Water, Electrolyte, Acid-Base Balance Flashcards
(413 cards)
1
Q
Describe the main components of extracellular fluid
A
Extracellular (outside cell membrane): increased Na+ (90% of sodium), Ca+2,Cl-, HCO3
2
Q
How much of the water is extracellular
A
1/3
3
Q
Most important component of extracellular fluid is
A
Na
4
Q
Describe the main components of intracellular fluid
A
Increased amounts of K,
Mg, PO4 -3, SO4 -2,
5
Q
Most important component of intracellular fluid
A
K
6
Q
Percentage of water in intracellular fluid
A
75%
7
Q
What makes molecules move from intracellular to extracellular regions?
A
Osmotic pressure
8
Q
Extracellular components
A
Na, Ca, Cl, HCO3, water
9
Q
Intracellular components
A
K, Mg, PO4, SO4, water
10
Q
Discuss sodium potassium output in the renal system
A
Na + your body conserves
Renal tubules increase the reabsorption of Na and excrete the K
11
Q
Discuss Ca +2 balance in the renal system
A
Renal tubules conserve the Calcium for bones and muscle flexion
2. Phosphate is excreted
12
Q
Ca +2 is regulated by which gland?
A
Parathyroid gland
13
Q
Kidneys function in electrolyte balance
A
Regulate Na and K, Ca and PO4,
Help make sure you have perfect amount of ions to maintain homeostasis
14
Q
Discuss the bicarbonate buffer system in detail
A
- One of three ways in which blood pH is maintained
- H+ HCO3—> H2CO3 —> H+ HCO3
- The bicarbonate ions convert a strong acid to a weak acid. Meanwhile, the carbonic acid converts a strong base to a weak base.
Helping maintain pH in the blood.
15
Q
Acids have an excess amount of
A
Hydrogen ions
16
Q
Bases have an excess of
A
OH
17
Q
Human blood pH
A
7.35-7.45
18
Q
Three ways in which blood pH is maintained
A
- Bicarbonate buffer system
- Phosphate buffer system
- Protein buffer system
19
Q
Why is it bad for people’s blood pH to change?
A
People can die
20
Q
List three ways to regulate hydrogen concentration
A
- Bicarbonate system
- Phosphate system
- Protein system
21
Q
How does the bicarbonate system help regulate hydrogen concentration
A
Uses the Carbon and hydrogens, goes back and forth between bicarbonate and carbonic acid
22
Q
How does the phosphate system help regulate hydrogen ion concentration
A
Uses phosphates
Goes back and forth with hydrogen
23
Q
What are the acidic values on the pH scale
A
0 to 7
24
Q
What are the basic values on the pH scale
A
7 to 14
25
What is a neutral pH
7
26
Which value represents severe acidosis in the blood
6.8
27
Which value represents severe alkalinity in the blood
8
28
List the four types of pH clinical problems giving symptoms
1. Respiratory acidosis
2. Respiratory alkalosis
3. Metabolic acidosis
4.Metabolic Alkalosis
29
CO2 is
Acidic
30
Respiratory acidosis
Patient is not breathing well and removing carbon dioxide from body
- increased CO2 and increased carbonic acid
31
What are the symptoms of respiratory acidosis
1. Not breathing well
32
Respiratory alkalosis
Hyperventilation
Getting CO2 out but not getting Oxygen in well
33
Symptoms of respiratory alkalosis
-lightheadedness
-dizziness
-agitation
-hyperventilation
34
Metabolic acidosis
Think digestion
-Kidneys start to fail during metabolic acidosis
-diarrhea and vomiting
35
Metabolic alkalosis
-think about diuretics
-vomiting
-decrease in gastric acid
36
Homeostasis
Bodies tendency to maintain a stable internal balance
37
How do water and electrolytes enter and exit the body
Water and electrolytes have equal amounts that enter and leave the body intake equals output
38
Water and electrolyte balance are interdependent true or false
True
39
Detrustors
Muscles that contract to control urination are
40
Electrolytes
Substances that release ions in water
41
Acids
Electrolytes that dissociate to release hydrogen ions into water
42
Bases
Substances that release ions that can combine with hydrogen ions
43
Salts
Electrolytes formed by the reaction between an acid and a base
44
Anaerobic respiration body makes energy without
Oxygen , helps release H+ in process
45
Anytime anaerobic respiration occurs to make energy , it's going to release
H+ ,
46
What rises when we break down sulfur and amino acids
H+
47
Indicates concentration of hydrogen ions in solution
pH
48
Indicates concentration of hydrogen ions in solution
PH
49
Indicates equal concentrations of hydrogen and hydroxide
Neutral pH 7
50
Occurs when blood pH rises to 7.5 to 7.8
Alkalosis occurs
51
Occurs when blood pH drops to 7.0 to 7.3
Acidosis
52
Chemicals which act to resist pH changes
Buffers
53
Inorganic substances
Small compounds that do not contain the atoms carbon and hydrogen
54
Water
-Polar molecule that demonstrates hydrogen bonding
-universal solvent
55
Blood moves around inorganic salts t/f?
