Urinary System 2 Flashcards

Terms Definitions
Juxtaglomerular Apparatus
if
Functional Unit of Kidney
Nephron
Passive Transport
used by water
Secretion
enhances excretion of substances already in lumen active process (secondary active trasport)secretion of H+ and K+ important
Active Transport
Primary=use of ATP Secondary=electrochemical gradientsused by Na+
Renal parenchyma
glandular tissue that forms urine
K+ secretion
influenced by hormone aldosterone (hormone produced in adrenal cortex)function is to: increase BP, increase K+ secretion, increase Na+ reabsorption released during by: increase plasma K+, decrease plasma Na+, angiotensin II stimulates principal cells in the distal tubuleincrease K+ secretion and Na+ reabsorption water wants to follow Na+ reabsorption (needs another hormone to increase permeability of distal tubule->anti-duretic hormone)
Glomerulonephriis
-kidney damage -produces large volume of urine
Anti-diuretic Hormone (ADH)
function: increase water permeability of collecting duct, increase blood volume and blood pressure, and decrease urine output synthesized from: posterior pituitary gland release stimulated by: angiotensin II stimulates hypothalamus to release ADH from posterior pituitarymajor mechanism for controlling water content in blood by regulating permeability of collecting duct to water absent=dilute urine, increase urine volume present=concentrated urine, decrease urine volume
Angiotensin II Effects
main effect=increase in BP vasoconstriction of arterioles stimulates cardio control center to increase cardiovascular response stimulates hypothalamus to increase thirst and release ADH from posterior pituitary gland stimulates adrenal cortex to release aldosterone to increase Na+ reabsorption and K+ secretion
Autoregulation
maintain a nearly constant GFR when mean arterial blood pressure is between 80-180mmHgaccomplish by controlling blood flow through arterioles protects filtration batteries from damage due to increase in BP 4 types1. Myogenic Response 2. Tubuloglomerular Feedback 3. Neural Control 4. Renin-Angiotensin System
Reabsorption Steps
Na+ reabsorbed by active transport anions reabsorbed water moves by osmosispermeable solutes (K+, Ca2+, urea) reabsorbed by diffusion
Five Kidney Functions
1. Maintain plasma volume, therefor BP2. Regulate H20 concentration3. Acid/base balance (blood pH)4. Eliminate wastes, drugs & hormones5. Endocrine organs: -produce renin -erythropoetin (RBC formation) -vitamin D
Two parts of renal parenchyma
Renal cortex, Renal medulla
Myogenic Response
overall effect is to decrease blood flow across a vessel after an increase in blood pressureincrease in BP causes smooth muscles in AFFERENT arterioles to stretch in response, AFFERENT arterioles constrict -increases resistance to blood flow -decreases renal blood flow to glomerulus-decrease GFR and BP helps conserve blood volume
3 Barriers to Filtration
1. glomerular capillary epithelium -fenestrated capillaries doesn't allow blood cells or plasma proteins to filter through 2. basal lamina -separates capillary endothelium from bowman's capsule epithelium -blocks filtration of plasma proteins3. epithelium of bowman's capsule -contain podocytes with foot processes -surround glomerular capillaries -form filtration slits to allow filtrate to enter bowman's capsule -increase surface area for more filtration
Three Parts of Filtration Membrane
1. Fenestrated Endothelium of Glomerulus2. Basement Membrane3. Filtration Slits b/w Podocyte
