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102 Cards in this Set
- Front
- Back
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What are the organs of the urinary system?
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kidneys, ureters, urinary bladder, and urethra
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What are kidney functions with regard to blood and metabolism?
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They regulate the volume and composition of blood, blood pressure, and some aspects of metabolism.
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Where are the kidneys located?
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They are retroperitoneal (behind the peritoneum) and attached to the posterior abdominal wall.
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What are the three layers of tissue surrounding the tissue?
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renal capsule
adipose capsule renal fascia |
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Internally, what does the anatomy of the kidneys consist of?
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Cortex, medulla, pyramids, papillae, columns, calyces, pelvis.
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What organs temporarily confine wastes, transport waste materials for disposal, and excrete excess of toxic substances and wastes, acting as body buffers?
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Blood, Liver, Kidneys, Lungs, Skin, Gastrointestinal Tract
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How does blood flow into the kidney?
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through the RENAL ARTERY and successively into segmental, interlobar arteries, AFFERENT ARTERIOLE, GLOMERULUS (CAPILLARY), EFFERRENT ARTERIOLES, peritubular capillaries and vasa recta, and interlobular, arcuate, interlobar, and segmental veins before flowing into the renal vein.
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What kind of innervation does the kidney have?
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Vasomotor nerves from the SYMPATHETIC branch of the autonomic nervous system supply kidney blood vessels and help regulate renal blood pressure.
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What is the functional unit of the kidneys?
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The nephron
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What is a nephron made up of?
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A renal corpuscle (glomerulus and glomerular or Bowman’s capsule) and a renal tubule
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What does a renal tubule consist of?
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onsists of a proximal convoluted tubule, loop of Henle, and distal convoluted tubule, which drains into a collecting duct (shared by several nephrons).
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What does a loop of Henle consist of?
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Consists of a descending limb of the loop of Henle and ascending limb of the loop of Henle.
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What is the filtering unit of a nephron?
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Endothelial-capsular membrane.
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What does the endothelial-capsular membrane consist of?
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glomerular endothelium, glomerular basement membrane, slit membranes between pedicels of podocytes.
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Where is a glomerulus of a CORTICAL NEPHRON?
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in the outer third of the cortex and a short loop that dips only in to the outer region of the medulla.
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Where does a JUSTAMEDULLARY NEPHRON have its glomerulus?
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Deep in the cortex, near the medulla and a long loop of Henle that stretches through the medulla almost to its renal papilla.
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What does the wall of the entire renal tubule consist of?
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Single layer of epithelial cells and a basement membrane.
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What does the juxtaglomerular apparatus (JGA) consist of?
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Juxtaglmerular cells of an afferent arteriole and the macula densa of a renal tubule.
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What is the function of the JGA (Juxtaglomerular apparatus)?
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It monitors blood pressure and secretes renin when blood pressure falls.
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Glomerular Filtration
What do Nephrons do with regard to blood volume and composition? |
They regulate blood volume and composition.
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Glomerular Filtration
How do the Nephrons form urine? |
They form it through glomerular filtration, tubular reabsorption, and tubular secretion.
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Are proteins and blood cells normally filtered by Bowman's Capsul?
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No, they are too big.
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Glomerular Filtration
Where do most substances in plasma enter and pass through? |
They enter the glomerulus (filter) and pass through into Bowman's Capsul.
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Glomerular Filtration
How many liters of fluid per day are filtered in glomerular filtration? |
180 liters of fluid per day
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Glomerular Filtration
Why is such a large amount of fluid filtered each day? |
Because the filter is porous and thin, the glomerular capillaries are long, and capillary blood pressure is high.
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Glomerular Filtration
Is capillary blood pressure high or low? |
It's high.
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Glomerular Filtration
Name a force that promotes glomerular filtration? |
GBHP, Glomerular Blood Hydrostatic Presure
(It's the one with the G in it) |
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Glomerular Filtration
Name two forces that oppose glomerular filtration. |
CHP - Capsular Hydrostatic Pressure
BCOP - Blood Colloid Osmotic Pressure (Both have Cs in them) |
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Glomerular Filtration
What is the formula for Net Filtration Pressure? |
NFP = GHBP - (CHP + BCOP)
Net Filtration Pressure is Glomerular Hydrostatic Blood Pressure minus the sum of Capsular Hydrostatic Pressure plus Blood Colloid Osmotic Pressure. |
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Glomerular Filtration
What is the approximate amount of Net Filtration Pressure? |
About 10 mm Hg.
