Chapter 26 Urinary System

Front 1

The main function of the urinary system is to maintain homeostasis via ____ ____ by regulating water, ions, and non-ionic solutes and elimination of ___ and ___ ___.

Back 1

osmotic regulation;

nitrogenous; other wastes

Front 2

Nitrogenous wastes are from ____ of ___ ___ and ___ ___.

Back 2

catabolism; nucleic acids; amino acids

Front 3

Nitrogenous wastes

Amino acid uses include

a.

b.

c.

d.

Back 3

protein synthesis

ATP synthesis

gluconeogenesis

fat synthesis

Front 4

Nitrogenous wastes

For ___ synthesis, ___, and __ synthesis, ___ (-NH2) must be removed from amino acids.

Back 4

ATP; gluconeogenesis; fat

Front 5

Nitrogenous wastes

Amino acids are converted into urea which is the chemical formula: ________

Back 5

H2N-CO-NH2

Front 6

Nitrogenous wastes

Ammonia is formed by ___ groups and ___.

Back 6

NH2; hydrogen

Front 7

Nitrogenous wastes

The chemical reaction that takes place to form ammonium hydroxide is... _____. It is very ___.

Back 7

NH3+ H2O -> NH4+ + OH-(base)

toxic

Front 8

Nitrogenous wastes

Ammonia is secreted by __ and ___.

Back 8

fish; amphibians

Front 9

Nitrogenous wastes

Urea is the main nitrogenous waste excreted by ___. It is less___ than ammonia. Synthesis requires significant amounts of ___.

Back 9

mammals; toxic; energy

Front 10

Nitrogenous wastes

The liver urea cycle is ______.

Back 10

CO2 +2NH2 + ATP -> urea and H2O

Front 11

Nitrogenous wastes

Uric acid is excreted by __, ___, and ___. It is relatively ____. It has low ___-____. Synthesis is ___-___.

Back 11

birds; reptiles; insects

non-toxic

water-solubility;

energy-demanding

Front 12

Nitrogenous wastes

Uric acid is formed by ___ ___metabolism, which is the conversion of ___ (__ & ___) into ___ and ____, which form___ ___.

Back 12

nucleic acid;

purines (G&A); xanthine; hypoxanthine; uric acid

Front 13

The components of the human urinary system include 2___, 2___, ___ ___ and ___.

Back 13

kidneys; ureters; urinary bladder; urethra

Front 14

Kidneys

___ ___-shaped. Near the center of the concave border is an indentation called the ___, through which the ureter emerges from the kidney along with blood vessels, lymphatic vessels, and nerves.

Back 14

kidney beaned;

hilum

Front 15

Kidneys

Location is ____ and ____; below the _____

Back 15

paravertebral; retroperitoneal; diaphragm

Front 16

Kidneys

They are surrounded by three layers: ___ __, ____ ___, and ___ ___.

Back 16

renal capsule; adipose capsule; renal fascia (inside -> outside)

Front 17

Kidneys

The inferior displacement or dropping of the kidney is due to ____ of renal fascia and ___ ___, which contributes to the condition ___ (aka ___ __). This condition contributes to ___, when the urine cannot drain from the kidney to the bladder and the kidney swells.

Back 17

weakening; adipose capsule; nephroptosis; floating kidney; hydronephrosis

Front 18

Kidneys

Contains three areas

1. ____

2. ___

3 ____ ___

all of which are composed of ___ and ____ ___.

Back 18

1. cortex;

2. medulla;

3. renal pelvis;

parenchyma (the functional portion of the kidney containing nephrons ); supporting stroma

Front 19

Kidneys (cortex)

Has ____, ____ and ____ areas. It is composed of ____ ___, which extend between renal pyramids.

Back 19

granular, outer, juxtamedullary

renal columns

Front 20

Kidneys (medulla)

It is ___, and located in the ____ ____.
It is composed of __ ___.

Back 20

striated; middle area;

renal pyramids

Front 21

Kidneys (renal pelvis)

It is a hollow, inner area for ___ ____ (via ____ ____). It is located within the __ ___ is a fat-filled cavity.

Back 21

urine collection; minor calyces; renal sinus

Front 22

Kidney functions include:

1. regulating ___ and ___ electrolytes

2. regulating blood ___

3. regulating blood __

4 removing __ ___ and ___ substances from blood

5. regulating blood __

6. maintaining blood ___

7. producing ___(___, ____=EPO)

8. helps regulating blood ___ via ___, ___, and _____

Back 22

1. blood; ECF

2. volume

3. pH

4. toxic wastes; foreign

5. pressure

6. osmolarity

7. hormones; calcitriol; erythropoietin

8. glucose; glycogenolysis; glycogenesis; gluconeogenesis

Front 23

There are about __ million nephrons per kidney.

