Physiology Osborn Renal Ps2: Functional Anatomy Of The Urinary System

Front 1

What is the order of blood vessels to and within the kidney from the aorta to the vena cava?

Back 1

1. Abdominal aorta to Renal artery

2. Renal artery to Renal vasculature

3. Renal vasculature to Renal vein

4. Renal vein to Inferior Vena Cava

5. (Inferior Vena Cava to Right heart)

A.A.
R.A
RVas.
RV
IVC

Front 2

6. Normally, an individual will have only one

A. inferior vena cava
B. ureter
C. renal artery
D. renal vein
E. kidney

Back 2

A. inferior vena cava

Front 3

7. The cells of the proximal tubule
A. are always impermeable to Na+
B. secrete renin
C. are always permeable to water
D. are modified smooth muscle cells
E. are relatively thin and flat, with few mitochondria

Back 3

C. are always permeable to water

Front 4

9. Fluid in the tubular segment with the macula densa will flow next and immediately into which tubular segment:
A. cortical collecting duct
B. distal convoluted tubule
C. thin descending limb of Henle’s loop
D. thin ascending limb of Henle’s loop
E. proximal convoluted tubule

Back 4

9. B The path of fluid flow is from the thick ascending limb of Henle’s loop, to the region of the macula densa, and then to the distal convoluted tubule.

Front 5

10. Fluid in the major calyx will flow next and immediately into the
A. ureter
B. medullary collecting duct
C. thick ascending loop of Henle
D. cortical collecting duct
E. renal pelvis

Back 5

10. E

Front 6

11. The passage of negatively charged molecules from the plasma to the urinary space is blocked primarily by which component of the glomerular filter
A. fenestrations of the endothelium
B. molecular composition of the basal lamina
C. slit between pedicels
D. molecular composition of the slit diaphragm

Back 6

11. B

Front 7

12. Glucose is reabsorbed from the tubular fluid in which segment of the nephron?
A. Bowman’s capsule
B. proximal tubule
C. descending thin loop of Henle
D. collecting tubule
E. macula densa

Back 7

12. B

Front 8

13. Vasopressin (ADH / antidiuretic hormone) regulates _________ in the ________ cells
A. water channels proximal tubule
B. Na+ channels juxtaglomerular cells
C. water channels collecting duct
D. Na+ channels distal convoluted tubule

Back 8

13. C. vasopressin (or ADH) stimulates the cell to insert water channels (aquaporins) into the apical membrane of the collecting duct cell.

Front 9

14. Select the answer below which lists renal blood vessels in their correct sequence (blood vessels which
immediately follow)
A. arcuate artery -> arcuate vein
B. cortical peritubular capillary -> interlobar vein
C. afferent arteriole
-> glomerular capillary
D. vasa recta -> interlobular vein
E. renal vein -> arcuate vein

Back 9

14. C

Arcuate artery --> interlobular artery
Cortical peritubular capillary -> interlobular vein
Vasa recta --> arcuate vein
Renal vein -> inf. vena cava

Front 10

15. Tubular cells with a high density of mitochondria, but no apical microvilli, are those that line the
A. thin descending limb of Henle’s loop
B. thick ascending limb of Henle
C. proximal tubule
D. cortical collecting duct
E. medullary collecting duct

Back 10

15. B
(also the distal convoluted tubule)

Front 11

16. A feature common to all of the epithelial cells of the tubular segments located both the cortex and the medulla is
A. the presence of extensive apical microvilli
B. the proximity to segments of the peritubular capillaries
C. a relatively thin (squamous) shape
D. the presence of high density of mitochondria near the apical cell membrane
E. the presence of podocytes

Back 11

16. B. Cells lining the different tubular segments vary quite a bit in size, function, and specialization, but they are all close to the peritubular capillaries (remember that in the medulla, the peritubular capillaries are the vasa recta).

