Anatomy Ch 26

Front 1

Kidney main functions are
– (i) ______; removal of metabolic
wastes
– (ii) Water/ion balance; ________
Other functions attributed to the kidneys
are:
– regulating RBC production through
_____
– regulation general (systemic) blood
pressure through _____
– ______ balance in the body fluid

Back 1

excretion
osmoregulation
EPO
rennin
acid - base

Front 2

The two kidneys are ______ and are
located close to the dorsal body wall,
partly protected by the floating ribs.
In a vertical section, the kidney shows:
(a)______- dense area packed with
nephrons,
(b) _______ with pyramids
(c) an inner space called ______
where urine collects before being drained
into the ureter and urinary bladder.

Back 2

retroperitoneal (behind the peritoneum)
cortex
middle medulla
renal pelvis

Front 3

Produces ______ to help
regulate blood pressure
and ______ to
stimulate red blood cell
production

Back 3

renin
erythropoietin

Front 4

a _______, which is a transparent, but tough
connective tissue wrapping of the kidney

Back 4

renal capsule

Front 5

a thick layer of fat,
forming an _______
which cushions the kidney
and keeps it in position

Back 5

adipose capsule

Front 6

an outer layer of ______ that connects the
blood vessels and adrenal
gland to the kidney

Back 6

renal
fascia

Front 7

A sudden decrease in the
adipose layer, as during
starvation, illness or
crash diet program, causes
kidneys to “drop” from
normal position, kinking
the ureters; condition is
known as ______ of
kidneys; it leads to _______ (fluid back-up in the

Back 7

Ptosis
Hydronephrosis

Front 8

Each kidney has about a million
______ which are the structural
and functional units of the kidney
functions.

Back 8

Nephrons

Front 9

Nephrons carry out kidney function in
three sequential steps:

Back 9

1. glomerular filtration
2. tubular reabsorption
3. tubular secretion

Front 10

What structure is made up of?
Bowman’s capsule
Glomerlus
(capillary network)
Capsular space

Back 10

Renal corpuscle:

Front 11

What structure is made up of?
proximal convoluted
tubule (DCT); has
microvilli; in cortex
distal convoluted
tubule (PCT)
Loop of Henle;
medulla
(U-shaped tube)

Back 11

Renal tubule:

Front 12

Filtration
produces a
protein-free
solutions called
the ______
which is similar
to blood
plasma.

Back 12

filtrate

Front 13

Epithelium of glomerulus consists
of large cells, ______, that wrap
around the special-ized dense layer
of glomerulus capillaries w/ complex
processes or “feet”, called pedicels.

Back 13

podocytes

Front 14

Materials filtering out of blood must
be small enough to pass through
filtration slits between _____

Back 14

pedicels

Front 15

Capillaries are fenestrated & are
controlled by ______
(supporting cells) with actin-like
filaments enabling them to contract
controlling capillary diameter
(angiostensin II, vasopressin, &
histamine have been shown to affect
mesangial cell contraction

Back 15

Mesangial cells

Front 16

The fenestrated endothelium, dense
layer, & filtration slits form the
______. Blood pressure
forces water & small solutes (wastes
excess ions, glucose, fa, aa, vit) into
capsular space; no large proteins

Back 16

filtration membrane

Front 17

Two kinds of Nephrons:
1)Cortex
2) Juxtamedullary

Back 17

1) within cortex; nephron loop is short delivering blood to capillaries surrounding tubule called perit
2) long nephron loop extending into medulla surrrounded by vasa recta: long straight capillaries which enable kidneys to produce concentrated urine

Front 18

The Collecting System:
In addition to transporting
tubular fluid, the collecting
system adjusts the flluid’s
composition & determines what?

Back 18

the final osmotic
concentration & volume of
urine

Front 19

The Collecting System:
In addition to transporting
tubular fluid, the collecting
system adjusts the flluid’s
composition & determines what?

Back 19

the final osmotic
concentration & volume of
urine

Front 20

1._____: this is a ______ of glomerular
blood by which a colorless, dilute solution called filtrate comes
out of the glomerulus. It is a non-selective, passive process by
which water and soluble molecules in blood ______ come out of
glomerular blood along their pressure gradient. The filtrate then
enters the renal tubule through the filtration membrane of the
_______. The filtrate is a dilute solution of both “useful”
and “useless” molecules and ions.