Back 23

1

Front 24

Nephron components

Renal Corpuscle is made of the

1. ___ __ (aka ___ ___)

2. _____

Back 24

1. Bowman's Capsule; glomerular capsule

2. Glomerulus

Front 25

Nephron components (renal corpuscle)

The Bowman's capsule is a ___ structure, which receives ___ ___. It's two layers are the ___ and ____ layer. The space between the two layers of the glomerular capsule, is called the _____ __, through which fluid filtered from the glomerular capillaries enters.

Back 25

cuplike; glomerular filtrate

visceral; parietal

capsular space (Bowman's space)

Front 26

Nephron components (glomerulus)

This is the __ ___ surrounded by the __ layer of ____ ___.

Back 26

capillary tuft; visceral; Bowman's capsule

Front 27

Nephron components (glomerulus)

The filtration membrane is composed of:

1.___ ___ ___

2. ___ ___ ___

3. ___ ___

Back 27

1. fenestrated glomerular endothelium

2. glomerular basement membrane

3. slit membrane

Front 28

Nephron components (filtration membrane)

The fenestrated glomerular endothelium is permeable to ___ ___ including all solutes. ___ ___ are located in this, that regulate the surface area available for ___.

Back 28

plasma components;

mesangial cells; filtration

Front 29

Nephron components (filtration membrane)

The glomerular basement membrane, aka ___ ___, is impermeable to ___ ___. The __ ___ prevents the passage of __ into urinary filtrate.

Back 29

basal lamina; larger proteins; heparan sulfate; albumin

Front 30

Nephron components (slit membrane)

The slit membrane is supported by ___ __, formed by __ of ___. It is impermeable to medium-sized ___. Albumin may penetrate, if not already excluded by ___ ___ of __

Back 30

filtration slits; pedicels; podocytes; proteins; heparan sulfate; GBM

Front 31

Nephron components

The renal tubule contains the

1.

2.

3.

4.

Back 31

1. proximal convoluted tubule (PCT)

2. nephron loop (Loop of Henle)

3. distal convoluted tubule (DCT)

4. connecting tubule (CT)

Front 32

Nephron components (renal tubule)

The PCT receives ___ ____ from the ___ ___.

It is made of ___ ___ epithelium with long ___ ___ which increases ___ ___.

Back 32

glomerular filtrate; glomerular capsule;

simple cuboidal; apical microvilli; surface area

Front 33

Nephron components (renal tubule)

The nephron loop consists of the ___ and ____ limbs. The _____ limb and _____ ____ portion of _____ limb is made of simple squamous epithelium.

Back 33

ascending; descending

descending; proximal thin; ascending

Front 34

Nephron components (renal tubule)

The DCT is also known as the ___ ___. It is made of ___ epithelial cells.

Back 34

early DCT; cuboidal

Front 35

Nephron components (renal tubule)

The connecting tubule aka the ___ ___ links the ___ to ___ ___ (CD). There are two cell types: ___ ___ (___-sensitive and ___ ___-sensitive cells) and ____ cells with ____ pumps and play a role in homeostasis of blood pH)

Back 35

late DCT;

nephron; collecting duct;

principal cells (aldosterone; antidiuretic hormone)

intercalated; H+ - ATPase

Front 36

Nephron components

The nephron wall is made of ___ epithelium (on basement membrane). It's epithelilal structure/ function varies with site.

Back 36

simple

Front 37

Nephron components

The distal thick portion of ascending limb of nephron loop (TAL) is made of ___ / ___ ___ epithelium. The TAL contain ____ ___ where it contacts the __ ___. The wall of the afferent arteriole contains modified smooth fibers called ______ cells that secrete____. Together with the macula densa, they constitute the ____ ____ that regulate ___ ___.

Back 37

cuboidal/ low columnar;

macula densa; afferent arteriole

juxtaglomerular (JG) cells; renin

juxtaglomerular apparatus (JGA);

blood pressure

Front 38

The nephron reserve capacity is __% of total nephron number. Nephrons show ___ but not ___ when they are injured or become diseased.

Back 38

60%; hypertrophy; hyperplasia

Front 39

There are two types of nephrons:

1. ____ ___

2. ___ ___

Back 39

cortical nephrons

juxtamedullary (J-M) nephrons

Front 40

Nephrons

The cortical nephrons are made of ____+___ +___+__ in outer third of cortex. They are made of short nephron loops. They contain a ___ ___ network (arises from ___ ___) that surround the loops.