True
56
Amount of Intracellular water
2/3 of water
57
Amount of extracellular water
One-third
58
Interstitial
Within tissue spaces
59
Transcellular
Includes CSF, aqueous and vitreous humor synovial fluid serous fluid within body cavities, fld secretions of exocrine glands
60
What helps you maintain water balance?
ADH: makes kidneys store urine
ALDOSTERONE
61
Greatest electrolyte output source is
Kidneys
62
Electrolytes come from
Foods
Fluids
Metabolic reactions
63
How are electrolytes lost?
Perspiration, feces, urine
64
Ions that are vital for nerve impulse conduction, muscle fiber contraction, and maintenance of cell membrane permeability
Na+
K-
Ca 2+
65
Which ions account for nearly 90% of the positively charged ions in extracellular fluids
Na
66
How is potassium and sodium balance regulated
1. Potassium ion concentration increases
2. Adrenal cortex is signaled
3. Aldosterone is secreted
4. Renal tubules increase reabsorption of sodium ions and increase secretion of potassium ions
5. Sodium ions are conserved and potassium ions are excreted
67
4 functions of Calcium
1.Muscle contraction
2.nervous system
3. Bone development
4. Blood clotting
68
How does calcium regulate muscle contraction
Binds to muscle cell and opens up the channel for depolarization
69
How does calcium help the nervous system
Helps signals jump the synapse
70
Hypercalcemia
High concentration of calcium
71
What causes hypercalcemia
-hyperparathyroidism
-cancers
72
Cancer induced symptoms of hypercalcemia
Weakness
Fatigue
Impaired mental function
Polyuria
Polydipsia
73
Hypocalcemia
Low calcium
74
Causes of hypocalcemia
-removal of parathyroid gland
-vitamin d deficiency
-may be life threatening- muscle spasms in airways, cardiac arrhythmias
75
What increases blood calcium
Parathyroid hormone
76
Vitamin D
Regulates calcium absorption
77
Calcitonin from thyroid function
Decreases Calcium in the blood
78
Five sources of H+ ions
1-2. Glucose metabolism (Aerobic and anaerobic)-carbonic and lactic acid
3.breaking down amino acids -sulfuric acids
4. Breaking down fats. Fatty acids. Acidic ketone bodies
5. Breaking down nucleic acids& phosphoproteins- phosphoric acid
79
Strong acids
Release more H+ , ionize more completely
80
Weak acids
Ionize less completely, release fewer H+
81
Strong bases
Ionize more completely and release more OH-
82
Weak bases
Ionize less completely and release fewer OH
83
Regulation of H+ ion concentration
1.Acid base buffer systems
2.Respiratory excretion of carbon dioxide
3.Renal excretion of hydrogen ions
84
Physiological buffers
1.Respiratory mechanism (CO2 excretion)
2. Renal mechanism (H+ excretion)
85
Phosphate system equation
H+HPO4-2---->H2PO4--->H+HPO4-2
86
Explain how the phosphate system works
1.The monohydrogen phosphate ion converts a strong acid to a weak acid
2. The dihydrogen phosphate ion converts a strong base to a weak base
87
Protein buffer system equation
-NH2+H+<--->-NH3+
NH3+ group releases a H ion in the presence of excess base
-COOH<---> -COO-+H+
COO- group accepts a hydrogen ion in the presence of excess acid
88
Respiratory excretion of CO2 is controlled by
Brainstem
89
What does the brainstem do?
-respiratory center
-controls the rate and depth of breathing
-INCREASES PRODUCTION OF CO2
90
What does increased CO2 do?
Stimulate the brain stem
91
CO2 reacts with H2O to produce
H2CO3
92
How does the body get rid of the excess H+ free radical?
Stimulating respiratory center in the brainstem
93
Survival range of pH
6.8-8.0
94
Respiratory acidosis
-Increased CO2,
-Increased carbonic acid
-Not breathing well
95
-excess breathing
-excessive CO2 coming out
-too few carbonic acid
Respiratory alkalosis
96
Metabolic acidosis
Kidneys may fail at excreting H+
Digestive
97
Diuretic, vomiting, decreased gastric juices
Metabolic alkalosis
98
Drowsiness, disorientation, stupor, labored breathing
Respiratory acidosis
99
What happens as CO2 levels rise?
