating the rate of filtrate formation
The juxtaglomerular apparatus
44
What are the 2 major parts of the juxtaglomerular apparatus
Modified portions of the afferent arteriole and distala convoluted tubule
45
What is the formula for filtrate
filtrate = Blood plasma - (proteins + blood cells)
46
What is a normal amount of urine to produce in one day
1.5 L
47
What percent of filtrate becomes urine
less than 1%
48
What are the 3 processes involved in the formation of urine and the adjustment of blood composition
1.Glomerular filtration
2. tubular reabsorption
3. tubular secretion
49
Which process filtrate void of cells and proteins
Glomerular filtration
50
Which process selectively returns 99% of substances from filtrate back to blood
Tubular reabsorption
51
Which process selectively removes substances from blood into filtrate
tubular secretion
52
What should be left after the processes of glomerular filtration, tubular reabsorption and tubular secretion
Pure waste (urine)
53
Does glomerular filtration need energy
No it is a passive process
54
Explain how glomerular filtration works and why it is passive
Hydrostatic pressures force fluids and solutes to through filtration membranes in the glomerular capsule
55
What gets filtered during glomerular filtration (what passes through and what shouldn't)
Water, glucose, amino acids, and nitrogenous wastes are filtered
proteins and cells shouldnt normally pass through
things like RBCs are too big to fit through the glomerular capillaries filters
56
What is GFR
interpretation and normal amount
Glomerular filtration rate
The volume of filtrate formed per minute by both kidneys
(normal 120-125)
57
What directly affects GFR
Net filtration pressure, total surface area available for filtration, and filtration membrane permeability.
58
What is net filtration pressure what causes it and how does it affect GFR
It is the total pressure forcing fluids and solutes through filters, the primary cause of the pressure is glomerular hydrostatic pressure. The higher Net filtration pressure is the higher GFR
59
How does the total surface area available for filtration affect GFR
The more available surface area the higher the GFR
60
What is a special characteristic of the filtration membrane
It is much more permeable than other capillaries
61
How does Filtration membrane permeability affect GFR
The more permeable it is the higher the GFR
62
What is the main function of the Renin-angiotensin-aldosterone System (RAAS)
Increase blood pressure
63
What are the 3 pathways for renin release
1. Direct stim by symp nervous system
2. stim activated by macula densa cells when filtrate salt concentration is low
3. reduced stretch of the juxtaglomerular cells
64
What is it called when urine output is abnormally low and what is the number
anuria (less than 50mL per day)
65
What can anuria be a sign of
Can be a sign of low glomerular pressure
can also be a sign of renal failure as a result of nephrons not functioning
66
What can cause nephrons to stop functioning
acute nephritis, transfusion reactions
67
What is reabsorbed during tubular reabsorption and how are some substances regulated
Almost all organic nutrient are reabsorbed
water and ion reabsorption are hormonally regulated and adjusted
(ADH,Renin, Aldosterone)
68
What is the most abundant cation in filtrate
Na+
69
How is sodium reabsorbed
Na+-k+ ATPase pumps Na+ into interstitial space than the Na+ is swept by bulk flow into the peritubular capillaries
70
What is transport maximum
It is when the blood becomes saturated with a substance and the substance must be excreted into the urine
For example if there is too much glucose in the blood it spills into the urine
71
What happens in the proximal convoluted tubule
All nutrients such as glucose and amino acids are reabsorbed, 65% of Na+ and water gets reabsorbed, many ions get reabsorbed, almost all uric acid gets reabsorbed, about half of urea gets reabsorbed ( later secreted back into filtrate)
72
What should you think when you see proximal convoluted tubule
Rebabsorption
73
What is the loop of henle also known as
The nephron loop
74
What does the descending loop of the nephron loop do(important)
water can return to blood but not solutes(important)
75
What happens in the ascending loop of nephron loop(important)
water stays but solutes can pass diffuse out and return to blood (Important)
76
Where is reabsorption hormonally regulated
In the distal convoluted tubule and collecting ducts
77
What does antidiuretic hormone do
It causes collecting ducts to insert aquaporins to increase water absorption
78
does ADH make you pee more or less
Less because more water is reabsorbed into the blood
79
Which hormone targets the collecting duct and the DCT