Front 12

17. For the renal transport process of REABSORPTION, number the correct sequence of structures a substance would pass through starting in the proximal convoluted tubule (PCT) lumen. Assume the substance is not metabolized by the PCT epithelial cell or endothelial cell and the substance follows a transcellular and not paracellular route.

order (1=1st, 9=last) structure or fluid space

plasma ultrafiltrate in proximal tubule lumen

plasma found in peritubular capillary adjacent to PCT epithelial cell

luminal-side plasma membrane endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

intracellular fluid of PCT epithelial cell

intracellular fluid endothelial cell of peritubular capillary adjacent to
PCT epithelial cell

interstitial-side plasma membrane of endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

interstitial fluid

basolateral plasma membrane of PCT epithelial cell
apical plasma membrane of PCT epithelial cell

Back 12

17.
1. plasma ultrafiltrate in proximal tubule lumen

2. apical plasma membrane of PCT epithelial cell

3. intracellular fluid of PCT epithelial cell

4. basolateral plasma membrane of PCT epithelial cell

5. interstitial fluid

6. interstitial-side plasma membrane of endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

7. intracellular fluid endothelial cell of peritubular capillary adjacent to
PCT epithelial cell

8. luminal-side plasma membrane endothelial cell of peritubular
capillary adjacent to PCT epithelial cell

9. plasma found in peritubular capillary adjacent to PCT epithelial cell

Front 13

18. During the process of filtration, solutes pass through a series of structures. Which of the following lists a pair of structures that immediately follow each other in this process, and in the order given
A. glomerular capillary plasma, Bowman’s space
B. Bowman’s space, podocyte slit
C. basement membrane, podocyte slit
D. endothelial fenestration, glomerular capillary plasma
E. basement membrane, endothelial fenestration

Back 13

18. C
Filtration proceeds from the capillary plasma -> endothelial fenestration
-> basement membrane -> podocyte slit -> fluid of Bowman’s space

Front 14

Urine flow:
formation, modification, and disposal

Back 14

Formed by filtration in the kidney, and modified by renal tubules
-> ureter -> bladder -> urethra

Front 15

What are the 2 Regions of the kidney?

Back 15

Cortex : outer region

Medulla, medullary pyramid: inner region
Tip of the pyramid= papilla

Front 16

The cortex of the kidney does what?

Back 16

All filteration and most of the re-absorption

Front 17

The medulla of the kidney does what?

Back 17

H20/Na+ adjustment

Front 18

What is the path of urine leaving the kidneys?

Back 18

minor calyx (“cup”) --> major calyx --> renal pelvis -->
ureter --> bladder

Front 19

Urine is formed in the ______; modified in the ____ & _____; Exits at the ______, and enters ________

Back 19

Urine is formed in the cortex; modified in the cortex and
medulla; Exits at the papilla, and enters excretory regions:minor calyx (“cup”) --> major calyx --> renal pelvis -->
ureter --> bladder

Front 20

Describe Urine flow process

Back 20

Formed by filtration in the kidney, and modified by renal tubules
-> ureter -> bladder -> urethra

Front 21

Functional unit of the kidney includes?

Back 21

renal corpuscle (where filtration occurs (initial formation of urine))
and elongated tubules (where urine is modified)

Front 22

All nephrons have ________ within the cortex

Back 22

Corpuscle

Front 23

What are the two types of nephrons in the kidneys?

Back 23

Cortical nephron: most of the tubule is also within the cortex

Juxtamedullay nephron: corpuscle is near cortical-medullary
boundary;

Front 24

Most of the Juxtamedullay nephron tubule extends into?

Back 24

the medullary pyramid

Front 25

All nephrons participate in formation of ___________, and all contribute to _________________, but only the _____________________
participate in the concentration of urine.

Back 25

- ultrafiltrate
- the urine outflow
- juxtamedullary nephrons

Front 26

Where does the initial formation of urine occur?

Back 26

Renal corpuscle

Front 27

What are the subdivisions of a nephron?

Back 27

Renal corpuscle
Proximal tubule
Loop of Henle (TDL, THINA, TALH)
Juxtaglomerular apparatus
Distal convoluted tubule
Cortical collecting duct

Front 28

What are the components/functions of the renal corpuscle?

Back 28

• Glomerular capillaries tuft of capillaries. This is the blood that will be filtered

• Bowman’s capsule: hollow capsule surrounding capillaries, ends in the proximal tubule.

• Ultrafiltrate: fluid and small molecules exit glomerular capillaries, and enter the fluid of Bowman’s capsule

Front 29

What are the components/functions of the proximal tubule?

Back 29

reabsorbs water and other molecules from the
ultrafiltrate, secretes other molecules into the ultrafiltrate

Convoluted initial portion
straight (thick descending loop of Henle)

Most re-absorption takes place here

Front 30

What are the components/functions of the Loop of Henle?

