✨✨✨Chapter 25: Urinary System

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Which arteries branch off the arcuate arteries?

a.) segmental arteries

b.) renal arteries

c.) cortical radiate arteries

d.) interlobar arteries

C (cortical radiate arteries)

Which vessels are most intimate with the nephron loop and serve as a point to collect ions and water back into the blood?

a.) vasa recta

b.) cortical radiate veins

c.) afferent arterioles

d.) efferent arterioles

A (The vasa recta are intimate with the nephron loop and serve as a point to collect ions and water back into the blood.)

Which vessels supply the cortical tissue of the kidney with blood?

a.) cortical radiate arteries

b.) interlobar arteries

c.) segmental arteries

d.) arcuate arteries

A (The cortical radiate arteries supply the cortical tissue of the kidney with blood.)

Which of the following is NOT a function of the kidneys?

a.) to regulate body fluid by controlling excretion from sweat glands

b.) to maintain the proper balance between water and salts and between acids and bases

c.) to metabolize vitamin D to its active form

d.) to carry out gluconeogenesis during prolonged fasting

A (to regulate body fluid by controlling excretion from sweat glands. The kidneys have no control over excretion at the level of sweat glands.)

Which statement does NOT accurately describe the renal gross anatomy?

a.) The space where blood vessels and nerves enter the kidney is called the hilum.

b.) The kidneys have partial protection from the rib cage.

c.) The left kidney is lower in position because of crowding by the liver.

d.) The fibrous capsule prevents infections from spreading away from the kidney.

C (The left kidney is lower in position because of crowding by the liver is INcorrect because it is the RIGHT kidney that is position slightly lower because of crowding by the liver.)

The __________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the __________.

a.) renal pyramids; calyces

b.) calyces; renal pelvis

c.) renal pyramids; renal pelvis

d.) renal pelvis; calyces

B (calyces; renal pelvis. Formed urine enters into the renal calyces and then the renal pelvis before entering the ureter.)

Hydronephrosis may be caused by all EXCEPT which of the following?

a.) renal ptosis

b.) kidney stones lodged in a ureter

c.) renal failure

d.) tumor in a ureter

C (renal failure. Renal failure is characterized by a significant decrease in urine output due to damage to the nephron.)

Efferent arterioles supply blood to the glomerulus. T/F?

false (the afferent arterioles supply blood to the glomerulus)

Name the strong transparent covering that encases the kidney.

renal (fibrous) capsule

Where does the ureter penetrate the kidney?

hilum

The ureter, blood vessels, and nerves penetrate the kidney on its medial surface. T/F?

true

Where does filtration of the blood occur within the kidneys?

renal cortex

Identify the correct direction of urine flow from formation to exiting the kidney. (using: medula, ureter, cortex, and pelvis)

cortex, medulla, pelvis, ureter

Where does the kidney filter the blood?

renal corpuscle (The renal corpuscle is an interface between the blood supply and the kidney. It consists of the glomerulus, which is a capillary bed, and the glomerular (bowman's) capsule, which is part of the nephron. Filtration is the exit of small substances from the blood in the glomerulus into the glomerular capsule of the nephron.)

Where does the efferent arteriole of the juxtamedullary nephron carry blood to?

a.) glomerulus

b.) peritubular capillaries

c.) afferent arteriole

d.) vasa recta

D (vasa recta. The efferent arteriole of the juxtamedullary nephron carries blood to the vasa recta.)

Which capillary bed produces filtrate?

a.) glomerulus

b.) vasa recta

c.) juxtaglomerular complex (JGC)

d.) peritubular capillaries

A (glomerulus. The glomerulosa (capillary bed) in the glomerular capsule produces filtrate due to the high fluid pressure within the vessels.)

What is the function of the macula densa cells of the juxtaglomerular complex (JGC)?

a.) production of filtrate

b.) monitoring the NaCl content of the filtrate

c.) passing regulatory signals between other cells of the juxtaglomerular complex

d.) sensing blood pressure in the afferent arteriole

B (monitoring the NaCl content of the filtrate . The macula densa cells monitor the NaCl content of the filtrate entering the distal convoluted tubule.)

Which cells of the juxtaglomerular complex secrete renin?

a.) glomerular mesangial cells

b.) extraglomerular mesangial cells

c.) macula densa cells

d.) granular cells

D (granular cells. Granular cells are mechanoreceptors that sense blood pressure in the afferent arterioles. They secrete renin when the blood pressure drops and are an important part of the renin-angiotensin-aldosterone regulatory pathway.)

