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What is the correct sequence of organs for the formation and elimination of urine?
Bladder, urethra, kidney, ureter
Kidney, ureter, bladder, urethra
Kidney, urethra, bladder, ureter
Kidney, bladder, ureter, urethra
Urethra, bladder, kidney, ureter

Kidney, ureter, bladder, urethra

Which is not a function of the kidneys?
Regulation of blood pressure
Removal of wastes from the blood
Regulation of erythrocyte production
Regulation of lymphocyte production
Regulation of acid-base balance

Regulation of lymphocyte production

In response to low blood ________, the kidneys secrete __________.
calcium, renin
oxygen, erythropoietin
sodium, calcitriol
potassium, erythropoietin
glucose, calcitriol

oxygen, erythropoietin

The kidneys are located ___________ the peritoneum.
within
anterior to
posterior to

posterior to

From innermost to outermost, the protective layers on the kidney are the:
fibrous capsule, perinephric fat, renal fascia, paranephric fat.
renal corpuscle, perinephric fat, renal fascia, paranephric fat.
renal fascia, paranephric fat, renal corpuscle, perinephric fat.
renal fascia, perinephric fat, fibrous capsule, paranephric fat.
fibrous capsule, paranephric fat, renal fascia, perinephric fat.

fibrous capsule, perinephric fat, renal fascia, paranephric fat.

Where are the renal pyramids located within the kidney?
Renal cortex
Renal sinus
Renal pelvis
Renal medulla
Renal papilla

Renal medulla

Which of the following choices lists structures in the order that urine flows through them?
Major calyx, minor calyx, renal pelvis
Renal pelvis, major calyx, minor pelvis
Minor calyx, major calyx, renal pelvis
Major pelvis, minor calyx, renal pelvis
Major calyx, renal pelvis, minor calyx

Minor calyx, major calyx, renal pelvis

The first structure in the kidney to collect newly formed urine is the:
renal capsule.
minor calyx.
renal pelvis.
renal sinus.
renal cortex.

minor calyx.

Which is not correct regarding the innervation of the kidney?
Parasympathetic innervation is from the vagus nerve.
The kidney is served by the renal plexus.
Sympathetic innervation is from segments T10-T12 of the spinal cord.
Sympathetic stimulation causes vasoconstriction of the renal blood vessels.
Parasympathetic stimulation decreases the rate of filtrate formation.

Parasympathetic stimulation decreases the rate of filtrate formation.

The renal corpuscle is located within the:
collecting duct.
renal medulla.
renal cortex.
renal pelvis.

renal cortex.

The thick tangle of capillary loops found within a corpuscle is known as the:
Bowman.
convoluted capillary bed.
glomerular capsule.
glomerulus.
nephron.

glomerulus.

The glomerulus is part of the renal tubule.
True
False

False

The nephron loop makes a hairpin turn within the ________ and its ________ limb ends at the distal convoluted tubule.
cortex, ascending
cortex, descending
medulla, ascending
medulla, descending

medulla, ascending

Both the proximal convoluted tubule and the distal convoluted tubule reside in the cortex of the kidney.
True
False

True

Which class of nephron is crucially important in establishing a salt concentration gradient in the kidney so that urine concentration can be regulated?
Intercalated nephrons
Juxtamedullary nephrons
Adrenal nephrons
Cortical nephrons

Juxtamedullary nephrons

Which is not correct regarding nephrons?
The renal corpuscle includes the glomerulus and the glomerular capsule.
The renal tubule is composed of the proximal convoluted tubule, nephron loop, and distal convoluted tubule.
The nephron is the functional filtration unit in the kidney.
Eighty-five percent of nephrons are cortical nephrons.
The renal corpuscle may be located in the renal cortex or renal medulla.

The renal corpuscle may be located in the renal cortex or renal medulla.

