Week 5 - Study Guide Flashcards

Urinary

1
Q

Hormones that regulate blood pressure & Na+/K+ balance

A

Renin-angiotensin → aldosterone
ADH

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2
Q

Blood cell production

A

Erythropoietin

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3
Q

Basic processes of urinary system

A

Filter
Secrete
Reabsorb

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4
Q

Toxicity in order of highest to lowest of Nitrogenous waste.

A

Ammonia
Urea
Uric Acid

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5
Q

Energy cost in order of highest to lowest of nitrogenous waste

A

Uric acid = 3 ATP
Urea = 1.5 ATP
Ammonia = NA

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6
Q

Water required for nitrogenous waste highest to lowest

A
  1. Ammonia (500 ml/g). (lot of h20)
  2. Urea (50 ml/g). (if trying to conserve h2o)
  3. Uric Acid (10 ml/g) (body under h20 constriction)
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7
Q

Solubility in highest to lowest for nitrogenous waste

A
  1. ammonia
  2. urea
  3. uric acid
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8
Q

Urine Formation - 4 basic steps

A
  1. Filtration
  2. Reabsorption
  3. Secretion
  4. Water conservation
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9
Q

Where kidneys are located

A

retroperitoneal (behind peritoneal cavity)

T-12 → L3

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10
Q

What holds the kidney in place

A

Perirenal fat capsule

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11
Q

Indent for ureter, blood & lymph vessels, nerves

A

Hilus

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12
Q

Protection of kidney (damage & Infection)

A

Protection (fibrous) capsule

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13
Q

Anchors kidney to abdominal wall

A

Renal Fascia

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14
Q

From fibrous capsule to medulla

A

cortex

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15
Q

Organized into renal pyramids, separated by renal columns, papilla

A

Medulla

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16
Q

Tip of pyramid releases urine to minor calyx

A

papilla

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17
Q

Contains branching extensions called calyces & is continuous with ureter (major calyces divide to minor calyces)

A

Pelvis

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18
Q

How much blood is reabsorbed at eth kidney

A

22% total Cardiac Output of Blood

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19
Q

Arteries blood supply for kidneys

A
  1. Aorta
  2. Renal Artery
  3. Segmental Artery
  4. Interlobar artery
  5. Arcuate Artery
  6. Cortical radiate artery
  7. Afferent arteriole
  8. Glomerulus (capillaries)
  9. Efferent arteriole
  10. (Peritubular capillaries and vasa recta)
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20
Q

Blood supply - veins back to heart

A
  1. Efferent arteriole
  2. Peritubular capillaries and vasa recta
  3. Cortical radiate vein
  4. Arcuate vein
  5. Interlobar vein
  6. Renal vein
  7. Inferior Vena Cava
  8. Right atrium
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21
Q

Bowman’s capsule & Glomerulus

A

Renal corpuscle

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22
Q

What projects into the medulla?

A

Loop of Henle

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23
Q

Nephrons have a portal = 2 capillary beds

A
  1. glomerulus
  2. peritubular capillaries or vasa recta
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24
Q

