✨✨CHAPTER 25: THE URINARY SYSTEM

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1) If the GFR is too low, needed substances may pass so quickly through the renal tubules that they are not absorbed and instead are lost in the urine.

F

2) In the kidneys, the countercurrent mechanism involves the interaction between the flow of filtrate through the nephron loop of the juxtamedullary nephrons (the countercurrent multiplier) and the flow of blood through the limbs of adjacent blood vessels (the countercurrent exchanger). This relationship establishes and maintains an osmotic gradient extending from the cortex through the depths of the medulla that allows the kidneys to vary urine concentration dramatically.

T

3) The path urine takes after it is formed until it leaves the body is the urethra, urinary bladder, and finally the ureter.

F

4) Water reabsorption through the proximal convoluted tubule is termed obligatory water reabsorption, whereas water reabsorption through the distal convoluted tubule is termed facultative water reabsorption.

T

5) The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.

T

6) The entire responsibility for urine formation lies with the nephron.

T

7) Both the male and female urethras serve the urinary and the reproductive systems.

F

8) The act of emptying the bladder is called voiding.

T

9) Glomerular filtration is an ATP-driven process.

F

10) In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water.

T

11) The collecting duct is impermeable to water in the presence of ADH.

F

12) The urethra contains an internal sphincter of smooth muscle.

T

13) Angiotensin II is a substance made by the body to lower blood pressure during stress.

F

14) Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.

T

15) Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water.

F

16) The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.

F

17) Urea is reabsorbed in the nephron loop.

F

18) Incontinence is the inability to control voluntary micturition.

T

19) The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.

F

20) An excessive urine output is called anuria.

F

21) Tubular secretion is effective in controlling blood pH.

T

22) The trigone is so named because of the shape of the urinary bladder.

F

23) Atrial natriuretic peptide inhibits sodium reabsorption.

T

24) The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate.

F

25) Blood in the urine may be a symptom of bladder cancer.

T

26) Obligatory water reabsorption involves the movement of water along an osmotic gradient.

T

27) Having a kinked ureter is called renal ptosis.

F

28) Fetal kidneys have the primary responsibility of clearing wastes from the fetal blood.

F

1) The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.

A) nephron loop

B) glomerular filtration membrane

C) collecting duct

D) distal convoluted tubule

A

2) Which of the following is not associated with the renal corpuscle?

A) a podocyte

B) a vasa recta

C) a fenestrated capillary

D) an efferent arteriole

B

3) An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.

A) decrease in the production of ADH

B) increase in the production of ADH

C) increase in the production of aldosterone

D) decrease in the concentration of the blood plasma

B

4) The urinary bladder is composed of ________ epithelium.

A) transitional

B) simple squamous

C) stratified squamous

D) pseudostratified columnar

A

5) The kidneys are stimulated to produce renin ________.

A) when the peritubular capillaries are dilated

B) when the pH of the urine decreases

C) by a decrease in the blood pressure

D) when the specific gravity of urine rises above 1.10

C

6) Which of the choices below is not a function of the urinary system?

A) helps maintain homeostasis by controlling the composition, volume, and pressure of blood

B) regulates blood glucose levels and produces hormones

C) maintains blood osmolarity

D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat

D

7) The ________ artery lies on the boundary between the cortex and medulla of the kidney.

A) lobar

B) arcuate

C) interlobar

D) cortical radiate

B

8) The glomerulus differs from other capillaries in the body in that it ________.

A) has a basement membrane

B) is impermeable to most substances

C) is drained by an efferent arteriole

D) has a blood pressure much lower than other organ systems

C

9) The descending limb of the nephron loop ________.

A) is not permeable to water

B) is freely permeable to sodium and urea

C) pulls water by osmosis into the lumen of the tubule

D) contains fluid that becomes more concentrated as it moves down into the medulla

D

10) Select the correct statement about the ureters.

A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.

B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch.

C) The ureters are capable of peristalsis like that of the gastrointestinal tract.

D) The ureter is innervated by parasympathetic nerve endings only.

C

1) The fatty tissue surrounding the kidneys is important because it ________.

A) ensures adequate energy for the adrenal glands to operate efficiently

B) stabilizes the position of the kidneys by holding them in their normal position

C) is necessary as a barrier between the adrenal glands and kidneys

D) produces vitamin D and other chemicals needed by the kidney

B

12) The renal corpuscle is made up of ________.