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Glomerular Filtration
What is Filtration Fraction? |
The percentage of plasma entering the nephrons that becomes glomerular filtrate, normally 16-20 percent.
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Glomerular Filtration
WHAT IS THE NORMAL GFR? |
Normally about 125 ml per minute.
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Glomerular Filtration
What is GFR or Glomerular Filtration Rate? |
The amount of filtrate formed in both kidneys per minute.
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Glomerular Filtration
What are the factors upon which glomerular blood flow depends? |
Renal autoregulation, hormonal regulation, neutral regulation.
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Tubular Reabsorption
What does Tubular Reabsorption do? |
It reclaims materials from tubular fluid and returns them to the bloodstream.
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Tubular Reabsorption
What do reabsorbed substances include? |
These substances include water, glucose, amino acids, and ions like sodium, chloride, potassium, bicarbonate.
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Tubular Reabsorption
Transport Maximum (Tm) |
The maximum amount of a substance that can be reabsorbed per unit time.
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Tubular Reabsorption
How are sodium ions reabsorbed throughout the renal tubule? |
Primary Active Transport is the method of their reabsorption.
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Tubular Reabsorption
How is the reabsorption of water accomplished? |
Osmosis
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Tubular Reabsorption
How is the reabsorption of substances other than water accomplished? |
Passive Diffusion
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Tubular Reabsorption
Where and how are nutrients such as glucose and amino acids reabsorbed? |
In the Proximal Convoluted Tubule by Symporters (Secondary Active Transport).
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Tubular Reabsorption
Symporters |
Secondary Active Transport
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Tubular Reabsorption
What does the loop of Henle Reabsorb? |
About 30% of the filtered K+, 20% of the filtered Na+, 35 percent of the filtered Cl-, and 15% of the filtered water.
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Tubular Secretion
How are substances not needed by the body removed? |
removed from the blood and discharged into the urine by tubular secretion.
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Tubular Secretion
What substances are included in tubular secretion? |
ions (potassium, hydrogen, ammonium) and nitrogen containing wastes (urea, creatinine) and certain drugs.
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Tubular Secretion
How do the kidneys help maintain blood pH? |
By secreting H+ and increasing or decreasing HCO3- production.
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Production of Dilute Urine
In the absence of what hormone do the kidneys produce dilute urine? |
In the absence of ADH
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ADH
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Anti Diuretic Hormone or Vasopressin; Produced by the Neurohypophysis (posterior pituitary), prevents urine formation. Normal functions, reabsorb water/electrolytes from kidney. Dysfunctions +=edema. -=duabetes ubsuoudys (always "sip" always thirsty, always need to pee). Desmopressin DDAVP prescribed for bedwetting. Check receptors if ADH levels are normal and still problem.
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Production of Concentrated Urine
In the presence of what hormone do the kidneys produce concentrated urine? Why? |
ADH, because in its presence large amounts of water are reabsorbed from tubular fluid into interstitial fluid.
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Mechanism of Urine Concentration
Countercurrent Mechanism - what does it do? |
The countercurrent mechanism establishes an osmotic concentration gradient. This enables production of concentrated urine when ADH is present.
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Evaluation of kidney function
Renal Clearance |
The ability of the kidneys to clear (remove) a specific substance from blood.
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Evaluation of Kidney Function
In diagnostic testing, what is the clearance if inulin equal to? |
Clearance of inulin is equal to the glomerular filtration rate.
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Evaluation of kidney function
In diagnostic testing, what is the clearance of PAH equal to? |
The clearance of PAH () is equal to the renal plasma flow.
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Evaluation of Kidney Function
Inulin |
a polysaccharide, (C6H10O5)n, obtained from the roots of certain plants, esp. elecampane, dahlia, and Jerusalem artichoke, that undergoes hydrolysis to the dextrorotatory form of fructose: used chiefly as an ingredient in diabetic bread and as a reagent in diagnosing kidney function.
