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Unit 13 Menti/Clicker/Book Questions
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Unit 13: Chapters (19) and (20) | The Kidneys & Endocrine Control of Growth and Metabolism M - Menti B- Book C -Clicker (ie. (19-B) chapter 19, book questions)
Terms in this set (55)
(19-B) List and explain the significance of the five characteristics of urine that can be found by physical examination.
- color (concentration)
- odor (infection or excreted substances)
- clarity (presence of cells)
- taste (presence of glucose)
- froth (presence of proteins)
(19-B) List and explain the six major kidney functions.
- regulation of extracellular fluid volume (to maintain adequate blood pressure)
- regulation of osmolarity
- maintenance of ion balance (neuron function)
- regulation of pH (proteins denature if pH not maintained)
- excretion of wastes and foreign substances (to prevent toxic effects)
- production of hormones (that regulate RBC synthesis, Ca2+ and Na+ balance)
(19-B) At any given time, what percentage of cardiac output goes to the kidneys?
20-25%
(19-B) List the major structures of the urinary system in their anatomical sequence, from the kidneys to the urine leaving the body. Describe the function of each structure.
nephrons through ureters to urinary bladder (storage), leaving through the urethra
(19-B) Arrange the following structures in the order that a drop of water entering the nephron would encounter them:
afferent arteriole
Bowman's capsule
collecting duct
distal tubule
glomerulus
loop of Henle
proximal tubule
renal pelvis
afferent arterioles
glomerulus
Bowman's capsule
proximal tubule
loop of Henle
distal tubule
collecting duct
renal pelvis
(19-B) Name the three filtration barriers that solutes must cross as they move from plasma to the lumen of Bowman's capsule. What components of blood are usually excluded by these layers?
Glomerular capillary endothelium
basal lamina
epithelium of Bowman's capsule
Blood cells and most plasma proteins are excluded.
(19-B) What force(s) promote(s) glomerular filtration? What force(s) oppose(s) it? What is meant by the term net driving force?
Capillary hydrostatic pressure promotes filtration. Fluid pressure in Bowman's capsule and colloid osmotic (oncotic) pressure of plasma oppose it. Net driving force is the sum of these pressures.
(19-B) What does the abbreviation GFR stand for? What is a typical numerical value for GFR in milliliters per minute? In liters per day?
GFR - glomerular filtration rate. 125mL/min or 180L/day
(19-B) Identify the following structures, then explain their significance in renal physiology:
juxtaglomerular apparatus
macula densa
mesangial cells
podocytes
sphincters in the bladder
renal cortex
Juxtaglomerular apparatus: Found where distal tubule passes between afferent and efferent arterioles. Composed of macula densa cells in the distal tubule and granular cells in arteriole wall.
Macula densa: paracrine signals control autoregulation of GFR and renin secretion.
Mesangial Cells: Alter the size of filtration slits.
Podocytes: Specialized epithelial cells that surround glomerular capillaries. Changes in slit size alter GFR.
Sphincters in the bladder: An internal smooth muscle sphincter that is passively contracted and an external skeletal muscle sphincter that is tonically (actively) contracted.
Renal cortex: Outer layer of the kidney that contains renal corpuscles, proximal and distal tubules, and parts of the loop of Henle and collecting ducts.
(19-B) In which segment of the nephron does most reabsorption take place? When a molecule or ion is reabsorbed from the lumen of the nephron, where does it go? If a solute is filtered and not reabsorbed from the tubule, where does it go?
70% occurs in the proximal tubule. Reabsorbed molecules go into the peritubular capillaries and the systemic venous circulation. If filtered and not reabsorbed, a molecule is excreted in the urine.
(19-B) Match each of the following substances with its mode(s) of transport in proximal tubule reabsorption.
