Chapter 26 - Urinary System

Front 1

Urinary system consists of...

Back 1

Kidneys, ureters, bladder, and urethra

Front 2

Kidney function regarding blood regulation

Back 2

Regulating Na+, K+, Cl-, Ca2+ and HPO3-

Front 3

Kidney function regarding clood pH

Back 3

regulating H+ and HC03-

Front 4

Kidney function regarding blood volume

Back 4

regulating H20

Front 5

Kidney function regarding blood pressure

Back 5

secretes renin (activates a pathway that increases blood pressure)

Front 6

Kidney function regarding blood osmolarity

Back 6

By regulating water and solute loss in urine

Front 7

Kidney function regarding blood glucose

Back 7

By gluconeogenesis and glucose reabsorption

Front 8

Kidney function regarding hormones

Back 8

Calcitrol and erythropoietin

Front 9

Kidney function regarding excretion

Back 9

excrete wastes and foreign substances

Front 10

Indented area of the kidney

Back 10

Hilum

Front 11

What enters and exits from the hilum of the kidney

Back 11

renal artery and vein, ureter, nerves, and lymphatics

Front 12

External layers of kidney

Back 12

Renal capsule, adipose capsule, and renal fascia

Front 13

Renal capsule characteristics

Back 13

Inner layer

Dense irregular connective tissue helps maintain shape

Continuous with ureter

Front 14

Adipose capsule characteristics

Back 14

Middle layer

Protects and anchors

Front 15

Renal fascia characteristics

Back 15

Outer layer

Dense irregular connective tissue

Protects and anchors to other structures

Front 16

Internal layers of kidneys

Back 16

Renal cortex and renal medulla

Front 17

Outer internal layer of kidney

Back 17

Renal cortex

Front 18

Renal medulla contains what two regions?

Back 18

Renal pyramids and renal columns

Front 19

Renal pyramids function

Back 19

Secreting apparatus and tubules

Front 20

Renal columns anatomy

Back 20

Medullary extension of the renal cortex

Front 21

The nephron is the ___ ___ of the kidney

Back 21

Functional unit

Front 22

Each nephron consists of ___ and ____.

Back 22

Tubules and capillaries

Front 23

Renal cortex and renal medulla are the ____ of the kidney which consists of ___.

Back 23

Parenchyma (functional unit)

Nephrons

Front 24

Urine passes through ducts called ____ ducts which exit the ____ at the papillae.

Back 24

Papillary

Pyramid

Front 25

Where do papillary ducts empty urine?

Back 25

Into minor then major calyces

Front 26

Calyces pass urine where?

Back 26

Ureters

Front 27

Where do the ureters transport urine?

Back 27

From the renal pelvis to the urinary bladder

Front 28

How does urine move from the ureters to the urinary bladder?

Back 28

Hydrostatic pressure, gravity, and peristaltic waves by the muscularis layer

Front 29

How is urine backflow into the ureters prevented?

Back 29

When the bladder fills it compresses the opening

Front 30

Inner layer mucosa of the ureters contain what kinds of cells?

Back 30

mucous cells

Front 31

What is the function of mucus in ureter

Back 31

Protects ureters from urine

Front 32

Capacity of the urinary bladder?

Back 32

400-800 mL

Front 33

In the floor of the urinary bladder, what is triangular area called?

Back 33

Trigone

Front 34

2 superior corners of the trigone

Back 34

Openings for ureters

Front 35

Anterior corner of the trigone

Back 35

Internal urethral orifice

Front 36

Mucosa of urinary bladder makeup?

Back 36

Lined with transitional epithelium surrounded by lamina propria

Front 37

The mucosa of the urinary bladder is folded into ___ which increases the stretching capacity of the urinary bladder.

Back 37

Rugae

Front 38

Smooth muscle name surrounding the mucosa

Back 38

Detrusor muscle

Front 39

Around the opening to the urethra, circular smooth muscle forms the ___ ___ ____.

Back 39

Internal urethral sphincter

Front 40

External urethral sphincter consists of what kind of muscle?

Back 40

Skeletal muscle

Front 41

Micturition

Back 41

Urination

Front 42

When volume in the bladder is 200-200 mL, ____ ____ are stimulated.

Back 42

Stretch receptors

Front 43

Micturition reflex

Back 43

Parasympathetic impulses propagate to the urinary bladder wall and the internal urethral sphincter.

This causes contraction of the detrusor muscle and relaxation of the internal urethral sphincter

Front 44

Urethra carries urine from the ___ to the exterior of the body.

Back 44

Internal urethral orifice

Front 45

3 portions of the urethra in males

Back 45

Prostatic

Intermediate

Spongy

Front 46

In females, where is the external urethral orifice located?

