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75 Cards in this Set

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What are some functions of the kidneys?
Regulate blood volume/chemical make up; gluconeogenesis; producing Renin and Erythropoietin; metabolizing vitamin D.
What are the parts of the urinary system?
Kidneys, Bladder, Ureters, Urethra.
What are the 3 layers of supportive tissue around kidneys?
Renal capsule (innermost), adipose capsule (middle), Renal fascia (outermost).
Define renal ptosis.
One or both kidneys drop to lower position.
Define hydronephrosis.
Backup of urine from ureteral obstruction or other causes.
What are the 3 distinct regions of the kidney?
Renal cortex, medulla and pelvis.
Define pyelitis.
Infection of renal pelvis and calyces.
What are nephrons?
Structural and functional units of kidneys. Each kidney contains 1 million.
What does the renal corpuscle consist of?
Glomerular capsule and enclosed glomerulus.
What are the 3 parts of a renal tubule?
Proximal Convuluted Tubule (PCT), Loop of Henle, and Distal Convoluted Tubule (DCT).
What two capillary beds are associated with nephrons?
Glomerulus and Peritubular.
What are Justaglomerular (JG) cells?
Enlarged, smooth muscle cells with prominent secetory granules containing renin.
What is the filtration membrane?
Porous membrane allowing free passage of water and solutes smaller than plasma proteins.
What are the 3 layers of the filtration membrane?
Fenestrated endothelium of the glomerular capillaries; podocyte-containing visceral layer of glomerular capsule; intervening basement membrane.
How much oxygen does the kidneys consume?
20 - 25% of all oxygen used by the body at rest.
Define filtrate.
Plasma-derived fluid that is processed by the renal tubules to form urine.
How much fluid does the kidneys process and how much becomes urine?
47 gallons; 1% becomes urine.
What is glomerular filtration?
Passive, nonselective process where hydrostatic pressure forces fluids and solutes through membrane.
Define Glomerular Filtration Rate (GFR).
Volume of filtrate formed each minute by combined activity of all 2 million glomeruli of the kidneys.
How is the GRF held constant in humans?
By intrinsic (renal autoregulation) and extrinsic (neural and hormonal) controls which regulate renal blood flow.
What 2 controls does renal autoregulation entail?
Myogenic mechanism and tubuloglomerular feedback mechanism.
What is myogenic mechanism?
Tendency of vascular smooth muscle to contract when stretched.
What is the purpose of the extrinsic controls regulating the Glomerular Filtration Rate?
To maintain systemic blood pressure.
What parts make up a nephron?
A glomerulus and a renal tubule.
What are the functions of collecting ducts?
To receive urine from nephrons and help concentrate urine. Form medullary pyramids.
What are the functions of nephrons?
filtration, tubular reabsorption, tubular secretion.
What is Anuria?
Abnormally low urinary output that may indicate glomerular bp is too low to cause filtration.
What actions take place during tubular reabsorption?
Needed substances are removed from filtrate by tubule cells and returned to peritubular capillary blood.
What drives passive tubular reabsorption?
Electrochemical gradients established by active reabsorption of sodium ions.
How does secondary active tubular reabsorption occur?
By co-transport with Na+ via protein carriers. Transport is limited by number of carriers available.
What substances are not reabsorbed and why?
Creatinine, drug metabolites, etc. Reason: loack of carriers, size, or nonlipid solubility.
What is the purpose of tubular secretion?
An active process of adding substances to filtrate. Important in eliminating drugs, urea, excess ions, and maintaing acid-base balance of blood.
What happens when antidiuretic hormone is absent?
Dilute urine is formed because dilute filtrate reaching the collecting duct is simply allowed to pass from kidneys.
What happens when antidiuretic hormone rises in the blood?
Collecting ducts become more permeable to water, and water moves out of filtrate as it flows through hyperosmotic medullary areas.; concentrated urine produced in small amounts.
Define facultative water reabsorption.
Water reabsorption that depends on the presence of ADH.
