Urinary system Flashcards
1
Q
The urinary system consists of what 6 organs ?
A
Kidneys(2, Ureters (2), urinary bladder, and urethra
2
Q
True or false the Right kidney is slightly lower than left due to space occupied by liver
A
True
3
Q
What does it mean to say that the kidney is retroperitoneal?
A
It lies between the peritoneum and body wall at the level of T12-L3
4
Q
What 8 things do the kidneys do?
A
1 Filter blood plasma (eliminates waste), regulates blood volume and pressure, regulates osmolarity of body fluids , Secretes Renin(activates angiotension and aldosterone), secretes erythropoietin(controls RBC count), regulates acid and base balance, detoxifies free radicals and drugs, and glucogenisis.
5
Q
What are the 5 nitrogenous wastes?
A
Urea, uric acid, creatine, renal failure, and BUN
6
Q
Define BUN
A
quantitative expression of blood nitrogenous waste products
7
Q
Define azotemia
A
abnormally elevated BUN in blood that may indicate renal insufficiency
8
Q
Define uremia
A
toxic effects as wastes accumulate
9
Q
Define excretion
A
Separation of wastes from body fluids and eliminating them using four organ systems
10
Q
What are the four organ systems the body uses to excrete waste? What do they excrete?
A
Respiratory System: CO2,
Integumentary system: water, salts, lactic acid, urea, and sweat
Digestivesystem: water, salts, CO2, lipids, bile pigments, cholesterol
Urinarysystem: many metabolic wastes, toxins, drugs, hormones, salts, H+and water
11
Q
True or false the kidneys are about the size of a bar of soap
A
True
12
Q
Define Hilum
A
slit where it receives the renal artery, vein, ureter and lymphatic vessels
13
Q
True or false the kidney is protected by three layers of C.T
A
True
14
Q
What is the outer most layer of the kidney ?
A
Renal fascia-binds the kidney and associated organs to the abdominal wall
15
Q
What is the middle protective layer of the kidney?
A
Adipose tissue , layer of fat that holds kidney in place.
16
Q
What is the inner most protective layer of the kidney ?
A
Renal capsule-a fibrous sac that is anchored at the hilum and encloses the rest of the kidney like a cellophane wrapper, and protects it from trauma and infection
17
Q
What is the Renal parenchyma and what two zones is it divided into?
A
Its the glandular tissue that forms the urine, appears C shaped and encircles the renal sinus . It is divided into the renal cortex and inner medulla
18
Q
What does the renal sinus contain?
A
containing blood vessels, nerves, and urine collecting structures
19
Q
_______ divides the medulla into 6-10 renal pyramids
A
Renal columns
20
Q
Each pyramid is conical with a broad base facing the cortex and a blunt point called _______
A
Renal papilla
21
Q
One pyramid and the cortex above it constitute a ____
A
Lobe
22
Q
Starting with a minor calyx how does urine make its way to the ureter?
A
Each renal pyramid releases its urine to a minor calyx which converges with others(2 or 3) to create a major calyx which converges (2 or 3 ) into a funnel like Renal pelvis which connects to a ureter
23
Q
True or false the kidneys receive 21% of the cardiac output
A
True
24
Q
True or false each kidney is supplied by a renal artery
A
True
25
Renal arteries enter the hilum and divide to ____ arteries
segmental
26
Segmental arteries divide into ___ arteries which penetrate each renal column.
interlobar
27
interlobar arteries travel up to the cortico-medullary junction where they form ___ arteries
arcuate
28
What kind of arteries branch upward into the cortex coming off of the arcuate areries?
interlobular
29
What kind of artery gives off afferent arterioles to the gomerulus of each nephron?
interlobar
30
True or false The glomerulus is drained by an efferent arteriole
True
31
True or false Each kidney contains 1.2 million functional units called nephrons
True
32
A nephron consist of what two principal parts? What are their functions?
Renal corpuscle-(glomerulus) where the blood plasma is filtered
Renal tubule-processes the filtrate into urine
33
What is the glomerulus?
a ball of capillaries
34
What is the glomerular (Bowmans)capsule?
A two layered capsule . The parietal layer is simple squamous and the visceral consists of podocytes wrapped around the capillaries.
35
Define glomerular filtrate and capsular space
fluid that filters from the glomerular capillaries collects in the capsular space between the parietal and visceral layer and then flows into the renal tubule.
36
Define Renal (Uriniferous) Tubule
a duct (divided into 4 regions) that leads away form the glomerular capsule and ends at the tip of a medullary pyramid
37
Name the four majore regions of the Renal tubule
Proximal convoluted tubule
Nephron loop(loop of Henle)
Distal convoluted tubule
Collecting duct(not really a part of the nephron-receives urine from many nephrons
38
True or false the PCT is the longest and most coiled and has simple cuboidal epithelium with microvilli
True
39
Thin segments are made if simple squamous have low metabolic rate but are very ____ to water
permeable
40
Thick segments have simple cuboidal with lots of mitochondria due to high metabolic activity of ___ _____.
