A&P 2 Chapter 25 The Urinary System A&P 2 Chapter 26 Fluid Electrolyte Acid Base
Macula densa
'dense spot' - a grp of tall, closely packed cells of the ascending limb of the loop of Henle that lies adjacent to the granular cells.
Changes in plasma sodium levels affect: Plasma volume, blood pressure ICF and interstitial fluid volumes
...
How does the detrusor muscle respond
...
K+ balance is controlled via secretion to filtrate
...
Reabsorption of Bicarbonate
1. Carbon dioxide combines with water in tubule cells, forming carbonic acid 2. Carbonic acid splits into hydrogen ions and bicarbonate ions 3. For each hydrogen ion secreted, a sodium ion and a bicarbonate ion are reabsorbed by the PCT cells 4. Secreted hydrogen ions form carbonic acid; thus, bicarbonate disappears from filtrate at the same rate that it enters the peritubular capillary blood 5. Carbonic acid dissociates carbon dioxide and water 6. Carbon dioxide diffuses into tubule cells more hydrogen ion secretion
3 layers of the filtration membrane
1. fenestrated endothelium of the glomerular capillaries; 2.the visceral membrane of the glomerular capsule, made of podocytes which have filtration slits between their foot processes; and between these two layers; 3. the basement membrane composed of the fused basal laminate of the two other layers.
GFR Factors
1. total surface area available for filtration; 2. filtration membrane permeability and 3. NFP in adults the normal GFR in both kidneys is 120-125 ml/min
NPF
10 mmHg - determined by the relationship between forces favoring filtration (glomerular hydrostatic pressure) and forces that oppose it (capsular hydrostatic pressure and blood osmotic pressure)
What do the carrier molecules of simple cuboidal cells of the thick ascending limb of the loop of Henle transport?
2 chloride ions, 1 sodium ion, 1 potassium ion
Everyday the kidneys filter
200 liters
Calculate the net filtration pressure if blood pressure in the glomerulus is unusually high, around 68 mm Hg.
23 mm Hg
The muscularis of the urinary bladder, detrusor muscle is made up of
3 layers of muscle
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
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
Calculate net filtration pressure given the following values: glomerular hydostatic pressure = 50 mmHg; blood colloid osmotic pressure = 25 mmHG; capsular hydostatic pressure = 20 Hg
5 [50 mmHg - (25 mmHg + 20 Hg)]
Acidosis - arterial pH < ____ (physiological acidosis)
7.35
Alkalosis - arterial pH > ____
7.45
1) The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________. A) loop of Henle B) glomerular filtration membrane C) collecting duct D) distal convoluted tubule.
A
14) The renal corpuscle is made up of ________. A) Bowmanʹs capsule and glomerulus B) the descending loop of Henle C) the renal pyramid D) the renal papilla
A
15) The functional and structural unit of the kidneys is ________. A) the nephron B) the loop of Henle C) Bowmanʹs capsule D) the basement membrane of the capillaries
A
18) Which of the following statements describes the histology of the ureters? A) They are trilayered (mucosa, muscularis, and adventitia). B) They are actually an extension of the visceral peritoneum. C) They are made up of several layers of endothelium. D) They are made up entirely of muscle tissue because they need to contract in order to transport urine efficiently.
A
20) Which of the following acts as the trigger for the initiation of micturition (voiding)? A) The stretching of the bladder wall serves as the trigger. B) Motor neurons control micturition. C) The pressure of the fluid in the bladder opens a sphincter and allows the urine to flow by gravity down the urethra. D) The sympathetic efferents are the predominant system controlling micturition.
A
28) The function of angiotensin II is to ________. A) constrict arterioles and increase blood pressure B) decrease the production of aldosterone C) decrease arterial blood pressure D) decrease water absorption
A
32) Select the correct statement about the nephrons. A) The parietal layer of the glomerular capsule is simple squamous epithelium. B) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule. C) Podocytes are the branching epithelial cells that line the tubules of the nephron. D) Filtration slits are the pores that give fenestrated capillaries their name.