Carbonic acid levels rise
100
What happens as carbonic acid levels rise?
pH decreases
101
Diuretic drugs and antacid intake
Metabolic alkalosis
102
Decrease in breathing rate and depth
Metabolic alkalosis
103
Decrease in breathing rate and depth results in
Increased concentration of carbon dioxide in blood
104
Dehydration
Lack of water
105
Who is more susceptible to dehydration
Infants and the elderly
106
Organs of the urinary system
Kidneys, ureters, urinary bladder, urethra
107
Filter blood and remove toxins , makes urine
Kidneys
108
Kidneys
Filter blood and form urine
109
Ureters
Transport urine from the kidneys to urinary bladder
110
Urinary bladder
Collects and stores urine
111
Urethra
Conveys urine from urinary bladder to outside of body
112
Functions of urinary system
Maintain composition, pH and volume of fluids within normal limits
113
Order or urinary system
Kidneys
Ureters
Urinary bladder
Urethra
114
Location of kidneys
-lateral to vertebral column
-behind abdominal cavity
115
Retroperitoneal
Behind the peritoneum of the abdominal cavity
116
Describe the surface of the kidney
Convex lateral surface and concave medial surface
117
Renal sinus
Hollow chamber in medial depression
118
Hilum
Entrance to renal sinus
119
Renal pelvis
Funnel-shaped sac; superior end of ureter
120
Major calyces
Large tubes that merge to form renal pelvis
121
Minor calyces
Small tubes that merge to form major calyces
122
Renal medulla
Inner region; composed of renal pyramids
123
Renal cortex
Outer region of kidney
124
Renal columns
Extensions of the cortex that dip into medulla
125
Renal capsule
Fibrous capsule around kidney
126
Renal capsule
Fibrous capsule around kidney
127
Nephrons:
functional units of kidney, each of which is a site of urine production
128
How many nephrons in each kidney
Over a million
129
Part of the nephron is in
The cortex, but it dips down into medulla
130
The left kidney is slightly superior to
The right kidney
131
What does the renal pelvis do?
Collects all of the urine from the kidney and then narrows as it leaves the kidney to become the ureter
132
All functions of the kidney
1.Filters blood and excretes waste
2. Regulates volume, composition, and pH of body fluids
3. Secretes erythropoietin
4. Secretes renin
5. Metabolizes vitamin D to active form to active form for Calcium absorption
133
Renin
Enzyme regulate blood pressure and kidney fx
134
Erythropoietin
Hormone that stimulates RBC production in bone marrow
135
Hemodialysis
Person's blood is re-routed so person's blood is re-routed so it crosses an artificial membrane that cleans out and filters the blood.
Usually occurs 3 times a week
136
Renal artery
Enters each kidney through the hilum and continues to branch through the nephrons
137
Describe the branching of the renal arteries
RIACA
1. Renal artery
2. Interlobar artery
3. Arcuate artery (arciform)
4.Cortical radiate (interlobular artery)
5. Afferent arteriole
138
Each enters a nephron
Afferent arteriole
139
From the nephron, venous blood returns to the
Renal vein
140
Branching of the renal vein
CAIR
1.Cortical radiate (interlobular) vein
2. Arcuate (arciform) vein
3. Interlobar vein
4. Renal vein
141
Renal artery comes from
Abdominal aorta
142
Hilum contains
Renal arteries, renal veins and the location where the ureters meet.
143
The abdominal aorta separates out into
Renal artery
144
Afferent arterioles go into
Glomerulus
145
Afferent arteriole leads to
Glomerulus
146
Describe the blood flow inside of each nephron
1.Afferent arteriole 2.glomerulus
3. efferent arteriole 4.peritubular capillaries
147
Interlobar artery branches into
ACAGE
1.Arcuate artery
2.Cortical radiate artery
3.Afferent arteriole
4. Glomerular capillaries
5. Efferent arteriole
148
Parts of a nephron
Renal corpuscle
Renal tubule
149
Parts of the renal corpuscle
1. Glomerulus
2. Glomerular bowman's capsule
150
Glomerulus
Cluster of capillaries
Filters blood
151
First step in urine formation
Glomerulus
152
Flow from afferent arteriole
Afferent arteriole>glomerulus>efferent arteriole
153
Glomerular (Bowman's) capsule
Receives filtrate from glomerulus
154
Renal tubule
Extends from the glomerular capsule to the collecting duct
155
Pathway of filtrate inside renal tubule
1.Glomerular capsule
2. Proximal convoluted tubule
3.Nephron loop (loop of Henle)
4. Distal convoluted tubule
156
Nephron loop is composed of
Ascending and descending limb
157
The distal convoluted tubules of several nephrons empty into each
Collecting duct
158
The collecting duct continues ...