Active transport
41
True or false the DCT is less coiled than the PCT
True and SCT has cubiodal epithelium
42
True or false both the DCT and the collecting duct are made of cuboidal epithelium
True
43
What does the juxtaglomerular apparatus consist of?
DCT, afferent, efferent arterioles
44
True or false the collecting duct has several DCT's that join it
True
45
True or False Near the papilla, several collecting ducts merge to form a larger papillary duct where they converge more to become a minor calyx
True
46
Define cortical nephrons
(85%) nephrons close to the kidney surface
47
Define Juxtamedullary nephron
-(15%) nephrons close to the medulla
48
what nephrons Have very long loops that extend to the apex of the renal pyramid
Juxtamedullary
49
True or false Juxtamedullary Responsible for maintaining the salinity gradient
True
50
The kidney converts blood plasma to urine in what three stages
Glomerular filtration
Tubular reabsorption and secretion
Water conservation
51
True or false Glomerular filtrate is fluid in the capsular space that is similar to blood plasma except that it has almost no protein
True
52
Define tubular fluid
fluid from the PCT through the DCT
53
When is fluid officially called urine?
When they exit DCT and enter the collecting ducts
54
Define the filtration membrane
barrier through which the fluid must pass to enter the capsular space
55
What three things compose the filtration membrane?Deep to superficial
fenestrated endothelium of the capillary, The basement membrane and, Filtration slits.
56
True or False Pedicles have a negatively charged filtration slits
True
57
Where exactly does filtration take place?
glomerulus
58
True or false
Kidney trauma and infections can damage the filtration membrane and allow albumin or blood cells to filter through
59
Define Proteinuria(albuminuria)
the presence of protein in the urine
60
Define Hematuria
the presence of blood in the urine
61
What can cause an temporarily cause proteinuria or hematuria
Strenuous exercise
62
Define Nephrotic syndrome
A group of symptoms caused by excessive loss of protein in the urine(Hypoalbuminemia, hypercholesterolemia,edema)
63
What are the two types of hematuria?
Microscopic- amount of blood so small that it can only be seen under a microscope.
Gross/macroscopic- Urine is pink or red and may contain some blood clots
64
Define pseudohematuria
Excessive consumption of beets, berries, or rhubarb; food coloring; and certain laxatives and pain medications can produce pink or reddish urine.
65
True or false the blood hydrostatic pressure is much higher in the glomerulus than most other capillaries
True, the afferent arteriole is substantially larger than the efferent arteriole, giving the glomerulus a large inlet and small outlet
66
True or false The glomerular filtrate is almost protein-free and has no significant COP (colloid osmotic pressure)
True
67
Define Glomerular filtration rate GFR
the amount of filtrate formed per minute by the two kidneys combined
68
True or false 99% of the filtrate is reabsorbed and approx. 1-2 L of urine are excreted per day
True
69
What can happen if the GFR is too high?
Fluid flows to fast for them to reabsorb the usual amounts of water and solutes .
Urine output rises and creates a threat of dehydration and electrolyte depletion
70
What can happen if the GFR is too low?
Fluid flows sluggishly through the tubules and they reabsorb wastes that should be eliminated and azotemiamay occur
71
What 3 ways can GFR be adjusted by adjusting glomerular blood pressure?
1. Renal auto-regulation
2. Sympathetic control
3. Hormonal control
72
Define Renal-Autoregulation
ability of the nephrons to adjust their own blood flow and GFR without external (nervous or hormonal) control.
73
What are the two mechanisms of auto regulation?
Myogenic mechanism and Tubuloglomerular feedback
74
How does the myogenic mechanism work to keep GFR constant ?
afferent arteriolar vasoconstrictionwould serve to protect the glomerulus from uncontrolled systemic hypertension
while afferent arteriolar vasodilatationwould allow for greater blood flow into the glomerulus in times of hypotension
75
The juxtaglomerular apparatus is made up of specialized cells in the walls of afferent, efferent, and DCT. The cells make up the ______ _____
Macula Densa
76
True or false the Juxtaglomerular apparatus is innervated byadrenergic fibersand the granular cells carry renin in intracellular granules
True
77
Define the tubuloglomerular feedback (TGF) loop
JGA adapts to the GFR to early distal tubule fluid by modulating renin synthesis and release
78
renin release is pricipally controlled by what 3 things
altered sodium concentration at the macula densa of the distal tubule
changes in the blood flow patterns of the afferent arteriole
adrenergic stimulation
79
True or false When blood pressure drops, the sympathetic nerves stimulate the JGA cells to secrete renin
True
80
Renin acts on angiotinsinogen to create _______
angiotensin I
81
Angiotensin I is converted to angiotensin II by the action of angiotensin-converting enzyme (ACE) from the ____
Lungs
82
Treu or false Renin-Angiotensin Mechanism Stimulates the adrenal cortex to secrete aldosterone, which in turn promotes sodium and water retention
True
83
True or false Renin-Angiotensin Mechanism Stimulates the sense of thirst and encourages water intake
True
84
Angiotensn II release is dependent on____release
renin
85
Sympathetics can ______urine production, redirecting blood flow to heart, brain and skeletal muscles
decrease
86
Tubular reabsorption removes useful solutes and returns them to the ___ and tubular secretion removes waste from the blood and adds them to the ______.