Aldosterone
80
How does Aldosterone work
It promotes synthesis of na+ and k+ channels and na+-k+ ATPases for Na+ reabsorption (water follows)
as a result only a small amount of na+ leaves the body
81
What would happen without aldosterone and what is its main function
You would not reabsorb enough Na+ and would die its main function is to lower k+ levels and increase blood pressure
82
What is ANP and what does it do
It is atrial natriuretic peptide and it reduces blood Na+ which lowers blood volume and pressure
83
What produces ANP
Cardiac atrial cells if blood volume or pressure is elevated
84
What does parathyroid hormone do
targets the DCT to increase Ca2+ reabsorption
85
Where does tubular secretion happen
Mostly in PCT but also in the DCT
86
What substances are moved from the peritubular capillaries into filtrate
k+,h+,nh4+, creatinine, organic acids and bases
87
Why is tubular secretion important ( long)
Disposes of substances such as drugs or metabolites that are bound to plasma proteins
eliminates undesireable substances that were passively absorbed like urea and uric acid
ridds body of excess k+ (aldosterone effect)
controls blood ph by controlling concentration of h+ or hc3o- in urine
88
what is osmolality
number of solute particles in 1 kg of h20
89
What is a urinalysis
Analyzing of urine to find signs of disease or for drug testing
90
What do you need to do to asses renal function
Blood AND urine test
91
What is renal clearance and how is it tested
it is the volume of plasma kidneys can clear of a particular substance in a given time
it can only be tested by testing both the blood and urine
92
Why are renal clearance tests important (important)
They are used to determine GFR and can help detect glomerular damage and follow progress of renal disease
93
What disease is defined as a GFR that is lower than 60 mL/min for 3 months
Chronic renal disease
94
What happens when you have chronic renal disease
Filtrate formation decreases, nitrogenous wastes accumulate and blood ph becomes acidic
95
When is chronic renal disease most commonly seen
diabetes and hypertension
96
What condition is defined as GFR less than 15 mL/min
Renal failure
97
What can cause renal failure
Uremia
98
what is uremia
Ionic and hormonal imbalances, metabolic abnormalities, toxic molecule formation
99
What are the following symptoms of
fatigue, anorexia, nausea, mental changes, cramps
Renal failure
100
What are the treatments Hemodialysis and transplant for
renal failure
101
What is the chemical composition of urine
95% water and 5% solutes
102
What are the 3 nitrogenous wastes found in urine
Urea, uric acid and creatinine
103
What does urea come from and why is it important
It comes from amino acid breakdown, it is important because it is the largest solute component of urine
104
What does uric acid come from
nucleic acid metabolism
105
What does creatinine come from
Breakdown of Creatine phosphate
106
What other solutes are found in urine (besides nitrogenous wastes)
na,k,po4, so4. ca, mg, hco3
107
What do high concentrations of glucose in the blood cause
Glycosuria
108
What do high concentrations of proteins cause
Proteinuria, albuminuria
109
What do high concentrations of ketone bodies cause
ketonuria
110
What do high concentrations of hemeglobin cause
hemoglobinuria
111
What do high concentrations of bile pigments cause
bilirubinuria
112
What do high concentrations of erythrocytes cause
hematuria
113
What do high concentrations of leukocytes cause
pyuria
114
What does cloudy urine indicate
UTI
115
What causes urine to be yellow
Urobilin (urochrome )
116
What does abnormal colors like pink, brown or smoky in urine indicated
can be caused by certain foods, drugs bile pigments, or blood
117
What may alter the smell of urine
asparagus and diabetes
diabetes makes it smell like acetone
118
What is the normal ph range of urine
4.5-8
119
What can affect urine ph
acidic(decrease ph) or alkaline diet, prolonged vomiting, UTI (all increase pH)
120
What is specific gravity (not very imporant)
The ratio of mass of substance to mass of an equal volume of water
121
What is the normal specific gravity range of urine(not very important)
1.001-1.035
122
What are ureters
slender tubes that convey urine from the kidneys to the bladder
123
Where are ureters and what are they a continuation of
they are retroperitoneal and enter the bladder at the posterior wall and they are a continuation of the renal pelvis
124
What prevents backflow of urine
As pressure increases within the bladder the distal ends of the ureters close
125
What are renal calculi
kidney stones in the renal pelvis
126
What are kidney stones made of
uric salts, crystalized calcium, or magnesium
127
What can happen as a result of kidney stones