Back 20

Glomerular filtration
pressure filtration
plasma
Bowman’s capsule

Front 21

______ depends upon glomerular blood pressure which
at rest is 55 mm Hg; this is much higher than the blood pressure
in the blood capillaries in the rest of the body. Though the changes
in the glomerular blood pressure can change the rate at which
filtrate is formed in the Bowman’s capsule, kidneys tend to
maintain a steady Glomerular filtration rate (GFR), which is
___liters per day or ___ liters per hour or ___ ml/ minute.

Back 21

Glomerular fitration
180
7.5
125

Front 22

GFR is directly proportional to ______
which is ______. (NFP is the difference between the glomerula
blood pressure and the forces that act against it).
NFP = Glomerular blood pressure (55 mm Hg) - (blood osmotic
pressure (30 mm Hg) + capsular hydrostatic pressure (15 mm Hg)

Back 22

net filtration pressure (NFP)
10 mm Hg

Front 23

If GFR is too _____, then the filtrate will pass
through the renal tubule too quickly, giving
little time for ______ of useful
molecules from the filtrate; if GFR is too
____, then the filtrate will remain in the
renal tubule too long, and useless molecules
may get back into the peritubular capillary
blood, and urine is likely to become more
and more concentrated; very little or no
urine will then be produced

Back 23

high
reabsorption
slow

Front 24

In order to
prevent either of the above events from
occurring, kidneys employ two regulatory
mechanisms:

Back 24

(i) renal autoregulation
(ii) rennin-angiotensin mechanism

Front 25

______: There are sensory
cells (chemoreceptors called ______) in the wall of renal tubules that can
detect changes in GFR. If GFR is too high,
then these sensory cells cause the
______ thereby
reducing blood supply to glomerulus; GFR is
then brought down to normal.

Back 25

Renal autoregulation
macula densa cells
constriction of afferent arterioles

Front 26

If GFR is too
low, then the afferent ______, thereby increasing blood supply to
glomerulus; GFR is then raised to the
optimum. Since the regulation involves the
smooth muscles of the afferent arterioles, it
is also known as the ______
of GFR.

Back 26

arterioles are made
to dilate
myogenic regulation

Front 27

______: Renin is an enzyme produced by
the renal tubules in the kidney when the
systemic blood pressure decreases and blood
flow to the glomeruli declines, thereby
reducing GFR.

Back 27

Renin-angiotensin mechanism of GFR
regulation

Front 28

Renin activates a powerful
vasoconstrictor called angiotensin.
Activated angiotensin causes _______, thereby increasing
systemic blood pressure; more blood reaches
the glomeruli and GFR goes up to the normal.

Back 28

vasoconstriction
of peripheral arterioles

Front 29

Activated angiotensin also causes the release
of ______ from adrenal cortex,
increasing sodium ion absorption; increased
sodium content increases water content,
increasing blood volume and systemic blood
pressure. Under stress, sympathetic nervous
system takes over the regulation of GFR.

Back 29

aldosterone

Front 30

______: This is the reclamation process by which
“useful molecules and ions” from the filtrate are selectively taken back
(reabsorbed) into the peritubular capillary bed through the wall of the
renal tubule. The “useless molecules and ions” are left behind in the
tubule. As the filtrate moves down the renal tubule, more and more
water is reabsorbed & the concentration of the filtrate inc considerably
by the time it reaches the collecting duct. The concentrated filtrate
that is in the collecting duct is called the _____.

Back 30

Tubular reabsorption
urine

Front 31

_______ – this is the
most active part of renal tubule in reabsorption.

Back 31

Reabsorption at PCT (proximal convoluted tubule)

Front 32

_______: more water is
reabsorbed

Back 32

reabsorption at the descending loop of Henle

Front 33

_______: More
sodium and chlorine ions are reabsorbed. Henle’s loop
is an adaptation for water conservation, and is seen in
all mammalian kidneys. The loop regulates urine
concentration

Back 33

reabsorption at the ascending loop of Henle

Front 34

_______(distal convoluted tubule)
here reabsorption is correlated to the needs of the
body, and is influenced by various hormones.

Back 34

reabsorption at the DCT

Front 35

When
water content decreases in the body, ______ causes more water reabsorption (conserve)
from DCT by making the collecting duct more
permeable to water

Back 35

ADH (antidiuretic
hormone)

Front 36

When sodium content decreases,
______conserves Na+ by increasing reabsorption
from the filtrate by DCT; PTH may cause more
reabsorption of Ca+ from the filtrate.

