A & P 2 - Chapter 23 - The Urinary System

Which can pass through the glomerular filtration membrane? Select all that apply. Blood cells Electrolytes Albumin Glucose Water

Electrolytes Glucose Water

Albuminuria is a common sign of diabetes mellitus. True/ False

False

Angiotensin-converting enzyme is found only in the kidneys and converts angiotensinogen to angiotensin I. True/ False

False

Ethyl (drinking) alcohol stimulates the secretion of ADH, thereby reducing reabsorption by the collecting duct. True/ False

False

Glomerular capillaries suffer little damage from hypertension because of the protective influence of the afferent arterioles. True/ False

False

Glomerular filtration occurs because glomerular oncotic pressure overrides glomerular blood pressure. True/ False

False

The countercurrent multiplier mechanism for water conservation was discovered by limiting studies to humans and thus hypothesizing how form determines function. True/ False

False

The ureters pass anterior to the bladder and enter it from below. True/ False

False

Normally very little glucose is reabsorbed from the tubular fluid and is therefore lost in the urine. True/ False.

False (All the glucose is reabsorbed, unless levels are really high)

Gestational diabetes, diabetes insipidus, and diabetes mellitus all are characterized by glycosuria. True/ False

False. Glycosuria is present in gestation and mellitus, but not insipidus.

Place in order, from the blood side to the capsular space, the structures through which any filtered substance must pass in glomerular filtration. Filtration slit Basement membrane Fenestrated endothelium

Fenestrated endothelium Basement membrane Filtration slit

From deepest to most superficial, list the layers of connective tissue that surround the kidney. Fibrous capsule Renal fascia Perirenal fat capsule

Fibrous capsule Perirenal fat capsule Renal fascia

In the kidney, tubular reabsorption refers to the movement of fluid and solutes where?

From the tubular fluid into the blood

Within the renal corpuscle, the colloid osmotic pressure (COP) is a pressure drawing fluid into what? Renal capsule Renal tubule Glomerular capillaries Peritubular capillaries

Glomerular capillaries

The glomerulus is surrounded by _______________________.

Glomerular capsule

What are the two components of the renal corpuscle? Nephron loop Glomerular capsule Juxtaglomerular apparatus Afferent arteriole Glomerulus

Glomerular capsule Glomerulus

Renal clearance is the net effect of which of the following? Select all that apply. Dietary intake Glomerular filtration Tubular reabsorption Metabolic deactivation Tubular secretion

Glomerular filtration Tubular reabsorption Tubular secretion

What is the amount of filtrate formed per minute by the two kidneys called? Minute urine volume Glomerular filtration rate Renal clearance

Glomerular filtration rate

Which can pass through glomerular filtration? Glucose Electrolytes Albumin Blood cells Water

Glucose Electrolytes Water

The kidneys help regulate acid-base balance through the tubular secretion of which molecules? Sodium & Potassium ions Hydrogen & bicarbonate ions Sodium & Chloride ions Glucose and amino acids

Hydrogen & bicarbonate ions

Which leads to an increased secretion of natriuretic peptides? Decreased blood pressure Decreased cardiac output Increased blood sodium Increased blood pressure

Increased blood pressure.

Which result from activation of the renin-angiotensin system? Select all that apply. Vasodilation of afferent arteriole Increased secretion of aldosterone Stimulated thirst Increased release of ADH Increased secretion of cortisol

Increased secretion of aldosterone Stimulated thirst Increased release of ADH

Which result from the activation of the renin-angiotensin system? Select all that apply. Increased water retention Increased blood pressure Decreased water reabsorption Vasoconstriction Decreased glomerular filtration

Increased water retention Increased blood pressure Vasoconstriction

Natriuretic Peptides Effect on water excretion.

Inhibits NaCl reabsorption by the collecting duct

As the urethra passes through the pelvic floor, it is encircled by which urethral sphincter?

Internal urethral sphincter

What is the importance of the medullary ECF osmolarity gradient? It allows for the production of very concentrated urine. It allows for the reabsorption for a large quantity of salt. It allows the production of very dilute urine.

It allows for the production of very concentrated urine.

How does hypertension lead to kidney damage? It can damage renal tubular walls. It can rupture glomerular capillaries. It can decrease renal blood flow. It can cause hypoxia of renal medullary tissue.

It can rupture glomerular capillaries.

How can hypertension damage the glomerular capillaries?

It can scar them.

Which describes the urethra? It conveys urine from the renal papillae tot he renal pelvis. It conveys urine from the kidneys to the bladder. It conveys urine from the bladder out of the body.

It conveys urine from the bladder out of the body.

How does antidiuretic hormone affect the permeability of the collecting ducts to water? It increases their permeability. It does not affect their permeability. It decreases their permeability.

It increases their permeability.

The tubuloglomerular feedback mechanism of GFR regulation relies not the monitoring of tubular fluid by a renal structure called the ___________________________ apparatus.

Juxtaglomerular

Renal Autoregulation Dilate/ constrict arterioles; release renin

Juxtaglomerular cells

Smooth muscle cells within wall of afferent arteriole.

Juxtaglomerular cells

Which nephrons have long nephron loops that extend deep into the medulla? Juxtamedullary Medullary Cortical

Juxtamedullary

Renal Autoregulation Monitor tubular fluid

Macula densa

Epithelial cells at the end of a nephron loop.

Macula dense cells

Cells between the arterioles and amongst the glomerular capillaries.

Mesangial cells

Renal Autoregulation Dilate/ constrict glomerular capillaries

Mesangial cells

The presence of which structures in the proximal convoluted tubule cause the lining to be referred to as a brush border?

Microvilli

Starting at the renal papilla, place the structures to which urine will follow in order. Renal Pelvis Minor Calyx Ureter Major Calyx

Minor Calyx Major Calyx Renal Pelvis Ureter

Urine is drained from the renal pyramid into which structure? Renal column Renal sinus Ureter Minor calyx

Minor calyx

What is the order of urine-collecting structures found within the kidney?

