Urinary System Flashcards

1
Q

Functions of the Urinary system

A

Balances concencetrations of (Ca, Na, K, Cl, H, etc)
Adjustihg pH
Eliminates waste (drugs, toxins)
Controls blood pressure (volume of blood)

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2
Q

What are the kidneys supported by?

A

Overlaying peritoneum
Contact with adjacent organs
Supporting connective tissues

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3
Q

Three layers of connective tissue on the kidneys

A
  1. firbous capsule
  2. perinephric fat
  3. renal fascia
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4
Q

Minor calyx serve how many lobes?

A

1

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5
Q

Major calyx serve how many lobes?

A

4-5

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6
Q

What are nephrons innervated by?

A

renal nerves (sympathetic: adjusts blood flow and renin release)

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7
Q

WHat type of nephrons are there and what time

A
Cortical nephrons (85%)
	Juxtamedullary nephrons (15%)
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8
Q

What are corticol nephrons used for?

A

regulatory functions

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9
Q

What are juxtamedullary nephrons used for?

A

Water conservation (concentrated urine)

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10
Q

What does the renal corpuscle contain?

2

A
glomerular capsule (bowmans)
capillary network
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11
Q

The main function of the proximal convuluted tubule?

A

Reabsorption of nutrients from the filtrate (tubular fluid)

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12
Q

What are the main functions of the nephron loop?

2

A

Establishes osmotic gradient in renal medulla

Promotes water reabsorption

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13
Q

What is the thin limb of the nephron loop made of?

A

simple squamous

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14
Q

What is the thick limb of the nephron loop made of?

A

simple cuboidal

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15
Q

What is the main funciton of the distal convoluted tubule?

2

A

Adjustments to composition of tubular fluid

Secretion and reabsorption

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16
Q

What is the main function of the collecting duct?

A

final adjustments by passing through osmotic gradient in renal medulla

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17
Q

What are intercalated discs?

A

cuboidal epithelium with microvilli

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18
Q

What are the function of intercalated discs in the collecting duct?

A

Secretion/reabsorption of H and bicarbonate (important for pH balance

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19
Q

What are principal cells in the collecting duct?

A

Reabsorb water and secrete potassium ions

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20
Q

Describe the flow of blood through the kidney

11

A
Renal artery
Segmental Artery
Interlobar arterties
Arcuate arteries
Cortical radiate arteries
Afferent arterioles

Glomerulus

Cortical radiate veins
Arcuate veins
Interlobar Veins
Renal vein

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21
Q

What is urea?

A

Breakdown of amino acids in the liver

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22
Q

Where is the waste product, creatine, produced?

A

Breakdown of creatine phosphate in skeletal muscles (gives P to ADP, anaerobic)

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23
Q

What is uric acid?

A

Recycling of nitrogenous bases of RNA

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24
Q

Kidney function requires 3 processes. What are they?

A

Filtration
Reabsorption
Secretion

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25
Q

Describe filtration

A

Blood pressure in glomerular capillary pushes water and solutes into capsular space

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26
Q

Describe reabsorption

A

transport of water and solutes from tubular fluid across membrane to the peritubular fluid

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27
Q

Desribe secretion

A

Transport of solutes from peritubular fluid to tubular fluid

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28
Q

Where does the majority of reabsorption occur in the kidney?

A

PCT

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29
Q

Where does the the rest of the reabsorption happen?

A

Nephron loop
DCT
collecting ducts and they are all in the renal medulla

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30
Q

Where are peritubular capillaries found?

A

renal cortex

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31
Q

Where is the vasa recta found?

A

renal medulla

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32
Q

What does the juxtaglomerular complex secrete and what does that stimulate in our nephron?

A

secretes renin which controls blood pressure

it tells our nephron to let out more water

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33
Q

When is renin secreted?

A

when glomerular blood pressure decreases

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34
Q

Where does filtration happen in the glomerular capsule?