Back 40

glomeruli + PCT + DCT+ CT;

peritubular capillary network; efferent arteriole

Front 41

Nephrons

The juxtamedullary (J-M) nephrons enable ____ of ____. They consist of the ___ + ____ + ___ + ____ near the cortical-medullary boundary. Their long nephron loops extend almost to the ___ __. Their loops are surrounded by long ___ __.

Back 41

concentration; urine;

glomeruli + PCT + DCT + CT; renal papillae;

vasa recta

Front 42

Collecting ducts (CD) have ___ and ___segments and consist of ___ and ___ cells. Several CTs link to a single ___ in the cortex, which conducts urine to ____ ___ and then to the ___ ___.

Back 42

corticol; medullary; principal; intercalated; collecting duct; papillary duct; renal pelvis

Front 43

Renal Pyramids (aka ___ ___) are __-shaped, striated kidney areas. Renal columns are located in the ___ between renal pyramids. Renal pyramids have an ____ pyramid shape. At its apex is the __ ___. In its striations contain nephron loops, CDs, and papillary ducts which converge on a ___ ____ ___.

Back 43

medullary pyramids; cone; striated;

cortex; inverted; renal papilla

striations; minor renal calyx

Front 44

Several minor calyces converge on a ___ ___, which open to the ____ __, then the ___, then the ___ ___. The calyces are contained within the ___ ___.

Back 44

major calyx; renal pelvis; ureter; urinary bladder; renal sinus

Front 45

The renal lobe is made of the ___ ____ + overlying ____ and half of two ____ ___ ____

Back 45

renal pyramid; cortex; adjacent renal columns

Front 46

There are

~___ million nephrons/kidney

~ ___nephrons/ collecting duct

~ _____collecting ducts/kidney

~_____collecting ducts/papillary duct

~___papillary ducts/renal papilla

Back 46

1

10

100,000

250

30

Front 47

Nephrons' blood supply

Aorta --> R & L ___ ____--> ___ artery --> ___ aa --> ___ aa --> ____ ___ aa --> afferent arteriole --> glomerulus --> efferent arteriole --> ___ ___ network (including __ ___) --> ___ ___ vv--> ___ vv--> ___ ___--> ___ ___--> R&L renal vein --> inferior vena cava

Back 47

renal artery; segmental; interlobar; arcuate; cortical radiate;

peritubular capillary network; vasa recta; cortical radiate; arculate vein; interlobar vein; segmental vein

Front 48

The renal blood flow is ~____mL / min in adults

Back 48

1200

Front 49

Urine formation is made of 3 processes:

1. ___ ___

2. ___ __

3. ___ ___

Back 49

1. glomerular filtration (F)

2. tubular reabsorption (R)

3. tubular secretion (S)

Front 50

The rate of urine excretion of a solute is in __/min = ___ + ___ - ___

Back 50

mg/min

FR + SR - RR (see previous flashcard)

Front 51

Glomerular filtration occurs when ___ ___ causes small water-soluble molecules to move into ___ ___ as ___ ___.

The afferent arteriole is ___ than the efferent arteriole

Back 51

hydrostatic pressure; Bowman's space; glomerular filtrate

Larger

Front 52

Glomerular filtration

___ ___ and most ___ ___ are usually excluded from glomerular filtrate by the 3 part ___ _____

Back 52

blood cells; plasma proteins; filtration membrane

Front 53

Glomerular filtration

The daily volume of glomerular filtrate is ___-___ liters

Back 53

150-180

Front 54

Glomerular filtration

Urine volume/day is ___L

Back 54

1-2

Front 55

Filtration fraction (FF) is the ___ ___ ___ entering ___ ___ that becomes glomerular filtrate. Normal is ___ - ____%. It increases in __________.

Back 55

% plasma volume; afferent arteriole; 16-20; glomerulonephritis,acute inflammation of the kidney, typically caused by an immune response

Front 56

Determinants of net filtration pressure (NFP) include

1.

2.

3.

Back 56

glomerular blood hydrostatic pressure (GBHP)

- blood pressure in glomerular capiillaries, promoting filtration

capsular hydrostatic pressure (CHP)

- exerted against the filtration membrane by fluid already in the capsular space and renal tubule, opposing filtration

blood colloidal osmotic pressure (BCOP)

- due to presence of proteins, opposing filtration

Front 57

The equation for net filtration pressure (NFP) is ______. Normally,

GBHP = ___ mmHg

CHP = ___mmHg

NCOP = ___mmHg

=> NFP = ___ mmHg

Back 57

GBHP - CHP - BCOP

55

15

30

10

Front 58

The glomerular filtration rate (GFR) is the total volume of ___ produced by ___ ____ of the 2 kidneys in __ minute.