(a) Na+
(b) glucose
(c) urea
(d) plasma proteins
(e) water
1. simple diffusion
2. primary active transport
3. indirect active transport
4. facilitated diffusion
5. movement through open channels
6. endocytosis
7. paracellular movement
Na: primary active transport, indirect active transport, movement through open channels
Glucose: indirect active transport, facilitated diffusion
Urea: facilitated diffusion, paracellular movement
Plasma proteins: endocytosis
water: movement through open channels, paracellular movement
(19-B) List three solutes secreted into the tubule lumen.
penicillin
K+
H+
K+ and H+ are secreted by the distal nephron
Penicillin is a organic molecule secreted by the Organic anion transporter
Kidney tubules secrete penicillin
(19-B) What solute that is normally present in the body is used to estimate GFR in humans?
creatinine
Creatinine is a breakdown product of phosphocreatine, an energy-storage compound found primarily in muscles. It is constantly produced by the body and need not be be administered. Creatine clearance is routinely used to estimate GRF.
(19-B) What is micturition?
urination
micturition: a spinal flex subject to higher brain control for urination
1. stretch receptor fire in the bladder
2. parasympathetic neurons fire. motor neurons STOP firing
3. smooth muscles contracts. internal sphincter is passively pulled open. External sphincter releases
(19-C) The kidney synthesize and realize which of the following proteins?
a. erythropoietin
b. renin
c. A and B
A and B (renin and EPO)
Kidney hormone production:
renin: Angiotensin II for salt/water balance
Erythropoietin (EPO): RBC synthesis
Ca++ regulation
(19-C) Which of the following is NOT a filtration barrier that solutes in the plasma must pass through to enter the lumen of Bowan's capsule?
a. glomerular capillary endothelium
b. proximal tubule endothelium
c. basal lamina
d. epithelium of Bowman's capsule
proximal tubule endothelium
Proximal tubule - Na+ reabsorption
3 barriers:
first filtration barrier: fenestrated capillaries (glomerular capillary endothelium)
- has pores that allow fluid and small solutes through it
second filtration barrier: basement membrane (basal lamina)
- connects capillary to Bowman's capsule; acts like a strainer that prevents proteins from entering
third filtration barrier: epithelium of bowman's capsule
- lined with podocytes that form filtration slits
(19-C) At rest, the kidneys receive what percentage of cardiac output?
a. 5%
b. 20%
c. 50%
d. 75%
20%
"At any given time, the kidneys receive 20-25% of the cardiac output, even though they constitute only 0.4% of total body weight. The high rate of blood flow through the kidneys ice critical to renal function" pg 589
(19-C) Which of the following describes the renal portal system?
a. arrangement between the renal artery and renal vein
b. two successive capillary networks and their connecting vessels
c. collecting ducts that several nephrons empty into
d. bends of the nephron as it loops back on itself
two successive capillary networks and their connecting vessels
portal system: consists of two capillary beds in series (one after another)
(19-C) An animal whose internal osmolarity is 300 mOsM lives in sea water (1000 mOsM). This animal's main osmotic challenge is
a. osmosis into body from environment
b. osmosis out of the body
c. salt influx from environment
d. salt loss to environment
osmosis out of the body
osmosis: the movement of water across a membrane in response to a solute concentration gradient
(19-C) What is the process called that removed selected molecules from the blood and added them to the filtrate?
a. excretion
b. filration
c. reabsorption
d. secretion
secretion
secretion: (1) the movement of selected molecules from the blood into nephron (2) the process by which a cell releases a substance into the extracellular space
excretion: the elimination of material from the body, usually through the urine, feces, lungs, or skin {rate depends on 1. its filtered load and 2. whether it is reabsorbed or secreted as it passes through the nephron}
filtration: Bulk flow of plasma-like fluid from the glomerular capillaries into Bowman's capsules
reabsorption: movement of filtered material from the lumen of th nephron to the blood
(20-B) What is an electrolyte? Name five electrolytes whose concentrations must be regulated by the body.
Electrolytes are ions, which can conduct electric current through a solution. Examples: Na+, K+, Ca+, H+
(19-C) Average glomerular filtration rate (GFR) is 125 ml/min (T/F)
True
Average is 125mL/min, or 180L/day
GFR is the volume of fluid that filters into Bowman's capsule per unit time
GFR is influenced by 2 factors: net filtration pressure and filtration coefficient
(19-C) What happens to GFR when the afferent arteriole dilates?
a. increases
b. decreases
c. stays the same
increases
GFR is controlled primarily by regulation of blood flow through the renal arterioles.
