Urinary System - Ch 25, Human Anatomy And Physiology Marieb And Hoehn

Front 1

Each day, the kidneys filter ________ liters of blood.

Back 1

180

Front 2

Name 5 functions of the kidney

Back 2

1) Filter blood 2) balance water/salt/acid/base levels in blood 3) gluconeogenesis 4) produce hormones renin (blood pressure) and erythropoietin (red blood cell production) 5) metabolize vitamin D

Front 3

Name the organs of the urinary system

Back 3

kidneys, urinary bladder, paired ureters, urethra

Front 4

Which kidney is slightly lower than the other? Why?

Back 4

The right, it is crowded by the liver

Front 5

What is the name of the vertical cleft that leads to an inner space within the kidney called the renal sinus?

Back 5

renal hilum

Front 6

The ureter, renal blood vessels, lymphatics and nerves all join each kidney at the _________and occupy the ___________.

Back 6

hilum, sinus

Front 7

The three layers of supportive tissue that surround each kidney are called:

Back 7

renal fascia (outer layer, dense fibrous anchor), perirenal fat capsule (cushion), fibrous capsule (seals out infection)

Front 8

What is the condition called when a kidney drops to a lower position (and may cause ureter blockage).

Back 8

renal ptosis (tosis means "to fall")

Front 9

What is the general term when improper drainage causes fluid backup in the kidney

Back 9

hydronephrosis

Front 10

What are the 3 distinct regions of the kidney? (List them from most superficial to deepest.)

Back 10

cortex, medulla, pelvis

Front 11

The _______ region of the kidney is light in color and has a granular appearance.

Back 11

cortex

Front 12

The darker, reddish-brown, "salty" section of the kidney is the________.

Back 12

medulla

Front 13

Cone-shaped tissue masses found in the renal medulla are called ________. These are oriented with their points toward the center of each kidney.

Back 13

renal (or medullary) pyramids

Front 14

Inward extension of cortical tissue that separate each renal pyramid are called __________.

Back 14

renal columns

Front 15

Each renal pyramid and its surrounding cortical tissue constitutes one of approximately 8 _______ of a kidney.

Back 15

lobes

Front 16

The ________ is a funnel-shaped tube that is continuous with the ureter leaving the hilum. This tube branches to form the major and minor calyces which then join with the tips (papillae) of the renal pyramids.

Back 16

renal pelvis

Front 17

The calyces collect __________ which drains continuously from the papillae (tips of the renal pyramids).

Back 17

urine

Front 18

True or False - The walls of the calyces, pelvis and ureter contain smooth muscle that contracts rhythmically to propel urine toward the bladder.

Back 18

TRUE

Front 19

Under normal resting conditions, the large renal arteries deliver about _________% of the total cardiac output to the kidneys each minute.

Back 19

25% (about 1200 ml)

Front 20

List subdivisions of the blood vessels from the renal artery to the renal vein.

Back 20

Arterial path in to kidney: Renal, Segmental, Interlobar, Arcuate, Cortical radiate
Venous path out: Cortical radiate, Arcuate, Interlobar, Renal

Hint: Renal Supply In A Circle can be used to and the word "supply" is left out of the return path so tracing the path in reverse skips segmental.

Front 21

As each renal artery approaches the kidneys, it divides into five _____________ which then further divide into interlobar arteries once they have entered the renal sinus.

Back 21

segmental arteries

Front 22

The _______ issue from the kidneys and empty blood into the inferior vena cava (because the inferior vena cava lies to the right of the vertebral column, the left is about twice as long as the right).

Back 22

renal veins

Front 23

The ________ is a variable network of autonomic nerve fibers and ganglia that provide the nerve supply to the kidney and its ureter. Largely supplied with sympathetic vasomotor fibers these nerves also regulate renal blood flow by adjusting the diameter of renal arterioles.

Back 23

renal plexus

Front 24

What are the structural and functional units of the kidneys?

Back 24

nephrons

Front 25

Back 25

Front 26

Each nephron consists of a tuft of capillaries called the __________ (meaning "ball of yarn") surrounded by the cup-shaped end of the renal tubule called the ___________.

Back 26

glomerulus, glomerular capsule (or Bowman's capsule)

Front 27

Collectively, the glomerulus and glomerular capsule are called the __________.