It is typically ~ ___mL/min in males; and ~___mL/min in females.

Back 58

filtrate; renal corpuscles; 1

125; 105

Front 59

When net filtration pressure (NFP) changes, this produces changes in the ___ ____ ___ as well.

e.g. Glomerulonephritis causes decreased ___, then increased ___ then increased ___.

e.g. hemorrhage or shock ___BP, which ____GBHP, which ___ NFP, which ____ GFR

e.g. Nephrolithiasis can ____CHP; __NFP, ___ GFR

Back 59

glomerular filtration rate;

BCOP; NFP; GFR

decreases; decreases; decreases; decreases

increase; decreases; decreases

Front 60

Glomerular filtration rate

To maintain homeostasis, GFR should remain ___ ___ over wide ranges of ___ ___. If too fast, essential solutes ____ in ___. If too slow, excess solutes and ___ _____ into ____.

Back 60

fairly constant; arterial pressures; lost; urine;

solutes; wastes; reabsorbed; blood

Front 61

The regulation of GFR is made up of ___ ___, ___ ___, and ___ ___.

Back 61

renal autoregulation

hormonal regulation

neural regulation

Front 62

Renal autoregulation is the ability of the kidneys to maintain a constant ___ and ___ despite changes in ___ ___ ___.

Back 62

BP; GFR; systemic blood pressure

Front 63

There are two mechanisms behind renal autoregulation: ___ ___ and ___ ___.

Back 63

myogenic mechanism

tubulo-glomerular feedback mechanism

Front 64

Renal autoregulation

With myogenic mechanism, an increased BP would ___ RBF and GBF which ___ GFR and ___ afferent arteriolar stretch.

_____ occurs which ____ GBF and RBF, which ___ GFR.

Back 64

increase; increase; increase;

vasoconstriction, decrease, decrease

(and vice versa)

Front 65

Renal autoregulation

With tubulo-glomerular feedback mechanism, decreased blood pressure ___ NFP and GFR, which ___ tubular flow rate, and causes the ___ and ___ of ___ to reabsorb more salt and water. This causes a decrease in Na concentration in fluid seen by ___ ___ of JGA, which leads to ___ NO release.

____ occurs and there is ___ blood flow; which ___ NFP and GFR, and ___ Na+ concentraiton.

Back 65

decreases; decreases; PCT & Loop of Henle; macula densa; increased;

vasodilation; increased; increases; increases

Front 66

Hormonal regulation

Angiotensin II causes afferent artierole ___ which ___ RBF and GBF, which ___ GFR.

This ___ tubular flow rate and ___ salt and water reabsorption in PCT and nephron loop, ___ blood pressure.

Back 66

vasoconstrict, decreases; decreases

decreases; increases; increases

Front 67

Hormonal regulation

Atrial natriuretic peptide (ANP) secretes with increase in blood volume, which leads to ___ atrial wall stretch, and ___ release.

This leads to ___ of mesangial cells, and ___ glomerular surface area.

There is then increased ___ (which leads to salt and water excretion and decreased blood volume)

Back 67

increased; ANP; relaxation; increased;

GFR

Front 68

Neural regulation

In fight or flight, sympathetic ___ ___ decrease ___ _____ ____ and decreases ___.

This ___ urine output and increases blood to __, __, and __.

Also, decreased GFR decreases __ ___ ___ and PCT and nephron loop reabsorb more __ and ___. This increases causes ___ BP.

Back 68

vasoconstriction fibers; glomerular blood flow; GFR;

decreases; muscles, heart, brain

tubular flow rate; salt and water; increase

Front 69

Tubular reabsorption occurs to maintain homeostasis by ____ reabsorbing water, nutrients, ions, etc from ___ ___ into blood. It occurs mostly in the ___, and occurs by __ or ___ transport. There are two reabsorption routes: ___ and ____. PCT cells include ___ ___ and many ___.

Back 69

selectively

urinary filtrate

PCT; active; passive;

transcellular (passing through tubule cell); paracellular (passing between tubule cells);

lumenal microvilli; mitochondria

Front 70

Selectivity of tubular reabsorption is shown by the use of ____ ___, including _____ transporters (i.e. ATPases) and ___ ___, which include ____ and ____.

Back 70

carrier molecules;

primary; secondary; symporters; antiporters

Front 71

Selectivity of tubular reabsorption

- the transport maximum (Tm) is the ___ amount of substance ___ per unit time.

