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Patho > Urinary System Phys (exam 5) > Flashcards

Urinary System Phys (exam 5) Flashcards

1
Q

What are the principle organs of the urinary system?

A

Kidneys

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2
Q

What are the accessory organs of the urinary system?

A

Ureter
Urinary bladder
Urethra

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3
Q

What are the jobs of the urinary system?

A

Filtration
Reabsorption
Secretion

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4
Q

Where does filtration occur?

Where is the filtrate moving, blood to tubules or tubules to blood?

A

In the glomerulus, which is inside bowman’s capsule
These are the parts of the renal corpuscle (in renal cortex)
Blood to tubules (blood to glomerulus), in renal corpuscle

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5
Q

What are the primary functions of the kidney?

A

cleanse and filter blood and regulate blood volume

filtration, reabsorption, secretion

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6
Q

What is filtered out during filtration?

A

Water, Electrolytes, urea, glucose, amino acids,
NO proteins
NO blood cells

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7
Q

Where does reabsorption primarily occur?

What direction are things moving, blood to tubule or tubules to blood?

A

PCT (mostly) into the peritubular (in the renal medulla)

Tubules to blood (tubules to peritubular capillaries, tubules to vasa recta)

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8
Q

What is reabsorbed?

A

Water!!!! Sodium!!! glucose (100% of what is filtered), amino acids (100% of what is filtered), some electrolytes (potassium, chloride, magnesium, calcium)

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9
Q

Where does secretion primarily occur?

What direction are things moving, blood to tubules or tubules to blood?

A

DCT (primarily)

Blood into tubules

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10
Q

What is typically secreted?

A

Ammonia (NH4+), urea, creatinine, hydrogen, potassium

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11
Q

What hormones regulate urine volume?

Where do they act?

A

Aldosterone, ANH, ADH

Act on the distal convoluted tubules (DCT)

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12
Q

What does aldosterone do?

A

Tells the DCT to reabsorb more sodium, which causes water to follow
Acts on DCT because there are sodium, potassium pumps that kick out potassium as sodium is reabsorbed

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13
Q

What does ANH do?

A

Tells the DCT to secrete more sodium, which causes water to follow

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14
Q

What does ADH do?

A

Tells the DCT and collecting duct to reabsorb more water

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15
Q

How much blood goes into the kidney per heart beat?

A

20-25% of blood every heart beat

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16
Q

What structure is the most frequent site of UTIs?

A

Trigone (in urinary bladder)

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17
Q

What is the number one bacteria that causes UTIs?

A

E coli

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18
Q

What muscles make up the urinary bladder?

A

Detrusor muscles

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19
Q

What is micturition?

A

The act of urinating

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20
Q

How many regions does the kidney have?

What are they?

A

2:
Renal Cortex
Renal Medulla

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21
Q

What occurs in the renal cortex?

What structures are in the renal cortex?

A

ALL filtration occurs here, reabsorption &some secretion
Renal corpuscle (glomerulus & Bowman’s capsule)
Proximal convoluted tubules (PCT)
Disatal convoluted tubules (DCT)

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22
Q

What occurs in the renal medulla?

What structures are in the renal medulla?

A 
Some reabsorption, secretion
Urine concentration (regulation of urine concentration and urine volume)
Renal pyramids (contain the loop of henle, collecting duct)
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23
Q

What is the functional unit of the kidney?

A

Nephron

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24
Q

How many types of nephrons are there?

What are they?

A

2
Cortical nephrons
Juxtamedullary nephrons

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25
Q

Where are cortical nephrons?

What are they responsible for?

A

Primarily in the renal cortex
Loop of Henle dips very little into the medulla (renal pyramids)
Blood filtration & urine production

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26
Q

Where are juxtamedullary nephrons?

What are they responsible for?

A

Renal corpuscle is in the renal cortex
Loop of Henle dips deep into are all the way through the renal pyramids (renal medulla)
Urine concentration

27
Q

What structure enters the glomerulus?

Exits the glomerulus?

A

Enters: Renal afferent arteriole
Exits: Renal efferent arteriole

28
Q

What type of blood is in the afferent and efferent arterioles?

A

Oxygen rich blood

Gas exchange does not occur in the glomerulus

29
Q

What does the efferent arteriole become once it exits the glomerulus?

A

Peritubular capillaries

30
Q

Where are the peritubular capillaries located?

A

Around the PCT and DCT

31
Q

What is the vasa recta?

What is it responsible for?

A

A special peritubular capillary that branches off and surrounds the loop of Henle
Countercurrent exchange with Loop of Henle (regulation of urine concentration and urine volume)

32
Q

What is the renal corpuscle?
What does it do?
Where is it located?

A

Made of the glomerulus and Bowman’s capsule
Filtration
In the renal cortex

33
Q

What is the glomerulus?
Where is it?
What does it do?

A

Capillary where gas exchange doesn’t occur
In Bowman’s capsule in the renal cortex
Filters the blood

34
Q

What is Bowman’s capsule?
Where is it?
What does it do?

A

Surrounds the glomerulus
Collects the filtrate from the glomerulus
In the renal cortex

35
Q

What is the glomerular filtration membrane?

A

Thin, negatively charged membrane that repels negative charged proteins from being filtered

36
Q

What is the juxtaglomerular apparatus?

Where is it located?

A

Made of the macula densa and juxtaglomerular cells

Located between the afferent arteriole and the collecting duct

37
Q

What does the macula densa do?

A

Measures pressure, sodium levels and oxygen levels

Detectors

38
Q

What does the juxtaglomerular apparatus?

