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247 Cards in this Set
- Front
- Back
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Kidney Functions
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-Secretes renin, activates angiotensin, aldosterone
-Secretes erythropoietin -Regulates Pco & acid based balance -Promotes gluconeogenesis -Partially regulates blood calcium levels |
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How do the kidney's filter blood plasma?
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By separating and eliminating waste; returns useful chemicals to the blood
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How do the kidneys regulate blood volume and blood pressure?
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eliminates or conserves water as needed
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How do the kidneys regulate osmolarity of body fluids?
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Controls amounts of water and solutes eliminated
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What do renin, which activates angiotensin, which activates aldosterone do?
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Control blood pressure and electrolyte balance
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How do the kidneys detoxify the blood?
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By eliminated free radicals and drugs
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When do the kidneys promote gluconeogenesis?
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During starvation
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How do the kidneys regulate blood calcium levels?
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By excreting phosphate
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Define Wastes
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Any substance that is useless to the body
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What are considered to be wastes?
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-Toxins
-Drugs -Hormones -Salts -Hydrogen ions -Excess water |
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What are the nitrogenous wastes?
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-Urea
-Uric acid -Creatinine |
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50% of nitrogenous wastes
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Urea
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How is urea formed?
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-Protein synthesis
-protein->amino acids->NH2 removed->forms ammonia-liver converts to urea |
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What organ converts ammonia to urea?
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Liver
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How is uric acid formed?
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-nucleic acid catabolism
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How is creatinine formed?
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creatinine phosphate catabolism
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Renal Failure
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Kidneys fail to eliminate wastes from the blood
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Azotemia
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Build up of nitrogenous wastes in the blood
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Uremia
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toxic effects as wastes accumulate
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What are the symptoms associated with uremia?
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-Diarrhea
-vomitting -dypsnea -cardiac arrythmia -convulsions -coma -death |
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What is the best treatment if kidneys fail?
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dialysis
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Excretion
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Separation of wastes from body fluids and eliminating them
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What wastes are excreted by the respiratory system?
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-CO2, H20 and small amounts of other gases
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Which 4 wastes are excreted by the integumentary system?
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1. water
2. salts 3. lactic acid 4. Urea |
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Which 6 wastes are excreted by the digestive system?
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1. water
2. salts 3. CO2 4. lipids 5. bile pigments 6. cholesterol |
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Which 7 wastes are excreted by the urinary system?
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1. many metabolic wastes
2. toxins 3. drugs 4. hormones 5. salts 6. Hydrogen ions 7. water |
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Position, weight, and size of kidney
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-Retroperitoneal
-Right kidney slightly lover due to liver -About the size of a bar of soap |
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What 4 structures can you find entering and exiting the kidney through the hilum?
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1. nerves
2. blood vessels 3. lymphatic vessels 4. ureter |
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____ _____ located on superior surface of the kidneys
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adrenal glands
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3 layers of Connective tissue
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1. Renal Fascia
2. Adipose capsule 3. Renal capsule |
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Renal fascia
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-Tough, fibrous outer layer
-binds to kidney, ureters and bladder to abdominal wall |
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Adipose Capsule
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-Fatty middle layer
-Cushions kidney |
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Renal Capsule
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-Fibrous inner sac
-Encloses kidney like cellophane wrap |
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Renal Parenchyma
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Kidney tissue that forms urine
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2 zones of Renal Parenchyma
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-Cortex
-Medulla |
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Renal Sinus
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Cavity within the kidney
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What is inside the Renal Sinus?