A

podocytes in the cell have pedicle and in between the pedicles are filtration slits. That is where filtration happens

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35
Q

What kind of capillaries are in the glomerular capsule?

A

fenestrated caps

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36
Q

What is the glomerular hydrostatic pressure?

Generally is this pressure high or low and why?

A

pressure in the glomerular capillaries

This pressure is generally high because its an artery moving from a large capillary to a smaller one

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37
Q

What is the BCOP and what is its goal?

A

Pressure that draws water out of the filtrate and back into the plasma.
It opposes filtration

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38
Q

What is capsular hydrostatic pressure?

A

Opposes GHP

Water and solutes out of filtrate and into plasma

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39
Q

What is the usual level of capsular colloid osmtoic pressure?

A

usually zero

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40
Q

As long as NFP is above zero what will occur?

A

Water will move out of the plasma and into the capsular space/filtrate

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41
Q

What is regulation of glomerular filtration rate (GFR)?

A

Amount of filtrate kidneys produce each minute

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42
Q

What will occur if there is a decrease in GFR? (decrease in filtrate and decrease in urine production)
AKA describe autoregulation
5

A

1a. Dilation of afferent aterioles, 1b. contraction of mesangial cells, 1c. constriction of efferent arterioles
2. Increase in glomerular blood pressure
3. Back to normal GFR

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43
Q

If autoregulation doesnt work what happens? list the steps

A

Central Regulation occurs

  1. Juxtaglomerular complex increases production of renin
  2. Renin triggers release of angiotensin II which triggers 3 things: Contriction of efferent arterioles, aldosterone secretion, neural responses
  3. These increase blood volume and blood pressure and result in increased glomerular pressure and normal GFR
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44
Q

In central regulation of GFR what does aldosterone secretion cause?
4

A

Increases Na retention
fluid consumption
Fluid retention
Constriciton of venous reservoirs

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45
Q

In central regulation of GFR what does angiotension in neural respones trigger?
3 actions that lead to 3 actions

A
  1. Increased stimulation of thirst centers
  2. Increased ADH production
  3. Increased sympathetic motor tone
  4. which all together increase constriciton of veins
  5. increased cardiac output
  6. stimulate peripheral vasoconstriction
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46
Q

In the PCT where does solute increase and decrease?

Where does water flow?

A

[Solute] decreases in tubular fluid
[Solute] increases in peritubular fluid and adjacent capillaries
Osmosis pulls water out of tubular fluid

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47
Q

What two things happen in the DCT?

A

Reabsorption AND secretion

15-20% of initial filtrate reaches the DCT

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48
Q

What two pumps are found in the DCT?

A

Na/K pump and Na/H pump

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49
Q

What is the Na/K pump stimulated by in the DCT?

What does this promote?

A

Aldosterone

Promotes water absorption into capillaries, increase in blood pressure and increase in blood volume

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50
Q

If the pH of blood gets too acidic what can be done in the DCT?

A

H ions in the blood can be exhanged for Na ions in the tubular space

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51
Q

How does the DCT play a role in drug/toxin removal?

A

The DCT has carrier proteins that transport drugs and toxins into the tubular fluid to be excreted in the urine

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52
Q

What is the descending limb permeable and impermeable to?

A

Permeable to water, impermeable to solutes

53
Q

What is the ascending limb permeable and impermeable to?

A

Impermeable to water, selectively permeable to solutes

54
Q

What is in between the descending and ascending limbs of the neprhon loop?

A

peritubular fluid

55
Q

What is countercurrent multiplication?

A
  • Fluids moving in opposite directions

- Effect of the exchange increases as movement of fluid continues

56
Q

What does countercurrent mulitiplication create?

And what does this enable the kidney to do?

A

osmotic gradient in the renal medulla

Make highly concentrated urine

57
Q

What is going out of the ascending limb of the nephron loop?

Which gives us what kind of concentrations?