Which of these cells is located interspersed between the capillaries of the glomerulus?

a.) macula densa cells

b.) proximal tubule cells

c.) glomerular mesangial cells

d.) extraglomerular mesangial cells

C (glomerular mesangial cells. Glomerular mesangial cells cover some of the glomerular capillaries and function in filtration and support.)

Which of the following is NOT a major urine formation process?

a.) glomerular filtration

b.) tubular reabsorption

c.) micturition

d.) tubular secretion

C (micturition. Micturition is the process of urinating, releasing stored urine after it is formed.)

Which of the following processes would be considered as a secretory rather than an excretory activity?

a.) sweat removal by the skin

b.) feces elimination by the colon

c.) carbon dioxide removal by the lungs

d.) aldosterone release by the adrenal glands

D (aldosterone release by the adrenal glands)

What is the chief force pushing water and solutes out of the blood and across the filtration membrane of the glomerulus?

a.) colloid osmotic pressure in glomerular capillaries (OPgc)

b.) colloid osmotic pressure in the capsular space

c.) hydrostatic pressure in glomerular capillaries (HPgc)

d.) hydrostatic pressure in the capsular space (HPcs)

C (hydrostatic pressure in glomerular capillaries (HPgc) . While diffusion rates are affected more by osmotic differences and concentration gradients, hydrostatic pressure in glomerular capillaries (HPgc) is the chief method of forcing water and solutes by filtration.)

How do we calculate the net filtration pressure?

Net filtration pressure is calculated by subtracting the inward pressures from the outward pressures: (HPgc) - (HPcs + OPgc).

Suppose that a patient has a failing liver and is unable to make normal levels of albumin for the blood plasma. If all other factors remain the same, what would be the effect on the amount of filtrate produced?

a.) Filtrate production would remain the same.

b.) Filtrate production would decrease.

c.) Filtrate production would increase.

C (filtrate production would increase. If the liver were making insufficient levels of albumin, which is the most important contributor to the blood's osmotic pressure, the blood's osmotic pressure would drop, leading to a rise in filtrate production.)

Capsular hydrostatic pressure is the chief force pushing water and solutes out of the blood and across the filtration membrane. T/F?

false (The net filtration pressure (NFP), responsible for filtrate formation, involves forces acting at the glomerular bed. Glomerular hydrostatic pressure, which is essentially glomerular blood pressure, is the chief force pushing water and solutes out of the blood and across the filtration membrane.)

The rate of kidney filtrate formation would normally be dependent upon all of the following factors except __________.

a.) systemic blood pressure

b.) filtration membrane integrity

c.) blood calcium level

d.) renal artery/arteriole diameters

C (blood calcium levels)

When given to a patient, which of the following substances would increase his or her urinary output?

a.) intravenous saline

b.) antidiuretic hormone

c.) aldosterone

d.) albumin

A (intravenous saline)

What hormone promotes active tubular secretion of potassium ions into, along with sodium reabsorption from, filtrate in the distal convoluted tubule (DCT) and collecting ducts?

a.) aldosterone

b.) parathyroid hormone (PTH)

c.) atrial natriuretic peptide (ANP)

d.) antidiuretic hormone (ADH)

A (aldosterone. Aldosterone from the adrenal cortex promotes active tubular secretion of potassium ions in the late distal convoluted tubule (DCT) and collecting ducts. It is secreted in indirect response to actions of the juxtaglomerular complex.)

What area of the nephron is responsible for the reabsorption of most of the water from the filtrate as well as most nutrients?

a.) proximal convoluted tubule

b.) collecting duct

c.) distal convoluted tubule

d.) descending nephron loop

A (proximal convoluted tubule. Most of the water from the filtrate as well as most nutrients are reabsorbed in the proximal convoluted tubule.)

In what part of the renal tubule does parathyroid hormone (PTH) promote the reabsorption of calcium ions?

a.) descending limb of the nephron loop

b.) proximal convoluted tubule (PCT)

c.) distal convoluted tubule (DCT)

d.) collecting duct

C (distal convoluted tubule (DCT) Parathyroid hormone (PTH) promotes the reabsorption of calcium ions in the distal convoluted tubule (DCT).)