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-Blood vessels
-Lymphatic vessels -Nerves -Urine Collecting Ducts -Fat |
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Renal Columns
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-Extensions of the cortex that project toward the renal sinus
-divide medulla into medullary pyramids |
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Lobe
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A pyramid and its overlying cortex
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papilla
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Renal columns, pyramids
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Lobe of kidney
-Broad side faces _____ -Papilla (pointy end) faces the ____ _____ -Nestled in the _____ _____ |
Lobe of kidney
-Broad side faces cortex -Papilla (pointy end) faces the renal sinus -Nestled in the minor calyx |
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Lobes, etc
-6-10 lobes in each adult _____ -2 or 3 ______ _____ empty into a _____ _____ -2 or 3 ______ ____ empty into -a ______ ______ -______ ______ empty into the ______ _____ -_____ _____ empties into the ______ |
-6-10 lobes in each adult kidney
-2 or 3 pyramidal papilla empty into a minor calyx -2 or 3 minor calyxes empty into the renal pelvis -Renal pelvis empties into the ureter |
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Minor Calyx
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Cup over papilla collects urine
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Path of Blood through Kidney
IAIAGEPIAI |
Interlobar arteries
arcuate arteries interlobar arteries afferent arterioles glomerulus efferent arterioles peritubular capillaries Interlobular veins arcuate veins interlobar veins |
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Nephron
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Functional unit of the kidney
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How many nephrons are contained in each kidney?
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1.2 million
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Each nephron consists of what?
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-Blood vessels
-Renal Corpuscle -Renal Tubule |
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Renal Corpuscle
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Glomerulus in a 2-layer sac
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What is another name for Bowman's capsule?
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Glomerular capsule
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_____ _____ collects in capsular space and flows into ____ ____
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Glomerular filtrate collects in capsular space and flows into renal tubule
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Renal Tubule
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Duct from glomerulus to tip of medullary pyramid
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Proximal Convoluted Tubule
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Longest, most coiled, simple cuboidal with brush border
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Nephron Loop
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U-shaped; descending + ascending limbs
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What cells make up the thick segment of the nephron loop?
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Simple cuboidal
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What is the function of the thick segment of the nephron loop?
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active transport of salts
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What cells make up the thin segment of the nephron loop?
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Simple squamous
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Is the thin segment of the nephron loop water permeable or impermeable?
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Very water permeable
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What cells make up the distal convoluted tubule?
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Cuboidal; minimal microvilli
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What structure of the nephron flows into the collecting duct?
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Distal convoluted tubles
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What percentage of nephrons are cortical nephrons?
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85%
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Are cortical nephron loops short or long?
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short
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In cortical nephrons, efferent arterioles branch off _____ ______
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In cortical nephrons, efferent arterioles branch off of peritubular capillaries
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Are juxtamedullary nephron loops long or short?
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Long
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What percentage of nephrons are juxtamedullary nephrons?
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15%
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What do juxtamedullary nephrons do?
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1. maintain salt gradient
2. helps conserve water |
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Flow of Urine
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1. Glomerular capsule
2. PCT 3. Nephron loop 4. DCT 5. Collecting duct 6. Papillary duct 7. Minor calyx 8. Major calyx 9.Renal pelvis 10. Ureter 11. Urinary bladder 12. Urethra |
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Urine Formation
(from blood plasma to urine) |
1. Glomerular filtration
2. Tubular reabsorption 3. Tubular secretion 4. Water conservation |
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Glomerular filtration
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Plasma-like filtration
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Tubular Reabsorption
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Returns solutes to bloodstream
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Tubular Secretion
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Removes additional wastes from the blood
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Water Conservation
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Returns water to the bloodstream
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____% of glomerular filtrate is reabsorbed into the bloodstream
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99% of glomerular filtrate is reabsorbed into the bloodstream
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What can pass through the filtration membrane?
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-water
-electrolytes -glucose -fatty acids -amino acids -nitrogenous wastes -vitamins |
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Most any unbound molecule smaller than ___ nm can pass through filtration membrane
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Most any unbound molecule smaller than 3 nm can pass through filtration membrane
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What are the 3 structures found in the filtration membrane?
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1. Fenestrated endothelium
2. Basement membrane 3. Filtration slits |
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Fenestrated endothelium
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-Like other fenestrated capillaries
-Pores are small enough to exclude blood cells |
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What size molecules can pass through the basement membrane of the filtration membrane?
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Excludes molecules>8nm
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Is the basement membrane of the filtration membrane negatively or positively charged?