Back 27

renal corpuscle

Front 28

Liquid that passes from the blood of the glomerular capillaries into the glomerular capsule is called ________.

Back 28

filtrate

Front 29

The visceral layer of the glomerular capsule clings to the glomerular capillaries. This layer consists of highly modified branching epithelial cells called ________

Back 29

podocytes

Front 30

Podocytes terminate in foot processes which cling to the basement membrane of the glomerulus. The openings between foot processes are called _____________ and allow filtrate to enter the capsular space.

Back 30

filtration slits

Front 31

Beyond the renal corpuscle, the renal tube has 3 major parts. Name these in the order in which filtrate passes through them.

Back 31

proximal convoluted tubule (PCT)
loop of Henle (also called nephron loop or Henle's loop)
distal convoluted tubule (DCT)

Front 32

The distal convoluted tubules empty into _______ which then fuse together and deliver urine to the minor calyces via the papillae (tips) of the medullary pyramids.

Back 32

collecting ducts

Front 33

The most common type of nephron (about 85% of total) resides almost entirely in the renal cortex. This type is called _________. Nephrons of the other type are called _____ and originate close to the cortex-medulla junction with loops of Henle deeply invade the medulla.

Back 33

cortical nephrons
juxtamedullary nephrons

Front 34

The glomerulus capillary bed is unique because it is both fed and drained by arterioles. These are called the ______ and _____ arterioles respectively.

Back 34

afferent (feeding)
efferent (draining)
Tip: these are in alphabetical order in the direction of flow

Front 35

The blood pressure in the glomerulus is extraordinarily high or low for a capillary bed?

Back 35

high (to force filtrate out of blood and into the capsule space)

Front 36

About what percentage of filtrate removed from the blood at the glomerulus is reabsorbed by the renal tubule cells and returned to the blood via the peritubular capillary beds?

Back 36

99%

Front 37

The ______ capillaries cling closely to renal tubules and absorb solutes and water as these substances are reclaimed from the filtrate.

Back 37

peritubular

Front 38

The renal tubules of juxtamedullary nephrons tend to have straight vessels called _________ instead of peritubular capillaries.

Back 38

vasa recta (means "straight vessels")

Front 39

What are the two capillary beds that serve each nephron called?

Back 39

glomerulus (produce filtrate) and peritubular (reabsorb water and solutes).

Front 40

Each nephron has a region called the juxtaglomerular apparatus (JGA). Where is it (what area of the nephron)?

Back 40

The most distal portion of the ascending loop of Henle (which lies against the arteriole feeding the glomerulus and senses blood pressure)

Front 41

Within the juxtaglomerular apparatus (JGA), granular cells act as ______receptors and juxtaglomerular (JG) cells secrete _________ which also aids in blood pressure regulation.

Back 41

mechano(receptors)
renin

Front 42

The _______ is a group of tall, closely packed cells of the ascending limb of the loop of Henle. These chemoreceptors respond to NaCl content of the filtrate.

Back 42

Macula densa

Front 43

The membrane that lies between the blood and the interior of the glomerular capsule and allows free passage of water and solutes is called the ___________.

Back 43

filtration membrane

Front 44

Does glomerular filtration use hydrostatic or osmotic pressure?

Back 44

hydrostatic (the physical force of blood pressure causes fluid to be squeezed through the pores. Osmotic pressure is based on a solute concentration gradient)

Front 45

The volume of filtrate formed each minute by the combined activity of both kidneys (all 2 million glomeruli) is called _________

Back 45

glomerular filtration rate (GFR)

Front 46

By adjusting its own resistance to flow, called _____, the kidney can maintain a nearly constant filtration rate.

Back 46

renal autoregulation

Front 47

The _______ mechanism is a type of renal autoregulation that reflects the tendency of vascular smooth muscle to contract when stretched (thus restricting flow into afferent arterioles when systemic blood pressure increases).

Back 47

myogenic

Front 48

The macula densa cells of the juxtraglomerular apparatus can trigger this type of autoregulation based on NaCl concentration.

Back 48

Tubuloglomerular feedback mechanism

Front 49

Autoregulatory mechanisms can maintain a relatively constant GFR (glomerular filtration rate) through what arterial pressure range?

Back 49

80 to 180 mm Hg

Front 50

What extrinsic controls can influence GFR (glomerular filtration rate)?