Minor calyx, major calyx, renal pelvis, ureter

The osmotic and electrical gradients that drive the reabsorption of water and solutes is created by reabsorption of the solute _____________.

Na - Sodium

What is the overall pressure found at the glomerulus that determines the amount of filtration called?

Net filtration pressure

What are the mechanisms of peritubular capillary absorption? Osmosis and solvent drag Active transport and solent drag Osmosis and bulk transport Active and passive transport

Osmosis and solvent drag

Within the filtration membrane, filtration slits are gaps between which of the following? Microvilli Fenestrations Pedicels Macula dense cells

Pedicels

What are the three protective layers of the kidney? Perirenal fat capsule Renal fascia Fibrous capsule Glomerular capsule Peritoneum

Perirenal fat capsule Renal fascia Fibrous capsule

Which variables affect the filtration coefficient? Select all that apply. Permeability of the filtration membrane The amount of sodium in the blood The surface area available for filtration The level of hydration

Permeability of the filtration membrane The surface area available for filtration

The nerves and ganglia serving the kidney make up the renal _______________.

Plexus

Fluid intake, diabetes and some medications can increase urine output, a condition called diuresis or _____________________.

Polyuria

Which symptoms are seen with diabetes mellitus? Anuria Azotemia Polyuria Dehydration Glycosuria

Polyuria Dehydration Glycosuria

What are the three segments of the male urethra? Internal urethra Prostatic urethra Spongy urethra Membranous urethra External urethra

Prostatic urethra Spongy urethra Membranous urethra

Starting from the renal artery, place the arteries carrying blood in to the renal cortex in order. Cortical radiate artery/ Interlobular artery Segmental artery Interlobar artery Arcuate artery Renal artery

Renal artery Segmental artery Interlobar artery Arcuate artery Cortical radiate artery/ Interlobular artery

A nephron consists of what two parts?

Renal corpuscle Renal tubule

Running from the glomerular capsule to the tip of the medullary pyramid is a series of ducts that, together, are referred to as what? Glomerulus Renal tubule Vasa recta Collecting duct

Renal tubule

When there is a drop in blood pressure, the juxtaglomerular cells respond by secreting which of the following?

Renin

Which of the following describes the location of the kidneys?

Retroperitoneal at the level of T12 to L3

Which solids are reabsorbed by the nephron loop? Select all that apply. Sodium ions Potassium ions Chloride Water Glucose and amino acids

Sodium ions Potassium ions Chloride

Aldosterone Effect on water excretion.

Stimulates sodium ion retention

The motor fibers of the renal plexus are branches of which nervous system?

Sympathetic

Sodium is transported into the cells of the PCT by a protein that simultaneously moves it and another solute in the same direction. This type of transport protein is called a __________________.

Symport

Clinically what is the level of nitrogenous waste in the blood typically expressed as? Blood urea nitrogen Azoexcretion Catabolic nitrogen

Blood urea nitrogen

How do the kidneys regulate blood volume and blood?

By regulating water output

The renal fraction is approximately what percent of the cardiac output? 1 83 21 5

21

Human urine can have as much as __________ times the osmolarity of the blood plasma, which is why it is called hypertonic. a. 1.5 b. 2.6 c. 4.0 d. 5.8

4.0

What is the normal range for the pH of urine?

4.5 - 8.2

What is a minor calyx? A cuplike structure that collects urine. A structure comprised of glomerular capillaries surrounded by the glomerular capsule. A region of cortical tissue extending into the medulla between the pyramids. A series of microscopic tubules that produce urine.

A cuplike structure that collects urine.

Trace the path of a red blood cell from the renal artery to the glomerulus: (1) interlobar artery (2) interlobular artery (3) segmental artery (4) arcuate artery (5) afferent arteriole a. 1, 2, 3, 4, 5 b. 1, 4, 2, 3, 5 c. 1,3, 2, 4, 5 d. 2, 1, 3, 5, 4 e. 1, 4, 3, 2

a. 1, 2, 3, 4, 5 (1) interlobar artery (2) interlobular artery (3) segmental artery (4) arcuate artery (5) afferent arteriole

Arrange the parts in order as fluid flows from the filtration membrane through the nephron. Given these parts of a nephron: 1. renal corpuscle 2. collecting duct 3. loop of Henle 4. distal tubule 5. proximal tubule a. 1,5,3,4,2 b. 2,4,1,3,5 c. 2,1,4,5,3 d. 4,2,3,5,1

a. 1,5,3,4,2

The average person has approximately _______ nephrons per kidney. a. 1.2 million b. 2.4 million c. 3.6 million d. 4.8 million e. 5.6 million

a. 1.2 million

Removal of the posterior pituitary will immediately cause: a. a decrease in urine volume. b. an increase in urine volume. c. no change in urine volume.

a. a decrease in urine volume.

The juxtaglomerular cells of the _____________ and the macula densa cells of the _____________ form the juxtaglomerular apparatus. a. afferent arteriole, distal tubule b. afferent arteriole, proximal tubule c. efferent arteriole, proximal tubule d. efferent arteriole, distal tubule

a. afferent arteriole, distal tubule

Which of the following is a direct result of antidiuretic hormones? a. decreased urine volume b. decreased urine molarity c. increased urine volume d. increased urine salinity e. increased urine acidity

a. decreased urine volume

Which muscle is located in the bladder? a. detrusor b. distractor c. pubococcygeus d. corpus spongiosum e. corpus cavernosum

a. detrusor

The transition from an afferent arteriole to an efferent arteriole occurs in the a. glomerulus. b. medulla. c. cortical radiate veins. d. peritubular capillaries. e. vasa recta.

a. glomerulus.