How are nephrons, collecting ducts, and collecting tubules related to each other?
One collecting duct drains into one nephron, and one nephron drains into one collecting tubule.
One nephron drains into one collecting tubule, and several collecting tubules empty into a collecting duct.
One nephron drains into one collecting duct, and several collecting ducts empty into a collecting tubule.
One collecting tubule drains into one nephron, and several nephrons drain into one collecting duct.
One nephron drains into several collecting tubules, and all tubules eventually lead to one collecting duct.

One nephron drains into one collecting tubule, and several collecting tubules empty into a collecting duct.

The juxtaglomerular apparatus is located:
within the renal sinus.
in the renal papilla.
in the perinephric fat.
inside the tubular pole of the glomerulus.
near the vascular pole of the renal corpuscle.

near the vascular pole of the renal corpuscle.

The main parts of the juxtaglomerular apparatus are the:
principal cells and macula densa.
granular cells and macula densa.
granular cells and intercalated cells.
intercalated cells and principal cells.
principal cells and granular cells.

granular cells and macula densa.

Stimulation of granular cells by the sympathetic nervous system causes them to:
contract.
relax.
release calcitriol.
increase endocytosis.

contract.

Granular cells synthesize and release the enzyme:
angiotensinogen.
antidiuretic hormone.
renin.
calcitriol.

renin.

Macula densa cells monitor the concentration of:
glucose in the blood.
antidiuretic hormone in the urine.
sodium chloride in the fluid within the distal convoluted tubule.
calcium in the fluid of the proximal convoluted tubule.
aldosterone in the afferent arteriole.

sodium chloride in the fluid within the distal convoluted tubule.

The capillaries of the glomerulus differ from most other capillary networks in the body because they:
carry only deoxygenated blood.
drain into an arteriole instead of a venule.
contain no endothelium.
absorb nutrients from the glomerular capsule.
secrete mucus.

drain into an arteriole instead of a venule.

Fluid contained within the lumen of a nephron loop would be considered to be:
plasma.
tubular fluid.
filtrate.
urine.

tubular fluid.

In the process of urine formation, first:
filtrate is formed, then tubular fluid, then urine.
tubular fluid is formed, then filtrate, then urine.

filtrate is formed, then tubular fluid, then urine.

Place the regions of the nephron in the correct order for the process of urine formation.
a: Capsular space of glomerulus
b: Nephron loop
c: Collecting duct
d: Distal convoluted tubule
e: Proximal convoluted tubule

a, e, b, d, c

Urine passes from a papillary duct into a:
major calyx, then to a minor calyx, then to a ureter.
minor calyx, then to a major calyx, then to the renal pelvis.
ureter, then to a minor calyx, then to a major calyx.
renal pelvis, then to a major calyx, then to a ureter.
collecting duct, then to a minor calyx, then to a major calyx.

minor calyx, then to a major calyx, then to the renal pelvis.

Which step(s) in the process of urine formation occur in the renal tubule?
Filtration only
Secretion only
Reabsorption only
Filtration, secretion, and reabsorption
Secretion and reabsorption only

Secretion and reabsorption only

How are the processes of reabsorption and secretion related?
They both involve movement of material from the blood into the tubular fluid.
Materials move in opposite directions: reabsorption moves materials into the blood, whereas secretion removes them from the blood.
Materials move in opposite directions: secretion moves materials into the blood, whereas reabsorption removes them from the blood.
They both involve movement of material from the tubular fluid into the blood.

Materials move in opposite directions: reabsorption moves materials into the blood, whereas secretion removes them from the blood.

The active transport of solutes out of the blood and into the tubular fluid is called:
filtration.
tubular reabsorption.
tubular secretion.
fenestration.
titration.

tubular secretion.

The endothelium of the glomerulus is made up of _________ capillaries.
fenestrated
continuous

fenestrated

The basement membrane of the glomerulus is composed of glycoproteins and _________, and it restricts the passage of _________.
phospholipids, plasma ions
phospholipids, plasma proteins
proteoglycans, plasma ions
proteoglycans, plasma proteins

proteoglycans, plasma proteins

Large proteins and red blood cells normally pass freely through the filtration membrane.
True
False

False

Water and glucose are freely filtered through the filtration membrane of a renal corpuscle.
True
False

True

Generally, negatively charged plasma proteins are:
moved across the filtration membrane by active transport pumps.
attracted by the positive charge of the filtration membrane.
repelled by the negative charge of the filtration membrane.
engulfed by endocytosis and reabsorbed at the filtration membrane.

repelled by the negative charge of the filtration membrane.

