210 terms

PRACTICE - Urinary System

STUDY
PLAY
The kidneys are considered to be the major homeostatic organ of the body because ________.
they excrete nitrogenous wastes, they maintain electrolyte balance, and they maintain acid-base and fluid balance
Of the following urinary system organs, the homeostatic functions are performed by the ________.
ureters;
urethra;
KIDNEYS;
urinary bladder
Select the structure or structures that are much longer in males than in females.
urethra
What is the function of the ureters, urinary bladder, and urethra?
transporting or storing urine
The outermost portion of the kidney is called the renal ________.
cortex
Name the structures in the kidney that produce urine.
nephrons
List the parts of the nephron in correct sequential order: ________.
glomerulus, proximal convoluted tubule, loop of Henle
The vessel that supplies blood to the nephron is called the ________.
afferent arteriole
Urine is formed by three processes. In which process do filtrate components that are useful to the body move from the nephron into the blood?
tubular reabsorption
What is true about the urethral sphincters?
The internal urethral sphincter is under involuntary control.
The pathway taken by blood from the renal artery to the afferent arteriole is, in correct sequence, ________.
segmental artery, interlobar artery, arcuate artery, cortical radiate artery
The functional units of the kidney, the nephrons, are located primarily in the renal ________.
cortex
In which segment of the nephron would you find cuboidal cells with many microvilli and mitochondria?
proximal convoluted tubule
These cells form a porous membrane surrounding the endothelial cells of the glomerulus.
podocytes
Many nephrons empty into a ________.
collecting duct
During filtration in the nephron, substances move ________.
from the glomerulus to the nephron
Tubular secretion in the nephron is a process by which substances move ________.
from the peritubular capillary into the nephron
What is true about the renal processes for making urine?
Filtration occurs only in the glomerular capsule.
The loops of Henle of the juxtamedullary nephrons are surrounded by a looping blood vessel called the ________.
vasa recta
The juxtaglomerular apparatus ________.
is found where the most distal part of the ascending limb of the loop of Henle touches the afferent arteriole, contains juxtaglomerular (granular) cells in the afferent arteriole that sense blood pressure, and contains a region of chemoreceptor cells called the macula densa in the distal loop of Henle
Which region of the kidney is the most superficial?
renal cortex
Where does filtration of the blood occur within the kidneys?
renal cortex
Where are the renal columns located?
renal medulla
Identify the correct direction of urine flow from formation to exiting the kidney.
cortex, medulla, renal pelvis, ureter
Which structure is found separating the renal pyramids?
renal columns
Name the strong transparent covering that encases the kidney.
fibrous capsule
Where does the ureter penetrate the kidney?
hilum
T OR F: The ureter, blood vessels, and nerves penetrate the kidney on its medial surface.
TRUE
T OR F: The fibrous capsule is a layer of adipose tissue that surrounds the kidney.
FALSE
Which of the following regions of the kidney is in contact with the fibrous capsule?
renal cortex
A major calyx is a component of which of the following anatomical structures?
renal pelvis
Where does the kidney filter the blood?
renal corpuscle
What is the function of the renal pelvis?
collects newly formed urine
T OR F: The medullary pyramids contain collecting tubules (ducts) that travel towards the renal cortex, carrying urine to exit the kidney.
FALSE
T OR F: The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.
TRUE
T OR F: The entire responsibility for urine formation lies with the nephron.
TRUE
T OR F: The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.
FALSE
T OR F: Having a kinked ureter is called renal ptosis.
FALSE
Urine passes through the ________.
pelvis of the kidney to ureter to bladder to urethra
Which of the following is not associated with the renal corpuscle?
an efferent arteriole
a podocyte
A VASA RECTA
a fenestrated capillary
Which of the choices below is not a function of the urinary system?
ELIMINATES SOLID, UNDIGESTED WASTES AND EXCRETES CARBON DIOXIDE, WATER, SALTS, AND HEAT
helps maintain homeostasis by controlling the composition, volume, and pressure of blood
maintains blood osmolarity
regulates blood glucose levels and produces hormones
Which gland sits atop each kidney?
adrenal
The ________ artery lies on the boundary between the cortex and medulla of the kidney.
arcuate
The glomerulus differs from other capillaries in the body in that it ________.
is drained by an efferent arteriole
The fatty tissue surrounding the kidneys is important because it ________.
stabilizes the position of the kidneys by holding them in their normal position
The renal corpuscle is made up of ________.