Where in the nephron does most solute reabsorption occur?

a.) collecting duct

b.) distal convoluted tubule

c.) glomerulus

d.) proximal convoluted tubule

D (The proximal convoluted tubule (PCT) is where most reabsorption takes place.)

Approximately 80% of the energy used for active transport is devoted to the reabsorption of __________.

a.) water

b.) glucose

c.) potassium

d.) sodium

D (sodium. Most of the energy used for reabsorption is used to transport sodium out of the proximal convoluted tubule (PCT). Remember: water follows salt)

Under normal conditions, the proximal convoluted tubule (PCT) reabsorbs all of the glucose, lactate, and amino acids in the filtrate and 65% of the Na+ and water. T/F?

true (The PCT quickly recovers nutrients, leaving the latter parts of the nephron to use the water and salt remaining as a vehicle for wastes, and without having to deal with nutrients while making electrolyte and volume adjustments.)

Upon reaching what point in the nephron is reabsorption (1) dependent upon the body's needs at the time and (2) regulated by hormones?

a.) descending limb of the loop of Henle

b.) ascending limb of the loop of Henle

c.) proximal convoluted tubule

d.) distal convoluted tubule

D (distal convoluted tubule.Distal convoluted tubule (DCT) reabsorption only occurs under the influence of hormonal regulation)

The ascending limb of the loop of Henle is permeable to water. T/F?

false (The countercurrent multiplier functions because of two factors: (1) the descending limb of the loop of Henle is relatively impermeable to solutes and freely permeable to water, and (2) the ascending limb is permeable to solutes but not to water.)

Which hormone(s) is/are required for facultative water reabsorption in the collecting ducts?

a.) ADH

b.) renin

c.) aldosterone

d.) both ADH and aldosterone

A (ADH. ADH creates the aquaporins used by the collecting duct to reabsorb water.)

Which of the following promotes the formation of dilute urine?

a.) increased osmolality of extracellular fluids

b.) an increased number of aquaporins in the collecting duct

c.) large amounts of antidiuretic hormone (ADH) released from the posterior pituitary

d.) decreased osmolality of extracellular fluids

D (decreased osmolality of extracellular fluids. A decrease in the osmolality of the extracellular fluids would indicate the presence of large amounts of water in these fluids. This would in turn lead to a drop in antidiuretic hormone (ADH) release and the subsequent increase of water in the urine.)

Where does antidiuretic hormone (ADH) exert its effects to promote water reabsorption?

a.) descending limb of the nephron loop

b.) distal convoluted tubule (DCT)

c.) ascending limb of the nephron loop

d.) collecting duct

D (collecting duct. Antidiuretic hormone (ADH) causes an increase in aquaporins in cells of the collecting duct. More aquaporins in the cell membranes causes them to reabsorb more water from the filtrate, and the urine becomes more concentrated.)

Vasa recta blood osmolality is critical to maintaining the countercurrent mechanisms of the nephron. Where is vasa recta blood osmolality the highest?

a.) It is the same throughout the nephron area.

b.) in the cortex

c.) in the shallow medulla

d.) in the deep medulla

D (in the deep medulla. Vasa recta blood osmolality is at its highest where the filtrate and interstitial fluid are the highest, which is in the deep medulla.)

External chemicals that enhance urinary output are called __________.

a.) secretagogues

b.) countercurrent exchangers

c.) diuretics

d.) countercurrent multipliers

C (diuretics)

A nonfasting urine sample from an individual who had previously ingested donuts and a soft drink showed the presence of sugar (glucose). Which of the following statements explains the presence of glucose in the urine?

a.) The individual exceeded the transport maximum.

b.) The individual is glucose intolerant.

c.) The individual has diabetes mellitus.

d.) Some glucose is always present in the urine.

A (The individual exceeded the transport maximum.. When an individual exceeds the transport maximum for any filtered substance, that substance will end up in the urine.)

Since most patients with renal failure produce little or no urine, hemodialysis often involves removal of water from the blood. However, side-effects may develop if too much fluid is removed from the blood. Which of the following is NOT one of the potential side-effects?

a.) dizziness

b.) vasoconstriction of afferent arterioles

c.) low blood pressure

d.) muscle fatigue

B (vasoconstriction of afferent arterioles. Vasoconstriction of the afferent arterioles occurs during times of high systemic blood pressure. This reflexive response lowers glomerular blood pressure and helps maintain normal glomerular filtration rates.)