The collecting duct continues through the medulla and joins other collecting ducts to drain through renal papillae into a minor calyx
159
Around the glomerulus
Bowman's capsule
160
What releases renin
Renal tubule
161
Renin
Hormone that regulates water balance and stimulates aldosterone which helps regulate BP
162
Helps with water balance and blood pressure
Renin
163
Site of blood filtration in the kidney
glomerulus
164
Flow of filtrate through renal tubule
1. Proximal convoluted tubule
2. Nephron loop
3. Distal convoluted tubule
4. Collecting duct
165
Which tubule is closest to glomerulus
Proximal convoluted tubule
166
The blood vessels associated with the nephron are unique to the
Kidney
167
Sequence of structures involved in the process of urine formation
1. Glomerulus
2. Glomerular capsule
3. Proximal convoluted tubule
4. Nephron loop (descending, ascending)
5. Distal convoluted tubule
6. Collecting duct
168
Sequence of structures involved in the process of urine elimination
1.Minor calyx
2. major calyx
3. renal pelvis
4. ureter
5. urinary bladder
6. urethra
169
Types of nephrons in the kidney
1.Cortical nephron 2.juxtamedullary nephron
170
The majority of nephrons are
Cortical nephrons
171
Cortical nephrons
Sit high in cortex with short nephron loops
172
Sit low in cortex and have long nephron loops
Juxtamedullary nephrons
173
Function of juxtamedullary nephrons
Important in regulating water balance and urine concentration
174
Which nephrons make up a small percentage of nephrons
Juxtamedullary nephrons
175
Which nephrons dip down into the medulla
The juxtamedullary nephrons
176
Which nephrons are more important
The juxtamedullary nephrons are the most important
177
Juxtaglomerular apparatus
A structure that regulates the secretion of renin
178
What forms the juxtaglomerular apparatus
The point where the ascending limb comes into contact with the afferent arteriole
179
The top portion of the ascending limb of the nephron loop of each nephron passes between the
Afferent and efferent arterioles
180
Macula densa
Tall closely packed cells of the ascending limb
181
Juxtaglomerular cells
Large vascular smooth muscle cells of the afferent arteriole
182
What regulates the renin angiotensin system which increases blood pressure
Renin secreted by the juxtaglomerular apparatus
183
Which system increases blood pressure
The renin angiotensin system increases blood pressure
184
Renin stimulates aldosterone to be released this is called
Renin angiotensin system
185
Nephritis
Inflammation of the kidney
186
Glomerulonephritis
Inflammation of the glomeruli, acute or chronic
187
Results of abnormal immune reaction one to three weeks after infection by the beta hemolytic streptococcus
Acute glomerulonephritis AGN
188
What occurs in acute glomerulonephritis AGN
-Infection does not start in kidney
-antigen-antibody complexes form insoluble immune complexes which lodge in the kidneys
-complexes deposit in and block glomeruli
189
Chronic glomerulonephritis
-progressive disease
- more and more nephrons are damaged until kidneys cannot function
-prolonged inflammation
-fibrous tissue replaces glomerular membranes disabling nephrons
190
-progressive disease
- more and more nephrons are damaged until kidneys cannot function
-prolonged inflammation
-fibrous tissue replaces glomerular membranes disabling nephrons
Chronic glomerulonephritis
191
Which glomerulonephritis is short lasted
Acute , comes from strep
192
Do kidneys regain function after glomerulonephritis
The kidneys regain function in acute glomerulonephritis AGN
193
What does urine contain
Wastes,
excess water,
and electrolytes
194
What are the three processes of urine formation
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion
195
Glomerular filtration
Blood is filtered in the glomerulus
196
Where does tubular reabsorption occur
Tubular reabsorption occurs in the proximal convoluted tubule and the descending loop of Henle
197
Where does the most of the tubular reabsorption occur
In the proximal convoluted tubule
198
Where does tubular secretion occur
In the ascending loop of Henley
199
First step in making urine
Glomerular filtration
200
What happens during glomerular filtration
Movement of water and small solutes from the glomerulus into the glomerular capsule.