A

pumping out solutes

High solute concentrations on the outside of the limb/nephron/tubular space

58
Q

What is going out of the descending limb in reaction to the solutes going out of the ascending limb?

A

Water is moving out of the descending limb since the peritubular space is now more concentrated because of solutes leavg the ascending tube

59
Q

Where in the nephron loop are solute concetrations high?

2

A

increase going down the descending limb and high at the bottom and connection point and the start of the ascending limb
Also increases while moving down the collecting duct and is high at the deepest portion in the renal medulla

60
Q

What is the purpose of ADH in the DCT?

A

Allows for more aquaporins to be embedded into the membrane wall of the nephron which allows more water to be absorrbed into the peritubular fluid/blood stream.

61
Q

How do aldosterone pumps increase the amount of water beig reabsorbed in the blood stream?

A

Aldosterone pumps Na out of the nephron and into the blood stream and K back into the nephron. This stimulates ADH to be secreted and stimulates more aquaporins to attach and let water out of the nephron to follow Na and be reabsorbed

62
Q

What structures are part of the obligatory water reabsorption?

A

PCT and descending loop

63
Q

What structures are part of the facultative water reabsorption?

A

DCT and collecting duct

64
Q

If ADH is not present what would happen?

A

Large volume of dilute urine

65
Q

With a lot of ADH?

A

small volumes of concetrated urine

66
Q

What signals the start of urination reflexes?

A

distortion of stretch receptors

67
Q

What do the strecth receptors signal?

A

Afferent fibers in pelvis to the sacral spinal cord this stimulates two different pathways: a local pathway and a central pathway

68
Q

What does the local pathway stimulate?

A

parasympathetic pregonaglioic motor fibers carry motor commands to the pelvis and postganglioinic stimulate detruor muscle contraction

69
Q

What does the central pathway stimulate?

A

Stimulates an interneuron to go to the thalamus then to the cerebral cortex.
Then if comfortable the person will voluntary relax their urethral sphincter

70
Q

As you age you get decreases in kidney mass, blood flow, GFR. What are the implications of this?
3

A

Decrease in urine output = build up of toxins, increase of urinary tract infection

71
Q

As you age you get reduced bladder elasticity, muscle tone, capacity? What are the implications of this?
3

A

Incontinence, frequency, might not realize you need to pee, issues with drugs, reduced secretion of different medications (drugs stay in system longer)

72
Q

As you age you get increased post-void residual, nocturnal urine production. What are the implicaitons of this?
2

A

Have some urine left in bladder, increased urgency, night time urgency

73
Q

In males the prostate enlarges as you age? What are the implications of this?

A

Urinate more frequently, physically larger and pushing on the bladder

74
Q

In renal failure, kidneys cannot perform the excretory functions needed to maintain homeostasis
Impairs all systems in the body resulting in:
6

A
  1. Blood pressure issues
  2. Filtration (fluid balance, pH)
  3. Muscle contractions and metabolism
  4. If youre not bringing glucose back in you have nervous system problems. Sleepiness, seizures, coma.
  5. Decrease in urine production
  6. Anemia-EPO drops in case of renal failure
75
Q

How would someone manage chronic renal failure?

What specifically would you manage 3 and what would this cause?

A
  1. Management: restricted water, salt, and protein intake 2.Minimize:
    Volume of urine produced
    Amount of nitrogenous waste generated
76
Q

Acidosis can be countered by what?

A

ingesting bicarbonate ions

77
Q

What is acute renal failure and what would cause it?

5

A

Sudden slowing or stopping of filtration caused by:
Exposure to toxic drugs, renal ischemia, urinary obstruction, or trauma
Allergic response to antibiotics or anesthetics in sensitized individuals

78
Q

How does dialysis remove waste?

A

brings blood into dialysis machine which has an artificial selectively permeable barrier. These waste product will cross the barrier and blood will be cleaned

79
Q

Why do dialysis patients often receive synthetic EPO (Epogen or Procrit)?

