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how much water is the male and female body made of? why is this difference?
male - 60%
female - 55%
males have more muscle mass which contains more water
what is urine? describe normal urine and abnormal urine
waste product excreted to maintain balance within the body
normal = water, salts, hormones, small proteins
abnormal = large proteins, RBCs, glucose
what are the major organs of the urinary system? how many of each?
2 kidneys, 2 ureters, urinary bladder and urethra
what is the function of the kidneys?
protection
storage
filtration
where are the kidneys located? what protects the kidneys?
between T12 and L3
11th and 12th ribs
where do the renal blood vessels, lymphatics, nerves and ureter enter the kidneys?
hilum
what kidney is closer to the aorta?
left
what are the 3 regions of the kidney?
cortex, medulla, pelvis
what is at the end of each medullary pyramid?
papilla
how many lobes are there per kidney?
5-11 lobes
urine drains from each papilla and collects where?
calyx
what joins to make the renal pelvis?
calyces
how is urine produced?
filtering waste from the blood into the nephron
where does filtration occur?
in the cortex of the kindey —> glomerular capillaries
what arteriole delivers blood from the arteries to the glomerulus?
afferent arteriole
what is the golmerulus made of?
glomerular capillaries
Where does the efferent arteriole carry blood from and to?
from glomerulus to pertitubular capillaires
where do the peritubular capillaries carry blood to?
the veins
In what order does the bloody supply get into the cortex to be filtered?
renal artery > series of ateries > afferent arteriole > glomerular capillary
In what order does the bloody supply get away from the cortex after being filtered?
efferent arteriole > pertibular capillaries > series of veins > renal veins > inferior vena cava
what 3 things does the nephrphron do?
filters blood
selectively reabsorbs or secretes
produces urine
how many nephrons are there per kidney?
1 million
what are the 2 types of nephrons and describe them
cortical - 85%, lie mainly in cortex
juxtamedullary - deep in medulla- conc urine
what is the function of nephrons?
filter blood
carry waste away
what 3 things is each nephron comprimised of?
glomerular capsule
renal tubules
collecting duct
what is the function of glomerular capillaries? what type of endothelial cells does it contain?
filtration
fed and drained by arterioles
fenestrated endothelial cells
what is the function of peritubular capillaries?
specialised for absoprtion
wrap around ranl tubules
receive filtered blood and reabsorbed filtrate
what nephrona are found in extensions that follow nephron loops deep into the medulla?
vasa recta
what is the renal corpuscle made of?
glomerulus enclosed by the glomerular capsule
where capillary and nephron meet
site of filtration barrier
what are the two layers of the glomerular capsule? what are they made of? what is found between these two layers?
outer parietal layer - simple squamous cells
inner visceral layer - podocytes
capsular space
where are podocytes located? what do the branches coming off them form?
around the glomerular capillaries
pedicels
what is found between the pedicels? what passes through these slits?
filtration slits
filtered blood passes through into capsular space
where does the filtration barrier lie? what does it allow for?
between blood and capsular space
allows free passage of water and small molecules but not proteins
what are the 3 layers of the filtration barrier?
fenestrated endothelium of glomerular capillary
fused basement membrane
filtration slits between the pedicels of the podocytes
What is the function and structure of the proximal convoluted tubule?
for bulk reabsoprtion
surround by peritubular capillaries
cuboidal epithelial cells, desnse microvilli, highly folded basolateral membrane, mitochondria for transport, leaky epithelium
What is the function and structure of the distal convoluted tubule?
fine tuning
cuboidal but thinner than PCT
fewer mitochondria
fewer microvilli
influenced by aldosterone
what is the nephron loo surrounded by
vasa recta
describe the structure of the thick and thin descending limb and thick and thin ascending limb
thick descending - cuboidal epithelium
thin descending - simple squamous epithelium
thick ascending - simple squamous epithelium
thin ascending - cuboidal but thinner
what is the structure of the colelcting duct?
wall of simple cuboidal epithelium
principal cells - reabsorption
intercalated cells - acid/base balance
what is reabsorption influenced by in the collecting duct?
aldosterone / ADH
what is transitional epithelium?
stratified rounded cells
flattened when stretched
for protection
connected by tight junctions
where do the ureter arise from? where do they descend
each renal pelvis at each hilum
retroperitoneally through the abdomen , vertically from the hila
what do peristaltic waves do?
move urine to bladder
what is the ureter made of? what 3 layers does it consits of?
smooth muscle and CT
transitional epithelium
muscularis (inner longitudianl, outer circular)
adventitia
the ureter prevents backflow? true or false?
true
what is the function of the urinary bladder?
stores and expels urine
describe what an empty bladder would look like?
pyramidal
lies within the pelvis
describe what a full bladder would look like
spherical
expands superiorly
can be palpated above the pubic pymphysis
where is the location of the bladder in males and females?
males - anterior to rectum, superior to prostate gland
females - anterior to vagins and uterus
describe detrusor muscle
thick smooth muscle
longitudinal, circular, oblique
expels urine
forms the wall of the bladder
what does the trigone area consist of?