how much plasma is filtered daily? what percent is excreted daily
180 L/ day
1%
Hilum in the Kidney
receives renal nerves, blood vessels, lymphatics, and ureter
Simplified Overview of Steps
kidneys produce urine ureters move urine from kidney to bladder bladder stores urine urethra excretes urine
Renin-Angiotensin System
function is to increase BP begins with release of renin from granular cells -macula densa signal actin when BP and NaCl is low-sympathetic neurons stimulate granular cells when BP is low renin converts angiotensinogen (inactive plasma protein in liver) to angiotensin IACE (angiotensin converting enzyme) found in lungs converts angiotensin I to angiotensin II angiotensin II effects-vasoconstriction -greater vasoconstriction of EFFERENT arterioles because more receptors for A2 then in afferent arterioles -increase GFR and BP
Myogenic Regulation of GFR
Increased BP --> Stretch --> Smooth Muscle Contraction --> Restricts Blood Flow --> Decreases GBP (glomerular BP)
can you describe the three pressure forces acting within the glomerular capsule that leads to filtration
-hydrostatic pressure: pressure against the walls of the vessels caused by a fluid (blood) 55 mmHg
-colloidal osmotic pressure: pressure due to the protien albumin in the blood that results in osmosis into the capillary. 30 mmHg
- Capsular pressure: backpressure form bowman's capsule that force filtrate back into the glomerulus. 15 mmHg
Primary Active Transport of Na+
Na+ enters by passive facilitated diffusion Na+ leaves by Na+-K+-ATPase (1* active transport because using ATP)
Two Kinds of Intrinsic Regulation of GFR
1. Myogenic (MAP)2. Juxtaglomerular Apparatus
what is the name for the types of chemicals thta inhibit ADH. examples
antidiuretics. caffeine, hypertension/edema drugs
production of urine in the kidney
for excretion of metabolic and foreign waste from the body
can you list the various substances that will leave the blood by filtration in the glomerular capsule
anything small enough to diffuse out of the capillary and past the filtration slits: includes water, sugars, amino acids, vitamins and metabolic wastes like urea, creatinine and uric acid
acid-base balance of blood in the kidney
controls homeostatic pH by release of HCO3-
can you describe the change in sodum concentration in the loop of henle?
entering the loop the concentration is 300 mOsm and the sodium is concentrated on the way down the tube. concentration at the bottom of the tube is 1200 mOsm. on the way up the ascending limb sodium is removed and thus is diluted to 100 mOsm by the time it leaves the loop
noct/i
night
nephr/o
kidney
ren
kidney
lith/o
stone
SG
specific gravity
-plasty
surgical repair
glycos/o
sugar (word root)
ESWL
extracorporeal shock-wave lithotripsy
GFR
Glomerular Filtration Rate
renin
converts angiotensionogen to angiotensin I. signal for renin release comes from either low arterial pressure or activated macula densa by low NaCl concentration
NAMEthese are bean shaped
kidneys
polyuria
condition of excessive urination
medulla
exhibits cone-shaped medullary (renal) pyramids
Renal Agenesis
Absence of one kidney
micturition
urination; the act of voiding
nocturnal enuresis
bed wetting during sleep
myogenic mechanism
part of renal autoregulation (intrinisc control); tendency of vascular smooth muscle to contract when stretched; increasing systemic BP causes afferent arteries to constrict which restricts flow into glomerulus; opposite when low BP
GFR is regulated mostly by
 