For example, glycosuria in diabetes mellitus leads to ___ ___ (increase in urination rate as a result of certain substances) related to ___.

Back 71

maximum; reabsorbed

osmotic diuresis, polyuria

Front 72

There is a dependence of water reabsorption on solute reabsorption shown by the processes of ____, ___ ___ reabsorption, and ___ ___ absorption.

Back 72

osmosis (all water reabsorption)

obligatory water reabsorption

facultative water reabsorption

Front 73

Obligatory water reabsorption is when water is reabsorbed with ___ in ___ __ because the water is "obliged" to follow the ___ when they are ___

Back 73

solutes; tubular fluid; solutes; reabsorbed

Front 74

Facultative water absorption occurs to 10% of the water, and is regulated by ___ ___ and occurs mainly in the ___ ___.

Back 74

antidiuretic hormone; collecting ducts

Front 75

Tubular secretion adds ___-____ wastes to ___ __, including ___, ___, ___ and ____ ___.

Back 75

non-filtered; tubular fluid;

ions, toxins, drugs, nitrogenous wastes

Front 76

reabsorption by glucose by ___-______ (e.g. __-___ ____) are used by the "early" ____

Back 76

Na+ symporters; Na+ glucose symporter

PCT

Front 77

___/____ ______ promote transcellular reabsorption of Na+ and secretion of ___ in the PCT

Back 77

Na+/H+ antiporters

Na+; H+

Front 78

____/____ _____ promote reabsorption of bicarbonate ions (HCO3-) in the PCT

Back 78

Na+/H+ antiporters

Front 79

The reabsorption of water in "early" ____ promotes reabsorption of ____ (i.e. ___,___,___,___ and ___) in the "late" ___

Back 79

PCT

ions (Cl-, K+, Ca++, Mg++), urea

PCT

Front 80

The PCT and descending limb is very permeable to water due to _____-__

Back 80

aquaporin-1

Front 81

nitrogenous wastes include ___ and ____ (which forms ___ cation)

Back 81

urea; NH3;

ammonium

Front 82

The tubular fluid within the Loop of Henle (Nephron loop) is still ___

Back 82

isotonic

Front 83

The ___ ___ ___ of the nephron loop is permeable to water but impermeable to solute, while __ and ___ ____ ___ of loop are impermeable to water but permeable to solute

Back 83

thin descending limb;

thin and thick ascending limbs

Front 84

nephron loop

there are different sites for electrolyte and water reabsorption in the nephron loop, that ____ regulate urinary ___ and urinary ____

Back 84

independently; volume; osmolarity

Front 85

the thick ascending limb has a __/___/___ ____ for ___ ____

Back 85

Na+/K+/2Cl- symporter

simultaneous reabsorption

Front 86

nephron loop

when ___ leaks back into tubular lumen, interstitial fluid becomes negatively charged, attracting ___,__,___,___ from the lumen into the interstitial fluid

Back 86

K+

Na+, K+, Ca2+, Mg2+

Front 87

since the ____ ___ ____ is water impermeable, when it reabsorbs electrolytes, fluid osmolarity ___

Back 87

thick ascending limb

drops

Front 88

there is a ____ ____ in the early DCT, to reabsorb Na+and Cl-. The early DCT is also a major site where ___ ____ stimulates reabsorption of ____.

Back 88

Na+Cl- symporter

parathyroid hormone; Ca2+

Front 89

There are two types of cells in the convoluted tubule (late DCT) and collecting duct, including

1. ___-____ ___ __

2. ____ ___

Back 89

1. aldosterone-sensitive principal cells

2. intercalated cells

Front 90

the aldosterone-sensitive principal cells unequally "exchange" (reabsorb) ___ and secrete ___. This mechanism is faciliated by apical membrane ___ and ___ ___ ____. It is the main mechanism for eliminating excess ___ ions.

The principal cells are also ___-sensitive, to increase ___ ___.

Back 90

Na+; K+

Na+ and K+ leak channels

K+

ADH; water reabsorption

Front 91

intercalated cells in the CT and CD reabsorb __ and ____, and secrete ___

Back 91

K+; HCO3-

H+

Front 92

an analysis of the volume and physical, chemical, and microscopic properties of urine is called a

Back 92

urinalaysis

Front 93

blood tests

BUN stands for ___ ___ ___. BUN increases in certain ___ ____

Back 93

blood urea nitrogen

kidney diseases

Front 94

blood tests

plasma creatinine comes from the breakdown of ___ ___ ___ ____.