These substances normally cannot pass through the filtration membrane: a. hemoglobin b. water c. sodium ions d. bicarbonate ions e. glucose

a. hemoglobin

Which of the following events would increase filtration pressure? a. increase in capsular pressure b. constriction of the efferent arteriole c. increase in colloid osmotic pressure d. decrease in renal blood flow e. dilation of the efferent arteriole

a. increase in capsular pressure

This effect is caused by increased aldosterone levels: a. increased reabsorption of Na+ b. decreased blood volume c. decreased reabsorption of Cl- d. increased permeability of the distal tubule to water e. increased volume of urine

a. increased reabsorption of Na+

Decreased blood pressure in the afferent arterioles results in: a. increased renin secretion. b. decreased ADH secretion. c. suppression of thirst. d. stimulation of the parasympathetic nervous system. e. decreased renin secretion.

a. increased renin secretion

Because of the great deal of active transport that occurs here, the _________ of all the nephrons collectively account for about 6% of one's daily resting ATP and caloric consumption. a. proximal convoluted tubules b. distal convoluted tubules c. loops of Henle d. collecting ducts e. glomeruli

a. proximal convoluted tubules

Blood vessels, lymphatic vessels and nerves enter and exit the kidney through this: a. renal hilus b. renal sinus c. renal calyces d. adrenal glands

a. renal hilus

The urine is most likely to be hypotonic when: a. the body's water volume is high. b. the body's pH is low. c. the output of antidiuretic hormone is high. d. the output of natriuretic peptides is high. e. a person is lost and deprived of drinking water.

a. the body's water volume is high.

Loop diuretics reduce body water content by acting on the feedback loop between the kidney and posterior pituitary gland. a. the countercurrent multiplier system. b. the countercurrent exchanger system. c. aquaporins of the collecting duct. d. the thirst mechanism and water intake.

a. the countercurrent multiplier system.

By the time the filtrate reaches this, the glucose is usually completely reabsorbed: a. the end of the proximal tubule b. the tip of the loop of Henle c. the end of the distal tubule d. the end of the collecting duct e. Bowman's capsule

a. the end of the proximal tubule

A renal pyramid voids urine into: a. the minor calyx. b. the major calyx. c. the renal medulla. d. the renal papilla. e. the ureter.

a. the minor calyx.

All of the following are composed of cuboidal epithelium with the exception of: a. the thin segment of the nephron loop. b. the thick segment of the nephron loop. c. the collecting duct. d. the proximal convoluted tubule. e. the distal convoluted tubule.

a. the thin segment of the nephron loop.

This byproduct of protein catabolism constitutes approximately one-half of all nitrogenous waste. a. urea b. creatinine c. uric acid d. azotemia e. ammonia

a. urea

Which of the following would reduce the glomerular filtration rate? a. vasoconstriction of the efferent arteriole b. a drop in oncotic pressure c. vasodilation of the afferent arteriole d. vasoconstriction of the afferent arteriole e. an increase in osmotic pressure in the glomerular capsule

a. vasoconstriction of the afferent arteriole

What enters at the vascular pole of the renal corpuscle and brings blood to the glomerulus?

afferent arteriole

When systemic blood pressure decreases, the result is that the ___________ arterioles change diameter by undergoing ______________.

afferent; vasodilation

Glucose that is reabsorbed into tubular cells travels __________ its concentration gradient through sodium-glucose symport channels at the luminal membrane. Glucose in tubular cells exits the basolateral membrane into interstitial fluid through the process of ______________________.

against; facilitated diffusion

Name the steroid hormone secreted in response to decreased blood sodium or increased blood potassium. It alters tubular handling of these electrolytes.

aldosterone

The hormone _____________ causes increased reabsorption of sodium (and the water that follows) and secretion of potassium from the later segments of the renal tubule.

aldosterone

Name the plasma protein that is converted by renin to angiotensin I.

angiotensinogen

Water is reabsorbed through specialized water channels called?

aquaporins

The ability of the nephrons to adjust their own blood flow and GFR without nervous or hormonal control is called renal ________________.

autoregulation

Arrange the vessels in the order in which a drop of blood from the interlobular artery passes through them. Given these vessels: 1. arcuate vein 2. afferent arteriole 3. efferent arteriole 4. interlobular vein 5. peritubular capillaries a. 1,2,4,5,3 b. 2,3,5,4,1 c. 4,2,5,3,1 d. 5,2,4,1,3

b. 2,3,5,4,1

Assuming all other values are normal, calculate the net filtration pressure in a patient with a drop in capsular hydrostatic pressure to 8 mmHg. a. 10 mm Hg out b. 20 mm Hg out c. 30 mm Hg out d. 40 mm Hg out e. 50 mm Hg out

b. 20 mm Hg out

This condition reduces filtration pressure in the glomerulus: a. elevated blood pressure b. constriction of the afferent arterioles c. decreased plasma protein in the glomerulus d. dilation of the afferent arterioles e. decreased capsule pressure

b. constriction of the afferent arterioles

The cortex of the kidney contains this: a. hilus b. glomeruli c. perirenal fat d. renal pyramids e. renal pelvis

b. glomeruli

Choose the one that does not belong. a. loop of Henle b. glomerulus c. distal convoluted tubule d. proximal convoluted tubule e. Bowman's capsule

b. glomerulus

What is the most common urinary symptom of diabetes mellitus? a. pyuria b. glycosuria c. hematuria d. albuminuria e. urobilinuria

b. glycosuria

Diuretics affect the urine in this manner: a. decrease the urine flow b. increase the urine flow c. increase the cellular composition of the urine d. none of the above

b. increase the urine flow

Which two substances are most useful for determining a patient's glomerular filtration rate? a. insulin and glucose b. insulin and creatinine c. sodium and water d. albumin and inulin e. insulin and urea

b. insulin and creatinine

Which is not a portion of the urethra? a. external urethral orifice b. internal urethral sphincter c. prostatic urethra d. membranous urethra e. spongy urethra

b. internal urethral sphincter

Which are primarily responsible for maintaining the salinity gradient of the renal medulla? a. cortical nephrons b. juxtamedullary nephrons c. collecting ducts d. proximal convoluted tubules e. distal convoluted tubules

b. juxtamedullary nephrons

A single lobe of a kidney is comprised of a. two calyces and a renal pelvis. b. one pyramid and the overlying cortex. c. one major calyx and all of its minor calyces. d. a renal medulla and two renal columns. e. one collecting duct and all nephrons that drain into it.

b. one pyramid and the overlying cortex.