Bowman's capsule and glomerulus
The functional and structural unit of the kidneys is the ________.
nephron
The juxtaglomerular apparatus is responsible for ________.
regulating the rate of filtrate formation and controlling systemic blood pressure
The filtration membrane includes all except ________.
basement membrane
RENAL FASCIA
podocytes
glomerular endothelium
The macula densa cells respond to ________.
changes in solute content of the filtrate
Select the correct statement about the nephrons.
The parietal layer of the glomerular capsule is simple squamous epithelium.
Which of the following is not a part of the juxtaglomerular apparatus?
PODOCYTE CELLS
granular cells
macula densa
mesangial cells
What is the function of the juxtaglomerular apparatus?
help regulate blood pressure and the rate of blood filtration by the kidneys
Which of the choices below is the salt level-monitoring part of the nephron?
macula densa
Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate?
macula densa
The capillary bed that surrounds the descending and ascending loop of Henle of juxtamedullary nephrons is called the ________.
vasa recta
Which of the following is not a function of the kidneys?
PRODUCING THE HORMONES MELANIN AND OXYTOCIN
Gluconeogenesis during prolonged fasting
Maintaining the proper balance between water and salts and between acids and bases
Metabolizing vitamin D to its active form
The _________ is an outer layer of dense fibrous connective tissue that anchors the kidney and the adrenal gland to surrounding structures. The _________ prevents infections in surrounding regions from spreading to the kidneys.
renal fascia; fibrous capsule
The _____________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the ______________.
calyces; renal pelvis
Each nephron consists of a _______________, which is a tuft of capillaries, and a ___________.
glomerulus; renal tubule
Where does most solute reabsorption occur in the nephron?
proximal convoluted tubule
Approximately 80% of the energy used for active transport is devoted to the reabsorption of _______________.
sodium
Which of the following is the functional unit of the kidney?
nephron
What is the juxtaglomerular apparatus?
a system that regulates the rate of filtrate formation and systemic blood pressure
What type of capillaries make up the glomerulus?
fenestrated
T OR F: If the GFR is too low, needed substances may pass so quickly through the renal tubules that they are not absorbed and instead are lost in the urine.
FALSE
T OR F: In the kidneys, the countercurrent mechanism involves the interaction between the flow of filtrate through the loop of Henle of the juxtamedullary nephrons (the countercurrent multiplier) and the flow of blood through the limbs of adjacent blood vessels (the countercurrent exchanger). This relationship establishes and maintains an osmotic gradient extending from the cortex through the depths of the medulla that allows the kidneys to vary urine concentration dramatically.
TRUE
T OR F: Water reabsorption through the proximal convoluted tubule is termed obligatory water reabsorption, whereas water reabsorption through the distal convoluted tubule is termed facultative water reabsorption.
TRUE
T OR F: Glomerular filtration is an ATP-driven process.
FALSE
T OR F: In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water.
TRUE
T OR F: The collecting duct is impermeable to water in the presence of ADH.
FALSE
T OR F: Angiotensin II is a substance made by the body to lower blood pressure during stress.
FALSE
T OR F: Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.
TRUE
T OR F: Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water.
FALSE
T OR F: Urea is reabsorbed in the loop of Henle.
FALSE
T OR F: The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.
FALSE
T OR F: An excessive urine output is called anuria.
FALSE
T OR F: Tubular secretion is effective in controlling blood pH.
TRUE
T OR F: Atrial naturetic peptide inhibits sodium reabsorption.
TRUE
T OR F: The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate.
FALSE
T OR F: Obligatory water reabsorption involves the movement of water along an osmotic gradient.
TRUE
The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.
loop of henle
An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.
increase in the production of ADH
The kidneys are stimulated to produce renin ________.
by a decrease in the blood pressure
The descending limb of the loop of Henle ________.
contains fluid that becomes more concentrated as it moves down into the medulla
The chief force pushing water and solutes out of the blood across the filtration membrane is ________.
glomerular hydrostatic pressure (glomerular blood pressure)
The mechanism of water reabsorption by the renal tubules is ________.
osmosis
Electrolyte reabsorption by the renal tubules is ________.
hormonally controlled in distal tubule segments
Which of the following is not reabsorbed by the proximal convoluted tubule?
Na+
glucose
K+
CREATININE
The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________.
plasma protein
Alcohol acts as a diuretic because it ________.
inhibits the release of ADH
The function of angiotensin II is to ________.
constrict arterioles and increase blood pressure
A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________.
diabetes insipidus
Place the following in correct sequence from the formation of a drop of urine to its elimination from the body.