Fenestrae allow small molecules to leave the glomerular capillaries
201
Glomerulus
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
202
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
203
Pressure behind glomerular filtration
Hydrostatic pressure
204
Pressure behind glomerular filtration
Hydrostatic pressure
205
As long as the net filtration pressure in the glomerulus is positive ________ will occur
Filtration
206
If the arterial BP drops...
The glomerular hydrostatic pressure falls
Can lead to acute renal failure
207
Glomerular hydrostatic pressure pushes in what direction
Out
208
The plasma colloid osmotic pressure pushes in what direction
Inward
209
What does the renin angiotensin system respond to
decrease in blood pressure
210
What does the renin angiotensin system use to regulate blood pressure
1.Vasoconstriction
2. secretion of ADH 3.aldosterone
211
What does the renin angiotensin system result in
Conservation of:
1.sodium
2. water
3. increase in blood pressure
212
What helps keep GFR constant
The renin angiotensin system
213
Renin stimulates the formation of
Aldosterone
214
ADH
Anti diuretic hormone
Stimulates nephrons to store water, put water back into the blood. Increases BP
215
How much glucose should be in your urine
None
216
What does glucose in the urine likely indicate
Diabetes
217
Tubular reabsorption
Movement of substances from the renal tubules into the interstitial fluid where they diffuse into the peritubular capillaries
Substances go out of the tube and into the blood
218
Direction of glomerular filtration
Out of the blood and into the tubule
219
Direction of tubular reabsorption
From the tubule back into the blood
220
Tubular secretion
Movement of waste from Peritubular capillaries into renal tubules
221
Most tubular reabsorption occurs in
The proximal convoluted tubule which is lined with microvilli
222
What percentage of tubular reabsorption occurs in the proximal convoluted tubule
70%
223
The proximal convoluted tubule is lined with
Microvilli
224
Just puts a little bit back
Tubular secretion
225
Different parts of the renal tubule reabsorb specific
Substances
226
Different substances are transported back into the internal environment by different methods of transport t/f?
True
227
Movement of substances against their concentration gradients limited transport capacity due to number of carrier proteins
Active transport
228
When is the renal plasma threshold reached?
When there is more transported substance in the plasma then the active transport mechanism can handle; excess spills into forming urine
229
Which substances are moved by active transport during tubular reabsorption
Glucose,
amino acids,
creatine,
lactic,
citric,
uric,
ascorbic acid,
ions
230
How is osmosis used in tubular reabsorption
Water reabsorption
231
How is endocytosis used in tubular reabsorption
Small protein reabsorption
232
Substances are transported out of the tubular fluid and into the peritubular capillaries
Tubular reabsorption
233
Percentage of water in the urine
95%
234
Nephrotic syndrome
A set of symptoms that occur in people with renal disease
-loss of plasma proteins,
-edema
-loss of plasma proteins into urine causes widespread edema and increased likelihood of infection
235
Kidneys maintain internal environment by reabsorbing
Water
236
In the proximal convoluted tubule sodium ions are reabsorbed by
Active transport
237
In the proximal convoluted tubule water is reabsorbed by
Osmosis
238
Substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules
Tubular secretion
239
Substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules
Tubular secretion
240
What is secreted during tubular secretion
waste destined to be excreted in the urine
241
Active transport mechanisms function in tubular secretion, but
Active transport happens in the opposite direction as tubular reabsorption
242
Secretion of substances such as drugs and ions such as potassium occurs in
Tubular secretion
243
Secretion of hydrogen ions important in regulating the pH of body fluids occurs in
Tubular secretion
244
Examples of drugs excreted during tubular secretion
Penicillin
Phenylbardenaul
245
Final secretions of hydrogen and potassium
Tubular secretion
246
Tubular secretion of potassium ions occurs in
The distal convoluted tubule
247
What occurs simultaneously as tubular secretion of potassium ions occurs
Sodium ions are reabsorbed as potassium ions are secreted
248
Antidiuretic hormone
Responsible for reabsorption of water
249
ADH comes from which gland
pituitary gland
250
If antidiuretic hormone is present the segments
Become permeable and water is reabsorbed by osmosis into the extremely hypertonic medullary interstitial fluid
251
Urine becomes very concentrated under the direction of
ADH
252
Juxtamedullary nephrons are more important in the regulation of
Water reabsorption
253
Urine becomes very concentrated under the direction of