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Dialysis Therapy
Hemodialysis |
Filtering blood through a kidney machine that cleanses the blood of wastes and adds nutrients.
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Dialysis Theraphy
Portable Method of Dialysis |
CAPD, Continuous Ambulatory Peritoneal Dialysis
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Ureters - Anatomy
Where are the Ureters located? |
They are retroperitoneal
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Ureters - Physiology
Function of the Ureters |
Transport urine from the renal pelvis to the urinary bladder, primarily through peristalsis.
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Hormone
Angiotensin II - Major Stimuli that trigger release |
LOW BLOOD PRESSURE OR LOW BLOOD VOLUME STIMULATES RENIN-INDUCED PRODUCTION OF ANGIOTENSIN II.
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Hormone
Angiotensin II - Mechanism and site of Action |
Stimulates activity of Na+/H+ anti-porters in proximal tubule cells.
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Hormone
Angiotensin II - Effects |
Increases reabsorption of Na+, other solutes, and water, which INCREASES BLOOD VOLUME (BLOOD PRESSURE).
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Hormone
Aldosterone - Major stimuli that trigger release |
INCREASED ANTIOGENSIN II LEVEL and increased level of Plasma Potassium (K+) promote release of aldosterone by adrenal cortex.
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Hormone
Aldosterone - Mechanism and site of action |
Enhances activity and synthesis of sodium pumps in basolateral membrane and Na+ channels in apical membrane of principal cells in collecting duct.
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Hormone
Aldosterone - Effects |
Increases secretion of K+ and reabsorption of Na+, Cl-, and water which INCREASES BLOOD VOLUME (BLOOD PRESSURE)
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Hormone
ADH (Anti-Diuretic Hormone)/Vasopressin - Major stimuli that trigger release |
Increased osmolarity of extracdllular fluid or increased angiotensin II level promote release of ADH from the posterior pituitary gland
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Hormone
ADH (Anti-Diuretic Hormone)/Vasopressin - Mechanism and site of action |
Stimulates insertion of water-channel proteins, called aquaporin-2, into the apical membrands of principal cells.
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Hormone
ADH (Anti-Diuretic Hormone)/Vasopressin - Effects |
Increases facultative reabsorption of water, which decreases osmolarity of body fluids. Increase fluid retention that INCREASES BLOOD VOLUME (BLOOD PRESSURE)
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Hormone
ANP (Atrial Natriuretic Peptide) - Major stimuli that trigger release |
Stretching of atria of heart stimulates secretion of ANP.
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Hormone
ANP (Atrial Natriuretic Peptide) - Mechanism and site of action |
Suppresses reabsorption of Na+ and water in proximal tubule and collecting duct; also inhibits secretion of aldosterone and ADH.
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Hormone
ANP (Atrial Natriuretic Peptide) - Effects |
Increases excretion of Na+ in urine (natriuresis); increases urine output (diuresis) and thus DECREASES BLOOD VOLUME THAT DECREASES BLOOD PRESSURE.
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Urinary Bladder - Anatomy
Location and function |
Posterior to the pubic syhmphysis. Function is to store urine prior to micturition (urination).
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Urinary Bladder - Physiology
Incontinence |
lack of control over micturition (urination)
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Urinary Bladder - Physiology
Retention |
Failure to void urine completely or normally.
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Definition of Urethra
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A tube leading from the floor of the urinary bladder to the exterior.
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Function of Urethra
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In both sexes, it functions to discharge urine from the body. In males, it discharges semen as well.
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What are factors that affect urine volume?
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blood pressure, blood concentration, blood osmotic pressure, temperature, diuretics, emotions.
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What are the physical charicterists of urine evaluated in a urinalysis?
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COLOR, ODOR, TURBIDITY (CLOUDINESS) PH, SPECIFIC GRAVITY
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What is the chemical composition of normal urine?
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95% water, 5% solutes
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What are the components of the solutes (5%) of normal urine?
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urea, creatinine, uric acid, hippuric acid, indican, ketone bodies, salts, ions
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Is urine normally acidic or base? Why?
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Acidic. Due to the constituents present in the solutes of normal urine (urea, creatinine, uric acid, hippuric acid, indican, ketone bodies, salts, ions)
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What would be some abnormal constituents of urine (diagnosed through urinalisis) be? NOTE: There should be -0- of these in the urine
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albumin (protein) glucose (sutar) erethrocytes, leukocytes, ketone bodies, bilirubin, uribilinogen, casts, microbes.