If resistance increases in the afferent arterioles, hydrostatic pressure decreases on the glomerular side of the constriction.
(19-C) With normal kidney function, which of the following is/are present in plasma but not filtrate?
a. glucose
b. proteins
c. blood cells
d. urea
e. B and C
B and C (proteins and blood cells)
Filtration of plasma out of the glomerular capillaries leaves behind a sludge of blood cells and proteins that could not not flow out of the glomerulus
(19-C) The plasma concentration at which a substance such a glucose first appears in urine is called the:
a. transport maximum
b. renal threshold
c. saturation
d. plasma threshold
renal threshold
transport maximum: the max transport rate that occurs when all carriers are saturated
saturation: all active sites on a given amount of proteins are filled with substrate and reaction rate is maximal
(19-C) The micturition reflex involves
a. sympathetic neurons
b. parasympathetic neurons
c. somatic motor neurons
d. A and B
e. B and C
B and C (parasympathetic neurons and somatic motor neurons)
sympathetic and parasympathetic work in opposition to another
The stimulus of a full bladder excites parasympathetic neurons leading to the smooth muscle in the bladder wall. The smooth muscle contracts, increasing the pressure on the bladder contents. Simultaneously, somatic motor neurons leading to the external sphincter are inhibited. pg. 612
(19-C) Secretion is a nephron always refers to transport of
a. water into the nephron lumen
b. water out of the nephron lumen
c. a solute into the nephron lumen
d. a solute out of the nephron lumen
a solute into the nephron lumen
secretion: the transfer of molecules from ECF into the lumen of the nephron
(20-B) List five organs and four hormones important in maintaining fluid and electrolyte balance.
Organs: kidneys, lungs, heart, blood vessels, digestive tract.
Hormones: vasopressin or antidiuretic hormone (AVP or ADH), aldosterone, atrial natriuretic peptides (ANP), RAS pathway.
(19-C) Which of the following opposes glomerular filtration?
a. fluid pressure in Bowman's capsule
b. capillary hydrostatic pressure
c. colloid osmotic pressure of plasma
d. A and C
e. All of the above
A and C (fluid pressure in Bowman's capsule and colloid osmotic pressure of plasma)
Filtration pressure depends on hydrostatic pressure, and is opposed by colloid pressure and capsule fluid pressure
(20-B) Compare the routes by which water enters the body with the routes by which the body loses water.
Entry: ingested and a small amount from metabolism. Loss: exhaled air, evaporation and perspiration from skin, excreted by kidneys, and in feces.
(20-B) List the receptors that regulate osmolarity, blood volume, blood pressure, ventilation, and pH. Where are they located, what stimulates them, and what compensatory mechanisms are triggered by them?
(20-B) How do the two limbs of the loop of Henle differ in their permeability to water? What makes this difference in permeability possible?
Descending limb: permeable to water but lacks transporters for salts.
Ascending limb: impermeable to water but reabsorbs NaCl.
(20-B) Which ion is a primary determinant of ECF volume? Which ion is the determinant of extracellular pH?
ECF volume - Na+; pH - H+
(20-B) What happens to the resting membrane potential of excitable cells when plasma K+ concentrations decrease? Which organ is most likely to be affected by changes in K+ concentration?
More K+ leaves the cell, and membrane potential becomes more negative (hyperpolarizes). The heart is most likely to be affected.
(20-B) Appetite for which two substances is important in regulating fluid volume and osmolarity?
salt and water
(20-B) Write out the words for the following abbreviations: ADH, ANP, ACE, ANG II, JG apparatus, P cell, I cell.
ADH = antidiuretic hormone
ANP = atrial natriuretic peptide
ACE = angiotensin-converting enzyme
ANG II = angiotensin II
JG (apparatus) = juxtaglomerular
P cell = principal cell
I cell = intercalated cell
(20-B) List and briefly explain three reasons why monitoring and regulating ECF pH are important. What three mechanisms does the body use to cope with changing pH?
pH alters protein structure (enzyme activity, membrane transporters, neural function).
Buffers, renal and respiratory compensation.