The major calyces of the kidney converge to form this enlarged channel: a. renal fascia b. renal pelvis c. renal pyramids d. renal papillae e. renal sinus

b. renal pelvis

This statement best describes principal cells in the distal tubules and collecting duct: a. secrete renin b. respond to ADH and aldosterone c. respond to ADH only d. respond to aldosterone only

b. respond to ADH and aldosterone

Hypocalcemia stimulates: a. a decrease in aldosterone production. b. secretion of parathyroid hormone. c. secretion of renin. d. an increase in blood urea nitrogen. e. vasoconstriction of the afferent arterioles

b. secretion of parathyroid hormone.

Which organ system does not excrete waste? a. the urinary system b. the cardiovascular system c. the integumentary system d. the digestive system e. the respiratory system

b. the cardiovascular system

The mechanism of stabilizing the GFR based on the tendency of smooth muscle to contract when stretched is known as what? a. renal autoregulation b. the myogenic mechanism c. tubuloglomerular feedback d. sympathetic control e. the renin-angiotensin-aldosterone mechanism

b. the myogenic mechanism

Glucose and amino acids are reabsorbed from the glomerular filtrate by: a. the renal corpuscle. b. the proximal convoluted tubule. c. the distal convoluted tubule. d. the glomerular capillaries. e. the collecting duct.

b. the proximal convoluted tubule.

Blood plasma is filtered in: a. the renal tubule. b. the renal corpuscle. c. the renal capsule. d. the renal column. e. the renal calyx.

b. the renal corpuscle

In which of the following locations is filtrate osmolality highest? a. end of proximal convoluted tubule b. tip of the loop of Henle c. end of distal convoluted tubule d. beginning of distal convoluted tubule e. descending loop of Henle

b. tip of the loop of Henle

This is the principal function of the ureter: a. transport blood to the efferent arterioles b. transport urine from the renal pelvis into the urinary bladder c. transport glucose and protein into the renal pelvis d. none of the above

b. transport urine from the renal pelvis into the urinary bladder

What is the term for the pigment responsible for the color of urine? a. monochrome b. urochrome c. cyanochrome d. multichrome e. pyuria

b. urochrome

Aldosterone enhances the reabsorption of sodium through the upregulation of the sodium-potassium pump found at the ________________.

basolateral membrane

Which of these correctly traces blood flow from the renal artery into the renal cortex? a. arcuate a. → interlobar a. → afferent arteriole → interlobular a. b. interlobar a. → interlobular a. → segmental a. → arcuate a. c. segmental a. → interlobar a. → arcuate a. → interlobular a. d. afferent arteriole → interlobular a. → arcuate a. → interlobar a. e. segmental a. → arcuate a. → interlobar a. → interlobular a.

c. segmental a. → interlobar a. → arcuate a. → interlobular a.

The innermost connective tissue layer protecting the kidney and assisting in staving off infection is known as the perirenal fat capsule. a. the renal fascia. b. the hilum. c. the fibrous capsule. d. the renal medulla. e. the fibrous capsule.

c. the fibrous capsule.

The overall purpose of the countercurrent exchange system is: a. to supply salt and urea to the renal medulla. b. to supply nutrients and oxygen to the renal cortex. c. to supply nutrients and oxygen to the renal medulla. d. to remove metabolic wastes from the renal cortex. e. to remove metabolic wastes from the renal medulla.

c. to supply nutrients and oxygen to the renal medulla.

In the nephron, the fluid that immediately precedes urine is known as: a. plasma. b. glomerular filtrate. c. tubular fluid. d. renal filtrate. e. medullary filtrate.

c. tubular fluid.

This process of urine production is the active transport of solutes across the walls of the nephron into the filtrate: a. filtration b. tubular reabsorption c. tubular secretion d. filtration fraction

c. tubular secretion

This small tube leads from the floor of the urinary bladder to the exterior of the body: a. renal pelvis b. ureter c. urethra d. calyx

c. urethra

Which of the following forces oppose glomerular filtration?

capsular hydrostatic pressure (HPc) and blood colloid osmotic pressure (OPg)

Hormones can alter the amount of water reabsorbed during urine production, allowing the production of either concentrated or dilute urine. This is the role of the _____________ duct.

collecting

The ___________ duct receives fluid draining from several nephrons and carries it through the medulla to the papilla.

collecting

Angiotensin II triggers the __________________________ of the intraglomerular mesangial cells which results in a(an) _______________________________ of the filtration surface area.

contraction; decrease

The kidney parenchyma consists of two regions: an outer ________ and an inner _______.

cortex medulla

Starting from the collecting duct, indicate the order in which urea molecules move to maintain the medullary concentration gradient. (1) ascending limb (2) distal convoluted tubule (3) interstitial fluid (4) collecting duct (5) descending limb a. 2, 5, 1, 4, 3 b. 1, 3, 5, 2, 4 c. 3, 5, 1, 2, 4 d. 4, 2, 1, 3, 5 e. 4, 3, 5, 1, 2

e. 4, 3, 5, 1, 2 (4) collecting duct (3) interstitial fluid (5) descending limb (1) ascending limb (2) distal convoluted tubule