2 openings of entry of ureter and 1 opening for urethra
what is the role of the urethra? In what order does the epithelium go? where is there mucus glands in the urethra?
drains urine from the bladder out of the body
transitional, columnar, stratified squamous
protect epithelium from urine
what are the differences between male and female urethras?
males = longer (25cm), part of reproductive system
3 sections = prostatic, membranous, spongy/penile
females = shorter (5cm)
describe the internal and external urethral sphincter
internal
junction of bladder and urethra
detrusor muscle - involuntary control
external
located where urethra passes through the urogenital diaphragm
skeletal muscle - voluntary control
descrieb the process of urination
bladder fills with urine and expands
AP from stretch receptors to brain
urgency increases as signal increases
internal sphincter relaxes
conscious relaxation of external sphincter
what are the 2 endocrine functions of the kidney? describe them?
erythropoietin (EPO)
low oxygen levels detected by the kidney
kidneys release EPO - produces more RBCs
chronic kidney/renal failure
kidneys cannot produce enough EPO
reduced RBC production
Anaemia
what is a metabolic function of the kidney? when does this process happen
gluconeogenesis
during fasting or when our body is under stress
kidneys make glucose from lactate
The more H+ ions there are the ________ the PH = more________
lower
acidic
The PH of blood is controlled by what 2 things?
lungs - exhalation of CO2
kidneys - reabsorption and secretion of bicarbonate and hydrogen
what is excreted in the kidneys after metabolism in the liver due to its fat soluble nature?
lidocaine
what pain killer is excreted directly by the kidnyes due to its high water solubility (hydrophillic)?
Aspirin
what are the 3 basic functions of the nephron?
filtration
secretion
reabsorption
where does filtration occur in the nephron? what is its function?
occurs in the renal corpsucle/glomerus
movement of blood from glomerulus capillaries into glomerular capsule
what 2 things are not filtered in plasma?
large proteins and substances bound to proteins
what is secretion in the nephron? what is its function?
movement of solutes from the peritubular capillaries into tubular fluid
removes waste from blood by excreting them into tubular fluid into urine
what is the function of reabsorption in the nephron?
movement of solutes from tubular fluid into peritubular capillaries
returns substances to the blood so they are not excreted
what 3 things determine glomerular filtration?
filtration barrier
renal blood flow
driving forces
what are the 2 types of driving forces of glomerular filtration? describe these
hydrostatic pressure - pressure due to the volume of fluid (Pushes fluid away)
colloid osmotic pressures - osmotic pressure due to protein (pulls fluid towards)
what are the 4 forces of glomerular filtration? describe them. what do these 4 pressure determine?
glomerular hydrostatic pressure = blood pressure
blood colloid osmotic pressure = albumin
capsualr hydrostatic pressure = pressure of filtrate already present
capsular colloid osmotic pressure = no protein in capsualr space
net filtration pressure
what is the filtration factor?
glomerular filtration rate / renal plasma flow
how much plasma is filtered by the kidney per day and per minute? how much urine is produced a day?
per day = 180L
per minute = 125ml
urine = 1.5L
what is the equation for filtered load?
GFR x solute plasma conc
what is renal clearance and what is it used for?
the volume of plasma that is cleared of a substance by the kidneys
estimate GFR
what is glomerular filtration rate described as?
amoutn of plasma filtered per unit time by the kidneys
to be sued to measure GFR a substance must? what 2 substances meet this criteria and why?
be freely filtered, not be reabsorbed, not be secreted
inulin - not found in body
creatinine - waste product produced by muscles, used clinically
When is plasma creatinine low?
when both kidneys are working
what 3 places is water reabsorbed in the nephron?
PCT
descending limb of loop
DCT
collecting duct
describe bulk and regulated water reabsorption
Bulk
not regulated
leaky epithelia
92% of total reabsorption
regulated
regulated by ADH
tight epithelia
only transcellular reabsorption
what is reabsorption of sodium into the nephron regulated by?
aldosterone
what is water reabsorption driven by in the Proximal tubule? what is transported through the proximal tubules?
Na+ reabsorption
glucose and sodium
where does chloride flow through in the proximal tubule?
paracellular pathway
what is the ascending and descending limb permeable to?
ascending = sodium
descending = water
where does the ascending loop reabsorb Na+ into?
the peritubular fluid
Describe the difference between normal urine and pathological urine
normal
1.5 L a day
H+, k+, Na+
medications, toxins
pathological
blood
organge
sweet - diabetes
fruity - ketones forming
rotten - infection, tumour