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Negative
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In the basement membrane of the filtration membrane, blood plasma ___% protein, glomerular filtrate ____%
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In the basement membrane of the filtration membrane blood plasma 7% protein, glomerular filtrate 0.03%
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Filtration Slits
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-podocyte arms have pedicels with negatively charged filtration to exclude large anions
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Why is the blood pressure in the glomeruli of the kidneys so high?
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Lots of filtration, little or no reabsorption
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Glomerular Filtration Rate
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Filtrate formed per minute
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Formula for Glomerular Filtration Rate
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GFR=NFP X K
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NFP
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Net filtration pressure
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K
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Filtration coefficient; depends on permeability and surface area of filtration barrier
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Too high GFR leads too...
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Urine output rises->dehydration, electrolyte depletion
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GFR is _____ related to urine output
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GFR is directly related to urine output
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Too low GFR leads to...
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Wastes reabsorbed into the blood stream->azotemia
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How is GFR controlled by adjusting glomerular blood pressure? (3 mechanisms)
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1. Autoregulation
2. Sympathetic control 3. Hormonal mechanism-renin and angiotensin |
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In renal autoregulation, when Blood pressure increases, how is glomerular blood pressure adjusted?
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Constrict afferent arteriole, dilate efferent arteriole
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In renal autoregularion, when blood pressure decreases, how is glomerular blood pressure adjusted?
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Dilate afferent arteriole, constrict efferent
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What is the blood pressure range for which renal autoregulation can compensate for glomerular blood pressure?
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Between 80 and 170 (systolic)
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In sympathetic control of GFR, ____ ____ or ____ _____ (_____ ____) stimulate afferent arterioles to constrict.
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In sympathetic control of GFR, strenuous exercise or acute conditions (circulatory shock) stimulate afferent arterioles to constrict.
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In sympathetic control of GFR, blood pressure is adjusted GFR and urine production decrease causing what to happen?
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Blood is redirected to flow to heart, brain and skeletal muscles.
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Proximal Convoluted Tubules reabsorbs ___% of GF to peritubular capillaries
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Proximal Convoluted Tubules reabsorbs 65% of GH to peritubular capillaries
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What 3 mechanisms make active transport possible in proximal convoluted tubules?
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1. Great length
2. Prominent microvilli 3. Abundant mitochondria |
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What mode of transportation are fluids moved through the proximal convoluted tubules?
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Active Transport
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The PCT reabsorbs _____ variety of chemicals when compared to other parts of the nephron
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The PCT reabsorbs greater variety of chemicals when compared to other parts of the nephron
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What is the transcellular route of the PCT?
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Through epithial cells of PCT
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What is the paracellular route of the PCT?
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Between epthilial cells of PCT
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Transport Maximum
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When transport proteins of plasma membrane are saturated.
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Where does Tubular Secretion happen?
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The Proximal Convoluted Tubule & Nephron Loop
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What 2 processes take place in tubular secretion?
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1. Waste Removal
2. Acid-base balance |
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What wastes are removed by the PCT during tubular secretion?
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-urea
-uric acid -bile salts -ammonia -catecholamines -many drugs |
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How is acid base balance maintained by the PCT during tubular secretion?
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-secretion of hydrogen and bicarbonate ions regulates pH of body fluids
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What is the primary function of the nephron loop?
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-water conservation
-also involved in electrolyte reabsorption |
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In the DCT, what hormone forms as a result of decreased blood pressure?
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Angiotensin II
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Which organ does angiotensin II stimulate?
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Adrenal Cortex
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In cases of decreased blood pressure which organ secretes aldosterone?
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Adrenal Cortex
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In cases of decreased blood pressure, what hormone is secreted by the adrenal cortex?
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Aldosterone
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Aldosterone promotes ____ reabsorption
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Aldosterone promotes Na+ reabsorption
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Na+ reabsorption promotes ____ reabsorption
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Na+ reabsorption promotes water reabsorption
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Water reabsorption ______ urine volume
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Water reabsorption decreases urine volume
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What effect does aldosterone have on blood pressure?
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It causes BP to drop less rapidly
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What effect does atrial natriuretic factor (ANF) have on blood pressure?