(20-B) Which is more likely to accumulate in the body, acids or bases? List some sources of each.
Acids from CO2, metabolism, and food are more likely. Sources of bases include some foods.
(20-B) What is a buffer? List three intracellular buffers. Name the primary extracellular buffer.
A molecule that moderates changes in pH. Intracellular: proteins, HPO4^2−,and hemoglobin. Extracellular:HCO3-
(20-B) Name two ways the kidneys alter plasma pH. Which compounds serve as urinary buffers?
Kidneys are exerted or reabsorb H+ or HCO3-.
Ammonia and phosphates
(20-B) When ventilation increases, what happens to arterial PCO2? To plasma pH? To plasma H+ concentration?
Arterial PCO2 decreases
pH increases
plasma H+ concentration decreases
(20-C) What likely occurs if the ECF osmolarity increases as a result of salt intake?
a. water moves into the cells and they shrink
b. water moves into the cells as they swell
c. water moves out of the cells and they swell
d. water moves out of the cells and they shrink
water moves out of the cells and they shrink
Cell shrinkage is caused by increased osmolarity disrupts cell function
(20-C) Which of the following would NOT be a physiological response to decrease in blood volume?
a. increased sympathetic output
b. vasoconstriction
c. increased thirst
d. increased secretion of renin
e. inhibition of vasopressin release
inhibition of vasopressin release
It would stimulate vasopressin
vasopressin: increases the water permeability of the renal collecting ducts, allowing water reabsorption to conserve fluid. Without fluid replacement, however, vasopressin cannot bring volume and osmolarity back to normal
(20-C) In the presence of vasopressin, the apical membrane of a collecting duct cell has ________ water pores
a. more
b. fewer
c. apical membrane is unaffected by vasopressin
more
When vasopressin acts on target cells, the collecting duct epithelium becomes permeable to water, allowing water to move out of the lumen
When vasopressin levels and, consequently, collecting duct water permeability are low, the collecting duct cell has few water pores in its apical membrane and stores its AQP2 water pores in cytoplasmic storage vesicles.
(20-C) Which of the following factors induce vasopressin release from the posterior pituitary?
a. increased osmolarity
b. decreased blood pressure
c. decreased osmolarity
d. A and B
e. B and C
A and B (increased osmolarity and decreased osmolarity)
3 mechanisms drive vasopressin release
- decreased BP
- decreased arterial stretch due to low blood volume
- osmolarity >280 mOsM* (MOST IMPORTANT FACTOR) osmolarity is increased
(20-C) If vasopressin secretion shows a circadian rhythm, would you expect it to be increased or decreased during the night?
a. increased
b. decreased
increased
(20-C) The apical surface of the ascending limb of the loop of Henle is NOT permeable to water (T/F)
true
The cells in the thick portion of the ascending limb of the loop have apical surfaces (facing the tubule lumen) that are impermeable to water.
(20-C) Where is the final osmolarity of urine established?
a. bladder
b. proximal convoluted tubule
c. collecting duct
d. loop Henle
e. Bowman's capsule
collecting duct
Final urine osmolarity depends on reabsorption in the collecting duct
(20-C) Which of the following stimulates the release of aldosterone from the adrenal cortex?
a. decrease in blood pressure
b. elevated plasma K (hyperkalemia)
c. increase renin
d. A and B
e. all of the above
all of the above
Two main signals for release of Aldosterone (steroid synthesized in the adrenal cortex)
- decreased blood pressure via RAS
- elevated K+ in he blood (hyperkalemia)
RAS (renin-angiotensin system)
-decreased BP signals for RAS, it also causes a drop in GFR (glomerular filtration rate) which directly stimulates the kidneys to release Renin.
Renin converts Angiotensinogen to ANG I (inactive) into ANG II (active)
ANG II interacts on the adrenal cortex to release aldosterone
(20-C) An 83-y/o woman with severe orthostatic hypertension due to loss of cardiovascular control center function is given Florinef (fludrocortisone acetate) a potent aldosterone agonist. In addition to monitoring her blood pressure what other parameters should also be monitored?
a. HR
b. serum K+
c. serum Cl-
d. serum HCO3-
e. None of the above
serum K+
Aldosterone plays a critical role in homeostasis
(20-C) Which of the following is/are target tissues for angiotensin II (ANG II)?
a. arterioles
b. cardiovascular control center
c. hypothalamus
d. proximal tubule
e. All of the above
All of the above
ANG II is the usual signal controlling aldosterone release from the adrenal cortex.