Back 36

aldosterone

Front 37

This is the process
by which some ions and large molecules
such as penicillin that are not filtered out by
the glomerulus are actively removed from
the peritubular capillary blood into the
filtrate (this is the opposite of tubular
reabsorption).

Back 37

Tubular secretion:

Front 38

is the end-product of the combined
activity of tubular reabsorption and tubular
secretion by the renal tubule?

Back 38

urine

Front 39

pressure _____,
decreases blood pressure

Back 39

diuresis

Front 40

Regulation of Sodium Balance: Aldosterone

Back 40

When aldosterone levels are high, all
remaining Na+ is actively reabsorbed
Water follows sodium if tubule
permeability has been increased with
ADH

Front 41

Atrial Natriuretic Peptide (ANP)

Back 41

Reduces blood pressure and
blood volume by inhibiting:
– Events that promote
vasoconstriction

Front 42

Influence and Regulation of
ADH

Back 42

Water reabsorption in
collecting ducts is proportional
to ADH release
Low ADH levels produce dilute
urine and reduced volume of
body fluids
High ADH levels produce
concentrated urine
Hypothalamic osmoreceptors
trigger or inhibit ADH release
Factors that specifically
trigger ADH release include
prolonged fever; excessive
sweating, vomiting, or
diarrhea; severe blood loss;
and traumatic burns

Front 43

Main metabolic waste is _____ which is formed in the liver by
_____; kidney also removes uric acid, creatinine and
traces of ammonia from blood. The concentrated solution sent
out of the body by the kidney is called _____ and it contains water,
urea, uric acid, and other metabolic wastes. The compositioin of
urine reflects the filtration, absorption & secretion activities of the
nephrons

Back 43

urea
deamination
urine

Front 44

Lining of urinary
bladders have folds
called _____ for
expansion and the
neck of the bladder
contains an _____ for voluntary
control of ______

Back 44

rugae
sphincter muscle
micturition

Front 45

______: may result from chronic kidney infections
(pyelonephritis) or low blood pressure and low blood supply
to kidneys, or crush injuries (constant muscle trauma) or
transfusion reactions. Kidney failure will result in increasing
urea content in blood, causing cell poisoning, called ______;
untreated uremia is a life-threatening condition

Back 45

Kidney failure
uremia

Front 46

– ______: Over the counter drugs (aspirin,
acetaminophen, & NSAIDS (ibuprofen); excessive use
can destroy kidney.
– Heavy ______ use is also hard on the kidneys
– Illegal street drugs: including amphetamines, cocaine,
& heroin can destroy kidney

Back 46

Painkillers
alcohol

Front 47

Urinary tract infections:
– ______: bladder inflammation in females caused by
bacteria
– STD: ______

Back 47

Cystitis
Chlamydia

Front 48

______: inflammation of the kidney; inflammed tissue
tends to swell as fluid acculumates but kidney is within a
“capsule”, causing pressure build up hampering or
preventing the flow of blood

Back 48

Nephritis

Front 49

_____: kidney stones form within the urinary tract
from ______ deposits, magnesium salt or crystal or uric
acid (gout)

Back 49

Renal calcui
calcium

Front 50

______: elimination of large amount of urine
______: are drugs that promote the loss of water in urine.
The usual goal in diuretic therapy is a reduction in
blood volume, blood pressure estra-cellular fluid
volume or all three. Bodybuilders (models, fighters, &
jockeys) abuse these drugs by taking large doses
which promote reduced body wt or “cosmetic
dehydration”; causing electrolyte imbalance

Back 50

Diuresis
Diuretics

Front 51

_______: several disorders that can lead to kidney
failure. Two major ones are chronic high blood pressure &
diabetes, both of which damage kidney capillaries.
– ______ can restore proper solute balances by cleansing blood
which is then returned to the body.

Back 51

Glomerulonephritis
Dialysis

Front 52

______: an inherited
disorder in which cysts (semisolid
masses) form in the kidneys and in
many cases gradually destroy normal
kidney tissue

Back 52

Polycystic kidney disease

Front 53

_______: on
the rise; higher in males; smoking &
exposure to industrial chemicals.
Kidney cancer easily metastasizes via
bloodstream to lungs, bone and liver.

Back 53

Carcinoma of the kidney & bladder

Front 54

______ is one of the most
common, inherited childhood kidney
cancers

Back 54

Wilms tumor

Front 55

_______: inability to control
urination (or defecation) voluntarily;
elevated intra-abdominal pressures,
produced sneezes or coughs, can
overwhelm the sphincter muscles
causing urine to leak out

Back 55

Incontinence