A

Kidneys aren’t making it anymore so they need more hormones stimulation to make more

80
Q

Blood pressure is required for which kidney function?

A

filtration

81
Q

Blood colloid osmotic pressure tends to draw water out of the nephron into the capillary. Why?

A

Draws water out nephron (capsular fluid) into capillaries. Hydrostatic pressure regulates it. Blood and capillaries have a higher solute concentration

82
Q

What effect does angiotensin II have on the nephron?

A

Increase blood pressure and glomerular pressure through the actions of renin(senses low glomerular filtration rate) Aldosterone actually has the effect and opens the channels in the nephron

83
Q

What about on the CNS?

A

Increases stimulation of thirst centers, production of ADH, increased sympathetic motor tone increasing blood volume/pressure and GF

84
Q

What effect would increased amounts of aldosterone have on potassium ion concentration in the urine?

A

Increase k in the urine, increase Na in blood works thorugh aldosterone

85
Q

What effect would a decrease in the sodium ion concentration of filtrate have on the pH of the tubular fluid?

A

Would make it more basic because you don’t have any Na to swap for H. Making overall blood pH acidic and tubular fluid basic

86
Q

An increase in sodium and chlorine ions in the peritubular fluid affects the thin descending limb in what way?

A

More water out of thin limb. Urine would be more dilute

87
Q

What effect does an increase in ADH levels have on DCT?

A

Increase water reabsorption and increased pumping of Na out of the nephron. More concentrated urine

88
Q

How is the concentration gradient in the renal medulla maintained?

A

Na/k and Na/H pumps

89
Q

What factors affect ECF?
2 in
4 out

A
In:
1. water absorbed across digestive epithelium
2. Metabolic water from the ICF
Out:
1. Water vapor lost at skin adn lungs
2. Water lost in feces
3. Water secreted by sweat glands
4. water lost in urine
90
Q

If ECF loses water what occurs?

What is this called?

A

ECF volume decreases
and becomes hypertonic compared to the ICF. Water from ICF goes into ECF. volume loss in ICF.

Recall of fluids

91
Q

Where does most ion absorption happen?

A

small intestine and colon

92
Q

Where are your ion reserve at?

A

primarily in skeletal bone

93
Q

Where does most ion excretion occur?

A

mostly kidneys

sweat glands secondary

94
Q

What does homeostatsis depend on?

A

Sodium levels

ECF volume

95
Q

What is hyponatremia and hypernatremia?

A

Hyponatremia (Na=salt): over hydration, not enough salt in diet
Hypernatremia: dehydration

96
Q

When sodium blood levels are high what happens?

3

A
  1. Osmoreceptors in hypothalamus are stimulated
  2. Increase in ADH
    - restricts water loss, stimulates thirst
  3. Recall of fluids. water in ICF goes to ECF
97
Q

When sodium blood levels are low?

A
  1. osmoreceptors in hypothalamus are inhibited
  2. ADH secretion decreases
    - osmotic gradient drops, thirst is suppressed, gotta pee
  3. Water loss reduces ECF volume
98
Q

What happens when blood pressure/volume increases?

A

1.High ECF/Na gain
Natriuretic peptides are released which
2. increases sodiuem loss in urine, increase water loss
3. decreases thirst, inhibits ADH, aldosterone, epi, and norepi
4. Decrease in blood volume and pressure

99
Q

What happens when blood pressure and volume decrease?

A
  1. Low ECF/Na loss
  2. Endocrine responses:
    - increase renin, and angiotensin, aldosterone
    - increase ADH release
  3. Combined Effects:
    - increase urinary Na retention
    - decrease water loss
    - Increase thirst>water intake
100
Q

Where is most of the potassium content in our body?

A

ICF

101
Q

How is potassium regulated in the kidneys?

A

In the DCT and the collectiing ducts through aldosterone regulated exchange pumps. Takes it from ECF to tubular fluid

102
Q

What can disrupt potassium levels in the nephron?