ADH
254
The distal convoluted tubule and the collecting duct are impermeable to water in the presence of
ADH
255
What causes water to be excreted as dilute urine
The absence of antidiuretic hormone
256
The ability of the kidneys to maintain the internal environment depends on their ability to concentrate urine by
Reabsorbing large volumes of water
257
Which hormones affect the solute concentration of urine particularly sodium
Aldosterone and cardiac natriuretic peptides
258
What happens when you have toxins I your blood like alcohol
You don't release ADH, so you pee a lot
259
What causes your head to hurt during a hangover
Dehydration
260
It's important to drink water while you
Drink alcohol
261
Counter current multiplier
The water, when there is ADH, it leaves the tubule and goes back into the capillaries
262
Filtration of water and dissolved substances from plasma
Glomerulus
263
Receives the glomerular filtrate
Glomerular capsule
264
Where does the Reabsorption of the following substances happen glucose, amino acids, creatine, lactic acid, uric acid, ascorbic acid, phosphate, sulfate, calcium, potassium, and sodium ions by active transport
Proximal convoluted tubule
265
Reabsorption of proteins by endocytosis
Proximal convoluted tubule
266
Reabsorption of water by osmosis happens in
Descending loop, distal convoluted tubule & collecting duct
267
Reabsorption of chloride ions and other negatively charged ions by electrochemical attraction
Proximal convoluted tubule
268
Act of secretion of substances such as penicillin, histamine, creatinine, and hydrogen ions
Proximal convoluted tubule
269
In which part of the nephron does Reabsorption of water by osmosis occur?
Descending limb of the nephron loop
270
Reabsorption of sodium, chloride, and potassium ions by active transport
Ascending limb of the nephron loop
271
Reabsorption of sodium ions by active transport
Distal & proximal convoluted tubule
272
Reabsorption of water by osmosis
Distal convoluted tubule
273
Active secretion of hydrogen ions
Distal convoluted tubule
274
Secretion of potassium ions both actively and by electrochemical attraction
Distal convoluted tubule
275
Collecting duct
Reabsorption of water by osmosis
276
Not anatomically part of the nephron but functionally linked in the process of urine formation
The collecting duct
277
Urea is a by-product of
Amino acid catabolism
278
The plasma concentration reflects the amount of
Protein in the diet
279
Describe the movement of urea
1.Enters the renal tubules through glomerular filtration,
2. undergoes both tubular reabsorption and
3. tubular secretion
280
Percentage of urea that is reabsorbed
80%
281
Percentage of urea that is excreted in the urine
20%
282
Product of nucleic acid catabolism
Uric acid
283
Describe the movement of uric acid
It enters the renal tubules through glomerular filtration
284
Active transport completely reabsorbed the
Filtered uric acid
285
What percentage of uric acid enters the urine through tubular secretion and is excreted
10%
286
Urea
A byproduct of amino acid catabolism
287
Uric acid
A product of nucleic acid metabolism
288
The majority of urine composition is
Water
289
Which metabolic waste products are normally found in the urine
Urea uric acid and creatinine
Trace amounts of amino acids and varying amounts of electrolytes
290
What is the typical urine volume
0.6-2.5 L/day; 50-60 mL of urine output/hr is normal
291
Urine volume varies with
Fluid intake and environmental factors
292
Less than 30 ml an hour indicates
Kidney failure
293
Renal clearance
-The rate at which chemical is removed from the plasma by kidney
-indicates kidney efficiency glomerular damage and progression of renal disease
294
-The rate at which chemical is removed from the plasma by kidney
-indicates kidney efficiency glomerular damage and progression of renal disease
Renal clearance
295
Renal clearance tests
1. Inulin clearance test(a polysaccharide of some plant roots)
2. Creatinine clearance test
296
Why can we use renal clearance test to calculate the glomerular filtration rate GFR
The substances are both filtered by the glomerulus but neither is reabsorbed nor secreted
297
Measures glomerular filtration rate
Renal clearance tests
298
Ureters
Tubular organs that join the urinary bladder in the pelvic cavity
299
Each ureter begins as
Renal pelvis in kidney
300
How long are the ureters
About 25 cms long
301
Layers of the walls of the ureter
1. Inner mucous coat (transitional epithelium)
2. Middle muscular coat
3. Outer fibrous coat
302
What transports urine along the ureters
Peristaltic waves
303
Kidney stone (renal calculus)
Stone
304
Renal calculus
Kidney stone
305
What triggers the ureterorenal reflex
An obstruction such as a kidney stone in a ureter
306
Ureterorenal reflex
-Strong peristaltic waves in the obstructed ureter to move Stone toward the urinary bladder.