Back 30

involved in the mechanism of concentrating urine, to
appropriately adjust Na+ excretion to Na+ and water balance.

Contains:
• Thin descending limb of Henle’s loop
• ascending thin limb of Henle’s loop
• Thick ascending limb of Henle’s loop

Front 31

Collecting ducts are found in both _______ & ________.

Back 31

cortex and medulla

Front 32

Juxtaglomerular apparatus is a ____________ point in the nephron

Back 32

Regulation

Front 33

What are the components/functions of the Distal convoluted tubule?

Back 33

part of the mechanism for Na+ balance

Front 34

What are the components/functions of the cortical collecting duct?

Back 34

several tubules flow into a single collecting duct

Front 35

What are the components/functions of the medullary collecting duct?

Back 35

Ducts flow into larger ducts of the tubules and ducts

participate in Na+/K+/water balance and acid/base balance.

found in both cortex and medulla

Front 36

Ultrafiltrate of the renal corpuscle is so named because

Back 36

it contains no proteins

Front 37

What is the 4 basic renal processes?

Back 37

Some of the plasma is filtered

Some of the filtered plasma (“ultrafiltrate”) is reabsorbed

Some of the solutes in the non-filtered plasma is secreted

The remaining fluid and solutes of the ultrafiltrate are excreted in the urine

Front 38

Components and circulation of the formation of the ultrafiltrate

Back 38

takes place in renal corpuscle:

involves Glomerular capillaries and Bowman’s capsule:

Has Portal circulation: (unusual)
afferent arteriole - > glomerular capillaries -> efferent arteriole

Front 39

what arteriole of the renal corpuscle controls the resistance?

Back 39

afferent arteriole

Front 40

what arteriole of the renal corpuscle controls the resistance for both blood in and out?

Back 40

efferent arteriole

Front 41

describe Glomerular capillaries

Back 41

tufts of interconnected capillaries

Front 42

describe Bowman’s capsule

Back 42

cup formed around the (glomerular) capillary network

Front 43

what is Bowman’s space:

Back 43

fluid interior of the Bowman’s capsule

Front 44

Fluid & solutes entering Bowman’s space from the capillary must pass through?

Back 44

1-Capillary endothelium – fenestrated

2-Basement membrane – extracellular material, negatively
charged

3-epithelial layer of Bowman’s capsule=Podocytes

Front 45

describe Podocytes?

Back 45

have cytoplasmic extensions / foot processes
spaces between adjacent foot processes form slits,
covered by a diaphragm

Front 46

What are Mesangial cells?

Back 46

These cells provide physical support for the glomerular
capillaries, and help “clean” the basal lamina.

Front 47

Disease processes affecting the mesangial cells affect?

Back 47

the ability to maintain the basal lamina, and change the composition of the ultrafiltrate

Front 48

Ultrafiltrate consists of?

Back 48

fluid, and particles that can pass between the slits of the podocyte process, and can also pass through the basal lamina of the endothelium and podocytes:

Front 49

The type of material that can enter the ultrafiltrate depends on?

Back 49

both size, and charge

Front 50

Most non-protein nutrients can easily enter the ultrafiltrate, and must be?

Back 50

reabsorbed (transported back into the blood) by the nephron. In addition, many waste products have additional mechanism (secretion ) to enter the urine.

Front 51

Most proteins ____ ______ from the blood into the ultrafiltrate (albumin is at the upper end of the
permitted size).

Back 51

cannot pass

Front 52

The appearance of significant amounts of albumen or other proteins in the ultrafiltrate is usually a sign of?

Back 52

renal disease.

Front 53

A leaky filter is very common in?

Back 53

Diabetic patients

Front 54

Tubules (collecting tubules) are lined by ___________, resting on _____________?

Back 54

a single layer of epithelium

a basement Membrane

Front 55

Epithelial cells are linked by?

Back 55

tight junctions, which can be tight or “leaky”

Front 56

Epithelial cells are polarized, with ?

Back 56

an apical (towards lumen) domain & a basolateral (towards interstitium)domain

Front 57

Epithelial cells with more ATP-requiring process have more ___________, and these are located near _______________ (i.e. basolaterally, or apically, depending on the location of the transporter)

Back 57

mitochondria

the ATP requiring transporters

Front 58

In collecting tubules, Size matters. Why?