A

If the pH falls in the ECF then we start pumping H into the tubular fluid and Na out but then K is stuck in the extracellualr fluid

103
Q

What could cause hypokalemia?

A

Diuretics

aldosteronism

104
Q

What coudl cause hyperkalemia?

A

Chronic low pH
Kidney failure
Certain drugs

105
Q

Classes of Acids

A

Fixed acids
Organic acids
Volatile acids

106
Q

What are fixed acids?

A

Do not leave solution

Stay in fluids until eliminated by kidneys

107
Q

What are organic acids?

A

Key players or byproducts of metabolism

-dont usually accumulate

108
Q

What are volatile acids?

A

Can leave the lungs as a gas

109
Q

When pH of blood goes below 7.35 what exists and what is the physical state?

A

acidemia exists. The
physiological state that results is
called acidosis.

110
Q

When the pH of blood goes above 7.45 what exists and what is the physicalogical state?

A

alkalemia exists.
The physiological state that
results is called alkalosis.

111
Q

What happens during severe acidosis?

3

A

CNS function deteriorates (comatose)
cardiac contractions become weak and irregular (heart failure)
dramatic drop in blood pressure (circulatory collapse)

112
Q

If CO2 increases how does that affect the pH?

A

pH goes down

113
Q

What buffer systems exist in the ICF?

A

Phophate buffer systems and protein buffer systems

114
Q

What buffer systems exist in the ECF?

A

Carbonic Acid-Bicarbonate buffer systems and protein buffer systems

115
Q

What buffers the H atoms in a red blood cell?

A

hemoglobin

116
Q

What binds the H in the amino acid to in protein buffer?

A

The R group

the side chain

117
Q

In a carbonic acid/bicarbonate buffer system what makes the solution more acidic and what makes the solution more basic?

A

Creation of carbonic acid from H+ ion and a bicarbonate = CO2 and water which is exspelled by the lungs

Can be a reversible reaction and H+ can dissociate creating a more acidic environment

118
Q

Metabolic acid base disorder?

3

A

Production or loss of excessive amounts of fixed or organic acids

Corrected by carbonic-acid bicarbonate system

Metabolic acidosis or alkalosis

119
Q

Respiratory acid base disorders?

3

A

Imbalance between CO2 production and elimination

Corrected by respiration changes

Respiratory acidosis or alkalosis

120
Q

Kidney response to acidosis?

A

secreting H+ ions
Removing CO2
reabsorbing bicarbonate

121
Q

Respiratory response to acidosis?

3

A

Increased respiratory rate
decreases partial pressure of CO2
carbonic acid converted to water

122
Q

Kidney responses to alkalosis?

A

conserving H+ ions and secreting bicarbonate

123
Q

Respiratory response to alkalosis?

3

A

Decrease respiratory rate
elevates partial pressure of CO2
Co2 turned into carbonic acid

124
Q

Hypoventilation causes increased partial pressure of CO2. What does this stimulate?
3

What does this result in?

A

Increase respiratory rate
Renal comensation- H+ secreted and bicarbonate generated
Other Buffer systems accept H+

Decrease in partial pressure of CO2
Decrease of H+
Increase of bicarbonate

125
Q

Hyperventilation causes decreased partial pressure of CO2. What does this stimulate?
3

What does this result in?

A

Decreased respiratory rate
renal compensation- H+ generated and bicarbonate secreted
Other buffer system release H+

Increase in partial pressure of CO2
Increase in H+
Decrease in bicarbonate

126
Q

If the kidneys are conserving HCO3- and eliminating H+ in acidic urine, which is occurring: metabolic alkalosis or metabolic acidosis?

A

acidosis

127
Q

How would a decrease in the pH of body fluids affect the respiratory rate?

A

increased

128
Q

Most of the buffering capacity of proteins is provided by which protein component?

A

R group or side chain

129
Q

Name three endocrine responses to decreased blood volume and pressure.

A

Renin/Angiotensin/Aldosterone, ADH, EPO