- reduced urine production in affected kidney
307
What can make a kidney stone
1.Uric acid
2.calcium oxalate
3. calcium phosphate
4. magnesium phosphate
308
Where do kidney stones form
In the collecting ducts or renal pelvis of kidney
309
Symptoms of a kidney stone
1.Severe pain
2. nausea
3. vomiting
4. blood in urine
310
What percentage of kidney stones pass on their own
60%
311
Lithotripsy
Shattering of a kidney stone with a laser
312
How can you get rid of a kidney stone
-60% pass on their own
-lithotripsy
-surgical removal
313
Can the tendency to form kidney stones be inherited
Yes, especially calcium stones
314
What are the causes of a kidney stone
1.Calcium supplements (in people with inherited tendency)
2. Excess vitamin D
3. Urinary tract blockage 4.urinary tract infections
315
Urinary bladder
Hollow dispensable muscular organ located within the pelvic cavity
Stores urine
316
What is the location of the urinary bladder
Posterior to the pubic symphysis and inferior to the parietal peritoneum
317
Trigone
Triangle at the floor of the bladder that has openings at each of its three corners: two to the ureters and one to the urethra
318
Detrusor muscle is made of
Smooth muscle fibers of muscular coat
319
What surrounds the neck of the bladder
Internal urethral sphincter
320
Micturition
Process of urinating
321
Bladder is anterior to
Uterus
322
Prostate gland is inferior to the
Male urinary bladder
323
Urethra
Tubular organ that conveys urine from the urinary bladder to the outside of the body
324
The urethra is lined with
The urethra is lined with a mucus membrane and has a thick layer of longitudinal smooth muscle fibers
325
Urethral glands
Many mucus glands in the urethra
326
Describe the female urethra
-4 cm long
- external urethral orifice is anterior to the vaginal opening
327
Describe the male urethra
-19.5 cm long
-functions in urination and reproduction
328
Three sections of the male urethra
1. Prostatic Urethra
2. Membranous urethra
3. Spongy urethra: terminates at the external urethral orifice in penis
329
Cystitis
Bladder infection
More common in females
330
Urine leaves the urinary bladder
Micturition urination reflex
331
Fused kidneys that lie on one side of the midline
Crossed fused ectopia
332
Fusion of kidneys at one pole, usually lower, with most of each kidney on opposing side of midline
Horseshoe kidney
333
Proteinuria (protein in urine) due to abnormal glomeruli
Nephrotic syndrome
334
Reduced number of nephrons that are abnormally large
Oligomeganephronia
335
Polycystic Kidney Disease
Cysts form in renal tubules and or collecting ducts
336
Renal agenesis
Absence of a kidney
337
Renal displasia
Abnormal kidney structure
338
Renal hypoplasia
Small kidney with fewer nephrons but development normal
339
Tubular dysgenesis
Abnormal formation of proximal tubules
340
Vesicoureteral reflux
Urine backs up from bladder to ureter of kidney
341
The urinary bladder holds how much urine
600 mL
342
The urge to urinate begins when the bladder contains
150 ml
343
Urinalysis
Can be used to diagnose certain diseases or disorders and check for drug usage
344
Why is urinalysis helpful
There are several harmful inherited disorders that alter the urine color and sometimes viscosity
345
Beeturia
urine turns pink after eating beets
346
Asparagus can cause
Urinary excretion of odiferous component of asparagus
347
People with untreated diabetes mellitus might have____ in their urine
Glucose
348
People with untreated diabetes mellitus might have____ in their urine
Glucose
349
What happens to urinary system as you get older
-Bladder, ureters and urethra lose elasticity.