Prednisone is a steroid that reduces inflammation and is used to treat autoimmune diseases. It has some aldosterone-like effects on the kidney and has this effect on the body: a. increases Na+ absorption b. increases blood volume c. increases blood pressure d. causes edema e. all of these

e. all of these

Putting a patient with hypertension on a low-sodium diet would have this effect: a. reduces the osmolality of blood b. ADH secretion is inhibited c. produces dilute urine and eliminates water d. reduces blood volume and blood pressure e. all of these

e. all of these

In response to a drop in overall blood pressure, ___ stimulates constriction of the glomerular inlet and even greater constriction of the outlet. a. azotemia b. sodium chloride c. parathyroid hormone d. aldosterone e. angiotensin II

e. angiotensin II

Drinking a large amount of beer results in this: a. increased aldosterone secretion b. increased permeability of the collecting ducts of the nephrons c. decreased urine osmolality d. increased urine volume e. both c and d

e. both c and d

Which of the following is not an organ of the urinary system? a. urethra b. ureter c. urinary bladder d. kidney e. collecting duct

e. collecting duct

Which of these correctly traces blood flow from the renal cortex to the renal vein? a. interlobular v. → interlobar v. → segmental v. → renal v. b. arcuate v. → interlobar v. → segmental v. → renal v. c. interlobar v. → interlobular v. → arcuate v. → renal v. d. segmental v. → arcuate v. → interlobar v. → renal v. e. interlobular v. → arcuate v. → interlobar v. → renal v.

e. interlobular v. → arcuate v. → interlobar v. → renal v.

Atrial natriuretic peptide reduces blood volume and pressure by all of the following means except a. increasing glomerular filtration rate. b. inhibiting renin and aldosterone secretion. c. inhibiting the action of ADH on the kidney. d. inhibiting NaCl reabsorption by the collecting duct. e. preventing sodium loss in the urine.

e. preventing sodium loss in the urine.

In a healthy kidney, very little ___ is filtered by the glomerulus. a. amino acids b. electrolytes c. glucose d. vitamins e. protein

e. protein

Which of the following is not found in the ureter? a. adventitia b. two layers of smooth muscle c. three layers of smooth muscle d. transitional epithelium e. skeletal muscle

e. skeletal muscle

Micturition is another term for: a. the production of nitrogenous wastes. b. glomerular filtration. c. the countercurrent multiplier process. d. inflammation of the urinary bladder. e. the elimination of urine.

e. the elimination of urine.

This triangular area of the urinary bladder is between the two ureters posteriorly and the urethra anteriorly: a. external urinary sphincter b. internal urinary sphincter c. smooth muscle d. transitional epithelium e. trigone

e. trigone

The process of separating wastes from the body fluids and eliminating them is called __________.

excretion

The glomerulus is composed of ____________________ capillaries.

fenestrated

In glomerular filtration , blood is filtered to form glomerular __________.

filtrate

The kidneys receive about 21% of the cardiac output. This value is called the renal ________.

fraction

What is a nephron?

functional unit of a kidney

If the glomerular filtration rate is too _______, fluid flows thought the renal tubules too rapidly. Urine output will increase and electrolyte depletion may occur.

high

Compared to capillary beds in the rest of the body, the hydrostatic pressure within the glomerular capillary bed is: lower higher

higher

The interstitial fluid within the medulla has a __________________ osmolarity than the interstitial fluid within the cortex.

higher

Within the renal corpuscle, blood __________ pressure is the pressure forcing fluid into the glomerular capsular space.

hydrostatic

An increase in the NFP would result in a(n) _______________ in the GFR.

increase

Inhibiting the sodium-glucose symport SGLT2 is expected to cause a(n) __________________________ in the osmolarity of the tubular filtrate, and would thus _____________________ the risk of dehydration.

increase; increase

Treatment with Probenecid® results in _________________ levels of uric acid in the urine and __________________ levels of uric acid in the blood.

increased; decreased

The accumulation of reabsorbed fluid not the basal side of the epithelial cells creates a high tissue fluid pressure that drives water ____ the peritubular capillaries.

into

Within the renal corpuscle colloid osmotic pressure forces fluid _______ the glomerular capillaries.

into

To measure glomerular filtration rate, a substance that is neither secreted, reabsorbed or metabolized is needed. The compound ______ is an example of a substance used to measure GFR.

inulin

How does activation of the angiotensin mechanism affect blood pressure?

it increases the blood pressure.

The organs that function to remove metabolic waste material by filtering the blood plasma are the:

kidneys

If the glomerular filtration rate is too _________, fluid flows through the renal tubules too slowly, urine output will decrease and azotemia may occur.

low

Individuals with Bartter syndrome have a defective gene coding for Na+/K+/2Cl- symport (NKCC2) that disables it from functioning. These individuals are expected to have ___________ than normal blood potassium levels. This response is the ___________ what is expected from individuals taking prescribed loop diuretics.

lower; same as

Decreased Na+ and water reaborption due to the use of loop diuretics and thiazides __________ the concentration gradient of the interstitial fluid, thereby _____________ the osmotic force at the collecting tubule and duct.

lowers; reducing

The majority of sodium reabsorption occurs at the proximal convoluted tubule. During this process sodium enters the tubule cells at the ___________________ and exits the tubule cells at the ____________________.

luminal membrane by facilitated diffusion; basolateral membrane through the sodium potassium pump

The renal pyramids make up the layer of the kidney called the renal ________.

medulla

Which structures increase the absorptive area of proximal convoluted tubule cells?

microvilli

The process of urination, or voiding urine is called __________________.

micturition

The _________________ of the nephron acts as a countercurrent multiplier.

nephron loop

The blunt tip of a renal pyramid from which urine is collected is a renal _________________.

papilla

Filtration is a ________________ process that depends on a ___________________ gradient.

passive; pressure

Constriction of the efferent arteriole by angiotensin II lowers blood pressure in the ___________________ capillaries and enhances the reabsorption of sodium and water.

peritubular

The ______________ capillaries pick up fluid and solutes that are reabsorbed in the proximal convoluted tubule.