Back 46

Anterior to vagina

Front 47

In females, the urethral wall consists of what?

Back 47

Deep mucosa and superficial muscularis

Front 48

Kidneys receive how much of resting cardiac output?

Back 48

20-25%

Front 49

The renal artery branches several times to become what?

Back 49

Cortical radiate arteries

Front 50

Cortical radiate arteries in the kidney branch to what?

Back 50

afferent arterioles

Front 51

Each afferent arteriole supplies what?

Back 51

One nephron

Front 52

What does each afferent arteriole in the kidney become?

Back 52

A ball shaped capillary network called the glomerulus

Front 53

What does the glomerulus exit as?

Back 53

the efferent arteriole

Front 54

What do efferent arterioles in the kidney divide into?

Back 54

peritubular capillaries

Front 55

Loop shaped capillaries extending from some efferent arterioles in the kidney

Back 55

Vasa recta

Front 56

Vasa recta and peritubular capillaries enter where?

Back 56

Cortical radiate veins

Front 57

Cortical radiate veins unite to form larger veins which eventually become what?

Back 57

Renal veins that leave the kidney

Front 58

Where do many renal nerves originate?

Back 58

In the renal ganglion

Front 59

Where do many renal nerves pass through?

Back 59

Renal plexus

Front 60

Renal nerves primarily carry ____ outflow. Most are ___ nerves that regulate ___ flow through the kidneys.

Back 60

Sympathetic

Vasomotor

Blood

Front 61

Two parts of the renal corpuscle

Back 61

Glomerulus and the nephron

Front 62

Mesangial cells

Back 62

Smooth muscle and phagocytic cells

Front 63

Where are mesengial cells found?

Back 63

Around the glomerulus

Front 64

The glomerulus is a mass of capillaries fed by ____ arteriole and drains into the ____ arteriole.

Back 64

Afferent

Efferent

Front 65

Functional unit of the kidney?

Back 65

Nephron

Front 66

Renal corpuscle function

Back 66

Filters blood plasma

Front 67

Renal tubule function

Back 67

Modifies the filtrate

Front 68

Glomerular capsule

Back 68

Double walled epithelial cup surrounding the capillaries

Front 69

Parietal layer of glomerular capsule made up of what cells?

Back 69

Simple squamous epithelium

Front 70

Visceral layer of glomerular capsule made up of what cells?

Back 70

Podocytes and projections that wrap around the capillaries

Front 71

Space between the visceral and parietal layer which contains fluid filtered from the glomerulus

Back 71

Capsular space

Front 72

Glomerular endothelial cells have ___, making them leaky.

Back 72

pores

Front 73

After fluids and solutes from blood pass through glomerular endothelial cells where does it go next?

Back 73

Basal lamina

Front 74

Basal lamina of the kidney

Back 74

non-cellular material prevents filtration of large proteins

Front 75

From basal lamina, where do fluid and solutes from blood go next?

Back 75

to Pedicels

Front 76

Pedicels of the kidneys

Back 76

filtration slits between projections on podocytes.

Front 77

Pedicels of the kidney prevent what?

Back 77

filtration of medium sized proteins into the glomerular space

Front 78

Blood from the glomerulus is ____.

Back 78

filtered

Front 79

Filtrate moves from the glomerular capsule to the ___ ___.

Back 79

Renal tubule

Front 80

3 main sections of renal tubule

Back 80

Proximal convoluted tubule

Nephron loop

Distal convoluted tubule

Front 81

Where does filtrate enter the kidney first?

Back 81

Proximal convoluted tubule

Front 82

From the proximal convoluted tubule where does it go next?

Back 82

Nephron loop

Front 83

2 sections of nephron loop?

Back 83

Descending limb of the loop of the nephron

Ascending limb of the loop of the nephron

Front 84

The ascending limb of the loop of the nephron is divided into what 2 parts?

Back 84

Thin and thick ascending limb

Front 85

What does the final portion of thick ascending loop of the nephron make contact with?

Back 85

Afferent arteriole

Front 86

What forms the macula densa?

Back 86

Tightly packed tubular cells

Front 87

Along the macula densa, the afferent arteriole has muscle cells called ____.

Back 87

Juxtaglomerular cells

Front 88

Juxtaglomerular apparatus makeup. What can it release?

Back 88

Juxtaglomerular cells + macula densa

Can release nitric oxide

Front 89

Function of nitric oxide (released by juxtaglomerular apparatus)

Back 89

Along with ANS, helps regulate blood pressure

Front 90

From the nephron loop filtrate enters what?

Back 90

Distal convoluted tubule

Front 91

From the distal convoluted tubule where does filtrate go?