- Bladder holds less urine
350
When does dehydration occur
When water output exceeds input
351
Who is most susceptible to dehydration
Infants and the elderly
352
What happens to the extracellular fluid when dehydration occurs
The extracellular fluid becomes concentrated
353
What happens to the skin and mucus membranes when a person is dehydrated
The skin and mucous membranes and mouth feel dry
354
What happens to body temperature during dehydration
Hyperthermia develops because it upsets the sweating mechanisms
355
What happens to cognition during dehydration
Cerebral circumstances, mental confusion,
delirium,
coma
356
Water intoxication
Hyponatremia as a result of excessive fluid intake can result in death
357
Often seen in runners with excessive fluid intake
Water intoxication
358
More likely with longer race time low or high body mass index significant weight gain during race
Water intoxication
359
What can happen to body weight during dehydration
Lower
360
Hyponatremia
Low sodium, result of excess fluid intake can cause death
361
Common causes of hyponatremia
1. Prolonged sweating
2. Vomiting
3.diarrhea
Can all decrease sodium levels
362
Common causes of hyponatremia
1. Prolonged sweating
2. Vomiting
3.diarrhea
Can all decrease sodium levels
363
Does drinking sports drinks prevent water intoxication
No significant difference
364
Does drinking sports drinks prevent water intoxication
No significant difference
365
Edema
Abnormal accumulation of extracellular fluid within interstitial spaces
366
Edema
Abnormal accumulation of extracellular fluid within interstitial spaces
367
What are the five causes of edema
1.Hypoprotenemia
2. Obstruction of lymph vessels
3. Increased venous pressure
4. Inflammation
5. Blood pressure meds
368
Hypoprotenemia
Low plasma proteins
369
-emia
Presence in the blood
370
Swelling
Edema
371
Hyponatremia causes
1.Prolonged sweating 2.vomiting
3.diarrhea
4.renal disease
5.adrenal cortex disease 6.drinking too much water
372
Renal disease
Inadequate reabsorption
373
Adrenal cortex diseases ex
Inadequate aldosterone such as Addison disease
374
What happens to cells during hyponatremia
1. Hypotonic extracellular fluid and resulting movement of water into cells by osmosis- water intoxication
375
Aldosterone
Hormone that comes from adrenal cortex and increases renal secretion of potassium
376
Hypernatremia is caused by
1.Excessive water loss 2.evaporation
3. fever
4. diabetes
5. insufficient ADH
377
What are the effects of hypernatremia
-CNS disturbances
-confusion
-stupor
-coma
378
Hypokalemia causes
1. Excessive release of aldosterone by the adrenal cortex- Cushing syndrome
2. Diuretics that promote potassium excretion
3.kidney disease
4. Prolonged vomiting or diarrhea
379
What are the effects of hypokalemia
Severe cardiac disturbances such as atrial or ventricular arrhythmias
380
Example of a disease that causes excessive release of aldosterone by adrenal cortex
Cushing syndrome
381
Hyperkalemia causes
1.Renal diseases that decrease potassium excretion
2. Drugs that promote renal conservation of potassium
3. Insufficient aldosterone secretion- Addison's Dx
4. Acidosis- causes shift in K
382
What are the effects of hyperkalemia
1.Paralysis of skeletal muscles
2. cardiac disturbances cardiac arrest
383
Natremia
Na+ ions
384
Calcemia
Ca +2 in blood
385
Kalemia
Potassium in blood
386
Why is hypocalcemia dangerous
-may be life threatening- muscle spasms in airways, cardiac arrhythmias
387
-explain the amine part of the protein buffer system
-NH2+H+<--->-NH3+
NH3+ group releases a H ion in the presence of excess base
388
Explain the COOH part of the protein buffer system
-COOH<---> -COO-+H+
COO- group accepts a hydrogen ion in the presence of excess acid
389
What branches off the renal artery
Interlobar artery
390
What branches off the renal artery
2.Interlobar artery
391
What branches off the interlobar artery?
3. Arcuate artery (arciform)
392
What branches off the arcuate arciform artery?
4.Cortical radiate (interlobular artery)
393
What branches off the arcuate arciform artery?
4.Cortical radiate (interlobular artery)
394
What branches off the cortical radiate interlobular artery
5. Afferent arteriole
395
How do collecting ducts drain?
collecting ducts drain through renal papillae into a minor calyx
396
Which kidney is higher up
Left kidney
397
Large vascular smooth muscle cells of the afferent arteriole
Juxtaglomerular cells
398
Tall closely packed cells of the ascending limb
Macula densa
399
Fenestrae
Fenestrae allow small molecules to leave the glomerular capillaries
400
Fenestrae
Fenestrae allow small molecules to leave the glomerular capillaries
401
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
402
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
403
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
404
Why is it bad to have a loss of plasma proteins?
loss of plasma proteins into urine causes widespread edema and increased likelihood of infection
405
What is impermeable to water in the presence of ADH
The distal convoluted tubule and the collecting duct
406
Why is the reabsorption of water important?
kidneys maintain the internal environment depends on their ability to concentrate urine
407
Why is the reabsorption of water important?
kidneys maintain the internal environment depends on their ability to concentrate urine
408
Cells of afferent arteriole
Juxtaglomerular cells
409
Cells of the ascending limb
Macula densa
410
Where does the reabsorption of water by osmosis happen?
Collecting duct
411
Where does the reabsorption of water by osmosis happen?
Collecting duct
412
Diuretics function
Get rid of potassium
413
Diuretics function
Get rid of potassium