high creatinine could indicate ___ ___ ___

Back 94

skeletal muscle creatine phosphate

poor renal function

Front 95

blood tests

renal plasma clearance reflects the ability of ___ to remove a specific substance from blood

its equation is ___

where U= ______

P= ____

V=_________

Back 95

kidneys;

UV/P (mL/min)

U= urinary concentration of substance (mg/mL)

P = plasma concentration of substance (mg/ml)

V=urine flow rate (mL/min)

Front 96

___% of water absorption is obligatory water reabsorption (linked to solute reabsorption)

___ % of water reabsorption is facultative water reabsorption (___-regulated in CT and CD)

Back 96

90;

10; ADH

Front 97

the production of a very hypotonic urine is a result of low ___ level (because CT and CD are regulated by ___, and impermeable to water in absence of ___)

Back 97

ADH

Front 98

the production of concentrated urine (hypertonic) depends on high ___ of ____ in interstitial fluid in the renal medulla, the main contributers being __ ____ ___ (impermeable to water)

Back 98

high concentrations of solutes

thick ascending limb

Front 99

when water intake is low and water loss is high, the kidneys are required to excrete a very ___ ___

counter-current mechanism refers to the flow of fluid in _____ tubes in ____ directions.

Back 99

hypertonic urine

parallel; opposite

Front 100

the countercurrent mechanisms exist due to ___ ___ (15-20% of nephrons) and the __ ____

Back 100

juxtamedullary nephrons; vasa recta

Front 101

because of the countercurrent mechanism, kidneys are able to excrete ____, ___ or ___- urine

Back 101

iso-molar;

hypo-osmolar;

hyper-osmolar

Front 102

countercurrent mechanism

the counter-current multiplier involve the ___ and ___ ____ of nephron loops of ___ nephrons

Back 102

ascending and descending limbs; juxtamedullary

Front 103

countercurrent multiplier

permeability characteristics differ in the loop of Henle that allow secretion of different urine concentrations

the thick ascending limb:

- impermeable to ____

- actively transports ___ via lumenal __/___/___ co-porter

descending limb

- permeable to ___, impermeable to ___

Back 103

water;

NaCl; Na+/K+/2Cl-

water; solutes

Front 104

countercurrent multiplier steps

1. ___ and ___ are pumped out of the ___ ___ ___ into peritubular fluid

2. osmolarity of peritubular fluid ___ near ____ limb

Back 104

1. Na+, Cl-; thick ascending limb

2. increases; descending limb

Front 105

countercurrent multiplier steps p2

3. water flows from ___ ___ to the ___ ___

4. there is ___ solute concentration in the ___ ___

Back 105

descending limb; peritubular fluid

increased; descending limb

Front 106

countercurrent multiplier steps p3

5. there is very concentrated solution in ___ ___, which _____ NaCl transport into ____ ____. The medullary concentration gradient from upper to lower is ____ to ____

Back 106

ascending limb; increases; peritubular fluid

300 ->1200

Front 107

countercurrent multiplier steps p4

6.____ ____ in deep medulla re-inforces salt gradient

7. ___ ___ arrives at DCT

Back 107

urea recycling

hypotonic fluid

Front 108

counter-current mechanism

the medullary concentration gradient is not washed away due to the ___ ___ ____, the process by which solutes and water re passively exchanged between the blood of the vasa recta and interstitial fluid of the renal medulla as a result of countercurrent flow

Back 108

counter current exchanger

Front 109

countercurrent exchanger

the ___ ___ are involved.

they are capillaries that run parallel with nephron loops of ___ nephrons

Back 109

vasa recta

juxtamedullary

Front 110

the vasa recta maintain ___ ___ ___, while delivering nutrient blood supply

Back 110

medullary concentration gradient

Front 111

the speed of vasa recta blood flow is very ____

Back 111

slow

Front 112

vasa recta are __ ___ to water and salt, so there is complete ___ between the blood and interstitial fluid

Back 112

freely permeable;

equilibrium

Front 113

since countercurrent flow between the descending and ascending limbs of the vasa recta allows for exchange of soolutes and water between the blood and interstitial fluid of the renal medulla , the vasa recta is said to function as a ____ ____

Back 113

countercurrent exchanger

Front 114

as blood flows into the inner medulla, ___ is lost and ___ is gained (300->1200)

Back 114

water; salt

Front 115

as blood flows back toward the cortex, ___ is gained and __ is lost (1200->320)

Back 115

water; salt

Front 116

removal of solutes and water by vasa recta balances ___ of solute and water reabsorption by __, so the medullary concentration gradient is protected and reabsorbed water/solutes are returned to general circulation

