Ch. 24 - Mostly Asked Questions

5. The portion of the kidney that extends between the renal pyramids is called the

A) renal columns

B) renal medulla

C) renal pelvis

D) calyces

E) renal papilla

A) renal columns

6. Which is the correct order of blood flow through the kidneys?

A) renal artery > segmental artery > interlobular artery > peritubular capillaries > afferent arterioles

B) interlobar arteries > arcuate arteries > glomerular capillaries > arcuate veins

C) arcuate veins > arcuate arteries > glomerular capillaries > renal vein

D) renal vein > segmental arteries > interlobar arteries > efferent arterioles

E) interlobar veins > afferent arterioles > efferent arterioles > glomerular capillaries

B) interlobar arteries > arcuate arteries > glomerular capillaries > arcuate veins

9. This is the structure of the nephron that filters blood. ***

A) glomerular capsule

B) loop of Henle

C) ascending limb

D) collecting duct

E) renal corpuscle

A) glomerular capsule

10. This term means the return of substances into the blood stream from the filtrate.

A) reabsorption

B) filtration

C) secretion

D) excretion

E) none of these choices

A) reabsorption

12. This layer of filtration membrane is composed of collagen fibers and proteoglycans in a glycoprotein matrix.

A) glomerular endothelial cells

B) basal lamina

C) pedicels

D) filtration slits

E) slit membrane

B) basal lamina

14. This occurs when a substance passes from the fluid in the tubular lumen through the apical membrane, across the cytosol, and then into the interstitial fluid.

A) paracellular reabsoprtion

B) transcellular reabsoprtion

C) apical reasborption

D) basolateral reabsorption

E) active transport

B) transcellular reabsoprtion

15. The proximal convoluted tubules reabsorb which percentage of filtered water?

A) 25%

B) 50%

C) 65%

D) 80%

E) 99%

C) 65%

18. Increased secretion of hydrogen ions would result in a ______________ of blood ____________.

A) increase, pressure

B) decrease, volume

C) increase, sodium levels

D) decrease, pH

E) increase, urea

D) decrease, pH

19. Increased secretion of aldosterone would result in a ______________ of blood ____________.

A) increase, potassium

B) decrease, volume

C) increase, calcium levels

D) decrease, pH

E) increase, sodium

E) increase, sodium

20. An analysis of the physical, chemical, and microscopic properties of urine is called

A) urinalysis

B) filtration study

C) concentration study

D) diuretic

E) osmolarity

A) urinalysis

21. Water accounts for which percentage of the total volume of urine?

A) 25%

B) 50%

C) 75%

D) 80%

E) 95%

E) 95%

22. This is a test to measure kidney function.

A) Plasma creatinine

B) Renal study

C) Kidney assay

D) Dialysis

E) Hilus study

A) Plasma creatinine

23. This transports urine from the kidney to the bladder.

A) Urethra

B) Ureter

C) Descending loop of Henle

D) Renal hilus

E) None of these choices

B) Ureter

24. This layer of the ureter is composed of connective tissue, collagen and elastic fibers.

A) Mucosa

B) Transitional epithelium

C) Lamina propria

D) Adventitia

E) Lamina elastica

C) Lamina propria

25. This lies in the anterior corner of the trigone of the bladder.

A) Urethral sphincter

B) Adventitia bundle

C) Ureter

D) Internal urethral orifice

E) Muscularis bundle

D) Internal urethral orifice

61. Anorexia, starvation, or a diet too low in carbohydrates indicates which condition?

A) albuminuria

B) glucosuria

C) urobilinogenuria

D) ketonuria

E) bilirubinuria

D) ketonuria

62. Stress, causing excessive amounts of epinephrine secretion which stimulates glycogen breakdown, indicates which condition? This condition can also indicate diabetes mellitus.

A) albuminuria

B) glucosuria

C) urobilinogenuria

D) hematuria

E) bilirubinuria

B) glucosuria

63. Excessive urine concentration of a normal breakdown product of hemoglobin, caused by pernicious anemia, infectious hepatitis, jaundice or cirrhosis, indicates which condition?

A) albuminuria

B) glucosuria

C) urobilinogenuria

D) hematuria

E) bilirubinuria

C) urobilinogenuria

64. This substance gives bile its major pigmentation:

A) ketone bodies

B) erythrocytes

C) casts

D) bilirubin

E) glucose

D) bilirubin

65. These are tiny masses of material, hardened in the lumen of the urinary tubule and are flushed out when filtrate builds up behind them:

A) ketone bodies

B) erythrocytes

C) casts

D) microbes

E) urobilinogen

C) casts

66. Candida albicans and E. coli are which type of abnormal constituent of urine:

A) ketone bodies

B) erythrocytes

C) casts

D) microbes

E) urobilinogen

D) microbes

67. Which is the normal pH range of urine in humans?

A) 8.1 - 10.6

B) 4.6 - 8.0

C) 1.0 - 3.0

D) 3.1 - 4.0

E) 10.0 - 12.