Blood, Filtrate
87
True or false PCT reabsorbs greater variety of chemicals than other parts of the nephron and use 6% of resting ATP and calories
True
88
What are the two routes PCTS reabsorb chemicals?
```
Transcellular (through epithelial cells of PCT)
paracellular route (between epithelial cells of PCT)
```
89
What creates the osmotic and electrical gradient ?
sodium
90
Whats the primary function of the nephron loop ?
water conservation, also involved in electrolyte re-absorption
91
DCT and collecting ducts Controls fluid and sodium/potassium balance because cells are subject to _____ control
Hromonal control , (esp. aldosterone, atrial natriuretic peptide, ADH, and parathyroid hormone)
92
DCT and collecting ducts have what two kinds of cells?What are they involved in?
```
Principle cells(most abundant ) have receptors for hormones and are involved chiefly in salt and water balance
Intercalated cells: reabsorb K+ into the tubule lumen and involved mainly in acid-base balance
```
93
How does atrial natiuretic factor (ANF) lower BP?
↑BP stimulates right atrium
atrium secretes ANF
ANF promotes Na+and water excretion
BP drops
94
How does ADH help raise BP?
dehydration stimulates hypothalamus
hypothalamus stimulates posterior pituitary
posterior pituitary releases ADHADH ↑water reabsorption
urine volume ↓
95
True or false Osmolarity 4x as high deep in medulla
True
96
True or false Medullary portion of Collecting duct is permeable to water but not to NaCl
True
97
The Kidney Has an Osmotic Gradient From _____ to _____.
Cortex to medulla
98
The countercurrent mechanism is based upon the ___ pump
Na , sodium is pumped out into the interstitial fluid in medulla
99
The concentration of the urine is adjusted in the ____ of the kidney
collecting ducts
100
Because there is such a high concentration of sodium in the medulla of they kidney Water will be sucked out of the tubules by osmosis if the tubules are _____.
permeable
101
The permeability of the collecting duct is determined by water pores(aquaporin-2) which are under the control of ______________________ from the posterior pituitary
antidiuretic hormone(ADH-also called vasopressin)
102
If ADH is high the kidney makes _____ urine and conserves water
concentrated
103
When a person is dehydrated the blood osmotic pressure_____.
rises
104
The ADH will cause the kidney collecting ducts to insert ______ pores.
Water pores
105
Define Diabetes insipidus
is the continuous production of large amounts of watery urine(5-10 L/day
106
Aldosterone acts by turning on genes (transcription), so its stimulation of Na retention is relatively ___.
slow
107
___ causes production of NA pump molecules
Aldosterone, secreated by adrenal gland in response to lowerd blood pressure.
108
True or false Parathyroid Hormone Effects the Kidney by promoting calcium reabsorption and Stimulates the kidney to complete the synthesis of calcitriol (Vit. D)
True
109
Define diuretic
causing increased passing of urine.
110
caffeine and alcohol are ____
Diuretics
111
Diabetes Mellitus-_______ urine reabsorption
decrease
112
Define Urinalysis
The examination of the physical and chemical properties of urine
113
What do abnormal pee colors mean?
red urine can be caused by red blood cells or hemoglobin in the urine or by the red pigments found in beets
beer-brown or yellow-brown urine is most often seen when bilirubin is present
black urine occurs when melanin is found in the specimen
orange, blue and green are often associated with the presence of drug, dye or food metabolites.
114
What does cloudy urine probably mean?
upon standing can develop bacteria growth
115
Define Pyuria
-pus in the urine, suggesting infection
116
Define Specific gravity
the ratio of the density of a substance to the density of distilled water
117
what are the two primary reasons why the kidney produces concentrated urine with a high specific gravity.
Dehydration and increased secretion of anti-diuretic hormone (ADH). can occur because of trauma, stress reactions, and surgery
118
Define oliguria
the production of abnormally small amounts of urine.
119
Define Azotemia
-A higher than normal blood level of urea or other nitrogen containing compounds in the blood due to low urine output
120
What are the three layers of the ureters?
adventitia –connective tissue
muscularis -2 layers of smooth muscle,Urine stretches tube causing the muscularis to contract in paristaltic waves, milking urine down to the bladder
mucosa -transitional epithelium
121
Explain the Micturition reflex
urine in bladder, stretch receptors send signal to spinal cord, parasympathetic reflex arc from spinal cord, stimulates contraction of detrusor muscle,relaxation of internal urethral sphincter.
122
The hypogastric nerve sympathetically surpresses ____________________________________________
contractions of the detrusor muscle and relaxation of the internal sphincter
123
The pelvic nerve parasympathetically ________
cause the detrusor to contract and relaxation of the internal sphincter.
124
The external sphincter is innervated by what nerve?
puendal