Back 116

rates

Tubule

Front 117

benefits of the counter-current mechanism

1. method for ____ solutes/water before the fluid reaches ___ and __

- prevents life-threatening ___ and ___

2. concentration gradient in medulla allow ___-____ ____ ___ from ___ and ____

Back 117

1. reabsorbing; CT and CD

hyperkalemia; alkalosis

2. ADH-dependent water reabsorption from CD and CD

Front 118

ADH increases __ and ___ permeability to water (Due to insertion of ___-_ ____ ___ proteins)

ADH is osmotically driven through these water channels, and would not occur without the presence of the ___ ___ set up in the medullary interstitium by the countercurrent mechanism

Back 118

CT and CD

aquaporin-2 water channel

salt gradient

Front 119

if blood osmotic pressure increases, the ___ ___ releases ADH

Back 119

posterior pituitary

Front 120

if blood osmotic pressure decreases, no ___ released, and ___ results

Back 120

ADH

diuresis

Front 121

__ ___ is a disorder in which the hormone ADH is absent

Back 121

diabetes insipidus

Front 122

___ inhibits ADH secretion, leading to diuresis

___ inhibits Na+ reabsorption by renal tubule

diuretic drugs are anti-______, as it increases___ and decreases ___ ___, ___ ___, and ____

Back 122

ethanol

caffeine;

hypertensive;

urine;

blood pressure; blood volume; pressure

Front 123

some examples of diuretic drugs:

1. furosemide (____) blocks _______ ____ of __ ___ ___

2. thiazides block ___-_________ in __ ____ __

3. IV mannitol blocks ____ ___ -uptake

Back 123

Lasix

Na+/K+/2Cl- coporter; thick ascending limb

Na+Cl--symporter; distal convoluted tubule

PCT Na+

Front 124

tubular reabsorption and secretion are regulated by the following hormones

1.

2.

Back 124

ADH

renin-angiotensin-aldosterone system

Front 125

the juxtaglomerular apparatus is the area of close contact between ___ ___ of ___ __ and neprhon's loop ___ ____ (top of ___)

Back 125

juxtaglomerular cells; afferent arteriole; macula densa; thick ascending loop

Front 126

the JGa monitors ____ ___ and ___ ___ within afferent arteriole

Back 126

blood volume; blood pressure

Front 127

if blood volume and blood pressure drop, there is a decrease in glomerular filtration rate. The afferent arteriole's ___ cells secrete ___.

- this converts ___ into ____.

Back 127

juxtaglomerular cells; renin

angiotensinogen; angiotensin I

Front 128

____ ____ ____ changes angiotensin I to angiotensin II

Back 128

angiotensin converting enzyme

Front 129

functions of angiotensin II

1. direct _____ which increases blood pressure and _____ _____ vasoconstriction

2. increased ___ _____ by ____, which increases blood pressure

3. ____ release by adrenal cortex

Back 129

vasoconstriction; afferent arteriole

Na+ reabsorption; PCT

aldosterone

Front 130

salt concentration is monitored by the ___ ___

- if there is increased salt concentration in lumen, there is no ___ release

- if there is decreased salt concentration in the lumen, ___ is released

Back 130

macula densa;

renin

renin

Front 131

____ may result if the renin-angiotensin-aldosterone system is defective and is ____ __

Back 131

hypertension;

continually stimulated

Front 132

kidney dialysis is treatment of ___ or ___ ___ ___. the two types include

____

___ ___

Back 132

temporary; permanent renal failure

hemodialysis

peritoneal dialysis

Front 133

in hemodialysis, a patient's ____ blood is passed through a ___ ___ ___ in contact with ___ which maintains diffusion gradients that remove wastes and adds needed substances to the blood

- substances in high concentration in blood move into ___

Back 133

heparinized; semipermeable membranous tube; dialysate

dialysate

Front 134

___-____g urea can be removed by __-___ hour dialysis treatment

Back 134

50-250; 4-6

Front 135

hemodialysis is done ___-__X per week

Back 135

2-3

Front 136

drawbacks of hemodialysis include

a. ____ use, leading to hemorrhage

b. ___, damage to RBC

c. infection risk and possible ____

d. restriction of dietary __ and __

e. ___ consuming

f. loss of ___, __, etc

Back 136

anticoagulant;

hemolysis

septicemia;

fluid; protein

time

nutrients; hormones

Front 137

peritoneal dialysis is done when ___ ___ is run into ___ ___. the peritoneal membranes represents the ___ ___.

there are __-__ exchanges per day, with each exchange lasting for __-___ hours.