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Lowers it
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___ blood pressure stimulates right atrium?
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high blood pressure stimulates right atrium?
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atrium secretes what hormone as a result of high blood pressure?
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atrial natriuretic factor
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What hormone promotes Na+ and water excretion?
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atrial natriuretic factor
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How does Anti diuretic hormone effect the volume of urine?
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It decreases it
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dehydration stimulates what organ which in turn stimulates the posterior pituitary?
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Hypothalamus
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Which organ releases antidiuretic hormone?
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Posterior pituitary
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antidiuretic hormone ____ water reabsorption
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antidiuretic hormone increases water reabsorption
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What is the function of the collecting ducts of nephrons?
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To concentrate urine
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Osmolarity is _____ related to how deep you go into the medulla
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Osmolarity is directly related to how deep you go into the medulla
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Medullary portion of collecting duct is ______ to water but not to _____
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Medullary portion of collecting duct is permeable to water but not to NaCl
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When producing hypotonic urine, _____ reabsorbed by cortical collecting duct
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When producing hypotonic urine, NaCL reabsorbed by cortical collecting duct.
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When producing hypotonic urine water _____ in urine
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When producing hypotonic urine water remains in urine
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What happens to the GFR when hypertonic urine is being produced?
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It drops
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When producing hypertonic urine, tubular reabsorption ____
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When producing urine, tubular reabsorption increases
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When producing hypertonic urine ____ NaCl remains in collecting duct
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When producing hypertonic urine less NaCl remains in collecting duct
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When producing hypertonic urine, ____ increases collecting ducts permeability
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When producing hypertonic urine, ADH increases collecting duct's permeability
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When producing hypertonic urine, _____ water is reabsorbed
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When producing hypertonic urine, more water is reabsorbed
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In hypertonic urine, the urine is _____ concentrated
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In hypertonic urine, the urine is more concentrated
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What is the function of the countercurrent multiplier?
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Recaptures NaCl and returns it to the renal medulla
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What does the countercurrent multiplier do to the descending limb of the nephron loop?
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-reabsorbs water but not salt
-concentrates tubular fluid |
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What does the countercurrent multiplier do to the ascending limb of the nephron loop?
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-reabsorbs Na+, K+, and Cl-
-maintains osmolarity of renal medulla -impermeable to water -tubular fluid becomes hypotonic because salts is sucked into the medulla and out of the nephron loop |
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Where does recycling of urea take place?
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In the collecting duct of the medulla
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Urea accounts for ____% of high osmolarity of medulla
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Urea accounts for 40% of high osmolarity of medulla
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What forms the countercurrent exchange system?
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The vasa recta
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The vasa recta provide ____ supply to the medulla
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The vasa recta provide blood supply to the medulla
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The vasa recta do not remove _____ from medulla
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The vasa recta do not remove NaCl from medulla
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In countercurrent exchange, what happens in the descending capillaries?
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-Water diffuses out of blood
-NaCl diffuses blood |
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In countercurrent exchange, what happens in the ascending capillaries?
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-water diffuses into blood
-NaCl diffuses out of blood |
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What is the average pH of urine?
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6.0
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Urochrome
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Yellow pigment produced from breakdown of hemoglobin of dead erythrocytes
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When urine is pink, green, brown or black, what might this be caused by?
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food, vitamins, drugs, metabolic disease
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When urine is cloudy what is this indicative of?
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Bacterial growth
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Pyuria
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Pus present due to kidney/bladder infection
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Hematuria
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Blood present in urine
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What causes hematuria
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-infection
-trauma -kidney stones |
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What does pungent odor in urine indicate?
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bacteria (converts urea to ammonia)
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What foods may cause odor in urine?
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asparagus
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What is foul odor in urine indicative of?
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Infection
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What is the range of specific gravity?
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1.001-1.035
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What is considered very dilute when it comes to specific gravity?
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1.001
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What is considered very concentrated when it comes to specific gravity?
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1.035
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If urine has specific gravity of 1.035 what is this indicative of?