Back 50

neural and hormonal mechanisms (sympathetic nervous system reactions and renin-angiotensin mechanism)

Front 51

Renin acts enzymatically on ______, a plasma globulin made by the liver, converting it to _______ which is then converted to ______ by ACE.

Back 51

angiotensinogen, angiotensin I, angiotensin II

Front 52

Name 2 of the 5 ways that angiotensin II acts to stabilize systemic blood pressure and extracellular fluid volume.

Back 52

1) Potent vasoconstrictor activates smooth muscle of arterioles
2) Stimulates reabsorption of sodium which causes water to follow osmotic pressure gradient
3) Stimulates hypothalamus to release ADH and triggers thirst
4) Increases fluid reabsorption by decreasing peritubular capillary pressure (because efferent arterioles constrict)
5) Targets glomerular mesangial cells causing them to contract and reduce surface area of glomerular capillaries.

Front 53

Which portion of the renal tubules are the primary "reabsorbers" of water and solutes.

Back 53

the proximal convoluted tubule (PCT)

Front 54

Water and solute reabsorption are handled separately in the loop of Henle. Which portion (ascending or descending limb) reabsorbs water?

Back 54

descending limb

Front 55

How does ADH affect the collecting ducts?

Back 55

It makes them more permeable to water so that more water will be reabsorbed from the filtrate.

Front 56

Aldosterone fine tunes blood pressure by regulating the reabsorption of ________.

Back 56

Na+

Front 57

The process of reabsorption in reverse -- when solutes move from the peritubular capillaries into the filtrate -- is called _________

Back 57

tubular secretion

Front 58

chemicals that enhance urinary output are called _____

Back 58

diuretics

Front 59

The volume of plasma that can be cleared of a particular substance in a given time (usually 1 minute) is called ____

Back 59

renal clearance

Front 60

_______ is defined as a GFR (glomerular filtration rate) of less than 60 ml/min for at least 3 months. This condition can become _______ when GFR drops below 15 ml/min.

Back 60

chronic renal disease, renal failure

Front 61

The process of passing blood through an artificial kidney and returning it to the patient's body is called _________

Back 61

hemodialysis

Front 62

The yellow color of urine is due to a pigment called _____ that results from the body's destruction of hemoglobin.

Back 62

urochrome

Front 63

One means of quantifying the solute concentration of urine is to compare the mass of urine to the mass of an equal volume of distilled water (which has no solutes and is therefore lighter). This mass ratio is called the ______ and typically ranges from 1.001 to 1.035 for urine (higher number means the urine contains a higher concentration of solutes).

Back 63

specific gravity

Front 64

Three nitrogenous wastes in urine are -

Back 64

Urea, uric acid, creatinine

Front 65

The slender tubes that convey urine from the kidneys to the bladder are called _______

Back 65

ureters

Front 66

Three tubes join with the bladder, the paired ureters and the urethra. The triangle formed by these three orifices is called the ________ (important clinically because infections tend to persist in this region)

Back 66

trigone of bladder

Front 67

The muscular layer of the urinary bladder is called ________

Back 67

detrusor muscle (detrusor means "to thrust out")

Front 68

The thin-walled muscular tube that drains the bladder is called the ___________

Back 68

urethra

Front 69

At the bladder-urethral junction, a thickening of the detrusor smooth muscle forms the __________ urethral sphincter which is __________(voluntary or involuntary).

Back 69

internal, involuntary

Front 70

The _______ urethral sphincter surrounds the urethra as it passes through the urogenital diaphragm. This sphincter is formed of skeletal muscle and is voluntarily controlled.

Back 70

external

Front 71

In males, the urethra is approximately ___ cm long, in females it is about ____ cm long. What condition does this make females more prone to getting.

Back 71

20 cm (males), 3-4 cm (females), females more prone to urinary tract infections.

Front 72

Name the three regions of the male urethra from superior to inferior.

Back 72

prostatic, membranous, spongy (a common problem affecting the male urethra is "prostate may swell" making urination difficult. The P.M.S. sentence can also be used to remember the order of the urethral regions)

Front 73

A clinical term for urinating is ______

Back 73

micturition

Front 74

An inability to control micturition is called ______

Back 74

incontinence

Front 75

An inability to expel contained urine is called ______ . What medical intervention can be used to relieve this condition?

Back 75

urinary retention, insertion of a catheter