ANG II is one of the renin-angiotensin system (RAS). The RAS pathway begins when the juxtaglomerular granular cells in the afferent arterioles of a nephron secrete an enzyme called renin.
ANG II increases BP both directly and indirectly through 5 pathways
- increases vasopressin secretion: ANG II receptions in the hypothalamus initiate this reflex
- stimulates thirst: behavior response that expands BV and raise BP
- ANG II is one of the most potent vasoconstrictors known in humans: vasoconstriction causes BP to increase w/o change in BV
- Activation of ANG II receptions in the cardiovascular control center increases sympathetic output to the heart and blood vessels: sympathetic stimulation increases cardiac output and vasoconstriction, both of which increase BP
- ANG II increases proximal tubule Na+ reabsorption: stimulates an apical transporter, the Na+ -H+ exchanger (NHE). Sodium reabsorption in the proximal tubule is followed by water reabsorption, so the net effect is reabsorption of isometric fluid, conserving volume.
(20-C) Which of the following factors affects the conversion of ANG I and ANG II?
a. release of angiotensinogen by the liver
b. decreased K+
c. release of renin by the kidney
d. decreased blood pressure
e.. A, C, and D
A, C, D (release of angiotensinogen by the liver, decreased K+, decreased BP)
Low BP stimulates aldosterone secretion (pg. 630)
Decreased BP initiates the RAS system that results in a release of ANG II,
ANG II is apart of the RAS pathway, to maintain BP
RAS beings when the juxtaglomerular granular cells in the afferent arterioles of a nephron secrete an enzyme called renin > Renin converts an inactive plasma protein, angioteniogen into ANG I. When ANG I is in the blood it meets an enzyme called ACE, and is then converted into ANG II.
(20-C) Hypokalemia causes a(n) _________________ in the resting membrane potential of cardiac cells so they are _______ likely to fire an action potential
a. increase; more
b. increase; less
c. decrease; more
d. decrease; less
e. Hyokalemia has no effect on excitable cells
decrease; less
Hyperkalemia and hypokalemia causes problems with excitable tissues, especially in the heart
Hypo = below, less than normal
Hypokalemia: plasma (and ECF) K+ concentrations decrease - the concentration gradient between the cell and the ECF becomes larger, more K+ leaves the cell and the resting membrane potential becomes more negative
Hyperkalemia: plasma (and ECF) connotations increase - the concentration gradient decreases and more K+ remains in the cell, depolarizing it.
Because of the effect of plasma K+ on excitable tissues, such as the heart, clinicians are always concerned about keeping plasma K+ within its normal range. If K+ falls below 3 mEq/L or rises above 6 mEq/L, the excitable tissues of muscle and nerve begin to show altered function. For example, hypokalemia causes muscle weakness because it is more difficult for hyperpolarized neurons and muscles to fire action potentials.
(20-C) Eating salty dry food w/o drinking will cause a(n) ____________ in ECF osmolarity and ________________ in the volume of the body fluids (before any compensator response)
a. decrease; no change
b. decrease; an increase
c. decease; a decrease
d. increase; no change
e. increase; an increase
increase; no change
Drinking water is normally the only way to restore lost water, and eating salt is the only way to raise the body's
Na +content.
It is interesting to note that although increased osmolarity triggers thirst, the act of drinking is sufficient to relieve thirst.
osmolarity: the concentration of a solution expressed as the total number of solute particles per liter
(20-C) Which of the following factors affect the release of natriuretic peptides (ANP)?
a. increased K+
b. decreased K+
c. increased Na+
d. decreased BP
e. increased BV
increased blood volume
ANP: promotes salt and water excretion
ANP and its co-secreted natriuretic peptides are released when increased blood volume causes increased atrial stretch.
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