Back 58

flat (squamous) cells have more passive processes than do large cuboidal or columnar cells

Front 59

All tubule cells are close to?

Back 59

a capillary

Front 60

Permeability to ______ & ______varies along the tubule

Back 60

water and/or NA+

Front 61

What is in the Proximal tubule?

Back 61

Large cells specialized for absorption:

Extensive apical (lumen facing) microvilli
pinocytotic vesicles;

Front 62

The Proximal tubule is always permeable to ______ because _____.

Back 62

water and Na+

apical water channels and Na+ transporters

Front 63

The Proximal tubule contains what kind of folds?

Back 63

Basolateral folds

Front 64

High density of mitochondria are found in the Proximal tubule, especially along?

Back 64

basolateral folds

Front 65

Proximal tubule cells reabsorb __% of the glucose, __% of the water and salt and ___% of A. Acids

Back 65

100%
70%
100%

Front 66

Thin loop of Henle is comprised of that type of cells?

Back 66

thin, squamous(flat)cells;

Front 67

Epithelial cells can increase membrane surface area (and number of transporters) apically with?

Back 67

microvilli, and basolaterally with basolateral membrane folds

Front 68

Thin descending segment of the loop of Henle is always highly permeable to ______, less permeable to ___ & ___

Back 68

water
urea and salt

Front 69

Thin ascending segment of the loop of Henle is always impermeable to _____, but permeable to ___.

Back 69

water
NaCl
- involves Na+/K+ ATPase

Front 70

Movement of salt but not water in the Thin loop of Henle allows……………, and is key to the formation of __________.

Back 70

the interstitium to become hyperosmotic
concentrated urine

Front 71

Thick ascending limb of Henle is comprised of that type of cells, folds, and microvilli?

Back 71

Cuboidal cells, basolateral folds (surface area) but very few microvilli;

Front 72

Thick ascending limb of Henle has what type of mitochondria?

Back 72

basolateral mitochondria (ATP)
involves Na+/K+ Atpase

Front 73

Thick ascending limb of Henle Transports ions from……………, but is impermeable to ____.
(for reabsorption)

Back 73

the lumen to the interstitium

water

Front 74

Macula densa is part of the ………… and is specialized for __________.

Back 74

juxtaglomerular appartus

monitoring osmolarity of filtrate

Front 75

Distal convoluted tubule cells are similar in morphology to those of the?

Back 75

TALH.

Front 76

Distal convoluted tubule is impermeable to _____ and permeability to _____.

Back 76

water
NA+

Front 77

Distal convoluted tubule permeability to NA+ is stimulated by?

Back 77

aldosterone

Front 78

The collecting duct is comprised of what type of cells?

Back 78

Cells are cuboidal in cortical collecting tubules and early ducts, and columnar in later ducts
(closer to the calyx)

(in other words, the height of the cell increases towards the distal region of the ducts).

Front 79

The collecting duct cells have no _____ & ________ and fewer __________ than
proximal or distal tubule cells.

Back 79

Microvilli & basolateral folds

mitochondria

Front 80

What are the two cell types:

Back 80

Principle cells and Intercalated cells

Front 81

Facts about Principal cells

Back 81

have water channels, AQP-2, that are regulated by the
hormone Vasopressin (antidiuretic hormone or ADH.)

Front 82

Principal cells are regulated by?

Back 82

aldosterone (increases with aldosterone)

Front 83

Facts about Intercalated cells

Back 83

participate in H+ and HCO3- balance
reabsorb K+.
These are found more in the initial, cortical regions than in the distal, medullary regions.

Front 84

Juxtaglomerular cells (JG cells) are and secrete?

Back 84

Modified smooth muscle cells of the afferent arteriole.

Secrete renin. (Renin catalyzes the conversion of angiotensinogen to antiotensin I, which is in turn converted to angiotensin II in the lung. Angiotensin II stimulates aldosterone secretion)

Front 85

Renin catalyzes the conversion of …………. to ………….., which is in turn converted to …….. in the lung. Angiotensin II stimulates ……….

Back 85

angiotensinogen to antiotensin I
angiotensin II
aldosterone secretion

Front 86

Angiotensin II stimulates?

Back 86

aldosterone secretion

Front 87

When rennin increases, angiotension 2 increases which is important for?

