anatomy & physiology 2 - urinary system (EXAM 3)

a major part of _____ is maintaining the composition, pH, and volume of body fluids within normal limits

homeostasis

the _____ system removes metabolic wastes and substances in excess, including foreign substances like drugs and their metabolites that may be toxic; it consists of a pair of kidneys, a pair of ureters, a urinary bladder, and a urethra

urinary

the renal _____ come off the aorta so tons of blood is going to be pushed into the kidneys, renal _____ will drain the blood after it’s been filtered, and the filtrates (the urine) is going to come down the two _____ and enter the _____

arteries; veins; ureters; bladder

the urinary system gets rid of forms of nitrogenous wastes; the most toxic products are nitrogen-containing metabolites of protein breakdown: _____, _____, and _____ acids

ammonia; urea; uric

most aquatic animals including most bony fish pee out _____, mammals, most amphibians, sharks, and some bony fish pee out _____, and many reptiles, including birds, insects, and land snails pee out _____

ammonia; urea; uric acid

we die if we lose about _____ of our water

12%

the _____ are highly vascular organs that receive about 20% of the cardiac output; they produce urine (about 1-2L/day) and filtrate the blood; they’re an endocrine organ that also make _____ which is involved with RBC formation; they can also sense BP so when BP drops, they secrete _____ which helps raise BP

kidneys; erythropoietin; renin

_____ refers to how the kidneys sit behind the peritoneum membrane of the abdominal cavity

retroperitoneal

the _____ kidney is higher up in the abdominal cavity because the liver is on the R side and takes up space

L

the _____ is the indentation in the kidney for the arteries, veins, and nerves to go in and out of the organ

hilum

as a fetus, the kidney looks “_____” and it smooths out as an adult

lobey

_____ are the units of the kidney; there’s about a million per kidney and this is where blood gets filtered and the tubes reabsorb most of the filtrate and kick out the bad stuff

nephrons

_____ are balls of capillaries where water is going to be pushed out of the blood

glomeruli

blood enters the kidney through the renal _____ which splits into the _____ arteries which then arcs to create the _____ arteries; once in the arc, the _____ arteries branch off leading to the capillaries through the _____ arteriole, passing through the _____, and exiting through the _____ arteriole; then the blood goes through the _____ capillaries into the _____ vein, then the _____ vein, the _____ vein, and finally exits the kidney through the renal _____

artery; interlobar; arcuate; cortical radiate; afferent; glomerulus; efferent; peritubular; interlobar; arcuate; cortical radiate; vein

the glomerulus has a cup around it called the _____ where the capillaries leak fluid into; it then turns into the _____ tube leading to a loop including the _____ and _____ tubes; then there are two _____ tubes that dump into the _____ where the pee is coming down

glomerular capsule; proximal convoluted; descending; ascending; distal convoluted; collecting duct

the function of the _____ is to filtrate water and dissolve substances from the plasma

glomerulus

the function of the _____ is to receive the glomerular filtrate

glomerular capsule

you can make really concentrated pee in the morning due to dehydration or you can make watery pee; this fluctuates due to how permeable the _____ is; for example, if you want to get rid of water, you make it not permeable to water and the pee just pours out whereas if you want to concentrate it, pores are opened up and the water will be sucked out and little pee will come out (AHD plays a role here)

collecting duct

the _____ layer of of the glomerular (Bowman’s) capsule is the outside of the capsule made of squamous cells whereas the _____ layer surrounds the capillaries and contains _____; the space between is called the _____ space

parietal; visceral; podocytes; urinary

the _____ arteriole is bigger than the _____ arteriole so that pressure backs up and more water comes out; muscular _____ can control this pressure so if the efferent arteriole was constricted, the higher the pressure, and if the afferent arteriole was restricted there would be less pressure

afferent; efferent; sphincters

the _____ tube is where the most reabsorption happens through active transport (reabsorption of glucose, amino acids, creatine, lactic, citric, uric, and ascorbic acid, phosphate, sulfate, calcium, potassium, and sodium)

