ap chpt 25

Created by dasani19 

Upgrade to
remove ads

86 terms

Urology

=the branch of medicine that deals with urinary system and male reproductive tract.

ureters

Two ____ that drain urine away from the kidneys

micturition, smooth muscle, transitional, rugae, trigone

Urinary bladder serves as the storage area until _____ occurs. Composed of _______and _____ tissues so that the bladder can stretch when full and then go back to its original shape when empty. Also possess___ and a ____.

Urethra, urethral sphincter

_____ drains urine from urinary bladder and transports the urine to the outside. In females, it only drains urine. In males, it drains urine and semen. Possess an internal and external _______.

12, 3rd

The kidneys are located retroperitoneally on each side of the vertebral column between the ___ thoracic vertebrae and the ___ lumbar vertebra.

Right kidney, left

___ is lower than the___ one because liver size and position.

Renal hilus

=notch where blood vessels, nerves, lymphatic vessels enter and exit the kidney

Renal capsule

adheres directly to the kidney surface.

Adipose capsule

is a middle layer of fatty tissue that insulates and cushions the kidneys.

Renal fascia

is the outermost dense connective tissue that anchors the kidney and adrenal glands.

Renal cortex

=outer most portion of the kidney which is light in color and has a granular appearance.

Calyces

=major and minor branches of the renal pelvis that enclose the tops of the renal pyramids.

Renal pelvis

=a flat funnel shaped tube drains urine from the cortex and medulla toward the ureters.

Renal columns

=inward extensions of cortical tissue that separates the pyramids.

Renal medulla

= "middle" or rather the next deeper layer that possess many cone shaper masses called renal pyramids.

Renal arteries

bring oxygenated unfiltered blood into the kidney
- The renal arteries branch into smaller and smaller vessels in the following order (S.L.I.A.I.A.G.E.P)

peritubular

The ____ capillary beds transport blood to the veins in a processed deoxygenated form in the following sequence.
(I.A.I.R.I.N)

Nephron

Functional unit of the kidney is a

regenerate, 25%

There are over 1million nephrons per kidney which do not ____. However, a person can survive as long as at least ___ of the nephrons are functional.

Glomerulus, filtrate

______=first capillary bed made of fenestrated capillaries which are exceptionally porous allowing large amounts of solutes to pass from blood and into the surrounding Bowman's capsule. This substance removed from blood is called ____.

Bowman's capsule, podocytes, simple squamous

_____=collection tubule that surrounds the glomerulus and is primarily ____ epithelium, a basement membrane, and is associated with specialized branching cells called_____. (J.M.M)

Juxtaglomerular cellS. JG. renin

_____=smooth muscle cells that act as mechanoreceptors that sense blood pressure in the afferent arteriole. ___ cells secrete ____ in response to low blood pressure.

Macula densa cells, vasodilation, vasoconstriction

______=osomoreceptors that respond to solute concentrations in the filtrate and filtrate flow. Low osmolality (slow flow) stimulates _____. High osmolaltiy (fast flow) stimulates _____.

Mesangial cells

______=possess phagocytic and contractile abilities to influence the total surface area available for filtration

Proximal, brush-border cuboidal

____ convoluted tubules with walls of _______ epithelium for absorption and secretion are located in the renal cortex

Loop of Henle, medulla

_____ with ascending and descending ends and a thick segment of cuboidal and low columnar and a thin segment of simple squamous are located in the _____.

Distal, non-ciliated cuboidal

_____ convoluted tubules with walls of ________ epithelium are more involved in secretion rather than absorption

Cortical, cortex

____ nephrons (85%) are located almost entirely in the _____.

Juxtamedullarey, medulla, vasa recta

______ nephrons have loops of Henle that deeply invade the ____. These are associated with ____ and the production of concentrated urine.

Renal Physiology

=Urine Formation

The production of urine involves three main processes:

1. Glomerular Non-selective filtration occurs at the glomerulus and Bowman's capsule.

2. Tubular reabsorption occurs in the proximal convoluted tubule (PCT), the loop of Henle, and the first part of the distal convoluted tubule (DCT).