peritubular

Fluid and solutes reabsorbed in the PCT are picked up by which capillary bed?

peritubular capillaries

The micturition center is located in the ____________ of the brain stem.

pons

Which of the following substances utilizes paracellular transport in order to cross the basolateral membrane of the tubule cell during the process of reabsorption?

potassium

Inactivating the sodium-glucose symport SGLT2 inhibits the reabsorption of glucose by ____________________________.

preventing glucose from entering the tubular cells

Under normal conditions the majority of uric acid reabsorption occurs at the _______________________.

proximal convoluted tubule

Which region of the nephron is adapted for reabsorption, as seen in its length and prominent microvilli?

proximal convoluted tubule

Antidiuretic hormone enhances water ______________ by _______________ the number of aquaporins at the tubular cell membrane.

reabsorption; increasing

Which structure is composed of a proximal convoluted tubule, nephron loop, distal convoluted tubule and collecting duct? Renal tubule Renal corpuscle Vasa recta Juxtaglomerular apparatus

renal tubule

The enzyme __________ converts angiotensinogen to angiotensin I.

renin

In addition to enhancing the reabsorption of sodium, aldosterone also enhances the __________________ of potassium.

secretion

The wall of the proximal convoluted tubule is comprised of ________________ ___________________ epithelium.

simple cuboidal

During reabsorption from the PCT, water can carry dissolved substances by which process?

solvent drag

The ratio of the density of a substance to the density of water is called its __________________ ___________________.

specific gravity

Renin is released in response to ________________________ stimulation.

sympathetic

The __________ nervous system causes vasoconstriction of the afferent arterioles, reducing glomerular blood flow and the GFR.

sympathetic

ACE inhibitors are prescribed to control blood pressure. These drugs work by reducing _____________________.

the conversion of angiotensin I to angiontensin II

The vasa recta is a network of blood vessels located mostly within?

the medulla

What effects do fibers from the micturition center in the brain have on the sympathetic neurons that control the internal urethral sphincter? inhibit excite

they inhibit them.

Glomerulosclerosis results in a ____________________ of the basement membrane

thickening

Tubular reabsorption and tubular secretion differ in that __________________________.

tubular secretion adds materials to the tubular filtrate while tubular reabsorption removes materials from the tubular filtrate

The mechanism by which the glomerulus receives feedback on the status of downstream tubular fluid is called ____________ feedback.

tubuloglomerular

Pendrin is found in __________ intercalated cells where it allows for the ________________ of bicarbonate

type B; secretion

The expected response to metabolic alkalosis is the ___________________ of Pendrin. Type _____________ also assist in buffering the alkaline blood through its transport of H+.

upregulation; B

Regarding nitrogenous wastes, the PCT reabsorbs most of the _________, but none of the __________.

uric acid; creatinine.

The color of urine is due to the presence of a pigment called __________, produced during the breakdown of hemoglobin.

urochrome

Within the glomerular capsule, podocytes form the________ (inner) layer of the capsule and simple squamous epithelium forms the _______ (outer) layer.

visceral; parietal

Podocytes form which of the following? Parietal layer of the glomerular capsule. Visceral layer of the glomerular capsule. Renin-secreting cells of the juxtaglomerular apparatus. Walls of the collecting ducts.

Visceral layer of the glomerular capsule.

The nephron reabsorbs about how much urea from the tubular fluid? All About half None

About half

Patients with poorly controlled diabetes mellitus may have urine with the odor of?

Acetone

The kidneys play a major role in which of the following? Select all that apply. Acid-base balance Electrolytes Body temperature Cholesterol levels

Acid-base balance Electrolytes

How does the ascending limb of the nephron loop shift sodium, potassium and chloride into the ECF? Active transport Bulk transport Osmosis Simple diffusion

Active transport

Which blood vessel carries blood into a glomerulus?

Afferent arteriole

What is azotemia? An increased level of blood sodium. An increased level of blood urea nitrogen. An increased level of blood acid. An increased level of blood bicarbonate.

An increased level of blood urea nitrogen.

The kidneys play a role in calcium homeostasis by participating in the synthesis of which hormone?

Calcitriol

Antidiuretic hormone Effect on water excretion.

Causes water to reenter the bloodstream via the collecting duct

The filtration pressure in the glomerulus is determined by the balance in which two pressures?

Colloid Osmotic Blood Hydrostatic

In clinical practice, glomerular filtration rate is estimated by measuring excretion of the compound ____________. Ammonia Creatinine Urea Phosphate

Creatinine

What are two examples of nitrogenous wastes that are excreted by the kidneys? Bicarbonate Creatinine Urea Phosphates

Creatinine Urea

When macula densa cells experience increased Na+ concentration in the filtrate, they respond by: a. increasing afferent arteriole constriction. b. decreasing urine production. c. decreasing renin secretion. d. increasing aldosterone secretion. e. increasing renin secretion

c. decreasing renin secretion.

Prior to chemical tests for glycosuria, clinicians checked for sweetness of the urine as a sign of: a. diabetes insipidus. b. acute glomerulonephritis. c. diabetes mellitus. d. renal calculus. e. pyelitis.

c. diabetes mellitus.

Normal urine from a healthy person can be expected to contain all of the following except: a. creatinine b. urobilin c. glucose d. ammonia e. magnesium

c. glucose

PCTs are responsible for reabsorbing all of the following except: a. potassium. b. sodium chloride. c. hydrogen ions. d. urea. e. water.

c. hydrogen ions.

This urinary system organ removes waste products from the body and helps regulate blood pressure: a. liver b. heart c. kidney d. lungs

c. kidney

Renin hydrolyzes angiotensinogen released from the ________ to form angiotensin I. a. lungs b. kidneys c. liver d. heart e. spleen

c. liver

This is the basic histological and functional unit of the kidney: a. glomerulus b. filtration membrane c. nephron d. podocyte e. renal corpuscle

c. nephron

Water leaves the nephron by this mechanism: a. active transport b. filtration into the capillary network c. osmosis d. facilitated diffusion e. cotransport

c. osmosis

Parathyroid hormone Effect on water excretion.