proximal convoluted

the _____ limb of the nephron loop functions to reabsorb water by osmosis

descending

the _____ limb of the nephron loop functions to reabsorb sodium, potassium, and chloride ions by active transport

ascending

the _____ tubule functions to reabsorb sodium ions by active transport and reabsorb water by osmosis; it actively secretes hydrogen ions ions, and it secretes potassium ions

distal convoluted

the _____ functions to reabsorb water by osmosis

collecting duct

80% of nephrons are _____ nephrons which are in the cortex and have short loops; 20% are _____ nephrons meaning they’re right next to the medulla which are important with water retention

cortical; juxtamedullary

the filtration apparatus of the kidney is known as the renal _____

corpuscle

3 components to filtration of the renal corpuscle include the _____ of glomerular capillaries because it has holes in it allowing it to be leaky, the glomerular _____ membrane, and the _____ of the visceral layer that create filtration slits

endothelium; basement; podocytes

the glomerular _____ membrane restricts large particles like big proteins

basement

_____ or hemoglobin in urine is bad however it can happen after heavy exercise

albumin

the _____ apparatus is adjacent to arterioles at the vascular pole (the distal straight tube comes here); this structure regulates BP by secreting the hormone renin which is released when BP and sodium concentration are low through sympathetic stimulation; there are also _____ which are tall, crowded cells of the ascending limb that monitor sodium concentration in the tubular fluid and regulate the renin secretion and filtration rate

juxtaglomerular; macula densa

_____ kidney disease is a genetic disease where the kidneys get fluid filled cysts on them making the kidneys weight 20-30lbs

polycystic

_____ is a machine that takes care of the kidney’s functions when it’s failing; it can be a stepping stone for a kidney transplant

hemodialysis

a _____ is done when a kidney is failing; when they put this new kidney in, it goes down in the pelvis and connected to the bladder

kidney transplant

_____ is inflammation of the kidney

nephritis

_____ is inflammation of the glomeruli; it’s usually due to an abnormal immune reaction from a bacterial infection due to antibody complexes lodging in the glomerular arteries; it’s chronic because fibrous tissue is replacing good kidney causing the kidneys to fail

glomerulonephritis

_____ form from the buildup of crystalline material like calcium and other salts due to not drinking enough fluids, eating too much calcium, proteins, or salts; they can be uric acid build up or calcium oxalate monohydrate build up

kidney stones

the main functions of the _____ and _____ are to control the composition of body fluids and remove wastes from the blood with the product being urine

nephrons; collecting ducts

_____ contains wastes, excess water, and electrolytes; it’s the final product of the processes of: _____ filtration, tubular _____, and tubular _____

urine; glomerular; reabsorption; secretion

filtration of small molecules is _____; the filtrate in the glomerular capsule mirrors the concentration of solutes in blood plasma

nonselective

the main force that moves substances by filtration through the glomerular capillary wall is _____ pressure of the blood inside; the factors that inhibit filtration are osmosis and pressure in the capsule

hydrostatic (BP)

_____ is directly proportional to the net filtration rate

glomerular filtration rate

due to the inhibiting factors of filtrate pressure: _____ = hydrostatic pressure - (osmotic pressure + capsular hydrostatic pressure);

GFR

if BP drops (i.e., shock), pressure may be below what’s needed for filtration, so tubular cells may die from a lack of nutrients causing permanent damage; this is know as _____

renal failure

if you were starving with few proteins in your plasma, GFR would _____ because osmosis pressure would be less creating a greater net output

increase

if urine was backed up and not draining, GFR would _____ because capsular pressure would be much greater

decrease

GFR remains relatively constant through a process called _____ which can be overridden when necessary; for example, it can be regulated through sympathetic impulses like when BP gets too high, the afferent arterioles can be constricted to decrease pressure in the glomerulus, and if BP is too low, the efferent arteriole can be constricted to increase pressure in the glomerulus; the renin-angiotensin system can also detect a rise in BP and sodium levels by juxtaglomerular cells vasoconstriction; the atrial natriuretic peptide (ANP) tries to increase GFR so that BP decreases

autoregulation

_____ is the precursor molecule made by the liver circulating in the blood; when renin hits this, it turns into _____ which does nothing, but when it’s converted by angiotensin-converting enzyme (ACE) it turns into _____ which plays a role in vasoconstriction, increases aldosterone secretion, increases ADH secretion, and increases thirst, all increasing BP

angiotensinogen; angiotensin I; angiotensin II

one of the main targets of high blood pressure medication is _____ which inhibit the ACE enzyme which doesn’t allow angiotensin I to be converted into angiotensin II with the goal of keeping BP lower