A
45) As the renal artery approaches the kidney, it branches to supply the renal tissue. Place the following in correct sequence starting from the renal artery. 1. segmental 2. cortical radiate 3. arcuate 4. interlobar A) 1, 4, 3, 2 B) 3, 1, 4, 2 C) 1, 2, 3, 4 D) 1, 4, 2, 3
A
46. The relative concentration of potassium is A. higher in urine than plasma or glomerular filtrate. B. higher in plasma and glomerular filtrate than in urine. C. about equal in plasma, glomerular filtrate, and urine. D. lower in urine than plasma or glomerular filtrate. E. none of the above.
A
47) Select the correct statement about urinary system development. A) Kidneys develop from urogenital ridges. B) The metanephric ducts will become the urethras. C) The pronephros (first tubule system) develops during the tenth week of gestation. D) The mesonephros will develop into the kidneys.
A
48. Autoregulation refers to A. maintaining constant GFR. B. secretion of atrial natriuretic peptide at a constant rate. C. secretion of renin at a constant rate. D. getting your driver's license renewed. E. training a toddler to use a toilet.
A
49) Which statement is correct? A) Reabsorption of water is hormonally controlled. B) Normal filtrate contains a large amount of protein. C) Most of the water passing through the kidney is eliminated as urine. D) The excretion of sodium ions is one of the mechanisms that maintains the pH balance of the blood.
A
5) The urinary bladder is composed of ________ epithelium. A) transitional B) simple squamous C) stratified squamous D) pseudostratified columnar
A
50. At the renal plasma threshold A. more glucose is in the filtrate than active transport can handle. B. blood volume is so great that nephrons cannot keep up. C. the urine has too little glucose. D. hemodialysis is needed. E. a kidney transplant is necessary.
A
53. The layers of a ureter are A. outer fibrous coat, middle muscular coat, inner mucous coat. B. inner fibrous coat, middle muscular coat, outer mucous coat. C. inner muscular coat, middle fibrous coat, outer inner mucous coat. D. inner vascular coat, middle neural coat, outer mucous coat. E. the intima, the media, and the superficial layer.
A
56. The micturition reflex center is in the A. sacral segments of the spinal cord. B. medulla oblongata. C. pons. D. hypothalamus. E. kidneys.
A
60. Which of the following correctly lists the order of structures through which urine flows after its formation in the nephron? A. calyx, renal pelvis, ureter, urinary bladder, urethra B. renal pelvis, calyx, ureter, urinary bladder, urethra C. renal pelvis, calyx, urethra, ureter, urinary bladder D. renal pelvis, calyx, urinary bladder, ureter, urethra E. glomerular capsule, proximal convoluted tubule, nephron loop, distal convoluted tubule, collecting duct
A
8) Which gland sits atop each kidney? A) adrenal B) thymus C) pituitary D) pancreas
A
3 kidney coverings
A fibrous capsule, a perirenal fat capsule, and renal fascia surround each kidney. The perirenal fat capsule helps hold the kidneys in position.
Which of the hormones below is responsible for facultative water reabsorption? A) ADH B) aldosterone C) atrial natriuretic peptide D) thyroxine
A) ADH
The renal corpuscle is made up of ________. A) Bowman's capsule and glomerulus B) the descending loop of Henle C) the renal pyramid D) the renal papilla
A) Bowman's capsule and glomerulus
Which of the following statements is true regarding fluid shifts? A) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts. B) Nonelectrolytes are the controlling factor in directing fluid shifts. C) Electrolytes are not as important as proteins in regulating fluid shifts in the body. D) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.
A) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.
Which of the following does not describe the juxtaglomerular complex? A) Its macula densa cells produce aldosterone. B) It helps control systemic blood pressure. C) Its granular cells produce rennin. D) It regulates the rate of filtrate formation.
A) Its macula densa cells produce aldosterone.
Which of the following describes the distribution of sodium and potassium between cells and body fluids? A) K+ mainly in the cells, Na+ in the body fluids B) equal amounts of each ion in the cells and body fluids C) Na+ mainly in the cells, K+ in the body fluids D) little of either in the cells, but large amounts of each in the body fluids
A) K+ mainly in the cells, Na+ in the body fluids
The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________. A) loop of Henle B) glomerular filtration membrane C) collecting duct D) distal convoluted tubule
A) Loop of Henle
After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What is the diagnosis, and what has caused this problem? A) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. B) Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. C) Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood. D) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood.
A) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood.
Select the correct statement about the nephrons. A) The parietal layer of the glomerular capsule is simple squamous epithelium. B) Podocytes are the branching epithelial cells that line the tubules of the nephron. C) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule. D) Filtration slits are the pores that give fenestrated capillaries their name.
A) The parietal layer of the glomerular capsule is simple squamous epithelium.
Which statement best describes the function of the urethra? A) The urethra transports urine from the bladder to the outside of the body. B) The urethra carries out processes that form urine. C) The urethra transports urine from the kidney to the urinary bladder. D) The urethra functions in urine storage.
A) The urethra transports urine from the bladder to the outside of the body.
Select the person in the following list who would have the highest percentage of water in his or her body. A) a 6-month-old baby boy B) a 25-year-old overweight female C) a 80-year-old man of average weight D) a 25-year-old male of average weight
A) a 6-month-old baby boy
What is the juxtaglomerular apparatus? A) a system that regulates the rate of filtrate formation and systemic blood pressure B) a system for concentrating urine C) a system for diluting urine D) a system that protects the nephron from some chemicals found in blood
A) a system that regulates the rate of filtrate formation and systemic blood pressure
Which gland sits atop each kidney? A) adrenal B) thymus C) pituitary D) pancreas
A) adrenal
What vessel directly feeds into the glomerulus? A) afferent arteriole B) cortical radiate artery C) vasa recta D) efferent arteriole
A) afferent arteriole
Total body water is not a function of which of the following? A) amount of water ingested B) body mass C) age D) amount of body fat
A) amount of water ingested
Which of the following hormones is important in stimulating water conservation in the kidneys? A) antidiuretic hormone B) progesterone C) aldosterone D) atrial natriuretic peptide
A) antidiuretic hormone
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 ________. A) appear in the urine B) be completely reabsorbed by secondary active transport C) be completely reabsorbed by the tubule cells D) be actively secreted into the filtrate
A) appear in the urine
The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) arcuate B) interlobar C) cortical radiate D) lobar
A) arcuate
What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) atrial natriuretic peptide B) ADH C) aldosterone D) thyroxine
A) atrial natriuretic peptide
The kidneys are stimulated to produce renin ________. A) by a decrease in the blood pressure B) when the specific gravity of urine rises above 1.10 C) when the peritubular capillaries are dilated D) when the pH of the urine decreases
A) by a decrease in the blood pressure
What arteries branch off the arcuate arteries? A) cortical radiate (interlobular) arteries B) interlobar arteries C) segmental arteries D) renal arteries
A) cortical radiate (interlobular) arteries
Which vessels supply the cortical tissue of the kidney with blood? A) cortical radiate arteries B) interlobar arteries C) segmental arteries D) arcuate arteries
A) cortical radiate arteries
Which of these is NOT usually secreted by the kidneys? A) creatine B) creatinine C) H+ D) penicillin
A) creatine
Which of the choices below is not a glomerular filtration rate control method? A) electrolyte levels B) renal autoregulation C) hormonal regulation D) neural regulation
A) electrolyte levels
The factor favoring filtrate formation at the glomerulus is the ________. A) glomerular hydrostatic pressure B) capsular hydrostatic pressure C) colloid osmotic pressure of the blood D) myogenic mechanism