A) Bowman's capsule and glomerulus

B) the descending nephron loop

C) the renal pyramid

D) the renal papilla

A

13) The functional and structural unit of the kidneys is the ________.

A) nephron

B) nephron loop

C) glomerular capsule

D) capsular space

A

14) Which of the following does not describe the justaglomerular complex?

A) It regulates the rate of filtrate formation.

B) It helps control systemic blood pressure.

C) Its granular cells produce rennin.

D) Its macula densa cells produce aldosterone.

D

15) The chief force pushing water and solutes out of the blood across the filtration membrane is ________.

A) the ionic electrochemical gradient

B) protein-regulated diffusion

C) glomerular hydrostatic pressure (glomerular blood pressure)

D) the size of the pores in the basement membrane of the capillaries

C

16) Which of the following acts as the trigger for the initiation of micturition (voiding)?

A) the stretching of the bladder wall

B) motor neurons

C) the pressure of the fluid in the bladder

D) the sympathetic efferents

A

17) The filtration membrane includes all except ________.

A) glomerular endothelium

B) podocytes

C) renal fascia

D) basement membrane

C

18) The mechanism of water reabsorption by the renal tubules is ________.

A) active transport

B) osmosis

C) filtration

D) cotransport with sodium ions

B

19) Most electrolyte reabsorption by the renal tubules is ________.

A) not limited by a transport maximum

B) in the distal convoluted tubule

C) hormonally controlled in distal tubule segments

D) accomplished after the nephron loop is reached

C

20) The macula densa cells respond to ________.

A) aldosterone

B) antidiuretic hormone

C) changes in pressure in the tubule

D) changes in solute content of the filtrate

D

21) Which of the following is not reabsorbed by the proximal convoluted tubule?

A) Na+

B) K+

C) glucose

D) creatinine

D

22) The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________.

A) glucose

B) hormones

C) electrolytes

D) plasma protein

D

23) Alcohol acts as a diuretic because it ________.

A) is not reabsorbed by the tubule cells

B) increases the rate of glomerular filtration

C) increases secretion of ADH

D) inhibits the release of ADH

D

24) The function of angiotensin II is to ________.

A) constrict arterioles and increase blood pressure

B) decrease the production of aldosterone

C) decrease arterial blood pressure

D) decrease water absorption

A

25) A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________.

A) diabetes mellitus

B) diabetes insipidus

C) diabetic acidosis

D) coma

B

26) An important characteristic of urine is its specific gravity or density, which is ________.

A) the same as water

B) slightly higher than water

C) much higher than water

D) less than water

B

27) Place the following in correct sequence from the formation of a drop of urine to its elimination from the body.

1. major calyx

2. minor calyx

3. nephron

4. urethra

5. ureter

6. collecting duct

A) 3, 1, 2, 6, 5, 4

B) 6, 3, 2, 1, 5, 4

C) 2, 1, 3, 6, 5, 4

D) 3, 6, 2, 1, 5, 4

D

28) Select the correct statement about the nephrons.

A) The parietal layer of the glomerular capsule is simple squamous epithelium.

B) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule.

C) Podocytes are the branching epithelial cells that line the tubules of the nephron.

D) Filtration slits are the pores that give fenestrated capillaries their name.

A

29) What would happen if the capsular hydrostatic pressure were increased above normal?

A) Net filtration would increase above normal.

B) Net filtration would decrease.

C) Filtration would increase in proportion to the increase in capsular pressure.

D) Capsular osmotic pressure would compensate so that filtration would not change.

B

30) Which of the following is not a part of the juxtaglomerular complex?

A) granular cells

B) macula densa

C) podocyte cells

D) mesangial cells

C

31) Which of the following is not true regarding tubular reabsorption?

A) It occurs via transcellular or paracellular routes.

B) It is a reclamation process.

C) It involves hormonal signals in the collecting ducts.

D) It is a purely passive transport process.

D

32) Which of the following is the least important influence on reabsorption of a substance in the nephron?

A) number of carriers.

B) lipid solubility.

C) molecule size relative to fenestrations.

D) molecular complexity

D

33) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.

A) facilitated diffusion

B) passive transport

C) countertransport

D) secondary active transport

D

34) Which of the choices below is a function of the nephron loop?