a) autoregulation
 
b)  autonomic regulation
 
c)  hormonal regulation
 
d)  all of the above
d
What is responsible for forming urine
nephron
The Nephron Capillary Beds are associated with two capillary beds
 
 
 
 
(The golmerulus and the Peritubular capillaries) 
NAMEthis has simple squamous epthiliea freely permeable to water
thin segment
incontinence
involuntary discharge of urine or feces
True or false. With non-ionic iodinated contrast media, there is no ionization, therefore no increase of iodine in the blood.
True
Spectrometer
instrument that measures index of light reflection
ADH
-more ADH = collecting duct more permeable to water
-more ADH = more water reabsorbed by blood/ concentrated urine
All of the following functions are carried out in the renal tubules except
 
a)  reabsorption
 
b)  filtration
 
c)  formation of urine
 
d)  secretion
b
As a diffusion medium for distribution of ions, nutrients and waste products, what does the operation of all cells rely on?
water
Define Metabolic waste
waste that our body produces
Renal Capsule
tough fibrous layer surrounding the kidney and covered in a thick layer of perinephric adipose tissue.
proximal convoluted tubules
cells responsible for tubular secretion of compounds such as choline, creatinine, and penicillin
NAMEthis arises from the inerlobular artries that run through the renal cortex
afferent arterioles
What is urea?
-the most abundant organic waste-produced during the breakdown of amino acids
Glucose in urine. Tubules overwhelmed with glucose will be present in urine
What is a cholecystogram?
Study of the gallbladder
many nephrons connect to ___ ducts where urine is drained
collecting
urobilinogen
chemical test used to detect bile pigment in the urine- increased amounts seen in gallbladder and live disease
filtration membrane
this membrane lies between blood and interior of glomerular capsule
As the urinary bladder fills with urine, what sensory receptors are activated, signaling the urge to urinate?
stretch receptors
What is glomerular endothelium
fenestrated epithelium that allows solute rich virtually protein free filtrate to pass from the blood into the glomerular capsule.
Macula Densa
- located in the distal convoluted tubule- responds to decrease in sodium by releasing prostaglandins, which stimulate renin secretion
How much blood is filtered per day?
180 liters
NAMEthis makes a loop called the loop of Henle then whends and twists as the DCT before emptying into the collecting duct
PCT
What delivers blood to the glomerulus? From the glomerulus?
-afferent arteriole-efferent arteriole
What are renal columns?
Cortical stroma between renal pyramids
Which hormone leads to contraction of the gallbladder to release bile?
CCK (cholecystokinin)
cystectomy
excision of a cyst or bladder, usually the urinary bladder.
albumin (def)
def: a protein that helps to absorb water
A urine sample is tested in the lab and the results show that sodium ions, urea, glucose, creatinine are present, which of the following statements is true?
 
a)  The glomerulus must not be properly filtering because creatinine should not be present
 