The stones can block flow from the ureters causes excruciating pain from the flank to the abdomen
128
What is the name for stones in the kidneys
nephrolithiasis
129
what is the name for stones lodged in the ureters
ureterolithiasis
130
True or false most kidney stones need surgery to be removed
false
most stones are small enough to pass on their own
131
What are treatments for kidney stones that are too large to pass on their own
Endoscopically removal, surgery, lithotripsy
132
What is the procedure that involves using strong acoustic waves to break up kidney stones
lithotripsy
133
What are risk factors for kidney stones
Obesity and elevated blood calcium levels
134
What is the urinary bladder and its main function
It is a muscular sac for temporary urine storage
135
Where is the urinary bladder anatomically
Retroperitoneal, on the pelvic floor posterior to the pubic symphysis
136
Where is the prostate in relation to the bladder
The prostate is inferior to bladder neck
137
Where is the vagina and uterus in relation to the bladder
the vagina and uterus are posterior to the bladder
138
Where do UTIs tend to persist
The trigone
139
What is the trigone
A triangular shaped smooth area outlined by openings for the ureters and urethra
140
What happens to the bladder when its empty
It collapses
141
Roughly how much can a full bladder hold
about 500mL but can be 2x that if necessary but cant burst
142
What is the muscular tube that drains the bladder
The urethra
143
What are the 2 sphincters in the urethra
Internal and external urethral sphincters
144
Which urethral sphincter is involuntary and where is it
The internal sphincter which is at the bladder-urethra junction
145
Which sphincter is controlled voluntarily and where is it
The external sphincter which surrounds the urethra as it passes through the pelvic floor
146
Who gets more UTIs and why
Women because their urethras are shorter than males making it easier for bacteria to make it to the bladder
147
What are the three regions of the male urethra
prostatic,membrenous ,and spongy
148
Which region of the male urethra runs through the end of the penis and eventually leads urine out of the body
Spongy urethra
149
What is the opening at the end of the penis called
external urethral orifice
150
Which region of the male urethra is within the prostate
The prostatic urethra
151
Which region of the male urethra passes through the urogenital diaphragm from the prostate to the beginning of the penis
Membranous urethra
152
What can uti's be caused by and what makes someone more likely to get them
Improper toilet habits lead to fecal matter getting into the urethra.
Women who are sexually active are most likely to get UTIs
153
What is the name for inflammation of the urethra
urethritis
154
what is the name for bladder infection
cystitis
155
What is the name for kidney infection
pyelonephritis
156
What is dysuria
painful urination
157
What are dysuria, increased urgency and frequency of urination, fever and sometimes cloudy or blood tinged urine symptoms of
Urinary tract infection
158
How are most UTIs treated
Antibiotics
159
What is micturition or voiding
Urination
160
What 3 events must happen simultaneously for micturition to happen
1. contraction of detrusor muscle by ANS
2. Opening of internal urethral sphincter by ANS
3. Opening of external urethral sphincter by somatic nervous system
161
When does the pons tend to develop for urinary control
2-3
162
What is urinary incontinence and what usually causes it in adults
Inability to control bladder
caused by weak pelvic floor muscles
163
What is stress incontinence and what can cause it
Loss of bladder control due to increased intra-abdominal pressure forcing urine through the sphincter.
coughing, laughter, sneezing
164
what is overflow incontinence
When urine dribbles out due to bladder overflow
165
What is it called when the bladder is unable to expel urine
Urinary retention
166
What causes urinary retention
common after general anesthesia, hypertrophy of prostate (benign prostatic hyperplasia)
167
How is urinary retention treated
Catheterization, medication
168
Go from large to small in the kidney and include flow
Blood flows into the kidney from the renal artery, brought into the renal cortex this is then filtered by nephrons, in the nephron it starts at the renal corpuscle, this has the glomerulus which is a tuft of highly porous capillaries to help efficiently form filtrate leaving behind organic macromolecules, Blood is brought to the golmerulus by the afferent arteriole ,this flows to the bowmans capsule, the stuff that does not become filtrate leaves through the efferent arteriole (large macromolecules), than flows into the proximal convoluted tubule (TBC)
