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83 Cards in this Set
- Front
- Back
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What are 8 general kidney fns? Describe each.
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Regulates blood ionic composition, blood pH (excretes H, conserves bicarbonate ions), blood volume (conserving/eliminating water), BP (adjust blood volume, secrete renin), blood osmolarity (regulate water/solutes), blood glucose levels (gluconeogenesis, release glucose). Produces hormones (calcitriol, hematopoeitin). Excretes waste/foreign substances (ammonia, urea, bilirubin, creatinin, diet, drugs, environment toxins).
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Kidneys are on (ant/post) abdominal wall, in front of ___. Superior pole of kidneys related to ___.
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Post. Diaphragm. Adrenal gland.
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What are the 3 layers that surround the kidney from deep to superficial & their fns?
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Renal capsule - protects & maintains kidney shape. Adipose capsule - protects, holds kidney in place, thermal insulation. Renal fascia - anchors kidney to surrounding structures & abdominal wall.
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Which kidney lies lower than the other?
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Right
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At what vertebral level do the kidneys lie?
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B/w T12-L3
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R kidney is related to what 4 structures?
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Liver, duodenum, pancreas, IVC.
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L kidney is related to what 3 structures?
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Spleen, stomach, pancreas
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What 5 structures enter/leave the kidney at the hilum?
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Renal pelvis, renal a/v, lymph vessels, nerves.
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Which ribs cover the L vs R kidney?
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L - 11-12. R - 12.
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What is the superficial region of the kidney? What are 3 subdivisions of this area?
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Renal cortex: outer cortical zone, inner juxta-medullary zone, renal column.
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Portion of renal cortex that extends b/w renal pyramids.
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Renal column
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Inner region of kidney.
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Renal medulla
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The bases of renal pyramids face the ___ while the apex or ___ faces the ___.
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Cortex. Renal papilla. Hilum.
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Renal lobe contains what 3 structures?
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Renal pyramid, overlying cortical area, 1/2 of each adjacent renal columns.
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Kidney parenchyma includes what 2 areas?
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Renal cortex, renal pyramids (functional part)
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Functional unit of kidney.
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Nephron (Majid: uriniferrous tubule)
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What is the 5-step pathway of urine drainage formed by nephron?
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Papillary ducts, major/minor calyces, renal pelvis, ureter, urinary bladder.
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Kidneys receive ___% of resting cardiac output.
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20-25%
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L/R renal a. arise from ___.
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Abdominal aorta
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What is the blood pathway entering/leaving kidneys? What structures form the renal v.?
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Renal a, segmental a, interlobar a, arcuate a, interlobular a, afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries (vasa recta). Peritubular venule, interlobular v, arcuate v, interlobar v form renal vein that exits kidney.
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Renal plexus (forms renal n.) formed by which sympa/parasympathetic fibers? What does it regulate?
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Sympathetic - T11-L2. Parasympathetic - Vagus n. Blood flow.
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Kidney referred pain is felt in what region?
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External genitalia
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What are the 3 parts of the uriniferrous tubule? Which form the nephron?
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Renal corpuscle, renal tubule, collecting duct. First 2 form nephron.
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The renal corpuscle consists of what 2 parts? What is its fn?
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Glomerulus, bowman's capsule. Fn to filter blood plasma.
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The renal tubule consists of what 3 parts?
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Proximal convoluted tubule, descending/ascending loop of henle, distal convoluted tubule.
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Renal corpuscle, both convoluted tubules are in ___ while loop of Henle is in ___.
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Cortex. Medulla.
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80-85% of nephrons are (cortical/juxta-medullary).
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Cortical
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What is the daily volume of glomerular filtrate?
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150-180 L
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Blood pressure of glomerular capillaries forcing water/solutes through filtration slits.
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Glomerular blood hydrostatic pressure
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Hydrostatic pressure exerted against filtration membrane by fluid already in capsular space & represents back pressure.
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Capsular hydrostatic pressure
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Pressure due to presence of proteins in blood plasma & also opposes filtration.
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Blood colloid osmotic pressure
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Glomerular filtration membrane permits filtration of what 2 substances? Prevents filtration of what 3 substances?
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Water, ions. Plasma proteins, blood cells, platelets.
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What 3 factors cause a high volume to pass through glomerular filtration membrane?
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Large surface area, thin porous membrane, high glomerular capillary blood pressure.
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Amount of filtrate formed in all renal corpuscles of both kidneys per min.
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Glomerular filtration rate
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What happens if glomerular filtration rate is too high vs too low?
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High - substances pass too quickly & aren't reabsorbed. Low - nearly all reabsorbed & some waste products not excreted.
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How does high BP affect glomerular filtrate rate?
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Increases GFR, increases loss of solutes.
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Bowman's capsule consists of a visceral/parietal layer made of what 2 cells?
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Parietal - squamous. Visceral - podocytes.
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What are the 2 poles of bowman's capsule?
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Vascular (arterioles), urinary (PCT)
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What are the 3 components of the blood filtrate barrier in glomerulus?
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Fenestrated endothelium, basal lamina, filtration slit diaphragm.
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Which 2 parts of nephron have endocytotic vesicles & basal striation?
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PCT, DCT
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Which part of uriniferrous tubule is made of tall cuboidal/columnar epithelium, microvilli, canaliculi?
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PCT
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Which part of uriniferrous tubule is made of simple squamous epithelium?
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Loop of Henle
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Which part of uriniferrous tubule is made of short cuboidal epithelium w/ round nucleus?
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DCT
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Which part of uriniferrous tubule is made of simple cuboidal/low columnar epithelium?
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Collecting duct
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What is the fn of principle cells, intercalated cells? Which 2 parts of uriniferrous tubule are they found?