Blood pressure in the glomerulus is _______ than in other capillaries due to the relatively large diameter of ________ arterioles.
higher, afferent
higher, efferent
lower, afferent
lower, efferent

higher, afferent

The presence of proteins in the plasma tends to:
push fluid across the filtration membrane.
draw fluid back into the glomerulus.

draw fluid back into the glomerulus.

Net filtration pressure is equal to the:
capsular hydrostatic pressure plus the sum of the blood colloid osmotic pressure and the glomerular hydrostatic pressure.
glomerular hydrostatic pressure minus the sum of the blood colloid osmotic pressure and capsular hydrostatic pressure.
capsular hydrostatic pressure minus the sum of the blood colloid osmotic pressure and glomerular hydrostatic pressure.
blood colloid osmotic pressure minus the capsular hydrostatic pressure.
glomerular hydrostatic pressure plus blood colloid osmotic pressure minus capsular hydrostatic pressure.

glomerular hydrostatic pressure minus the sum of the blood colloid osmotic pressure and capsular hydrostatic pressure.

Increases in the levels of plasma proteins result in increases in net filtration pressure.
True
False

False

Sympathetic nervous system influences on glomerular filtration rate are considered ________ controls.
intrinsic
extrinsic

extrinsic

The myogenic mechanism of autoregulation that occurs within afferent arterioles of the kidney is an __________ control of GFR.
intrinsic
extrinsic

intrinsic

If there is an increase in systemic blood pressure, the resulting stretch of afferent arterioles results in reflexive:
vasoconstriction of efferent arterioles to raise GFR.
vasoconstriction of afferent arterioles to keep GFR normal.
vasodilation of efferent arterioles to lower GFR.
vasodilation of afferent arterioles to keep GFR normal.

vasoconstriction of afferent arterioles to keep GFR normal.

The tubuloglomerular feedback mechanism responds to an increase in:
systemic blood pressure by signaling for a decrease in heart rate through blood-borne hormones.
urine production by signaling for a decrease in urine production through the hormone ADH.
NaCl concentration in tubular fluid by signaling for afferent arteriole constriction with local chemical messengers.
glomerular capillary hydrostatic pressure by signaling for afferent arterioles to constrict and increase filtration rate.

NaCl concentration in tubular fluid by signaling for afferent arteriole constriction with local chemical messengers.

If someone is bleeding severely, the body's adaptive response is to:
increase sympathetic stimulation of the kidney and therefore increase GFR.
increase sympathetic stimulation of the kidney and therefore decrease GFR.
decrease sympathetic stimulation of the kidney and therefore decrease GFR.
decrease sympathetic stimulation of the kidney and therefore increase GFR.

increase sympathetic stimulation of the kidney and therefore decrease GFR.

Sympathetic stimulation causes:
mesangial cells to release angiotensin, which ultimately leads to granular cell contraction.
mesangial cells to release angiotensin, which ultimately leads to granular cell relaxation.
granular cells to release renin, which ultimately leads to mesangial cell contraction.
granular cells to release renin, which ultimately leads to mesangial cell relaxation.
inhibited release of erythropoietin and contraction of granular and mesangial cells.

granular cells to release renin, which ultimately leads to mesangial cell contraction.

Sympathetic stimulation of the kidney results in:
constriction of afferent arterioles and an increase in the surface area of the glomerulus.
constriction of afferent arterioles and a decrease in the surface area of the glomerulus.
dilation of afferent arterioles and an increase in the surface area of the glomerulus.
dilation of afferent arterioles and a decrease in the surface area of the glomerulus.

constriction of afferent arterioles and a decrease in the surface area of the glomerulus.