ACE inhibitors

angiotensin II causes an increase in aldosterone which helps you retain sodium in the kidneys, in turn causing the body to retain more water, thus _____ BP

increasing

certain substances are _____: partially _____ include water, sodium, and bicarbonate, and completely _____ includes glucose; other substances are added to the _____ like creatinine and organic acids

reabsorbed; reabsorbed; reabsorbed; filtrate

during tubular _____, substances move from the renal tubules into the interstitial fluid where they then diffuse into the peritubular capillaries; the _____ tubule reabsorbs about 70%

reabsorption; proximal convoluted

_____ needs active transport meaning it uses energy (ATP), but there are only so many carrier proteins; in other words, there’s _____ capacity so when it’s overwhelmed, glucose ends up in urine (i.e., diabetes)

glucose; limited transport

_____ transport is used for amino acids, and although proteins shouldn’t make it through the filter, small proteins like albumin can squeeze through the glomerular capillaries; the frothyness of urine indicates protein in urine

active

water reabsorption is _____ transport; for instance, sodium ion are reabsorbed by active transport, and negatively charged ions are attracted to positively charged ions; therefore, as the concentration of solute increases in the plasma, osmotic pressure increases and water moves from the proximal tubule to the capillaries by osmosis; 180L is produced a day, but 99% is water is reabsorbed

passive

tubular _____ is when substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules; active transport mechanisms function here and involve the secretion of substances like drugs and ions

secretion

some _____ leaves the peritubular capillary passively because the sodium pump causes a negative charge in the tube, attracting these ions to the distal convoluted tube to keep the pH slightly acidic

potassium

hormones such as _____ and _____ affect the solute concentration of urine, specifically sodium

aldosterone; ANP

the ability of the kidneys to maintain the internal environment rests in a large part on their ability to concentrate urine by reabsorbing large volumes of _____

water

the _____ convoluted tubule and the collecting duct are impermeable to water, so water may be excreted as dilute urine unless ADH makes them permeable to water in the event of dehydration

distal

a _____ mechanism is in the nephron loops (descending and ascending limbs) which ensures that the medullary interstitial fluid becomes hypertonic; the vasa recta also contributes here; this mechanism is known as the _____

countercurrent; countercurrent multiplier

the role of _____ in regulating urine concentration and volume is as follows:

1. the concentration of water in the blood decreases

2. the osmotic pressure of body fluids increases, stimulating osmoreceptors in the hypothalamus

3. the hypothalamus signals the posterior pituitary gland to release _____

4. the blood carries _____ to the kidneys

5. _____ causes the distal convoluted tubules and collecting ducts to increase water reabsorption by osmosis

6. the urine becomes more concentrated and urine volume decreases

ADH

_____ is a by-product of amino acid catabolism; it enters the renal tubules through glomerular filtration and is highly soluble in water; it contributes to the reabsorption of water from the collecting duct and 80% of it is recycled; in water, the amine groups undergo slow displacement by water molecules, producing ammonia causing the smell of stinky urine

urea

_____ is a product of nucleic acid metabolism; it’s solubility is rather low and it enters the renal tubules through glomerular filtration

uric acid

_____ is a type of arthritis when uric acid crystals build up in joints; over half the cases are found in the big toe and are more common in men than women

gout

_____ composition reflects the volumes of water and solutes that the kidneys must eliminate from the body or retain in the internal environment to maintain homeostasis; it varies from time to time due to dietary intake, physical activity, and environmental factors, but it’s mostly water (95%), it usually contains urea, uric acid, and creatine, and it may contain traced amounts of amino acids and varying amounts of electrolytes