Back 137

dialysis fluid; peritoneal cavity

dialysis membrane

4-5;

4-6

Front 138

one variation of peritoneal dialysis is ___ ___ ___ ___ which can be performed at home/work

Back 138

continuous ambulatory peritoneal dialysis

Front 139

the drawback to peritoneal dialysis is ____

Back 139

peritonitis (infection)

Front 140

the mucosa of the ureters include the _____ ___ (aka ____) + ____ ___ + ____ ____

Back 140

transitional epithelium (urothelium) + goblet cells + lamina propria

Front 141

the muscularis of the ureters include ____ _____ (inner _____ + outer ____)

- distal 1/3

its function is ____

Back 141

smooth muscle; longitudinal; circular

peristalsis

Front 142

the adventia of the ureters is a ____ ___ ____

Back 142

fibrous outer coat

Front 143

the function of the ureters is to ____ urine from ___ to ___ via ___ ____

Back 143

transport; kidney; bladder

peristaltic contractions

Front 144

the ureters contain ___-____ ____ (between ureters and urinary bladder)

a long intra-mural segment = a ___ valve.

- as bladder fills, ureter compressed closed

a short intra-mural segment = a ___ valve.

if sphincter defective, ascending infection leads to ____

Back 144

vesico-ureteral sphincters

good;

poor

pyelonephritis (can cause scarring of kidney)

Front 145

the urinary bladder is a ___ muscular sac behind the ___ ___. its function is to store urine until ____.

Back 145

distensible; pubic symphysis

micturition (ejection of urine to outside)

Front 146

the urinary bladder contains two ___ (ureters) and 1 ___ (internal urethral orifice) which form a ____

Back 146

inlets;

outlet;

trigone

Front 147

the mucosa of the bladder wall is ___ ___( aka ____) which changes as stored urine volume ____. it also contains ___

Back 147

transitional epithelium; urothelium

increases;

rugae

Front 148

the muscularis of the urinary bladder includes ___ ____ which contracts to expel urine.

note: micturition involves both ___ ___ ___ (involuntary) and ___ ___ ___ (voluntary) of urethra must be relaxed

- the micturition reflex is associated with ___ ___ contraction + ___ ___ ___ relaxation

Back 148

detrusor muscle;

internal urethral sphincter;

external urethral sphincter

detrusor muscle contraction; internal urethral sphincter relaxation t

Front 149

the adventitia of the urinary bladder involves the ___, ___ ___ covering top of bladder

Back 149

serosa; visceral peritoneum

Front 150

a ____ is an endoscopic exam of urethra and bladder, which is used to assess ___ and ___ (biopsy of abnormal tissue).

it can be used to remove ___ in ____.

it is used to evaluate obstruction due to ___ ___ ____

Back 150

cystoscopy

cancer; infection

calculi; urolithiasis;

benign prostatic hyperplasia (enlarged prostate)

Front 151

urinary retention is the failure to void completely, which leads to ___, and possible ___ and ____

this occurs in BPH or bladder atony

Back 151

stasis; cystitis (inflammation of bladder); pyelonephritis (scarring of kidney)

Front 152

urinary incontinence is lack of voluntary control over ___

Back 152

micturition

Front 153

stress incontinence represents a weak ____ ____ ____

Back 153

external urethral sphincter

Front 154

overflow incontinence occurs when continuous ___ of urine is released from ____ bladder

Back 154

dribble; over-full

Front 155

urgency incontinence is failure to restrain ___ __, despite desire to do so

Back 155

urine discharge

Front 156

functional incontinence is when a person recognizes the need to urinate but is ________

Back 156

unable to get to the otilet t

Front 157

total incontinence is a return to the _____ ____ ____

Back 157

return to pre-potty training state

Front 158

the urethra is a tube from urinary bladder to ___ ___ ____

Back 158

external urethral orifice

Front 159

gender differences

female: external urethral orifice is between ___ and ___

male: external urethral orifice opens at tip of ___ ___

Back 159

clitoris; vagina;

glans penis

Front 160

in the male, there are 3 segments to the urethra:

Back 160

prostatic urethra, intermediate (membranous) urethra, spongy urethra which passes through penis within corpus spongiosum

Front 161

the mucosa of the urethra is ___ ___,

___ ___ or ____ ___ ___ and _____ ___ ___ ___

Back 161

transitional epithlelium

stratified columnar/psuedostratified columnar epithelium

non-keratinized stratified squamous epithelium

Front 162

the muscularis of the urethra is ____ ____ (inner ___ and outer ____ ___)

Back 162

smooth muscle; circularis; longitudinal muscle

Front 163

the adventitia of the urethra is ___ ___

Back 163

areolar C.T.