ANP is a hormone that causes:
constriction of the afferent arterioles and release of renin.
constriction of the afferent arterioles and inhibition of renin release.
dilation of the afferent arterioles and release of renin.
dilation of the afferent arterioles and inhibition of renin release.

dilation of the afferent arterioles and inhibition of renin release.

Most tubular reabsorption occurs in the:
proximal convoluted tubule, where cells have many flagella.
proximal convoluted tubule, where cells have many microvilli.
distal convoluted tubule, where cells have many flagella.
distal convoluted tubule, where cells have many microvilli.

proximal convoluted tubule, where cells have many microvilli.

The largest possible amount of a substance that can be reabsorbed or secreted across a kidney tubule wall in a given duration of time is known as the:
glomerular filtration rate.
renal threshold.
transport maximum.
net filtration pressure.
renal clearance exponent.

transport maximum.

For glucose to be reabsorbed from the tubule lumen, it is transported into the tubule cell by means of a:
glucose uniporter.
Na+/glucose symporter.
glucose protein channel.
Na+/glucose antiporter.

Na+/glucose symporter.

Nutrients such as glucose and amino acids within the tubular fluid:
are completely secreted.
are completely reabsorbed.
have half of their plasma concentration secreted.
have a little less than half of their tubular fluid concentration reabsorbed.
have concentrations in the filtrate and urine that match their transport maximum.

are completely reabsorbed.

Generally, a very _______ percent of Na+ in the tubular fluid is reabsorbed, and the reabsorption takes place _________.
high, only in the nephron loop
high, along the entire tubule
small, only in the nephron loop
small, along the entire tubule

high, along the entire tubule

Parathyroid hormone (PTH):
stimulates reabsorption of both calcium and phosphate.
stimulates reabsorption of calcium but inhibits phosphate reabsorption.
inhibits reabsorption of calcium but stimulates phosphate reabsorption.
inhibits reabsorption of both calcium and phosphate.

stimulates reabsorption of calcium but inhibits phosphate reabsorption.

The primary mechanism of water reabsorption in the kidney is:
primary active transport by means of a protein pump.
osmosis through aquaporins.
secondary active transport by means of a sodium-water symporter.
bulk transport by means of endocytosis.

osmosis through aquaporins.

Generally, most water reabsorption in a nephron occurs at the:
nephron loop and is called obligatory water reabsorption.
nephron loop and is called facultative water reabsorption.
proximal convoluted tubule and is called obligatory water reabsorption.
proximal convoluted tubule and is called facultative water reabsorption.

proximal convoluted tubule and is called obligatory water reabsorption.

Dehydration results in:
increased ADH secretion and increased water reabsorption.
increased ADH secretion and decreased water reabsorption.
decreased ADH secretion and increased water reabsorption.
decreased ADH secretion and decreased water reabsorption.

increased ADH secretion and increased water reabsorption.

Which of the following is a nitrogenous waste product produced from nucleic acid breakdown in the liver?
Urea
Deoxyribose
Uric acid
Creatinine

Uric acid

The countercurrent multiplier is a system by which the:
nephron loop multiplies the concentration of salts in the interstitial fluid of the kidney medulla.
nephron loop dilutes the concentration of solutes in the tubular fluid at its hairpin turn.
vasa recta secretes multiple amounts of metabolic wastes against their concentration gradient.
vasa recta becomes more concentrated with nitrogenous wastes than the urine.

nephron loop multiplies the concentration of salts in the interstitial fluid of the kidney medulla.

Careful measurements of GFR are made by injection of _______, but approximations of GFR can be made more simply by measuring renal plasma clearance of _________.
creatine phosphate, insulin
insulin, creatine phosphate
inulin, creatinine
creatinine, inulin

inulin, creatinine

The normal pH for urine:
is anything below 7.0.
is anything above 7.0
ranges between 4.5 and 8.0.
ranges between 3.0 and 6.0.
ranges between 8.0 and 9.0 for someone with a diet high in protein.

ranges between 4.5 and 8.0.