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Casts
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formations of white blood cells, called casts, shaped like tubes in the kidneys. abnormal finding in urinalysis
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After what age does kidney function decrease?
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40
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What are common kidney problems related to aging?
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incontinence, UTI, prostate disorders, renal calculi (stones)
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What do the kidneys develop from?
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Intermediate mesoderm.
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In what order do kidneys develop?
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pronephros, mesonephros, metanephros. Only metanephros remains and develops into a functional kidney.
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Homeostatic Imbalance
UTI - Urinary Tract Infection |
infection of part of urinary system or presence or large numbers of microbes in urine. More common in females due to short urethra.
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Homeostatic Imbalance
Acute Glomerulonephritis (Bright's Disease) |
Inflammation of kidney that involves glomeruli. Allergic reaction to toxins of strep bacteria infecting throat or skin. Strep in blood causes heart/kidney problems.
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Homeostatic Imbalance
Nephrotic Syndrome |
proteinuria (protein, primarily albumin in urine). Edema with hypertension, hyperlipidemia (cholesterol, phospholipids, triglycerides). Due to increased permeability of endothelial capsular membrane, which permits proteins to escape from blood into urine.
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Homeostatic Imbalance
Renal Failure |
decrease/cessation of glomerular filtration with decrease or leack of urinary output. ARF (acute renal failure) - abruptly stop entirely. CRF (Chronic) progressive/irreversable decline in GFR (Glomerular Filtration Rate)
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Homeostatic Imbalance
Polycystic Kidney Disease - PKD |
most common inherited disorder of kidneys. Familial/hereditary.
break in chrom 16, affects gene PKD1. Tubules riddled w/cysts, increase in size, squeeze out normal tissue. progressive renal impairment, end-stage renal failure. |
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Homeostatic Imbalance
Diabetes Insipidus - DI |
Think "Sip", always thirsty always pee. Excretion of large volume (5-20 liters/day) of very dilute urine. Defect in ADH production (Central DI) or an insensitivity of principal cells in renal collecting ducts to stimulation of ADH (nephrogenic DI).
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What do the characteristics of the Loop of Henle allow it to act as?
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It acts as a COUNTERCURRENT MULTIPLIER.
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What will disruption of any of the characteristics of the loop of Henle cause?
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Disruption of any of characteristics Loop of Henle diminishes osmolarity of medullary interstitium & decrease ability of kidney to form concentrated urine.
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Loop of Henle
Countercurrent flow |
Overrides diffusion of salt, continually recaptures salt and returns it to deep medullary tissue.
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Renin
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A proteinase (Enzyme) of high specificity that is released by the kidney and acts to raise blood pressure by activating angiotensin.
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Loop of Henle
Descending Limb |
PERMEABLE to water. Water diffuses to the interstitium and tubular fluid osmolarity INCREASES reaching a maxiumum at the tip of the Loop of Henle.
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Loop of Henle
Ascending Limb |
IMPERMEABLE to water. Pumps NaCl from tubule to interetitium fluid osmolarity decreases along ascending loop and leaves loop as HYPOTONIC Fluid.
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Loop of Henle
Speed of Flow |
This is also a characteristic of flow through the vasa recta. Anything that increases flow will decrease the ability of the system to maintain a high medullary osmolarity and reduce the ability of the kidney to form a concentrated urine.
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Collecting Duct without ADH
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Without ADH, completely IMPERMEABLE to water and the DILUTE fluid leaving the LOOP OF HENLE becomes HYPOTONIC urine.
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Evaluation of Kidney Function
PAH |
For instance, para aminohippuric acid (PAH) is almost completely excreted in the final urine, and thus almost none is found in the venous return (Pv ~0). Therefore, the extraction ration of PAH ~1. This is why PAH is used in PAH clearance to estimate renal plasma flow.
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ADH and the permeability to water
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ADH increases the permeability to water and allows the passive reabsorption of water. The osmolarity of collecting duct fluid can increase to, but never exceed, the osmolarity in the interstitium at the tip of the medulla.
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