1. major calyx
2. minor calyx
3. nephron
4. urethra
5. ureter
6. collecting duct
3, 6, 2, 1, 5, 4
What would happen if the capsular hydrostatic pressure were increased above normal?
net filtration would decrease
Tubular reabsorption ________.
by active mechanisms usually involves movement against an electrical and/or chemical gradient
Which of the following is not a reason why substances are either not reabsorbed or are incompletely reabsorbed from the nephron?
They are not lipid soluble.
THEY ARE EXTREMELY COMPLEX MOLECULES
They are too large to pass through the fenestrations.
They lack carriers.
Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.
secondary active transport
Which of the choices below is a function of the loop of Henle?
form a large volume of very dilute urine or a small volume of very concentrated urine
The factor favoring filtrate formation at the glomerulus is the ________.
glomerular hydrostatic pressure
If the Tm for a particular amino acid is 120 mg/100 ml and the concentration of that amino acid in the blood is 230 mg/100 ml, the amino acid will ________.
appear in the urine
Excretion of dilute urine requires ________.
impermeability of the collecting tubule to water
Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?
by reabsorbing filtered bicarbonate ions
by producing new bicarbonate ions
by secreting hydrogen ions into the filtrate
BY SECRETING SODIUM IONS
In the ascending limb of the loop of Henle the ________.
thick segment moves ions out into interstitial spaces for reabsorption
Which of the choices below does not describe the importance of tubular secretion?
disposing of substances not already in the filtrate, such as certain drugs
RIDDING THE BODY OF BICARBONATE IONS
eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes
ridding the body of excessive potassium ions
Which statement is correct?
Reabsorption of water is hormonally controlled.
Which of the hormones below is responsible for facultative water reabsorption?
ADH
Which of the choices below is not a glomerular filtration rate control method?
hormonal regulation
neural regulation
ELECTROLYTE LEVELS
renal autoregulation
Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion?
angiotensin II and aldosterone
The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched.
myogenic
Sodium-linked water flow across a membrane is called ________ water reabsorption.
obligatory
In which part of the kidney is reabsorption (1) dependent upon the body's needs at the time, and (2) regulated by hormones?
distal convoluted tubule
Chemicals that enhance urinary output are called _______________.
diuretics
The _______ keeps the urethra closed when urine is not being passed from the bladder, and prevents leaking between voiding.
internal urethral sphincter
Which of the following is not one of the things that must happen for micturition to occur?
THE EXTRUSER MUSCLE MUST RELAX
The detrusor muscle must contract
The external urethral sphincter must open
The internal urethral sphincter must open
Which of the following congenital abnormalities of the urinary system is found in male infants only?
hypospadias
T OR F: Under normal conditions, the large renal arteries deliver one-fourth of the total cardiac output (about 1200 ml) to the kidneys each minute.
TRUE
T OR F: Glomerular hydrostatic pressure (HPg) is the chief force pushing water and solutes out of the blood and across the filtration membrane
TRUE
T OR F: Despite the fact that the kidney's intrinsic controls work to maintain a constant GFR, in some situations the body's extrinsic controls will work to override these intrinsic controls in order to maintain systemic blood pressure.
TRUE
Overall, which of the following pressures is ultimately responsible for glomerular filtration?
net filtration pressure
Which of the following is NOT a major urine formation process?
MICTURITION
glomerular filtration
tubular secretion
tubular reabsorption
Which hormone(s) is/are required for facultative water reabsorption in the collecting ducts?
ADH
A non-fasting urine sample from an individual who has previously eaten donuts and a soft drink showed the presence of sugar (glucose). Which of the following statement explains the presence of the glucose in the urine?
The individual exceeded the transport maximum.
Which of the following substances is not normally found in filtrate?
water and small solutes
BLOOD CELLS AND LARGE PARTICLES
ions, such as sodium and potassium
nitrogenous waste particles, such as urea
What is the primary driving force (pressure) that produces glomerular filtration?
hydrostatic pressure of blood (blood pressure)
Which of the following would only be found in the glomerular filtrate if the glomerular membrane were damaged?
protein
If the osmotic pressure in the glomerular capillaries increased from 28 mm Hg to 35 mm Hg, would net filtration increase or decrease?
net filtration would decrease
Calculate the net filtration pressure if capillary hydrostatic pressure is 60 mm Hg, capillary osmotic pressure is 25 mm Hg, and capsular hydrostatic pressure is 10 mm Hg.