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dehydration
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The chemical composition of urine consists of ____% water, ___% solutes
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The chemical composition of urine consists of 95% water, 5% solutes
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What are the normal solutes in urine?
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-urea
-NaCl -creatine -uric acid -phosphates -sulfates -calcium -magnesium -bicarbonate -H+ |
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What are abnormal solutes in urine?
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-Glucose
-Free hemoglobin or whole RBCs -Albumin -Kentones (ok if pregnant) -Bile pigments |
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Polyuria
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Urinate more than 2L/day
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What causes polyuria?
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-Disease long term (ie diabetes)
-drugs temporary |
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Oliguria
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Urinate less than 500mL/day
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Anuria
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Urinate 0-100mL
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What causes anuria?
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-disease
-dehydration -circulatory shock -enlarged prostate gland (males only) |
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Effects of diuretics
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-increased urine output
-decreased blood volume |
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What are diuretics used for?
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-hypertension
-congestive heart failure |
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What do diuretics do to GFR?
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Increases it
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What do diuretics do to tubular reabsorption?
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Decrease it
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ureter
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muscular tube from renal pelvis of kidney to bladder
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Where is the ureter located?
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Dorsal to bladder and enters it from below
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How long are ureters?
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25cm
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What are the 3 layers of the ureters?
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1. adventitia
2. muscularis 3. mucosa |
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What is the adventitia of the ureters made of?
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connective tissue
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What is the muscularis of the ureters made of?
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2 layers of smooth muscle
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How does the muscularis of the ureter work?
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The urine enters, it stretches and contracts in peristaltic wave
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What is the mucosa layer of the ureter made of?
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Transitional epithelium
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Why are the ureters so easily obstructed?
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Lumen very narrow
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Urinary bladder
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muscular sac on floor of pelvic cavity
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what are the four layers of the bladder?
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1. Parietal peritoneum
2. Fibrous adventitia 3. Muscularis 4. Mucosa |
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Where is the parietal peritoneum of the bladder located?
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On the flat superior surface
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Where is the fibrous adventitia of the bladder located?
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Everywhere but the flat superior surface of the bladder
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What is another name for the muscularis layer of the bladder?
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detruser muscle
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What is the muscularis layer of the bladder made up of?
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smooth muscle
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What are the wrinkles on the mucosa of the bladder called?
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rugae
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Rugae
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wrinkles found on the mucosa of the bladder
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Trigone
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Triangular area on floor of bladder where ureters enter and the urethra exits
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How much does the bladder normally hold before urination?
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500ml
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How much urine is the bladder capable of holding?
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700-800ml
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Are men or women more susceptible to bladder infection?
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Women
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Why are women more susceptible to bladder infection?
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Because their urethra is so short
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How long is the female urethra?
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3-4 cm long
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What are the 3 structures of the female urethra?
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1. External orifice
2. Internal urethral sphincter 3. External urethral sphincter |
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Where is the external orifice, of the female urethra, located?
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Between vaginal orifice and clitoris
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What is the internal urethral sphincter, of the female urethra, made of?
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-thickened detruser muscle
-smooth muscle |
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Is the internal urethral sphincter of the female controlled voluntarily or involuntarily?
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involuntarily
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What is the external urethral sphincter, of the female urethra, made of?
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Skeletal muscle
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Is the external urethral sphincter, of the female urethra, controlled voluntarily or involuntarily
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voluntarily
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How long is the male urethra?
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18 cm
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What are the three regions of the male urethra?
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1. Prostate urethra
2. Membranous urethra 3. Penile urethra |
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What is the function of the prostate urethra in males?
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During orgasm receives semen
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Where is the membranous urethra located?
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Passes through pelvic cavity
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What is the largest region of the male urethra?
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The penile urethra
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micturition
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voiding the bladder
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In infants, how much urine is in the bladder before stretch receptors send signal to spinal cord?
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200ml
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In infants, what stimulates the contraction of the detruser muscle?
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Parasympathetic reflex from spinal cord
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In infants, the signal for micturition does not go all the way to the ____
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In infants, the signal for micturition does not go all the way to the brain
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Do infants have an external sphincter?