Decreases hydrostatic pressure in the peritubular capillaries

Lithotripsy is a medical procedure used to treat: a. acute glomerulonephritis. b. nephrotic syndrome. c. renal calculi. d. hydronephrosis. e. prostatic hypertrophy.

c. renal calculi

AnswerThis hormone secreted by the kidney triggers a cascade that regulates blood Na+ and blood pressure: a. erythropoietin b. vasopressin c. renin d. angiotensin

c. renin

What is the action of parathyroid hormone on the kidneys? Decreases calcium reabsorption & increases phosphate reabsorption. Decreases phosphate reabsorption & increases calcium reabsorption. Decreases phosphate & calcium reabsorption. Increases phosphate & calcium reabsorption.

Decreases phosphate reabsorption & increases calcium reabsorption.

The collecting duct receives fluid from the _______________________.

Distal convoluted tubule

Proteinuria occurs when the filtration membrane becomes leaky, allowing proteins to cross. This impacts the blood colloid osmotic pressure by ____________________ the osmolarity gradient between the blood and filtrate, thereby ________________ the strength of this pressure.

decreasing; reducing

Antidiuretic hormone is secreted in response to ___________________.

dehydration

A chemical that enhances urine volume is called a __________________.

diurectic

Parathyroid hormone increases phosphate excretion by the proximal convoluted tubule as well as promotes synthesis of calcitriol. True/ False

True

The fenestrated endothelium of the capillary has pores small enough to exclude blood cells from the filtrate. True/ False

True

The most toxic of our metabolic wastes are nitrogenous wastes. True/ False

True

The thick segment of the nephron loop is impermeable to water. True/ False

True

The urinary bladder can contain 1 L of urine, but discomfort becomes noticeable when the volume exceeds 500mL. True/False

True

Glomerular filtrate is similar to blood plasma except that it contains little or no proteins. True/ False

True Other than plasma proteins, small substances can pass through the filtration membrane.

Aspirin, penicillin and other drugs are cleared from the blood via the kidneys by which of the following processes? Tubular excretion Tubular reabsorption Tubular filtration Tubular secretion

Tubular secretion

What wastes are removed from the blood by tubular secretion?

Urea Ammonia Bile

Match each nitrogenous waste with the substance from whose catabolism it results. 1. Urea 2. Uric Acid 3. Creatinine A. Proteins B. Creatine Phosphate C. Nucleic Acids

Urea - Proteins Uric Acid - Nucleic Acids Creatinine - Creatine Phosphate

As urine stands, it develops a pungent odor due to the degradation of what? Creatinine to urea Ammonia to sulfuric acid Glucose to lactate Urea to ammonia

Urea to ammonia

Name the condition that develops when blood levels of nitrogenous wastes reach toxic levels. Symptoms include diarrhea, vomiting, dyspnea, and cardiac arrhythmia.

Uremia

The renal pelvis of each kidney funnels urine into a tube called a ___________.

Ureter

Which structure acts as a countercurrent exchanger? Nephron loop Vasa recta Collecting duct

Vasa recta

Angiotensin II stimulates the anterior pituitary gland to secrete ____________________ hormone.

ADH - Antidiuretic

Name the hormone that makes the collecting duct more permeable to water thus increasing its reabsorption.

ADH - Antidiuretic hormone

The salts in the medullary ECF were transported from which limb of the nephron loop?

Ascending

Which renal tubule segments are influenced by aldosterone? Select all that apply. Descending limb of the nephron loop Ascending limb of the nephron loop Collecting duct Distal convoluted tubule Proximal convoluted tubule

Ascending limb of the nephron loop Collecting duct Distal convoluted tubule

Which hormones regulate the amount of water and salt reabsorbed by the DCT and collecting duct? Select all that apply. Epinephrine Atrial natriuretic peptide Angiotensin converting enzyme Antidiuretic hormone Aldosterone

Atrial natriuretic peptide Antidiuretic hormone Aldosterone

What is the source of the salts that contribute to the high osmolarity of the medullary ECF?

The active transport of Na+, K+, Cl- from the ascending limb of the nephron loop.

The primary function of the nephron loop is to generate a medullary ECF osmotic gradient that allows for what?

The concentration of urine

What is tubular secretion?

The movement of water and solutes from the blood into the tubular fluid

If a patient presents with a Streptococcus viridans infection, his doctor may prescribe oral penicillin taken four times daily. Why does he have to take the penicillin so often?

The renal tubules extract penicillin from the blood and secrete it into the urine.

Which segment of the nephron loop actively transports salts?

Thick

What are the leaky junctions between epithelial cells in the proximal convoluted tubule that allow water to move through called?

Tight junctions

When the transporters within the proximal convoluted tubule are saturated and no additional solute can be reabsorbed, what has been reached?

Transport maximum

A decrease in systemic blood pressure results in dilation of the afferent arterioles which prevents a decrease in renal blood flow and filtration pressure. True/False

True

Cells in the cleft between the afferent and efferent arterioles and among capillaries of the glomerulus are known as mesangial cells. True/ False

True

Diseases that affect the descending corticospinal tracts may limit inhibition of the sacral somatic motor neurons and thus could result in urinary incontinence True/ False

True

Arrange the following in the sequence in which filtrate moves through them. (1) loop of Henle (2) Bowman's capsule (3) distal convoluted tubule (4) proximal convoluted tubule a. 1, 2, 3, 4 b. 4, 2, 1, 3 c. 2, 4, 3, 1 d. 2, 4, 1, 3 e. 3, 4, 1, 2

c. 2, 4, 3, 1 (2) Bowman's capsule (4) proximal convoluted tubule (3) distal convoluted tubule (1) loop of Henle