A 
Secretes Renin (when low sodium, or low blood pressure or renal hypoperfusion, Renin increases sodium retention, increases BP)
Secretes EPO (when low oxygen, hypoxic, EPO causes more RBCs to be made to carry oxygen)
39
Q

What (primarily) occurs in the proximal convoluted tubules?

A

Reabsorption (of water, sodium, 100% of filtered glucose & amino acids, some electrolytes

40
Q

What (primarily) occurs in the loop of Henle?

A

Regulation of urine concentration and urine volume

Part of countercurrent exchange

41
Q

What (primarily) occurs in the distal convoluted tubules? What affects the function of the DCT?

A

Secretions (end product secretions)

Aldosterone, ANH, ADH work at DCT

42
Q

Where does the collecting duct lead to?

A

Drips into the papilla (cup like structure at the bottom of the renal pyramids)

43
Q

Trace the final urine product pathway

A

Drips from collecting duct into papilla of renal pyramid
Moves from papilla into minor calyces
Moves from minor to major calyces
All major calyces drain into the renal pelvis
Renal pelvis drains into the ureter
Ureter to urinary bladder to urethra

44
Q

Trace the RAAS pathway

A

Macula Densa cells detect low sodium or low BP
Juxtaglomerular cells secrete Renin from the kidney
RENIN: converts angiotensinogen into angiotensin 1 in the blood
ANGIOTENSINOGEN: is released from the liver, is a “ProProEnzyme”, is converted into angiotensin 1 by renin
ANGIOTENSIN 1: is a “ProEnzyme”, is converted from angiotensinogen by renin, converted to angiotensin 2 by ACE
ANGIOTENSIN CONVERTING ENZYME (ACE): is released by the lungs, converts angiotensin 1 into Angiotensin 2
ANGIOTENSIN 2: is converted from angiotensin 1 by ACE, the bad mamajama, affect the system, hypothalamus, posterior pituitary, and adrenal cortex
SYSTEMIC VASOCONSTRICTION: angiotensin 2 causes this to increase BP, most important effect
THIRST: angiotensin 2 acts of the hypothalamus, increasing thirst, increasing water content, increasing blood volume, increasing BP
ADH: angiotensin 2 affects the post pit to secrete ADH to increase reabsorption of water, to increase blood volume to increase BP
ALDOSTERONE: angiotensin 2 affects the adrenal cortex to secrete aldosterone to increase reabsorption of sodium and water, to increase blood volume to increase BP

45
Q

What is the purpose of the RAAS system?

A

To increase BP

46
Q

What does the body secrete to counteract the RAAS system?

A

ANH to increase secretion of sodium and water to decrease blood volume and decrease BP

47
Q

What pathologies arise from an overactive RAAS system?

A

Hypertension (chronic high BP)
Overactive angiotensin 2: increased BP & increased blood volume causes hypertrophy of the heart which can cause congestive heart failure, increased endothelial damage leading to atherosclerosis or increased vascular inflammation or increased coagulation cascade (thrombus production), decreased apoptosis putting you at risk for cancer, increased thrombosis

48
Q

What happens to urine pH when hydrogen excretion is increased? Decreased?

A

Excrete more hydrogen, blood becomes more basic, retain more bicarb
Excrete less hydrogen and blood becomes more acidic, excrete more bicarb

49
Q 
What is ammonia? 
What is it converted into?
What does it do?
What happens when excretion is increased?
Where does ammonia come from?
A 
Ammonia (NH4+) is a base
Converted into urea in the liver
Urea is neutral
Helps maintain normal blood pH
Increase ammonia excretion, blood becomes more acidic
Ammonia comes from protein metabolism
50
Q

What is the normal pH range of the blood?

A

7.35-7.45

51
Q

What is the normal pH range of the urine?

A

4.6-8.0

52
Q

What do natriuretic peptides (ANH) do?

What is an example of a synthetic ANH?

A

Decrease BP
Inhibits sodium and water reabsorption
Urodilation is a synthetic ANH

53
Q

What affect does vitamin D have on reabsorption?

A

Released by the kidney
Acts on the intestine
Absorb more calcium

54
Q

What tests measure renal function?

A

Creatinin Clearance test (urine test)
Plasma creatinine concentration (blood test)
Blood urea nitrogen (BUN) (blood test)

55
Q

What is the creatinin clearance test?

When does it indicate renal failure?

A

Want creatinine in the urine, so we want high creatinine clearance
It is how we measure GFR
Decrease creatinine clearance indicates a bad kidney

56
Q

What do we want on a plasma creatinine concentration test?

What indicates a bad kidney?

A

Want a low number

Increased blood creatinine indicates a bad kidney

57
Q

What do we want on a BUN test?

What indicates a bad kidney?

A

Want less in blood, more in urine

Increased BUN indicates a bad kidney

58
Q

What are the 4 pressures of the kidney?

A

Glomerular Hydrostatic Pressure (BP driving, push glomerulus into capsule)
Glomerular Oncotic Pressure (albumin driven, pull from capsule into glomerulus)
Capsular Hydrostatic Pressure (push from capsule into glomerulus, important when theres an obstruction then increases)
Capsular Oncotic Pressure (pull from glomerulus into capsule, negligible)

59
Q

If we increase BP what happens to the glomerular filtration rate?

A

It increases

60
Q

If we increase CHP what happens to the glomerular filtration rate?

A

It decreases because it is pushing back into the glomerulus

61
Q

Does a decreased glomerular filtration rate indicate a good or bad kidney?

A

Bad kidney functioning

62
Q

What is the first step in renal functioning?

A

Filtration

63
Q

Where does reabsorption pull fluid and electrolytes from and into?

A

From blood (peritubular capillaries/ vasa recta) into the tubule

64
Q

What effect does increased secretion of fluid have on the blood?

A

Decreased blood volume

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