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No
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What finally voids the bladder in infants?
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The relaxation of the internal urethral sphincter
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Receptors sends stretch signals via _____ nerves to micturition center in ____ of brain
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Receptors send stretch signals via pelvic nerves to micturition center in the pons of the brain
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During voluntary micturition, micturition center receives stretch signals and integrates ____ _____ (voluntary control)
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During voluntary micturition, micturition center receives stretch signals and integrates cortical input (voluntary control)
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If urination is appropriate, ____ sends signal for stimulation of detrussor and relaxes internal urethral sphincter.
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If urination is appropriate, pons sends signal for stimularion of detrussor and relaxes internal urethral sphincter
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If urination is inappropriate, impulses sent to ____ _____ _____ keep it contracted
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If urination inappropriate, impulses sent to external urethral sphincter keep it contracted
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When urination become appropriate, the impulses are ____ and the external urethral sphincter will relax.
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When urination becomes appropriate, the impulses are inhibited and the external urethral sphincter will relax.
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What is an alternative name for kidney stones?
|
Renal calculi
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Kidney Stones
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Calcium, phosphate, uric acid and protein crystallize
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Where do Kidney Stones form?
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In the renal pelvis
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Kidney stones cause blockages that destroy _____
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Kidney stones cause blockages that destroy nephrons
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What does the jagged nature of kidney stones lead to?
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-pain
-hematuria |
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What are the 5 causes of kidney stones?
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-hypercalcemia
-dehydration -pH balance -frequent urinary infections -enlarged prostate |
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What are the treatments for kidney stones?
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-Stone dissolving drugs
-Surgery -Lithotripsy |
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Lithotripsy
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Ultrasonic vibrations
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Acute Glomerularnephritis
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Destruction of glomeruli
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What type of disease is acute glomerularnephritis?
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autoimmune disease
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When does acute glomerularnephritis occur?
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After an infection
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How long does acute glomerularnephritis last?
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usually temporary-most recover
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Hydronephrosis
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increased fluid pressure to blockage in kidney
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Nephroptosis
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Floating kidney
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What 2 things cause Nephroptosis?
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1. too little body fat to hold kidney in place
2. Prolonged vibration-truck drivers, jackhammer operators |
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Nephrotic Syndrome
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Glomerular injury causes large amounts of protein to be excreted in urine.
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What are possible consequences of Nephrotic Syndrome?
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-hypotension
-edema -increased susceptibility to infection |
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Acute Renal Failure
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Traumatic damage to nephrons
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What is a symptom of Acute Renal Failure
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Great blood loss
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Chronic Renal Failure
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-Slow, progressive
-irreversible loss of nephrons -trauma -metal poisoning -glomeruli blocked by protein -atherosclerosis |
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Urinary Incontinence
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Inability to control urination
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What are the 4 causes of Urinary Incontinence?
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-Inncompetence of urethral sphincters
-Bladder irritation due to infection -Pressure during pregnancy -Obstruction |
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Stress Incontinence
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Uncontrolled urination due to brief surges in bladder pressure due to laughter, coughing, sneezing
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Diabetes
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Chronic polyuria of metabolic origin
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What are the four types of diabetes with hyperglycemia and glycosuria?
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-Diabetes Mellitus I & II
-Gestation Diabetes -Pituitary diabetes -Adrenal Diabetes |
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What type of diabetes is accompanied by glycosuria but no hyperglycemia?
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Renal Diabetes
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What type of Diabetes is not accompanied by hyperglycemia nor glycosuria?
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Diabetes Insipidus
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Diabetes Mellitus I & II
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Insulin hyposecretion/insensitivity
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Gestational Diabetes
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1-3% of pregnancies
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Pituitary Diabetes
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Hypersecretion of GH
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Adrenal Diabetes
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Hypersecretion of cortisol
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Renal Diabetes
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Hereditary deficiency of glucose transporters
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Diabetes Insipidus
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ADH hyposecretion; CD decreases water reabsorption
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