What is a diuretic?
Chemical that enhances urinary output.
What is an osmotic diuretic?
Substance that is not reabsorbed and carries water out with it (diabetes mellitus).
How do alcoholic drinks encourage diuresis?
By inhibiting release of ADH.
How do caffeine beverages and hypertension drugs encourage diuresis?
By inhibiting Na+ reabsorption and obligatory water reabsorption that normally follows.
What is renal clearance?
Volume of plasma cleared of a particular substance in a given time, usually 1 minute.
What is renal clearance used for?
To determine the GFR, which provides info re: amount of functioning renal tissue, detect glomerular damage, and follow renal disease progress.
What is the most abundant protein found in urine?
Albumin.
What tests are used to evaluate renal function?
Creatinine clearance, serum creatinine, and blood urea nitrogen (BUN).
What races are most likely to develop renal failure?
African Americans, American Indians, Alaska Natives (4x).
Why is it essential to know a drug's renal clearance?
Because if it is high, the drug dosage must also be high and administered frequently to maintain therapeutic level.
What is the color of freshly voided urine?
Clear and pale to deep yellow.
Where does urine's color come from?
Urochrome, a pigment that results from body's destruction of hemoglobin.
Under what circumstances may urine change to an abnormal color?
Eating certain foods, presence of bile pigments or blood, prescribed drugs, vitamin supplements.
What is the usual pH of urine?
around 6.
What activities cause the urine to become alkaline?
Vegetarian diet, prolonged vomiting, bacterial infection of urinary tract.
What is the chemical composition of urine?
95% water, 5% solutes (Urea, Na+, K+, PO, SO, creatine, uric acid).
What are ureters?
Slender tubes that convey urine from kidneys to bladder.
How do renal calculi (kidney stones) form?
Calcium magnesium, or uric acid salts in urine crystallize and precipitate in the renal pelvis.
What is the urinary bladder?
Smooth, collapsible muscular sac that stores urine temporarily.
What forms the trigone?
Both ureters and urethra.
What is significant about the trigone?
Infections persist in this area.
What are the 3 layers of the bladder?
Mucosa, detrusor muscle, and adventitia.
What is the maximum capacity of the bladder?
800 - 1000 ml.
What is the urethra?
Thin-walled muscular tube that drains urine from bladder and conveys it out of body.
What is the function of the internal urethral sphincter?
Involuntary sphincter keeps urethra closed when urine is not being passed and prevents leakage.
Define micturition.
Aka voiding, urination. Act of emptying the bladder.
What activities lead up to micturition?
200 ml of urine accumulates; afferent impulses transmit to brain, creating urge to void; bladder contractions become frequent; voiding flexes initiated.
In embryonic development, the ureteric buds eventually become what?
Ureters.
When do the metanephric kidneys begin functioning?
By the 3rd month of fetal life.
What parts of the urinary system develop from the cloaca?
Rectum, anal canal and urogenital sinus.
What parts of the urinary system develop from the urogenital sinus?
Bladder and urethra.
What are the 3 most common congenital abnormalities of the urinary system?
Horseshoe kidney, hypospadias, and polycystic kidney.
What is hypospadias?
Found only in male infants; urethral orifice is located on ventral surface of penis.
What is congenital polycystic kidney disease?
Inherited condition where baby's kidneys have many urine-filled cysts.
What is adult polycystic kidney disease?
Inherited condition where cysts develop very gradually and produce no symptoms until age 40. Both kidney enlarge with chloride-rich fluid.
How many times may a newborn void daily?
5 to 40 times.
What bacteria is responsible for most urinary tract infections?
Escherichia coli
What percentage of elderly have histologically normal kidneys?
3%
What happens to to bladder of an aged person?
It shrinks to half the capacity of a young adult (250ml vs. 600ml).
What is Diabetes Insipidus?
Condition where large amounts of dilute urine flush from body, resulting in malfunction or deficiency of aquaporins or ADH receptors in collecting duct.