Where in the urinary tract is transitional epithelium found?
Urinary bladder
Urethra
Ureters, urinary bladder, and prostatic urethra
Ureters
Ureters and urinary bladder

Ureters, urinary bladder, and prostatic urethra

Micturition:
is another name for urination.
is a reflex triggered by stretch receptors in the urinary bladder.
requires the opening of two sphincters.
requires contraction of the muscularis layer of the urinary bladder.
All choices are correct.

All choices are correct.

Which structure of the urinary system forms urine, and which structure stores urine?

Kidney, and Urinary Bladder

What are the two means that the kidney helps to regulate blood pressure?

The kidneys alter the amount of fluid lost in the urine. They also release renin, required for production of angiotensin II, a hormone that increases blood pressure.

What are the regions of the kidney that drain urine?

Urine is drained from the minor calyces to the major calyces to the renal pelvis to the ureter.

What two structures compose the renal corpuscle?

The glomerulus (a thick tangle of capillary loops) and the glomerular capsule, a two-layered structure directly overlying the capillaries.

What structure directly drains a nephron?

collecting tubule

Which cells of the JGA synthesize, store, and release renin?

granular cells

What is the pathway that blood follows as it enters via the renal artery and later leaves via the renal vein?

renal artery, segmental artery, interlobar artery, arcuate artery, interlobular artery, afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries or vasa recta, interlobular vein, arcuate vein, interlobar vein, renal vein

What is the pathway of fluid filtered by the kidney from the glomerulus to its eventual excretion?

capsular space, PCT, nephron loop, DCT, collecting tubules, collecting duct, papillary duct, minor calyx, major calyx, renal pelvis, ureter, urinary bladder, urethra

What kinds of substances are normally not filtered by the glomerular filtration membrane?

Formed elements (e.g., erythrocytes) and large proteins

What is the value of the NFP if the glomerular hydrostatic pressure (HPg) is 65 mm Hg, Opg is 30 mm Hg, and HPc is 20 mm Hg?

65 mmHg - (30 mmHg + 20 mmHg) = 15 mmHg

Does urine production increase, decrease, or stay the same in response to an increase in glomerular filtration rate?

increase

How does the afferent arteriole of the glomerulus respond to decreased systemic blood pressure? To increased systemic blood pressure?

It vasodilates. It vasoconstricts.

How is glucose reabsorbed across the two membranes of the tubule cells?

Glucose is transported across the luminal membrane by the Na+/glucose symporter protein, then moved out of the tubule cell across the basolateral membrane down its concentration gradient by facilitated diffusion.

Which two hormones are involved in Na+ and water reabsorption? How do they work?

1. Aldosterone stimulates protein synthesis of Na+ channels and Na+/K+ pumps, with water following by osmosis. 2. ANP (Atrial natriuretic peptide) inhibits reabsorption of Na+ in the proximal convoluted tubule and collecting tubules and inhibits the release of aldosterone.

What is the effect of parathyroid hormone on the reabsorption of both PO_4^3- and Ca^2+ ?

It inhibits phosphate reabsorption and stimulates calcium reabsorption.

What are the body's main nitrogenous waste products?

urea, uric acid, creatinine

Which three mechanisms help establish and maintain the concentration gradient in the kidney interstitial fluid?

Nephron loop countercurrent multiplier, vasa recta countercurrent exchange system, and urea recycling

How is the glomerular filtration rate calculated?

GFR = UV/P
U = concentration of inulin/creatinine in urine
V = volume of urine per minute
P = concentration inulin/creatinine in plasma

What happens to the specific gravity and color of urine during dehydration?

Specific gravity increases and urine color becomes darker.

What steps lead to micturition?

The bladder distends and activates baroreceptors in the bladder wall. These baroreceptors send nerve signals to stimulate the micturition reflex center in the pons. This center alters signals through the pelvic splanchnic nerves. Parasympathetic stimulation causes the detrusor muscle to contract and internal urethral sphincter to relax. If desired, the adult sends a voluntary signal from the cortex to relax the external urethral sphincter and initiate micturition.

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