3. Tubular secretion occurs mostly in DCT

Glomerular Filtration Rate

_____ is the amount of filtrate formed in both kidneys per minute. In a healthy individual the kidneys produce about 125 ml of filtrate per minute. The majority of this (124 ml) is reabsorbed in the renal tubule portion of the nephron. Therefore, only about 1 ml of urine is produce for each 125 ml of glomerular filtrate.

peritubular

As the glomerular filtrate enters the PCT, the loop of Henle, and the first part of the DCT, water, ions and other substances are reabsorbed into the blood via the second capillary bed called the ____ capillary bed.

Antidiuretic hormone (ADH)

_____plays a role in water reabsorption at the collection ducts. Increased ___=increased water reabsorption which in turn means less urine is produced. The increase in water retention causes and increase in blood volume which in turn causes blood pressure to increase.

Aldosterone, reabsorption

____ promotes the ____ of sodium ions (Na+) and the secretion of potassium ions (K+) within the renal tubules. For example: Low sodium concentration causes suprarenal cortex to increase secretion of _____. This excites tubular cells resulting in sodium transport into capillaries. Because water follows sodium, water reabsorption occurs which causes blood pressure to rise.

Atrial natriuretic peptide (ANP), aldosterone, Na+, K+. ANP

______is a hormone that inhibits the secretion of _____ therefore promoting the excretion of __ and ultimately the reabsorption of ___ Remember that "water follows sodium" so if sodium is excreted, more water will be lost via urine. Therefore, __ acts as a diuretic.

Renin, decreases, renin, vasoconstrictor

(recall from blood studies) and Angiotensin II=___ release is triggered by a drop in blood pressure causing Angiotensin II development (a potent _____). Angiotensin II _____ the glomerular filtration rate which in turn raises blood volume which in turn raises blood pressure.

Ptosis

=kidneys drop in position resulting in kinked ureters

Hydronephrosis

=fluid building up in the kidney and renal pelvis because of ptosis.

Pyelitis

=infection of the renal pelvis and calyces.

Pyelonephritis

=infection or inflammation of the entire kidney

Anuria

=low urinary output as a result of injury, transfusion reactions, low blood pressure, etc.

Hyperuria

=excess urinary output

Hypospadias

=urethral orifice is located on the ventral surface of the penis

Diabetes insipidus

=production of large quantities of urine resulting in dehydration and intense thirst. Occurs as a result of low ADH release

Renal calculi

=kidney stones

Cystocele

=herniation of the urinary bladder into the vagina

Renal infarct

=area of dead, or necrotic, renal tissue

Polycystic kidney

=an inherited condition that results in urine-filled cysts (or a chloride-rich fluid) forming within the kidney

Horseshoe kidney

=developmental disorder resulting in the two kidneys being very close together or joined. (1 in 600 people).

Urinary retention

=inability to expel urine

Urethritis

=inflammation of the urethra

Incontinence

=inability to control micturition

Cystitis

=inflammation of the bladder

glomerulus, Bowman's

Glomerular Non-selective filtration occurs at the _____ and ______ capsule.

Tubular reabsorption

____ occurs in the proximal convoluted tubule (PCT), the loop of Henle, and the first part of the distal convoluted tubule (DCT).

Tubular secretion

occurs mostly in DCT

SMOOTH MUSCLE

INTERNAL URETHRAL SPINCTER

SKELETAL

EXTERNAL URETHRAL SPINCTER

100%

PCT
NUTRIENT (GLUCOSE) REABSORBED

65%

PCT
SODIUM AND WATER REABSORBED

80%

BICARBONATE

60%

CHLORIDE

55%

POTASSIUM

ION+

CATION

ION-

ANION

H+

ACID

OH-

BASE

PARACELLULAR

BETWEEN ADJACENT CELLS (PASSIVE)

TRANSCELLULAR

THROUGH CELLS (ACTIVE OR PASSIVE)