If the following hypothetical conditions exist in the nephron, calculate the net filtration pressure. glomerular capillary pressure = 80 mmHg blood colloid osmotic pressure = 20 mmHg capsular hydrostatic pressure = 10 mmHg a. 110 mmHg b. 90 mmHg c. 50 mmHg d. 30 mmHg e. 20 mmHg

c. 50 mmHg

A hospital patient produces 4 mL/min of urine with a urea concentration of 8 mg/mL. Venous blood draw reveals urea concentration of .4 mg/mL. What is the percentage of cleared urea from glomerular filtrate? a. 40% b. 56% c. 64% d. 72% e. 80%

c. 64%

Why is the external urinary sphincter under conscious control? a. It is made of smooth muscle. b. It is part of the detrusor muscle. c. It is made of skeletal muscle. d. It is made of adventitia.

c. It is made of skeletal muscle

A patient enters a hospital after a motorcycle accident. He complains of mid-back pain. X-rays reveal both rib and pelvic fractures. His emergency room examination includes urinalysis. Which of the following findings from the urinalysis would most likely suggest trauma to the kidneys from the accident, but not to the urinary bladder? a. pyuria b. hematuria c. albuminuria d. uremia e. phenylketonuria

c. albuminuria

In life-threatening starvation, the kidneys synthesize glucose by a. secreting erythropoietin. b. secreting renin. c. deaminating amino acids. d. contributing to calcium homeostasis. e. producing uric acid.

c. deaminating amino acids

The minimum daily output of urine to meet the definition of polyuria is: a. 0.5 L. b. 1.0 L. c. 1.5 L. d. 2.0 L. e. 3.0 L.

d. 2.0 L.

Put the following in the correct order after the blood pressure increases. (1) decreased sympathetic stimulation (2) increase in glomerulus filtration rate (3) increase in arterial blood pressure (4) increase in urine production (5) afferent arterioles dilate a. 1, 3, 5, 2, 4 b. 3, 2, 1, 5, 4 c. 2, 3, 5, 1, 4 d. 3, 1, 5, 2, 4 e. 3, 2, 5, 4, 1

d. 3, 1, 5, 2, 4 (3) increase in arterial blood pressure (1) decreased sympathetic stimulation (5) afferent arterioles dilate (2) increase in glomerulus filtration rate (4) increase in urine production

Which is not a function of the kidneys? a. They regulate osmolarity of the body fluids. b. They fight osteoporosis by synthesizing vitamin D. c. They help control blood pressure. d. They release waste into the bloodstream. e. They indirectly increase oxyhemoglobin.

d. They release waste into the bloodstream.

Which of the following is NOT an effect of aging on the kidneys? a. decrease in kidney size b. loss of nephrons c. decreased response to hormonal control of urine volume d. a marked decrease in the ability to maintain homeostasis

d. a marked decrease in the ability to maintain homeostasis

Total saturation of protein transporters for a given solute in the renal tubules would result in: a. reabsorption of all the solute. b. a renal clearance of zero. c. a net filtration pressure of 1.0. d. appearance of that solute in the urine. e. absence of that solute from the urine.

d. appearance of that solute in the urine.

Which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass through? a. glomerulus b. proximal convoluted tubule c. distal convoluted tubule d. collecting duct e. nephron loop

d. collecting duct

Which of the following does not contribute to water conservation? a. the collecting duct b. the countercurrent multiplier c. the countercurrent exchange system d. diuretics e. the length of the nephrons

d. diuretics

Which of the following urinary tract disorders seems most likely to occur in someone who frequently participates in marathon runs? a. osmotic diuresis b. renal hypertension c. cystitis d. hematuria e. renal calculi

d. hematuria

Creatinine has a renal clearance of 140 mL/min due to the fact that: a. it is absorbed by the loop of Henle. b. it is secreted by the glomerulus. c. it is absorbed by the renal tubules. d. it is secreted by the renal tubules. e. it is produced in the pulmonary tissue.

d. it is secreted by the renal tubules.

Which of these induces renin secretion, constricts afferent arterioles, and reduces GFR and urine volume? a. aldosterone b. antidiuretic hormone c. parathyroid hormone d. norepinephrine e. angiotensin II

d. norepinephrine

Which of these form the inner layer of the glomerular capsule and wrap around the capillaries of the glomerulus? a. macula densa cells b. mesangial cells c. nephrocytes d. podocytes e. monocytes

d. podocytes

The countercurrent multiplier recaptures ______ and is based on fluid flowing in ______ direction in two adjacent tubules. a. potassium; the same b. calcium; the opposite c. calcium; the same d. sodium; the opposite e. sodium; the same

d. sodium; the opposite

Aldosterone acts on: a. the proximal convoluted tubule. b. the medullary portion of the collecting duct. c. the descending limb of the nephron loop. d. the distal convoluted tubule. e. the glomerulus.

d. the distal convoluted tubule

A renal calculus can be up to 2 cm wide, but even then, it would not obstruct: a. the major calyx. b. the ureter. c. the urethra. d. the urinary bladder. e. the renal pelvis.

d. the urinary bladder.

The urinary bladder is lined with this tissue: a. simple cuboidal epithelium b. simple columnar epithelium c. smooth muscle d. transitional epithelium

d. transitional epithelium

If both the glomerular and capsular hydrostatic pressures remain unchanged, an increase in the blood colloid osmotic pressure results in a(n) _____________ in the net filtration pressure.

decrease

The nephron loop is responsible for approximately 25% of the reabsorption of sodium. Loop diuretics cause an overall __________________ in the reabsorption of sodium in this region resulting in a(n) ________________________ in the osmolarity of the tubular filtrate.

decrease; increase

Plasma angiotensin II levels would be higher when mean arterial blood pressure is _____________.

decreased.

A decreased GFR results in a(n) ___________ urine volume and ________ blood volume.

decreased; increased