A) glomerular hydrostatic pressure
The chief force pushing water and solutes out of the blood across the filtration membrane is ________. A) glomerular hydrostatic pressure (glomerular blood pressure) B) protein-regulated diffusion C) the ionic electrochemical gradient D) the size of the pores in the basement membrane of the capillaries
A) glomerular hydrostatic pressure (glomerular blood pressure)
Which capillary bed produces filtrate? A) glomerulus B) juxtaglomerular complex (JGC) C) vasa recta D) peritubular capillaries
A) glomerulus
Most electrolyte reabsorption by the renal tubules is ________. A) hormonally controlled in distal tubule segments B) accomplished after the nephron loop is reached C) not limited by a transport maximum D) in the distal convoluted tubule
A) hormonally controlled in distal tubule segments
Which pressure is the chief force pushing water and solutes out of the blood and across the filtration membrane of the glomerulus? A) hydrostatic pressure in glomerular capillaries (HPgc) B) colloid osmotic pressure in glomerular capillaries (OPgc) C) hydrostatic pressure in the capsular space (HPcs) D) colloid osmotic pressure in the capsular space
A) hydrostatic pressure in glomerular capillaries (HPgc)
The most important force causing net water flow across capillary walls is ________. A) hydrostatic pressure of capillary blood B) intracellular hydrostatic pressure C) osmotic pressure of plasma proteins D) hydrostatic pressure of interstitial fluid
A) hydrostatic pressure of capillary blood
What is the hallmark of hypotonic hydration? A) hyponatremia B) hypoproteinemia C) hypernatremia D) hypercalcemia
A) hyponatremia
Which of the following would NOT be expected to lead to edema? A) hyponatremia B) incompetent venous valves C) hypoproteinemia D) inflammation
A) hyponatremia
Which of the following conditions promotes edema? A) hypoproteinemia B) diabetes mellitus C) hemorrhage D) hyponatremia
A) hypoproteinemia
What type of water imbalance increases the amount of fluid in all compartments? A) hypotonic hydration B) edema C) dehydration D) inflammation
A) hypotonic hydration
The role of ADH is to __________. A) increase water reabsorption B) produce dilute urine C) decrease water reabsorption D) lower blood pressure
A) increase water reabsorption
Which of the following is not a trigger for juxtaglomerular granular cells to release renin? A) increased extracellular fluid water levels B) decreased filtrate NaCl concentration C) sympathetic stimulation D) decreased stretch due to decreased blood pressure
A) increased extracellular fluid water levels
The __________ keeps the urethra closed when urine is not being passed from the bladder and prevents leaking between voiding. A) internal urethral sphincter B) prostatic urethra C) external urethral orifice D) external urethral sphincter
A) internal urethral sphincter
Where is the majority of water stored in the human body? A) intracellular fluid (ICF) compartment B) interstitial fluid (IF) C) extracellular fluid (ECF) compartment D) plasma
A) intracellular fluid (ICF) compartment
Which organs are the ultimate acid-base regulatory organs? A) kidneys B) lungs C) cardiovascular organs D) GI tract organs
A) kidneys
The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________. A) loop of Henle B) distal convoluted tubule C) glomerular filtration membrane D) collecting duct
A) loop of Henle
Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate? A) macula densa cells B) mesangial cells C) podocytes D) juxtaglomerular cells
A) macula densa cells
The most important renal mechanism for regulating acid-base balance of the blood involves __________. A) maintaining HCO3- balance. B) maintaining phosphate balance C) maintaining water balance D) maintaining CO2 balance
A) maintaining HCO3- balance.