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Principle cells - respond to antidiuretic hormone, aldosterone. Intercalated cells - role in blood pH homeostasis. DCT, collecting duct.
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What is the fn of ADH? Where is it produced? Which part of uriniferrous tubule does it target?
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Increases water absorption, decreases urine. Hypothalamus. Targets DCT, collecting duct (principle cells).
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What is the fn of aldosterone? Where is it produced? Which part of uriniferrous tubule does it target?
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Balances Na+ level. Adrenal gland. Targets DCT, collecting duct (principle cells).
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Juxtaglomerular apparatus consists of what 3 parts?
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Macula densa, JG cells, extraglomerular mesangial cells.
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What is the fn of macula densa?
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Monitors Na level in filtrate
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What is the fn of JG cells?
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Smooth mm produce renin, angiotensin I/II, ACE.
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What is the fn of extraglomerular mesangial cells?
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Releases NO
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Extraglomerular mesangial cells surrounded by what 3 structures?
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Afferent/efferent arterioles, macula densa.
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How does the macula densa decrease GFR by constricting afferent arteriole?
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Inhibits release of NO from EGM cells which constricts afferent arteriole to decrease blood flow.
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How does the macula densa decrease GFR by constricting efferent arteriole?
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Causes JG cells to release renin into blood which converts angiotensinogen into angiotensin I, ACE converts angiotensin I to angiotensin II, constricts efferent arteriole.
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How does the macula densa increase resorption of Na/Cl ions in the DCT?
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When ACE converts to angiotensin I to angiotensin II (lungs), this influences adrenal cortex to release aldosterone which acts on DCT to increase resorption of Na/Cl ions.
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What 2 cells are found in the cortical interstitium of the kidney?
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Fibroblasts, macrophages
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What cell is found in the medullary interstitium of the kidney? What is its fn?
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Interstitial cell - makes medullipin I which converts to medullipin II in liver. Causes vasodilation = decrease BP.
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What 3 mechanisms regulate GFR?
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Renal, neural, hormonal regulation
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Describe 2 mechanisms of renal autoregulation. Does it increase/decrease GFR?
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Myogenic mechanism - stretching triggers contraction of smooth mm in afferent arterioles which decreases GFR. Tubuloglomerular mechanism - EGM inhibits NO release causing afferent arterioles to constrict, decreases GFR.
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Describe neural regulation of GFR. Does it increase/decrease GFR? Moderate vs greater stimulation?
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Kidney BVs supplied by sympathetic ANS fibers release norepinephrine = vasoconstriction. Moderate stimulation - afferent/efferent arterioles constrict, decreases GFR. Greater stimulation - afferent arterioles constrict, decreases GFR.
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Hormone that decreases GFR. Vasoconstrictor of afferent/efferent arterioles.
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Angiotensin II
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Hormone that increases GFR. Where is it released? What is the effect?
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Atrial natriuretic peptide. Atria stretching = ANP release = EGM cells stimulate NO release = dilates arterioles to increase capillary surface for filtration.
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How does ADH increase water permeability in DCT, collecting duct? What happens in absence of ADH?
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Inserts aquaporin 2 channels. ADH absence - diabetes insipidus.
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ANP produced by ___ cells in response to large increase in blood volume. Decreases blood volume/BP by inhibiting reabsorption of ___ & ___ in PCT/collecting duct, & suppresses secretion of ___ & ___.
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ANP produced by ATRIAL MYOCARDIAL cells in response to large increase in blood volume. Decreases blood volume/BP by inhibiting reabsorption of NA+ & WATER in PCT/collecting duct, & suppresses secretion of ADH & ALDOSTERONE.
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How does high vs low ADH affect urine concentration?
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Low ADH - dilute urine. High ADH - concentrated urine.
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What are the 3 major solutes that contribute to high osmolarity?
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Na, Cl, urea
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Process of progressively increasing osmotic gradient in renal medulla by countercurrent flow.
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Countercurrent multiplication
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Which part of nephron functions as countercurrent multiplier?
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Long loops of Henle of juxtamedullary nephrons
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Countercurrent flow (increases/decreases) osmolarity of interstitial fluid.
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Increases
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Process by which solutes/water are passively exchanged b/w blood of vasa recta & interstitial fluid of renal medulla.
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Countercurrent exchange
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What structure functions as countercurrent exchanger?
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Vasa recta
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Renal pelvis starts/ends at what structures?
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Renal hilum. Urinary bladder.
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What 3 factors move urine?
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Peristaltic waves, hydrostatic pressure, gravity
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Where are the 3 narrowings in the length of ureters?
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Junction w/ renal pelvis (L1), passing over superior pelvic aperture (SI jt), entering urinary bladder (S2)
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Kidney stone pain is usually referred where?
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Lower abdominal wall, external genitalia (dermatomes T11-L1)
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Urinary bladder is found in (true/false) pelvis.
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True pelvis
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Bladder apex points to what structure?
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Symphysis pubis
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What do each surface of the bladder relate to? Superior, posterior, 2 inferolateral.
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Superior - small intestine, uterus. Posterior - rectum, seminal vesicles, vagina. Inferolateral - pubic bones, pelvic floor mm, prostate.
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What is urine capacity?
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700-800 mL
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Discharge of urine from bladder.
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Micturition
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Small tube leading from internal urethral orifice in bladder floor to exterior body.
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Urethra
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What 3 parts compose male urethra?
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Prostatic part, membranous part (through pelvic floor mm), phalic/penile/spongy part (through corpus spongiosum of penis).
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What are the 3 layers of cells that make up ureter, bladder, urethra?
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Mucosa transitional epithelium, muscular coat, fibrous outer coat.
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