b
major calyces structure
 
-how many tubes
divisions of renal pelvis
 
2-3 tubes
DCT and collecting duct reabsorption
hormonally regulatedCa2+ (PTH), water (ADH), Na+(aldosterone and ANP)
juxtamedullary nephrons follow with:
descending vasa recta and ascending vasa recta
NAMethe blood pressure here is about 95 mm Hg
the renal arteries
Tubular maximum
the maximum rate at which a substance can be actively reabsorbed; unique for each substance; determined by the number of active transport molecules and the rate at which they are able to transport the substance
What kind of capillaries are in the PCT, Loop of Henle, and DCT?
Peritubular capillaries
urines drained in the
renal papilla, renal pelvis, into ureter, bladder
What is tubular reabsorption
the movement of substances from renal tubules into peritubular capillaries
Function of the renal capsule
fibrous capsule that prevents kidney infection
What are (3) distinct regions of the kidney?
(1)cortex (2)medulla (3)pelvis
What are two benefits of countercurrent multiplication?
-efficiently reabsorbs solutes and water (before tubular fluid reaches DCT and collecting system)-establishes concentration gradient (permits passice reabsorption of water from tubular fluid in collecting system)
Intrinsic Control: Tubuloglomerular Feedback
Macula Densa cells cetect changes in GFRWhen GFR increases they release adenosine which leads to constriction of afferent arterioles
What is the name of the reflex that opens the internal urethral sphincter?
Micturition Reflex
make up of loop of Henle thin segments
simple squamous epithelium
The juxtaglomerular complex secretes what?
the enzyme, renin and the hormone, erythropoeitin
myogenic mechanism in renal autoregulation
* involves smooth muscle in arteriole walls* when blood pressure goes up, smooth muscle in the afferent arteriole is stretched* smooth muscle fibers respond to the stretch by contracting => vasoconstriction of the afferent arteriole* decrease vol. of blood going into the glomerulus, decreases glomerular blood hydrostatic pressure => FIXES BLOOD PRESSURE ISSUE
What is the renal capsule?
is a fibrous transparent capsule that prevents infections in surrounding regions from spreading the kidneys
Cells of the juxtaglomerular apparatus release renin in response to what stimuli?
-if blood pressure in the afferent arteriole decreases, renin secretion increases-if the Na+ conc. of the filtrate decreases as it passes by the macula densa cells, renin secretion increases
What is the hepatopancreatic ampulla?
(Ampulla of Vater) Enlarged chamber in the distal aspect of the common bile duct
What causes variation of composition of urine produced each day?
metabolic and hormonal events of the body
neural mechanism for filtrate formation
* sympathetic nerve fibers that go to smooth muscle fibers in the afferent and efferent arterioles* SNS fibers release norepinephrine when stimulated; norepinephrine binds to alpha one receptors on the smooth muscle fibers * there are far more alpha one receptors in the afferent than the efferent arteriole* AT REST, the nervous system does nothing to blood flow (renal autoregulation)* IN MODERATE SNS STIMULATION, equal vasoconstriction of afferent and efferent arterioles results in a slight reduction of filtrate formation
What is the perietal epithelium made of?
-a simple squamous epithelium, forms the outer wall-continuous with visceral epithelium
What is the renin - angiotensin cascade.
Renin cleaves angiotensinogen I --> angiotensin IAngiotensin I converted at alveolar endothelium --> angiotensin IIAngiotensin II signals aldosterone production at the zona glomerulosa of Adrenal Cortex.
Water loss is balance by gains such as
eating - drinking - metabolic generation
What can of molecules can pass through the renal tubule?
molecules smaller than 3 nm in diamter such as water, glucose, amino acids, and nitrogenous bases
what happens as filtrate passes up ascending limb?
these cells are impermeable to water, but permeable to solutes, so solutes are pumped out and filtrate becomes hypoosmotic to plasma
How does the filtrate compare to blood plasma which is a result of glomerular filtration?
-very similar but none (or very few) plasma proteins
modified cells in the ascending loop of Henle
* a region of the ascending limb of Henle touches the afferent arteriole, modified cells @ site* in the ascending limb => macula densa* in the afferent arteriole => modified smooth muscle cells called juxtaglomerular cells*** COMBINED, they form a unit called the juxtaglomerular apparatus (JGA) ====> FUNCTION: monitors BP; when BP decreases, JGA secretes renin
nocturia
night urination
polyuria 
much (excessive) urine
anuria
abscence of urine
involuntary micturation
urinary incontinence
Renin activates
angiotensin II
pyuria
pus in the urine
glycosuria
sugar in the urine
turbid
another name for cloudy
ADH affects the
collecting ducts
nephrogram
radiographic image of the kidney
Cystogram
radiographic image of the bladder
ureteroscopy
visual examination of the ureter
cystoscopy
visual examination of the bladder
ADH controls reabsorption of ___
water
Urology
study of the urinary system
study of the urinary system
Urology
urinometer
an instrument used to measure urine
cystoscope
instrument used for visual examination of the bladder
1,000 mL
maximum volume of the bladder
maximum volume of the bladder
1,000 mL
Kaliuresis refers to the renal excretion of
potassium
specific gravity of normal urine
1.010 - 1.025
Which is correct?
 
A) One kidney
B) One ureter
C) Two urinary bladders
D) One urethra
D) One urethra
The calyces receive urine from the
collecting ducts
The detrusor muscle is concerned with
 
A) urine formation
B) micturition
C) sodium reabsorption
D) potassium excretion
B) micturition
The juxtagolmerular apparatus is located near the
 
A) collecting duct
B) afferent arteriole
C) ureter
D) renal pelvis
B) afferent arteriole
processes of urine formation
glomerular filtration, tubular reabsorption, an tubular secretion.
the glomerulus is partially enclosed in a funnel-shaped structure called ____
Bowman's capsule
Which structure plays the most important role in reabsorption?
peritubular capillaries
This substance is filtered by the glomerulus and is excreted in the urine; there is minimal reabsorption
creatinine
uroloigist
a physician who studies and treats the urinary tract
Which structure filters 180 L of water per day?
glomeruli
Which blood vessels are primarily concerned with reabsorption?
 