urine

_____ is the rate at which a chemical is removed from the plasma and indicates kidney efficiency; in other words, it = the volume of plasma from which a substance is completely removed by the kidney/min; tests for this include an insulin clearance test (plant root you can inject) and a creatinine clearance test (natural)…these tests are used to calculate GFR

renal clearance

once urine drips out of the renal pyramids through the papilla, the passages do not modify it but _____ it

store/pass

_____ epithelium lines the calyces, ureters, bladder, and initial segment of the urethra; it’s impermeable to salts and water; it has about 2-6 cell layers, and has the ability to be thick when the bladder is empty, and as the bladder fills, the cells slide by each other to become much thinner

transitional

after forming along the nephrons, urine passes through the _____ then through the renal _____ which causes it to enter the minor and major _____ where it can collect in the renal _____ which brings it to the _____ leading to the _____ so it can exit the body through the _____

collecting ducts; papillae; calyces; pelvis; ureters; urinary bladder; urethra

_____ moves urine along which describes a rhythmic movement of the urine being squeezed down the ureter

peristalsis

each _____ is about 25 cm long and extends downward, posterior to the parietal peritoneum and runs parallel to the vertebral column; they join the urinary bladder in the pelvic cavity and consist of three layers: the inner mucous coat, the middle muscular coat, and the outer fibrous coat; they also enter the bladder at an oblique angle to work as a valve because as the bladder fills, the muscle closes off the opening of this structure so the urine doesn’t go back to the kidneys

ureter

the _____ is a hollow, distensible, muscular organ located within the pelvic cavity, posterior to the symphysis pubis, and inferior to the parietal peritoneum; it contacts the anterior walls of the uterus and vagina in females and lies posteriorly against the rectum males; the openings for the ureters is the _____ including the R and L openings of the ureters and the urethra; this structure has four layers: the inner mucous coat, a submucous coat, a muscular coat, and an outer serous coat; smooth muscle fibers compromise the _____ which is the muscle of the bladder

urinary bladder; area of trigone; detrusor muscle

the _____ urethral sphincter is made of smooth muscle and is autonomically controlled whereas the _____ urethral sphincter is made of skeletal muscle so we can control it

internal; external

the _____ is a fibromuscular tube that conveys urine from the urinary bladder to the outside of the body; it’s wall is lined with a mucous membrane and has a thick layer of longitudinal smooth muscle fibers; in females it’s about 4cm long whereas in males it’s about 17.5cm long, has a dual function of both urination and reproduction, and has three sections: the _____ urethra, the _____ urethra, and the _____ urethra

urethra; prostatic; membranous; penile

urine leaves the urinary bladder by _____ or urination reflex; the major events include:

1. the urinary bladder distends as it fills with urine

2. stretch receptors in the bladder wall are stimulated and they signal the _____ center in the sacral spinal cord

3. parasympathetic nerve impulses travel to the detrusor muscle which responds by contracting rhythmically

4. the need to urinate is urgent

5. voluntary contraction of the external urethral sphincter takes place and inhibition of the _____ reflex occurs by impulses from the brainstem and the cerebral cortex to prevent urination

6. following the decision to urinate, the external urethral sphincter is relaxed and impulses from the pons and the hypothalamus facilitate the _____ reflex

7. the detrusor muscle contracts and urine is expelled through the urethra

8. neurons of the _____ reflex center fatigue, the detrusor muscle relaxes, and the bladder begins to fill with urine again

micturition

a _____ kidney is a fusion of kidneys at one pole, usually lower, with most of each kidney on opposing sides of the midline

horseshoe

_____ changes of the urinary system are sufficiently redundant in both structure and function to mask age-related changes; the kidneys become slower to remove nitrogenous wastes and toxins and to compensate for changes that maintain homeostasis

lifespan

_____ of the urinary system with age include the kidneys appear scarred and grainy, kidney cells die, by age 80 the kidneys have lost 1/3 of their mass, proteinuria may develop, the renal tubules thicken, it’s harder for the kidneys to clear certain substances, the bladder, ureters, and urethra lose elasticity, and the bladder holds less urine

changes