Ch 42 Urinary

excretory

urinary system also called the ____ system

180L

how much water per day do kidneys filter

water, nutrients, ions

kidneys remove waste while retaining what 3 things

kidneys

what organ is primary filter system for body

1. regulation of blood ionic composition

2. regulation of blood pH

3. regulation of blood volume/BP

4. regulation of blood glucose

5. excretes waste/foreign substances

5 functions of urinary system

ureters

what structures drain urine from kidneys to bladder

muscular

rugae

bladder is a ____ structure with distensable ____ to help it expand

external

urethra gets urine from bladder to ____ environment

liver lies on top of it

why is R kidney lower than the L

kidneys

what are these

ureters

what are these

bladder

what is this

urethra

what is this

peritoneal

(behind the peritoneum/intestines)

kidneys are retro________

fascia

the kidneys are not free floating and are anchored via renal ______

hillus

what is this concave curve

renal vessels

what are these

major calyx

what is this (collecting duct for urine)

minor calyx

what is this (feeds into major calyx)

renal pyramids

what are these (projections off the calyx)

renal columns

what are these (areas between renal pyramids)

pelvis of kidney

what is this

ureter

the pelvis of kidney then becomes the

calyces

calyx/calyces

pelvis

ureter

bladder

1. blood gets filtered through pyramids, comes out as urine

2. drops into minor _____

3. collects into major _____

4. then drops into _____ of kidney which becomes the _____

5. then goes to _____

renal cortex

the outer layer of kidney (urine formation begins here)

renal medulla

the area that makes up the pyramids

renal arteries

kidney blood flow:

1. oxygenated blood comes down from the descending aorta to what

segmental arteries

kidney blood flow:

2. renal arteries split into two _____ and then break down smaller and smaller

afferent arterioles

kidney blood flow:

3. the segmental arteries break down smaller until they become ______ ______

glomerulus

kidney blood flow:

4. the afferent arterioles are traveling towards the ______ (A), the structure where the beginning of blood filtration starts

nephrons

kidney blood flow:

5. what the glomerulus wants to excrete as urine will travel through the _______

efferent arterioles

kidney blood flow:

6. what the glomerulus wants to send back through circulation will then get sent to the ______ _____

peritubular capillaries

kidney blood flow:

7. the efferent arterioles will then become _______ _______

interlobular veins

kidney blood flow:

8. the peritubular capillaries will then connect with the ______ ______

segmental veins

kidney blood flow:

9. the interlobular veins will then become ______ veins

renal vein

kidney blood flow:

10. the segmental veins will then become the ____ vein (D)

inferior vena cava

kidney blood flow:

11. the renal vein will then flow to the _____ vena cava to go back into circulation/the heart

cortical nephrons

nephrons in the cortex are called

juxtamedullary nephrons

nephrons in the medulla are called

about 25%

the heart pumps 5 ml of blood per minute, and the kidneys can filter how much of that

smooth muscle

the ureters do not have valves but are lined with what for peristalsis so the urine doesn't just drop down

if there's too much urine in bladder, bladder will expand and ureters will close off preventing backflow

explain how urine doesn't back flow from the bladder into the ureters

UTI (if it travels all the way up to the kidneys, becomes a kidney infection)

sometimes urine can go back up from the bladder into the ureters. this could cause what

mucosa

innermost layer of bladder

detrusor muscle

second layer of bladder: smooth muscle called

no, it's an ANS function

do we have voluntary control over detrusor muscle

adventitia

outermost bladder layer (what anchors it onto back of peritoneum membrane)

symphysis

uterus

in females, the bladder is right behind the pubic _____ and right in front of the ____

trigone

the triangle structure in the bladder that drops down into the urethra is called the

mucus

the trigone is heavily lined with what to help move bacteria so it is less likely to colonize and go back up through ureters into the kidneys

symphysis

rectum

in males, the bladder is right behind the pubic ____ and anterior to the _____

internal sphincter

what is this part of the urethra (involuntary control)

external spincter

what is this part of the urethra (voluntary control, where arrow is)

to help with urinary incontinence because of how short the urethra is

why do female external sphincters have a little more anterior muscle

males (extends all the way through the penis)

urethra longer in males or females

1. urethra is much closer to the rectum than males

2. females have much shorter urethra- in males, immune system has more chance to fight off bacteria in urethra since it's longer and takes longer to gets up to kidneys

see slide 22 for visual

2 reasons why women get bacterial infections easier

pudendal nerve

what nerve plays a critical role in controlling when we pee/poop

spinal cord

internal

1. as the bladder is filling up, detrusor muscle stretches -> stretch reflexes send message to brain via ___