A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) metabolic alkalosis B) metabolic acidosis C) respiratory alkalosis D) respiratory acidosis
A) metabolic alkalosis
Which of the following is the functional unit of the kidney? A) nephron B) renal pyramid C) renal corpuscle D) renal pelvis
A) nephron
The mechanism of water reabsorption by the renal tubules is ________. A) osmosis B) cotransport with sodium ions C) active transport D) filtration
A) osmosis
The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________. A) plasma protein B) glucose C) hormones D) electrolytes
A) plasma protein
Which of the following is NOT a function of the kidneys? A) producing the hormones melanin and oxytocin B) maintaining the proper balance between water and salts and between acids and bases C) metabolizing vitamin D to its active form D) gluconeogenesis during prolonged fasting
A) producing the hormones melanin and oxytocin
Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) reduce blood pressure and blood volume by inhibiting sodium and water retention B) prevent pH changes caused by organic acids C) enhance atrial contractions D) activate the renin-angiotensin mechanism
A) reduce blood pressure and blood volume by inhibiting sodium and water retention
Each minor calyx receives urine from the _____. A) renal papillae B) pelvis C) ureter D) columns
A) renal papillae
A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) respiratory acidosis B) metabolic acidosis C) respiratory alkalosis D) metabolic alkalosis
A) respiratory acidosis
Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________. A) secondary active transport B) facilitated diffusion C) countertransport D) passive transport
A) secondary active transport
Approximately 80% of the energy used for active transport is devoted to the reabsorption of __________. A) sodium B) potassium C) glucose D) water
A) sodium
Newborn infants have a relatively higher ________ content in their ECF than do adults. A) sodium B) magnesium C) bicarbonate D) iron
A) sodium
The body's water volume is closely tied to the level of which of the following ions? A) sodium ions B) hydrogen ions C) potassium ions D) calcium ions
A) sodium ions
The fatty tissue surrounding the kidneys is important because it ________. A) stabilizes the position of the kidneys by holding them in their normal position B) produces vitamin D and other chemicals needed by the kidney C) is necessary as a barrier between the adrenal glands and kidneys D) ensures adequate energy for the adrenal glands to operate efficiently
A) stabilizes the position of the kidneys by holding them in their normal position
The maintenance of the proper pH of the body fluids may be the result of ________. A) the control of respiratory ventilation B) the active secretion of OH- into the filtrate by the kidney tubule cells C) the operation of the various buffer systems in the stomach D) control of the acids produced in the stomach
A) the control of respiratory ventilation
Which of the following acts as the trigger for the initiation of micturition (voiding)? A) the stretching of the bladder wall B) motor neurons C) the sympathetic efferents D) the pressure of the fluid in the bladder
A) the stretching of the bladder wall
Which of the following is NOT a hormone involved in water and electrolyte balance? A) thyroxine B) ADH C) aldosterone D) atrial natriuretic peptide
A) thyroxine
The urinary bladder is composed of ________ epithelium. A) transitional B) simple squamous C) stratified squamous D) pseudostratified columnar
A) transitional
Which urinary structure serves as the temporary storage site for urine? A) urinary bladder B) renal pelvis C) ureter D) urethra
A) urinary bladder
What accounts for the route through which most fluid is lost in a day? A) urine B) insensible loss through skin and lungs C) feces D) sweat
A) urine
Where does the efferent arteriole of the juxtamedullary nephron carry blood to? A) vasa recta B) peritubular capillaries C) glomerulus D) afferent arteriole
A) vasa recta
Which blood vessels surround the loops of Henle? A) vasa recta B) peritubular capillaries C) interlobular arteries D) efferent arterioles
A) vasa recta
66. Kidney cells die as early as age A. 20. B. 30. C. 40. D. 50. E. 60
A. 20.
7. A nephron consists of A. a renal corpuscle and a renal tubule. B. an afferent and efferent arteriole. C. a cortex and a medulla. D. a bladder and a ureter. E. peritubular and paratubular capillaries.
A. a renal corpuscle and a renal tubule.
69. The story of Balkan endemic nephropathy indicated that A. a toxin in food can damage kidneys and cause kidney cancer. B. kidney disease only affects people in Croatia. C. drinking too much alcohol can strain the kidneys. D. a terrorist can poison peoples' urinary systems by putting bacteria in the water supply. E. kidneys can regenerate
A. a toxin in food can damage kidneys and cause kidney cancer.
71. Hemodialysis is also called A. an artificial kidney. B. a bionic nephron. C. a kidney transplant. D. a bone marrow transplant. E. an artificial liver.
A. an artificial kidney
10. A renal corpuscle is a _____, whereas a renal tubule is a _____. A. cluster of blood capillaries and glomerular capsule; highly coiled tubule exiting the glomerular capsule B. special blood cell in the kidneys; tubule that leads from the kidneys to the bladder C. storage area for urine; tubule that carries urine from the urinary bladder outside D. glandular structure that regulates blood pressure; blood vessel that regulates the flow of blood into the glomerulus E. structure composed of connective tissue; blood vessel
A. cluster of blood capillaries and glomerular capsule; highly coiled tubule exiting the glomerular capsule
26. The countercurrent mechanism in the nephron A. creates a highly concentrated interstitial fluid so that urine can be concentrated by the collecting ducts when they are permeable to water. B. is a method to move sodium to control its concentration. C. keeps the volume of water lost in the urine relatively constant. D. keeps interstitial fluid hydrated to maintain blood pressure. E. none of the above.