A) renal artery
B) glomeruli
C) renal vein
D) peritubular capillaries
D) peritubular capillaries
Where does aldosterone exert its effects?
distal convoluted tubule
Which of the following is not "plumbing"?
 
A) glomeruli
B) ureters
C) urinary bladder
D) urethra
A) glomeruli
The renal cortex descends between the pyramids as the
renal columns
The kidneys are said to be ______ because they lie behind the peritoneum
retroperitoneal
function of ANP
increase kidney filtration and blood flow when blood volume increases.
Which of the following is absorbed across the walls of the collecting duct under the influence of ADH?
 
A) potassium
B) urea
C) water
D) albumin
C) water
The functioning unit of the kidney is the ___
 
Nephron
mechanisms that cause reabsorption (types of reabsorption)
active and passive transport
tubular secretion
process by which substances move from the blood into the urine
the process by which substances move from the urine to the blood
tubular reabsorption
process by which substances move from the blood into the urine
tubular secretion
hormone produced by the kidneys that stimulates the stem cells in red bone marrow
erythropoetin (EPO)
erythropoetin (EPO)
hormone produced by the kidneys that stimulates the stem cells in red bone marrow
Which condition is associated with proteinuria?
 
A) bladder infection
B) urethritis
C) glomerular disease
D) deficiency of ADH
C) glomerular disease
How does renal failure lead to anemia
lack of erythropoietin.
Which of the following is caused by prolonged hypotension?
 
A) oliguria
B) albuminuria
C) cystitis
D) glomerulonephritis
C) cystitis
The maximum amount of a substance that is reabsorbed back into the body from the kidney tubules
Renal threshold
glomerular filtrate contains what?
water, glucose, urea, creatinine and electrolytes
The renal capsule
 
A) lines the tubules
B) lines the urinary bladder
C) surrounds the kidneys
D) outlines the trigone
C) surrounds the kidneys
The proximal convoluted tubules extend to become the ___
decending limb of Henle
contains the loops of Henle and the collecting tubules
renal medulla
 Describe the renal pyramids (anatomy)
cone-shaped structures formed from the collecting tubules
the JGA secretes ___ into the bloodstream, activating the _____, which raises blood pressure
renin / renin-angiotensin-aldosterone (RAA) mechanism
major cause of incontinence as a result of aging
loss of muscle tone.
What is the approximate urine output for an adult per day?
1,000 - 1,500 mL/day
Which effect could lead to stress incontinence?
 
A) Reduced bladder capacity
B) Decreased urine formation
C) Reduced renal blood flow
D) Loss of muscle tone
D) muscle tone loss
Which is a common site for herniation in men?
 
A) Inguinal canal
B) Prostate gland
C) Cowper's glands
D) Scrotum
A) Inguinal canal
Which of the following hormones is not responsible for sodium and water regulation in the body?
 
A) Atrial natriuretic peptide
B) Aldosterone
C) ADH
D) Angiotensin II
D) Angiotensin II
 
 
the amount of filtrate formed in all glomeruli of both kidneys per minute
glomerular filtration rate (GFR)
Which of the following is found in the kidney?
 
A) detrusor muscle
B) trigone
C) nephron units
D) urethra
C) nephron units
Which of the following is most apt to cause polyuria
 
A) oversecretion of aldosterone
B) oversecretion of antidiuretic hormone
C) deficiency of ADH
D) activation of angiotensinogen
C) deficiency of ADH
urine is carried through the walls of the ureters by what method?
peristalsis (similar to the intestine)
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