Juxtaglomerular apparatus = JGA contains

A

DCT joins with afferent arteriole

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25
Where is Juxtaglomerular cells located, what does it monitor and secrete?
Afferent arteriole Monitors Blood pressure - when BP is low it secretes Renin
26
What has chemoreceptors in DCT and measures solutes
Macula Densa cells
27
Where are Macula Densa Cells located, what do they secrete, what do they measure?
DCT Measures solutes releases Renin if solutes are low
28
Name for urination
micturition
29
Which sphincter has voluntary control
external
30
What sphincter is under control of CNS
Internal sphincter
31
Glomerulus is porous and is wrapped in what kind of cells?
Podocytes (endfeet)
32
What surrounds the glomerulus and captures filtrate
Bowman's capsule
33
The component that attaches the kidneys to the abdominal wall is the ____ ?
renal fascia
34
The two components of the renal corpuscle are ---?
Glomerulus & Bowman's capsule
35
If bood pressure increased, in theory, what should this do to the rate of glomerular filtration?
⬆BP ⬆NGF. (more particles get through)
36
HPg = BP - what is the normal rate?
55 mmHg
37
HPc =
hydrostatic pressure in capsule fluid pressure as it filters to capsule
38
OPg =
osmotic pressure on glomerulus albumin & solutes in blood water to move back via osmosis
39
Average NFP =
10 mmHg NFP = HPg - (OPg + HPc) 10 mmHg = 55-(30+45)
40
Average GFR
120 ml/min
41
How much filtrate a day
180 L filtrate/day
42
What are the impacts of kidney disease on NFP & GFR?
Elevates NFP & GFR low BV and low BP more fluid going through glomerulus becomes permeable to protein (albumin) decreasing OPg
43
What are the impacts of Hemorrhage on NFP & GFR?
Decreases NFP and GFR less fluid going through reduces HPg (BP)
44
What are the impacts of nervous control on NFP & GFR?
Decreases NFP & GFR sympathetic NS constricts afferent & efferent arteriole
45
What is NFP = 0
renal suppression No net drive/movement
46
Smooth membrane, tightly adherent to the kidney surface
fibrous capsule
47
Portion of the kidney containing mostly collecting ducts
medulla
48
portion of the kidney containing the bulk of the nephron structures
cortex
49
Superficial region of kidney tissue
cortex
50
basinlike area of the kidney, continuous with the ureter
renal pelvis
51
a cup-shaped extension of the pelvis that encircles the apex of a pyramid
minor calyx
52
area of cortical tissue running between the medullary pyramids
renal column
53
Tonicity drives
osmosis
54
Where does most of the reabsorption happen in the tubulars?
PCT = 65% DCT
55
What is the maximum reabsorption capacity of tubes, excess goes to urine (diabetes & glucose)
Tubular Maximum
56
If reabsorption declines, which of the following occur? a. more urine produced b. loss of potentially valuable resources c. decline in filtration d. inability to rid body of appropriate toxins and waste e. both a & b f. a, c, & d are all true g. all of the above
e. both a & b Solutes first followed by water
57
What are the commonly secreted items?
K+ NH4- (ammonium) H+ foreign substanes NH4- & H+ are pH issue
58
Hypotonic urine =
well hydrated low solutes - high volume got rid of solutes produced more urine volume
59
Hypertonic urine =
Dehydrated high solutes - low volume holding onto urine ADH - Aldosterone
60
cortical nephrons =
peritubular capillaries
61
Which capillaries are about filtering?
peritubular capillaries cortical nephrons filtering - not concentrated urine
62
Which capillaries are about concentrated urine?
Vasa Recta juxtamedullary nephron Creates concentrated urine
63
Countercurrent exchange
Vasa Recta
64
Countercurrent multiplier
Loop of Henle
65
What cells secrete renin if BP falls and where are they located?
Juxtaglomerular cells in the afferent arteriole
66
What cells secrete renin if solutes fall and where are they located?
Macula densa cells - chemoreceptors in the DCT
67
What are the concentration levels in the cortex vs the medulla in a juxtamedullar nephron?
300 mOsm in the cortex 1200 mOsm in the medulla
68
Define counter-current flow
opposite directions in 2 tubes More efficient
69
Counter-current multiplier refers to what structure within the kidney?
Loop of Henle of the Juxtamedullary nephrons
70
Counter-current exchanger refers to what structure within the kidney?
Vasa Recta of the juxtamedullary nephrons
71
What happens to the solute concentration within the interstitial space as you move from the cortex to the medulla?
Increases - 300-1200 mOsm
72
If the descending limb of the vasa recta vessels suddenly became more permeable to H2O, what impact could this have on the function of the kidney?
Job of exchanger - create a concentration gradient
73
During respiratory acidosis, the kidneys should?
Reabsorb HCO3- (blood) and retain H+ & NH4+ Get rid of bicarb - making pH too high Remember - Reabsorption of flitered HCO3- is coupled to H+ secretion Inverse relationship
74
If the levels of aldosterone increased in the body which of the following would occur? a. [sodium] in the urine rises b. urine volume increases c. [sodium] in the blood rises d. urine volume decreases e. [potassium] in the blood decreases
c. [sodium] in the blood rises d. urine volume decreases e. [potassium] in the blood decreases
75