ADH

HYPOTHALAMUS
POSTERIOR LOBE OF PITUITARY

ALDOSTERONE

ADRENAL GLAND
(ZONE OF GLOMERULOSA)

ATRIAL NATRIURETIC PEPTIDE

ATRIA OF HEART

(1.005-1.035) avg(1.010-1.025)

GRAVITY OF URINE

UREA

GREATEST SOLUTE

KIDNEYS, JG CELLS

RENIN IS FOUND IN THE ___ AND SECRETED BY __

Non-Selective Filtration

1. Unfiltered blood in the afferent arterioles enters the glomerulus.

2. Recall NFP, or Net Filtration Pressure, from chapter 19. Because hydrostatic pressure is high inside the glomerulus, filtrate is forced out of the blood plasma and into the Bowman's capsule.

3. Pretty much everything (except for blood cells and plasma proteins) is forced into the Bowman's capsule as the filtrate.

4. Efferent arterioles transport filtered blood away from the glomerulus towards the next capillary bed.

Non-Selective Filtration

5. NOTE: the glomerulus is a unique capillary bed because arterioles move blood into the capillary bed and transport blood away from the capillary bed! Almost all other capillary beds in the body have venules taking blood away from the capillary bed!!!

6. Glomerular Filtration Rate (GFR) is the amount of filtrate formed in both kidneys per minute. In a healthy individual the kidneys produce about 125 ml of filtrate per minute. The majority of this (124 ml) is reabsorbed in the renal tubule portion of the nephron. Therefore, only about 1 ml of urine is produce for each 125 ml of glomerular filtrate.

Tubular Reabsorption

1. As the glomerular filtrate enters the PCT, the loop of Henle, and the first part of the DCT, water, ions and other substances are reabsorbed into the blood via the second capillary bed called the peritubular capillary bed.

2. Na+ is moved out of the tubule and into the blood by facilitated diffusion whereas glucose, amino acids, lactic acid, vitamins, and most cations are reabsorbed by secondary active transport.

Tubular Reabsorption

3. Some substances (K+ and anions like Cl-) move through the intercellular spaces to leave the tubules to the interstitial spaces and then simply diffuse into the bloodstream.

4. Most other substances (urea, fat-soluble vitamins, and some drugs) simply diffuse from the tubule lumen directly into the capillary bed.

5. Again about 98-99% of all filtrate is reabsorbed. See Table 25.1 on page 1013.

Tubular Secretion

1. The remaining fluid that enters the rest of the distal convoluted tubule is not quite complete.

2. Tubular secretion involves the movement of substances out of blood (peritubular capillary bed) and back into the remaining filtrate.

3. Some substances move by active transport while others move by passive transport

Tubular Secretion

4. Substances commonly secreted include potassium ions, hydrogen ions, ammonia ions, by products of drugs and penicillin, creatinine, and some hormones.

5. The final fluid that now drains from the DCT and into the collection ducts is called urine.

6. The collection ducts drain into the renal pelvis which is connected to the tops of the ureters which undergo peristalsis to transport urine to the bladder for storage.

Substances that are NOT reabsorbed easily!

Urea
Uric acid
Creatinine (which is secreted rather than filtered).

Urine composition

1. 90% water

2. Metabolic or nitrogenous wastes (urea, creatinine, uric acid)

3. Salts

4. Toxins

5. Pigments such are urochrome (breakdown of hemoglobin and bile pigments)

6. Hormones

7. If blood, protein, or glucose are detected in urine this is usually an indication of kidney troubles.

Urine characteristics

1. Color=clear, deep yellow in color

2. Odor=slightly aromatic when fresh but tends to develop and ammonia odor due to bacterial metabolism

3. pH=urine is slightly acidic (about pH 6)

4. Specific gravity=1.001 to 1.035

Hormones associated with kidney

Antidiuretic hormone (ADH), Aldosterone , Atrial natriuretic peptide, Renin

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

NEW! Voice Recording

Click the mic to start.

Create Set