Back 91

The collecting duct (final portion of the nephron)

Front 92

Distal portion of the collecting duct

Back 92

Papillary duct

Front 93

The papillary ducts delivers urine where?

Back 93

Into the minor calyces

Front 94

What 2 cells are present in the distal portion of the DCT and continuing into the collecting duct?

Back 94

Principal cells and intercalated cells

Front 95

Principal cells in the distal portion of the DCT and collecting duct function

Back 95

Receptors for ADH and aldosterone

Front 96

Intercalated cells in the distal portion of the DCT and collecting duct function

Back 96

Help regulate blood pH

Front 97

2 kinds of nephrons

Back 97

Cortical and juxtamedullary

Front 98

Cortical nephrons anatomy

Back 98

Short loops of the nephron extend only into outer region of medulla

Front 99

Cortical nephrons function

Back 99

create urine with osmolarity similar to blood

Front 100

Juxtamedullary nephrons anatomy

Back 100

Renal corpuscles deep in cortex with long nephron loops

Front 101

Juxtamedullary nephrons receive blood from where?

Back 101

Peritubular capillaries and vasa recta

Front 102

Juxtamedullary nephrons function

Back 102

Enable kidney to secrete concentrated urine

Front 103

3 processes for urine formation

Back 103

glomerular filtration

tubular reabsorption

tubular secretion

Front 104

glomerular filtration + secretion - absorption = ?

Back 104

Excretion of a solute

Front 105

Glomerular filtration

Back 105

Water and most solutes in blood plasma move across the glomerular capillaries where they are filtered and move into the glomerular capsule

Front 106

Filtration depends on 3 ____

Back 106

pressures

Front 107

3 major pressures filtration depends on

Back 107

Glomerular Blood Hydrostatic Pressure (GBHP)

Opposed by:

Capsular Hydrostatic Pressure (CHP)

Blood Colloid Osmotic Pressure (BCOP)

Front 108

Glomerular blood hydrostatic pressure

Back 108

Forces water and solutes in blood through the filtration membrane

Front 109

CHP and BCOP due mainly to what?

Back 109

Proteins in plasma

Front 110

Net filtration pressure

Back 110

Total pressure that promotes filtration

NFP = GBHP-CHP-BCOP

Front 111

Glomerular filtration rate

Back 111

Amount of filtrate formed by both kidneys each minute

Front 112

How many liters of fluid pas into the glomerular capsules every day?

Back 112

150-180 liters

Front 113

GFR too high

Back 113

Substances pass too quickly and are not reabsorbed back into blood

Front 114

GFR too low

Back 114

Nearly all reabsorbed and some waste products not adequately excreted

Front 115

GFR (glomerular filtration rate) controlled by what three regulations?

Back 115

Renal autoregulation

Neural regulation

Hormonal regulation

Front 116

2 mechanisms of GFR autoregulation

Back 116

Myogenic mechanism and tubuloglomerular feedback

Front 117

Renal autoregulation maintains GFR despite changing ____ ____.

Back 117

Blood pressure

Front 118

Myogenic mechanism for renal autoregulation

Back 118

Smooth muscle cells in afferent arterioles contract in response to elevated blood pressure and relax in response to lowered BP

Front 119

Tubuloglomerular feedback for renal autoregulation

Back 119

High GFR diminishes reabsorption. Less time to reabsorb Na+, Cl-, and H2O

Macula densa detects and inhibits release of nitric oxide by JGA.

Afferent arterioles constrict

Front 120

Neural regulation of GFR

Back 120

Sympathetic fibers release norepinephrine which constricts arterioles

Front 121

Moderate Neural regulation of GFR

Back 121

Afferent and efferent arterioles constrict - GFR drops slightly

Front 122

Strong Neural regulation of GFR

Back 122

Exercise of hemorrhage

Greater constriction of afferent arterioles

Urine output is reduced, and more blood is available for other organs

Front 123

Hormonal regulation of GFR - Angiotensin II

Back 123

constricts afferent and efferent arteriole, decreasing GFR

Front 124

Hormonal regulation of GFR - Atrial natriuretic peptide. Function and why is it secreted?

Back 124

Relaxes mesangial cells, increasing capillary surface area and GFR

Secreted in response to stretch of the cardiac atria

Front 125

Tubular reabsorption definition

Back 125

movement of substances in filtrate back into the blood (mainly what we want to keep)

Front 126

Where is most filtrate reabsorbed?

Back 126

proximal convoluted tubule (PCT)

Front 127

Filtrate passes from lumen through ___ ____ (linked by tight junctions).

Back 127

Lumen

tubular cells

Front 128

After filtrate passes from lumen through tubular cells it goes to ___ ___ then to ____.