If ADH is produced, which of these processes occur? a. decreased H2O reabsorption b. increased plasma solute concentration c. increased sodium reabsorption d. decreased urine production e. decreased urine concentration
d. decreased urine production
76
What is the specific action of ADH on the nephrons?
Aquaporins in the collecting ducts allow water to leave the collecting ducts via osmosis. WATER FOLLOWS NA+ into interstitial fluid water moves into vasa recta and back into general circulation
77
Diabetes Insipidus does not make what hormone?
ADH Urine volume up due to lack of ADH. Nothing to stop the urine Excess sugar - glucose
78
SIADH does what?
Syndrome of inappropriate ADH When hydrated - retaining H2O when not needed. Dilutes concentration
79
Temperature effects urine - If you want to decrease the frequency of urination would it better to crank heat up to 90° or turn the heat off.
Crank the heat up to 90°
80
Diuretics -
increase urine volume by decreasing reabsorption of water or solutes
81
What inhibits ADH
Alcohol - no ADH more fluid out
82
What inhibits Na+ reabsorption
caffeine
83
Increases urine
Increase in BP = increases filtration increase in [na+ solute] = excessive sodium intake = more urine Decreased blood [plasma protein] liver damage - liver disease -- not producing Albumin in - not enough osmosis pressure in glomerulus to pull fluid back = more urine
84
Renal clearance RC=UV/P
volume of blood plasma from which a substance is completely removed in one minute U= urine concentrtion V= flow rate of urine formation P = concentration of substance in plasma Three options only: Fliter Reabsorb Secrete
85
What does a urinalysis reveal?
Kidney disease gall bladder problems heart disease pregnancy
86
What damage does albuminuria indicate? abnormal constituents of albumin
Damage chemical toxicity High BP all at the kidney
87
What damage does glycosuria indicate?
glucose > tubular maximum cortisol stress pregnancy diabetes excess carbs not making insulin - mobilizing sugar into the bloodstream
88
What damage does hematuria indicate?
erythrocytes - RBCs in urine indicates inflammation of glomerulus or serious damage
89
What damage does pyuria indicate?
Leukocytes - milky - WBCs should not be there indicates UTI
90
What damage does acetonuria indicate?
Ketone bodies Not always bad - burning fat you will see ketones indicates starvation or depressed CHO intake
91
Different colors of urine: red-brown =
presence of blood
92
Different colors of urine: red-amber =
urobilinogen (cirrhosis of the liver) fecal waste is why it is brown
93
Different colors of urine: brown-green =
bile pigments - gall bladder
94
Different colors of urine: milky =
bacteria WBCs or urate infection
95
Specific gravity of urine density/water density
1.010-1.020 don't go below or don't go over
96
Urinary Disorders: Inflammation of urinary bladder. Caused by bacterial infection OR chemical OR
Cystitis
97
Urinary Disorders: Inflammation of kidney tissue
Nephritis
98
Urinary Disorders: Inflammation of nephron
Glomerulonephritis Associated with streptococcal infections due to toxins filtered from blood Gold, lead, & mercury can also damage glomerulus
99
Urinary Disorders: Inflammation of renal pelvis & calyces
Pyelitus
100
Urinary Disorders: Inflammation of renal pelvis, calyces, & renal tubules
Pyelonephritis
101
Another name for kidney stones
renal calculi insoluble salts of various metabolic products. 1. Obstruct urinary pathway 2. Exact formation process unkown 3. Predisposing factors
102
What are some predisposing factors of kidney stones?
1. milk consumption (and a lot of tea) 2. low water consumption 3. extensive bed reset with little urine output 4. some infections
103
What is it called - passing kidney stones?
renal colic
104
Renal Failure =
abnormally low urine production low bp = does not allow filtration extensive blood loss = low cardiac output
105
Artificial filtration of blood in patients with urinary disease or loss
Hemodialysis
106
Net filtration pressure is calculated by: equation
NFP = (HPg) - (OPg +HPc) This balance tells you how much fluid will be filtered based upon glomerular blood pressure, [solute] in glomerulus, and the fluid pressure of the filtrate itself.
107
NFP tells us about filtration dynamics..
which will be regulated in part by the function of the podocytes regulating the degree of permeability at the glomerulus If you look at the NFP value over time - you can determine GFR
108
CounterCurrent mechanism =
juxtamedullary nephron
109
Countercurrent Multiplier =
Vasa Recta
110
Important in filtrating blood, but do NOT produce concentrated urine, and HAVE peritubular capillaries
Cortical Nephrons
111
Produce concentrated urine by descending deep into the medulla where solute concentration is very high (1200 mOsm)
Juxtamedullary nephrons
112
Three filtration membranes of the glomerulus
1. Fenestrated Epithelia 2. Basement Membrane. (negatively charged) (connective tissue that is filled with collagen) 3. Podocytes
113
Glomerulus filtration rate is higher means -
get rid of more stuff
114
Glomerulus filtration rate is lower means -
hold on to more stuff
115
How to influence GFR - in the afferent arteriole
making diameter smaller (vasoconstrict) - less blood going to the glomerulus Pressure in glomerulus ⬇ Less filtration. ⬇
116
How to influence GFR - in the efferent arteriole
Make diameter smaller (vasoconstrict) Pressure in glomerulus ⬆ More filtration ⬆