2. the brain then sends message back down for ____ anal sphincter to open (now we feel like we have to go)

spinal cord

if the bladder gets too full, the voluntary control of external sphincter will be overridden. This reflex only happens at the level of the ____

nephron

the functional filtration unit of the kidney

cortex

medulla

(the cortical nephrons create pressure for the blood to go down into the medullary nephrons)

20% of nephrons are in the ____

80% are in the ____

Bowman's capsule

what is the epithelial wrap around the glomerulus

Bowman's capsule

nephron

in the glomerulus, anything that needs to go back into circulation will pass through _____ _____. Anything that needs to go out as urine will keep travelling through the ______

millions

how many nephrons are in our kidneys

proximal tubule

also called proximal convoluted tubule or PCT

travel of urine:

1. after glomerulus, will travel to the

loop of Henle

travel of urine:

2. after the proximal tubule, urine will drop down into the

descending loop of Henle

loop of Henle

ascending loop of Henle

3 parts of loop of Henle

distal tubule

AKA distal convoluted tubule or DCT

travel of urine:

3. after the loop of Henle, goes to the

collecting duct

travel of urine:

4. after the distal tubule, goes to the

yes

do multiple nephrons attach onto one collecting duct

water

salt

glucose

what can filter out of Bowman's capsule and go back into circulation

protein

drugs

what can't filter out of Bowman's capsule

Bowman's capsule

in the nephron, filtration is happening at the level of where

PCT

loop of Henle

DCT

(things that get secreted out are reabsorbed via the peritubular capillaries that wrap around the nephron)

in the nephron, absorption and secretion are happening at the level of where

water

salt

glucose

at the PCT, more of what 3 things are going to come back out

descending loop of Henle

the primary secretion of water happens where in the nephron

ascending loop of Henle (will also loose some water in this area as well between ascending loop and collecting duct)

most of the salt is coming out where in the nephron

DCT

what area of the nephron fine tunes salt and water balance

collecting duct

formation of urine happening where in the nephron

urea

what substance is also traveling through the nephron that gives urine its smell and yellow color

ammonia

urea is a byproduct of

aldosterone

what hormone is regulating electrolyte/sodium balance at the area of the DCT

ADH (antidiuretic hormone)

what hormone is also starting to do its work at the DCT and a lot at the collecting duct (will determine if we need more water or need to pee out more water)

Lasix

what is a loop diuretic drug that acts on the loop of Henle

CHF or hypertension

loop diuretics will often be prescribed to patients with what conditions to get them to pee out more fluid

they stop sodium from getting secreted out of the nephron (water will also follow it and won't go out of the nephron) hence more urine being created in the nephron

how do loop diuretics (Lasix) work

kidney

principal urinary system organ

cystitis

an inflammation of the urinary bladder, often caused by a bacterial infection. It's a type of urinary tract infection (UTI). Symptoms include a frequent and urgent need to urinate, a burning sensation during urination, and pain in the lower abdomen.

urethritis

an inflammation of the urethra, the tube that carries urine from the bladder to the outside of the body. It is commonly caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Other causes include bacterial infections, irritation from chemicals or soaps, and certain medical conditions

hydronephrosis

a condition where one or both kidneys swell due to a buildup of urine, often caused by a blockage or obstruction in the urinary tract. This blockage prevents normal urine drainage from the kidney to the bladder, leading to urine backup and kidney swelling

the liver (they're both the same size though)

why is right kidney lower than the left

nephron

basic functional unit of kidney

180

how many liters filtrated in kidney each day

urea

most abundant nitrogenous waste product excreted in the urine

review GI slide 13 about dialysis (frequency/duration, access point, settings they occur in)

review GI slide 13 about dialysis (frequency/duration, access point, settings they occur in)

Blockage is a concern with lymphedema. Can the fluid even move to the kidneys to get processed out of the body? Blockage needs to be addressed first

Diuretic makes you pee more. With lymphedema, why don't they prescribe diuretics?