25mm Hg;
Yes, 60 - (25 + 10) = 25 mm Hg. The two pressures that oppose filtration must be subtracted from the force favoring filtration.
Most solutes that are reabsorbed in the proximal convoluted tubule use which of the following pathways?
transcellular
During reabsorption of water in the proximal convoluted tubule, what causes water to diffuse from the lumen into the interstitial space?
an increase in the osmolarity of the interstitium
The decreased intracellular concentration of sodium in tubular cells during active transport is caused by which of the following mechanisms?
the sodium-potassium ATPase pump in the basolateral membrane
The active transport of which ion out of proximal convoluted tubule cells causes the reabsorption of both water and solutes?
sodium
Which of the following transporters in the luminal membrane results in secretion?
Na+-H+ countertransport
What is the limiting factor for the reabsorption of most actively transported solutes in the proximal tubule?
number of transport carriers in the luminal membrane
What clinical effects would high blood pressure have on the kidneys of a bedridden patient?
This patient would have a much lower glomerular hydrostatic pressure, and would therefore lose less fluids than normal.
How can an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril be effective as an antihypertensive?
ACE inhibitors reduce blood pressure by causing less aldosterone and antidiuretic hormone to be released, resulting in more water output and a lowering of the blood volume, which lowers the blood pressure.
Which of the following best describes glomerular filtration rate (GFR)?
the volume of filtrate created by the kidneys per minute
GFR regulation mechanisms primarily affect which of the following?
glomerular hydrostatic pressure (HPg)
Which of the following are mechanisms of intrinsic control of glomerular filtration (renal autoregulation)?
myogenic mechanism and tubuloglomerular feedback
Macula densa cells of the juxtaglomerular apparatus (JGA) regulate GFR through which intrinsic mechanism?
tubuloglomerular feedback
The myogenic mechanism of renal autoregulation primarily involves smooth muscle in which blood vessels?
afferent arterioles
What does a high concentration of NaCl in the renal tubule at the juxtaglomerular apparatus (JGA) most likely indicate?
insufficient NaCl reabsorption due to high GFR
Through the tubuloglomerular feedback mechanism, how would an increase in filtrate NaCl concentration affect afferent arteriole diameter?
afferent arteriole diameter would decrease
Granular cells of the juxtaglomerular apparatus (JGA) regulate GFR through which mechanism?
renin-angiotensin mechanism
T OR F: Urine is 95% water by volume.
TRUE
T OR F: Blood in the urine may be a symptom of bladder cancer.
TRUE
An important characteristic of urine is its specific gravity or density, which is ________.
1.001-1.035
If one says that the clearance value of glucose is zero, what does this mean?
normally all the glucose is absorbed
The presence of pus in the urine is a condition called ________.
pyuria
What is the largest component of urine by weight, other than water?
urea
Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs?
Proteinuria is a condition in which large amounts of plasma proteins pass into the glomerular filtrate and are excreted in the urine, decreasing the osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema.
T OR F: The ureter transports urine from the kidney to the urinary bladder.
TRUE
Select the correct statement about the ureters.
The ureters are capable of peristalsis like that of the gastrointestinal tract.
Which of the following statements describes the histology of the ureters?
They are trilayered (mucosa, muscularis, and adventitia).
An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. X-rays indicate a shadow on his right ureter. What is the diagnosis, and what is the recommended treatment?
Kidney stone; treatment would be IV therapy to flush the stone out, surgery, or ultrasound waves to shatter the calculi.
T OR F: The trigone is so named because of the shape of the urinary bladder.
FALSE
The urinary bladder is composed of ________ epithelium.
transitional
Urine crystals in the renal pelvis are called ________.
renal calculi
The area between the ureters and urethra is called the ________ in a bladder.
trigone
Which urinary structure serves as the temporary storage site for urine?
urinary bladder
T OR F: The urethra contains an internal sphincter of smooth muscle.
TRUE
Which of the following statements is a false or incorrect statement?
The male urethra is longer than the female urethra.
The male urethra serves both the urinary and reproductive systems but at different times.
THE MALE URETHRA SERVES BOTH THE URINARY AND REPRODUCTIVE SYSTEMS AT THE SAME TIME.
The male urethra is a passageway for both urine and semen.
T OR F: Under normal conditions, the proximal convoluted tubule reabsorbs all of the glucose, lactate, and amino acids in the filtrate and 65% of the Na+ and water.
TRUE
Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harry's signs and symptoms, what is his diagnosis and what is the relationship (if any) between his present condition and his earlier sore throat?