A) form a large volume of very concentrated urine or a small volume of very dilute urine

B) form a large volume of very dilute urine or a small volume of very concentrated urine

C) absorb electrolytes actively and water by osmosis in the same segments

D) absorb water and electrolytes into the tubular network

B

35) Which of the following is the correct sequence of kidney development from embryo to fetus?

A) pronephros, mesonephros, metanephros

B) mesonephros, pronephros, metanephros

C) pronephros, metanephros, mesonephros

D) mesonephros, metanephros, pronephros

A

36) Which of the following best describes kidney function in older adults (70 years or older)?

A) Kidney function remains the same throughout life, regardless of age.

B) Only about 3% of older adults have any loss of kidney function.

C) Only obese and diabetic older adults have any kidney dysfunction.

D) Kidney function decreases due to kidney atrophy.

D

37) The factor favoring filtrate formation at the glomerulus is the ________.

A) colloid osmotic pressure of the blood

B) glomerular hydrostatic pressure

C) capsular hydrostatic pressure

D) myogenic mechanism

B

38) If the Tm for a particular amino acid is 120 mg/100 ml and the concentration of that amino acid in the blood is 230 mg/100 ml, the amino acid will ________.

A) be actively secreted into the filtrate

B) be completely reabsorbed by the tubule cells

C) appear in the urine

D) be completely reabsorbed by secondary active transport

C

39) If one says that the clearance value of glucose is zero, what does this mean?

A) The glucose molecule is too large to be filtered out of the blood.

B) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules.

C) Normally all the glucose is reabsorbed.

D) The clearance value of glucose is relatively high in a healthy adult.

C

40) Excretion of dilute urine requires ________.

A) relative permeability of the distal tubule to water

B) impermeability of the collecting tubule to water

C) transport of sodium and chloride ions out of the descending nephron loop

D) the presence of ADH

B

41) Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?

A) by secreting hydrogen ions into the filtrate

B) by reabsorbing filtered bicarbonate ions

C) by producing new bicarbonate ions

D) by secreting sodium ions

D

42) In the ascending limb of the nephron loop the ________.

A) thin segment is freely permeable to water

B) thick segment is permeable to water

C) thin segment is not permeable to sodium and chloride

D) thick segment moves ions out into interstitial spaces for reabsorption

D

43) Select the correct statement about urinary system development.

A) Kidneys develop from urogenital ridges.

B) The metanephric ducts will become the urethras.

C) The pronephros (first tubule system) develops during the tenth week of gestation.

D) The mesonephros will develop into the kidneys.

A

44) Which of the choices below is the least important role of tubular secretion?

A) disposing of substances not already in the filtrate, such as certain drugs

B) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes

C) ridding the body of bicarbonate ions

D) ridding the body of excessive potassium ions

C

45) What is the most direct function of the juxtaglomerular apparatus?

A) help regulate blood pressure and the rate of blood filtration by the kidneys

B) help regulate blood pressure and the rate of excretion by the kidneys

C) help regulate urea absorption by the kidneys

D) help regulate water and electrolyte excretion by the kidneys

A

46) Which of the choices below is the salt level-monitoring part of the nephron?

A) macula densa

B) principal cell

C) vasa recta

D) nephron loop

A

47) Which of the hormones below is responsible for facultative water reabsorption?

A) ADH

B) thyroxine

C) aldosterone

D) atrial natriuretic peptide

A

48) Which of the choices below is not a glomerular filtration rate control method?

A) renal autoregulation

B) neural regulation

C) electrolyte levels

D) hormonal regulation

C

49) Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion?

A) angiotensin II and ADH

B) angiotensin II and aldosterone

C) angiotensin I and epinephrine

D) angiotensin I and atrial natriuretic peptide

B

50) Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate?

A) juxtaglomerular cells

B) mesangial cells

C) macula densa cells

D) podocytes

C

1) ADH activated water channels called ________ are essential for water reabsorption in the collecting duct.

AQUAPORINS

2) The need to get up in the middle of the night to urinate is called ________.

NOCTURIA

3) The area between the ureters and urethra is called the ________ in a bladder.

TRIGONE

4) The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched.

MYOGENIC

5) The presence of pus in the urine is a condition called ________.

PYURIA

6) Sodium-linked water flow across a membrane not under hormonal control is called ________ water reabsorption.

OBLIGATORY