Back 128

Interstitial fluid

Capillaries

Front 129

Secretion in kidneys definition

Back 129

movement of substances in blood into the filtrate/urine (what we want to get rid of)

Front 130

What if the function of secretion in the kidneys?

Back 130

Manage pH

Rid the body of toxic and foreign substances

Front 131

2 routes of reabsorption

Back 131

Paracellular reabsorption

Transcellular reabsorption

Front 132

Paracellular reabsorption definition. Example?

Back 132

Passive fluid leakage between cells

Tight junctions in the proximal convoluted tubule are leaky

Front 133

Transcellular reabsorption path

Back 133

From apical lumen across the entire tubular cell and through the basolateral membrane to interstitial fluid

Front 134

Transport mechanisms may be ___ or ___.

Back 134

passive or active

Front 135

Passive transport does not require ___. Type of transport?

Back 135

ATP

Diffusion driven by chemical or electrical gradient

Front 136

Primary and secondary active transport requires breakdown of ____.

Back 136

2 ATP

Front 137

Where is energy derived from in order to pump a substance across a membrane?

Back 137

Hydrolysis

Front 138

Secondary active transport driven by what?

Back 138

ion's electrochemical gradient created by primary active transport

Front 139

Symporters move 2 or more substances in the ____ direction.

Back 139

Same

Front 140

Antiporters move 2 or more substances in the ____ direction.

Back 140

Opposite

Front 141

Where does obligatory water reabsorption occur?

Back 141

PCT and descending limb of the loop of the neprhon

Front 142

What regulates facultative water reabsorption? Where does it occur?

Back 142

ADH regulates it

Occurs in the end of DCT and collecting duct

Front 143

Most reabsorption occurs in which tubule?

Back 143

PCT

Front 144

What brings Na+ and glucose into tubular cells?

Back 144

Na+-Glucose symporters

Glucose diffuses to basolateral membrane where it exits by facilitated diffusion

Front 145

Na+/K+/ATPase in the basolateral membrane pumps ____ into the _____ then to _____.

Back 145

Na+ into the interstitial fluid then to blood

Front 146

What transports Na+ into the tubule cells and H+ out of the tubule cell?

Back 146

Na+-H+ antiporters in PCT

Front 147

Most HCO3- in filtered fluid is ____

Back 147

reabsorbed

Front 148

CO2 diffues into ___ ____.

Back 148

tubule cells

Front 149

HCO3- leaves the basolateral membrane by ___ ___ and enters blood with Na+

Back 149

facilitated diffusion

Front 150

What greatly increases water movement in the PCT and descending limp of the loop of the nephron?

Back 150

many membrane H20 channels of Aquaporin 1

Front 151

How does the concentration of filtered solutes increase in tubular fluid?

Back 151

Water leaves

Front 152

In the second half of PCT what promotes passive diffusion into the peritubular capillaries?

Back 152

electrochemical gradients

Front 153

What converts most ammonia to urea?

Back 153

Hepatocytes

Front 154

Where are both ammonia and urea secreted?

Back 154

PCT

Front 155

How much water is reabsorbed in the descending limb of the loop of the nephron? Ascending limb?

Back 155

Descending-15%

Ascending- little to none

Front 156

What stimulates reabsorption of Ca2+?

Back 156

Parathyroid hormone

Front 157

RAA pathway stimulated by what?

Back 157

Na+ deficiency, dehydration, hemorrhage, decreased blood volume decreases BP

Front 158

How does low BP stimulate the RAA pathway?

Back 158

Decreases stretch in afferent arterioles causing juxtaglomerular cells to secrete renin.

Front 159

Renin is an enzyme that causes what conversion?

Back 159

converts angiotensinogen to angiotensin 1

Front 160

What converts angiotensin 1 to angiotensin 2?

Back 160

ACE (secreted by lungs and kidneys)

Front 161

Angiotensin 2 main actions?

Back 161

decreases GFR by vasoconstriction of afferent arterioles

stimulates activity of Na+/H+ antiporters resulting in reabsorption of Na+, Cl-, and water in PCT

stimulates adrenal cortes to release aldosterone- causes principal cells in collecting duct to reabsorb more Na+ and Cl- (water follows)

Front 162

What releases ADH or vasopressin? In response to what?

Back 162

Posterior pituitary

Response to high osmolarity in hypothalamus

Front 163

ADH stimulates the insertion of water channel protein ____ in the apical membrane of ___ cells in DCT and collecting duct. What does this cause? What kind of feedback regulates this?

Back 163

aquaporin-2

principle

Causes increasing reabsorption of water

Front 164

ADH stimulates the insertion of water channel protein aquaporin-2 in the apical membrane of principle cells in DCT and collecting duct. What does this cause? What kind of feedback regulates this?

Back 164

Causes increasing reabsorption of water

Negative feedback