Harry is showing the symptoms of kidney inflammation. Kidney inflammation usually results from infections either of the lower urinary tract or from an earlier infection in the body.
Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms?
Cystitis is a condition in which the mucous membrane lining the bladder becomes swollen and bleeding occurs. This condition is caused by bacterial invasion of the bladder or by chemical or mechanical irritation.
A patient is 18 years old and has a complaint of painful urination, fever, chills, and back pain. This is her second urinary tract infection (UTI) within 5 months. How can the RN instruct the patient on prevention of another UTI?
The nurse can instruct the patient on the proper wiping technique (front to back), and explain that sexually transmitted infections can also inflame the urinary tract, clogging some of its ducts.
T OR F: The act of emptying the bladder is called voiding.
TRUE
T OR F: Incontinence is the inability to control voluntary micturition.
TRUE
Which of the following acts as the trigger for the initiation of micturition (voiding)?
the stretching of the bladder wall
T OR F: The descending limb of the loop of Henle is permeable to both solutes and water.
FALSE
Which part of the brain controls the micturition reflex?
pons
A 58-year-old woman complains of loss of urine when coughing and sneezing, and during exercise. She has had three children. What is the possible cause of urinary incontinence in this patient?
Stress incontinence is found most commonly in women with relaxed pelvic musculature deprived of estrogen.
Fetal kidneys do not have to work very hard because ________.
the placenta allows the mother's urinary system to clear the waste from fetal blood
Which of the following best describes kidney function in older adults (70 years or older)?
Kidney function decreases due to kidney atrophy.
Select the correct statement about urinary system development.
Kidneys develop from urogenital ridges.
The need to get up in the middle of the night to urinate is called ________.`
noturia
T OR F: The leading cause of chronic renal disease is hypertension.
FALSE
The tube that carries urine from the kidney to the urinary bladder is the _____.
Ureter
The renal medulla is also called the _____.
renal pyramids
The space inside the kidney is the:
renal sinus
Which of the following empties urine directly into the renal pelvis?
Major calyx
Which of the following vessels would be found in the renal columns?
Interlobar artery
Nephrons are found mostly in the:
renal cortex
The renal corpuscle consists of a:
glomerulus; glomerular capsule
Which of the following structures is not part of the Nephron?
Distal convoluted tubule
Glomerulus
Loop of Henle
COLLECTING DUCT
Podocytes are part of the:
glomerular capsule
The visceral layer of the glomerular capsule is part of the:
filtration membrane
Which of the following conditions would increase the glomerular filtration rate?
An increase in glomerular hydrostatic pressure
Which of the following substances would not be found in normal filtrate?
ALBUMIN
Glucose
Potassium
Urea
Which of the following would be a result of an increase in systemic blood pressure?
afferent arterioles constrict
What is the NFP if GHP is 60 mm Hg, COP is 35 mm Hg, and CHP is 25 mm Hg?
120 mm HG
Which of the following will reduce the glomerular filtration rate?
Angiotensin II
Most of the nutrients in the filtrate are reabsorbed in the:
proximal convoluted tube
In the distal convoluted tubule, a _____ is secreted for every sodium ion that is reabsorbed.
potassium ion
When glucose spills over into the urine it has:
exceded its transport maximum
If your urine contains fewer potassium ions than your filtrate, then the potassium has been:
filtered and reabsorbed
Which of the following is actively transported out of the loop of Henle?
sodium ion
Which of the following would be an abnormal constituent of urine?
albumin
The collecting ducts are _____ to water when the hormone _____ is present.
permeable; ADH
Which of the following would be an abnormal pH for urine?
11.0
The portion of the nephron that maintains the hypertonicity of the renal medulla is the:
loop of henle
When urine enters the collecting duct it is ______ to the blood.
Hypotonic
Which part of the nephron employs a countercurrent mechanism?
loop of henle
Which of the following is not a function of the kidneys?
BILE PRODUCTION
Excretion of excess ions
Release of erythropoietin
Activation of vitamin D
Urine collection occurs in the ____ of the kidney.
pelvis
What fraction of the cardiac output is delivered to the kidneys each minute?
1/4
The blood-filtering structure of the kidney is called the ______.
glomerulus
The urine-forming units of the kidney are the ______.
nephrons
Based on the histology of the renal tubule, which section would be most severly inhibited if simple squamous epithelium were damaged?
Thin segment of the loop of henle
The vasa recta are associated with what structures in the kidney?
Juxtamedullary nephrons
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