Back 87

Blood Pressure

Front 88

Relationship to systems regulating ECF volume and blood pressure: Systematic response

? Plasma volume ? sympathetic nerve outflow ? renin ? angiotensin 2 & aldosterone

Back 88

Decrease Plasma volume; Increase sympathetic nerve outflow; Increase renin; Increase angiotensin 2 & aldosterone

Front 89

Relationship to systems regulating ECF volume and blood pressure: Local response

? Arterial pressure ? stretch of muscle in afferent arteriole ? renin ? angiotensin 2 & Aldosterone

Back 89

Decrease Arterial pressure; Decrease stretch of muscle in afferent arteriole; Increase renin; Increase angiotensin 2 & aldosterone

Front 90

Relationship to systems regulating ECF volume and blood pressure: Local response

? Flow rate of fluid in the tubule ? NaCa delivery to macula densa ? rennin

Back 90

Decreased Flow rate of fluid in the tubule; Decrease NaCa delivery to macula densa; Increase rennin

Front 91

The Macula densa is?

Back 91

Modified cells of the distal tubule.

Front 92

The cells of the Macula densa are ____ & _____ and in contact with _______ .

Back 92

tall and narrow (“densa”),
the JG cells

Front 93

Macula densa cells sense the osmolarity of …………… in ………..

Back 93

the tubular fluid in the distal tubule.

Front 94

Macula densa cells sense the osmolarity of the tubular fluid in the distal tubule

A high load of NaCl ? signal (probably ATP) ? JG cells, and inhibits ?

Back 94

A high load of NaCl sends a signal (probably ATP) to the JG cells, and inhibits renin secretion

Front 95

Macula densa afferent Arial smooth muscle provides?

Back 95

tubuloglomerular feedback

Front 96

Blood enters in the ________ from the __________.

Back 96

renal artery
Abdominal aorta

Front 97

What are 3 arteries of the kidneys?

Back 97

interlobar arteries (in between the medullary pyramids)

arcuate arteries (along the border between cortex and medulla)

interlobular arteries

Front 98

There are no anastomoses in the kidneys which means?

Back 98

the loss of blood supply is not compensated, so that cell death occurs if any artery is blocked (this is not the case in most organs)

Front 99

There is no direct arterial supply to what part of the kidney?

Back 99

the medulla

Front 100

Capillary system in the kidney is unusual. What is the path of blood flow from Interlobular artery to efferent arteriole.

Back 100

Interlobular artery ~> afferent arteriole ~> glomerular capillary ~> efferent arteriole

Front 101

How many sets of arterioles does the kidney have?

Back 101

Two. Afferent and efferent arterioles

Front 102

Where does where filtration occur in the kidneys?

Back 102

glomerular capillaries

Front 103

How can afferent and efferent arterioles can be regulated
independently?

Back 103

portal circulation

Front 104

Blood in the efferent arterioles heads to?

Back 104

second set of capillaries called the peritubular capillaries in the cortex

Front 105

The peritubular capillaries surround ?

Back 105

The tubules

Front 106

What is the blood path from the Peritubular capillaries of the cortex to the inferior vena cava?

Back 106

Peritubular capillaries ~> interlobular vein, ~> arcuate vein ~> interlobar vein ~> renal vein ~> inferior vena cava

Front 107

In the medulla , these peritubular capillaries are called the _________ , which are adjacent to, and parallel to ………………………..

Back 107

vasa recta

the long loops of Henle and the collecting tubules

Front 108

Blood in the vasa recta flows down to …………, then back up to ………………, and empties into the ………….

Back 108

the tip (papilla) of the pyramid

the junction between cortex and medulla

arcuate veins

Front 109

What is the blood path from the Peritubular capillaries (Vasa Recta) of the medulla to the inferior vena cava?

Back 109

Vasa Recta ~> the tip (papilla) of the pyramid ~> the junction between cortex and medulla ~>
arcuate veins ~> interlobar vein ~> renal vein ~> inferior vena cava

Front 110

Modification of the ultrafiltrate involves ………………….. into the capillaries

Back 110

reabsorption and/or secretion

Front 111

Peritubular capillaries are essential for?

Back 111

reabsorption and/or secretion of most solutes

Front 112

Vasa recta is essential for?

Back 112

Na, urea and water transport involved in concentrating urine.

Front 113

With ultrafiltration, changing the charge can change the?

Back 113

permeability of a molecule