B) 4.6 - 8.0

68. What is the normal volume of urine produced in humans?

A) 1L / hr

B) 2L / day

C) 2L / hr

D) 3L / week

E) 10L / 24 hours

B) 2L / day

72. This hormone is released when the blood volume increases.

A) Parathyroid Hormone

B) Renin

C) ADH

D) Atrial Natriuretic Peptide

E) Aldosterone

D) Atrial Natriuretic Peptide

74. Consumption of salty food will cause an increase in this hormone.

A) Aldosterone

B) Renin

C) ANH

D) Angiotensin-II

E) ADH

E) ADH

75. Absence of angiotensin converting enzyme will lead to

A) decreased blood pressure

B) increased blood pressure

C) will not have any effect on blood pressure

D) All of these choices

E) None of these choices

A) decreased blood pressure

76. If the urinary excretion rate of a drug such as penicillin is greater than the rate at which it is filtered at the glomerulus, how else is it getting into the urine?

A) movement through intercellular clefts in the glomerular capillaries

B) active transport

C) blood colloid osmotic pressure

D) tubular reabsorption

E) tubular secretion

E) tubular secretion

77. How does the urinary system help the nervous system?

A) The kidneys synthesize calcitonin, which decreases blood calcium levels.

B) The urinary bladder secretes erythropoietin, which acts as a neurotransmitter.

C) The kidneys activate vitamin C, which regulates brain growth in the fetus.

D) The kidneys perform gluconeogenesis, providing glucose for neurons.

E) The urinary bladder filters out used neurotransmitters.

D) The kidneys perform gluconeogenesis, providing glucose for neurons.

78. Which condition is characterized by elevated blood levels of cholesterol, phospholipids and triglycerides with depressed blood levels of albumin?

A) glomerulonephritis

B) polycystic kidney disease

C) urinary bladder cancer

D) renal calculi

E) nephrotic syndrome

E) nephrotic syndrome

79. The liver contributes to waste management by detoxifying substances and the lungs participate by excreting carbon dioxide. True or False.

TRUE

80. What type of embryonic tissue develops into nephrons?

A) Endoderm

B) Ectoderm

C) Mesoderm

D) Pyoderm

C) Mesoderm

81. Intercalated cells resorb potassium ions, bicarbonate ions and secrete hydrogen ions. True or False.

TRUE

Kidney malfunction would affect which bodily function?

excretion of urea

Identify a hormone produced by the kidneys that stimulates the production of red blood cells.

erythropoietin

Why is dramatic reduction in the adipose capsule surrounding a kidney dangerous?

Kidney dropping could lead to ureter kinking and blockage of urine flow

Each kidney has about 1 million of which of the following?

afferent arterioles

Which of the following would necessarily characterize a solute in the glomerular (Bowman's) capsule?

A. charged

B. waste

C. lipid soluble

D. small

D. small

In an analogy to a recycling center, which event best illustrates tubular secretion?

workers place additional garbage left at the center and larger items onto the conveyor belt

Identify the correct tubuloglomerular feedback response to increased glomerular filtration rate.

afferent arterioles constrict

Assuming GFR is 180 liters per day, which substance would be completely reabsorbed (returned to blood)?

glucose

Which of the following drives obligatory water reabsorption?

reabsorption of solutes

How does alcohol affect renal function?

decreased ADH secretion, more dilute urine

In forming dilute urine, the osmolarity of the fluid in the tubular lumen ________ as it flows down the descending limb of the nephron loop and ________ as it flows up the ascending limb.

increases; decreases

Which urinalysis indicates altered body metabolism or kidney function?

glucose present

What quality of the plant polysaccharide inulin allows it to be used clinically to determine the GFR?

inulin is filtered but neither reabsorbed nor secreted

Which of the following allows urine to be delivered to the urinary bladder when performing a hand-stand?

Peristaltic waves along the ureters

Women are more likely to acquire a urinary tract infection (UTI) than men because of the anatomical differences in which structure?

urethra

The collecting ducts, calyces, renal pelvis, and ureter develop most directly from which of the following structures?

ureteric bud

Identify the method or structure that does NOT assist in waste management.

thyroid gland

Besides the kidney, several organs, tissues, and processes contribute to the management of wastes in the body. These include all of the following EXCEPT

sebaceous glands

Which embryonic kidney is normally retained in the fetus?

metanephros

Which of the following is associated with normal aging?

decreased filtration, reabsorption and secretion

Kidney production of the enzyme renin affects the

cardiovascular system

By increasing reabsorption of water filtered from blood, kidneys function to

increase blood pressure

Which is NOT a cause of acute renal failure?

increased cardiac output

Select the correct order of structures from urine production to urine leaving the body.

kidney, ureter, urinary bladder, urethra

The kidneys help regulate the pH of body fluids through selective reabsorption of which of the following?

bicarbonate ions

Which of the following correctly traces the flow of blood through the kidney after entry through the renal arteries and prior to entry into the peritubular capillaries?

segmental arteries, interlobar arteries, arcuate arteries, interlobular arteries, afferent arteriole, glomerulus, efferent arteriole

Screening tests which detect the concentration of _____ in the blood are commonly used to provide information about kidney function.

blood urea nitrogen and creatinine

The micturition reflex uses

parasympathetic impulses to contract the detrusor muscle and relax the internal urethral sphincter.

Urine produced by the kidneys is transported by the ______ to the urinary bladder where it is stored until being excreted from the body.

ureters

The kidneys and which other organ significantly affects the pH of body fluids?

lungs

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.) vasa recta

(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.) cortical radiate arteries

(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.

(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 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.)

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 level

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.) proximal convoluted tubule

(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