A. creates a highly concentrated interstitial fluid so that urine can be concentrated by the collecting ducts when they are permeable to water.
18. The hormone ADH promotes water reabsorption through the wall(s) of the A. distal convoluted tubule and collecting duct. B. proximal convoluted tubule and collecting duct. C. ascending limb of the nephron loop. D. descending limb of the nephron loop. E. glomerulus.
A. distal convoluted tubule and collecting duct.
12. The first capillary bed associated with the nephron A. filters. B. reabsorbs nutrients. C. adjusts pH. D. forms urine. E. reverses the flow of blood
A. filters.
5. A renal corpuscle includes the A. glomerulus and glomerular capsule. B. glomerulus and renal tubule. C. glomerular capsule and renal tubule. D. renal tubule and collecting tubule. E. red blood cells and hemoglobin
A. glomerulus and glomerular capsule.
30. An increase in glomerular osmotic pressure ________ the rate of glomerular filtration. A. increases B. decreases C. does not change D. has a variable effect on E. stops
A. increases
64. Females are at higher risk of contracting a urinary tract infection because A. the female urethra is shorter than the male's. B. the female urethra is longer than the male's. C. women sit down to urinate. D. women use toilet paper when they urinate. E. the female urethra is wider than the male's.
A. the female urethra is shorter than the male's
24. In the disease gout, plasma has excess A. uric acid. B. urea. C. calcium ions. D. amino acids. E. hemoglobin.
A. uric acid
44. A product of the metabolism of certain nucleic acid bases is A. uric acid. B. urea. C. ammonia. D. water. E. adenine.
A. uric acid.
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.
Increases in plasma osmolality trigger thirst and release of
ADH
Which hormone(s) is/are required for facultative water reabsorption in the collecting ducts?
ADH
Which of the hormones below is responsible for facultative water reabsorption?
ADH
Under what conditions is ADH released from the posterior pitutary? What effect does ADH have on the collecting ducts?
ADH is released from the posterior pituitary in response to hyperosmotic extracellular fluid. ADH causes insertion of aquaporins into the luminal membrane of the principal cells of the collecting ducts
Shock of physical trauma to the kidneys
Acute renal failure
8) Explain how an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as an antihypertensive.
Answer: Angiotensin II is a potent vasoconstrictor activating smooth muscle of arterioles throughout the body, causing mean arterial blood pressure to rise. ACE inhibitors reduce blood pressure by interrupting the renin-angiotensin-aldosterone system
11) Explain what is meant by the terms cotransport process and transport maximum.
Answer: Cotransport process refers to the active transport of one solute "uphill" (against a concentration gradient) coupled to the "downhill" (with a concentration gradient) movement of another during tubular reabsorption. Transport maximum reflects the number of carriers in the renal tubules available to "ferry" a particular substance.
16) Freshly voided urine has very little smell, but shortly after voiding it can give off a very strong smell. Why
Answer: Freshly voided urine is relatively sterile but if it is allowed to stand, bacteria begin to metabolize the urea solutes to release ammonia and other smells depending on the person's diet. A fruity smell generally means there is a diabetes problem.
13) List and describe three pressures operating at the filtration membrane, and explain how each influences net filtration pressure
Answer: Glomerular hydrostatic pressure is the chief force pushing water and solutes across the filtration membrane. The higher the glomerular hydrostatic pressure, the more filtrate is pushed across the membrane. Colloid osmotic pressure of plasma proteins in the glomerular blood, and capsular hydrostatic pressure exerted by fluids in the glomerular capsule, drive fluids back into the glomerular capillaries. The net filtration pressure equals glomerular hydrostatic pressure minus the sum of colloid osmotic pressure of glomerular blood and capsular hydrostatic pressure.
14) In addition to the renin-angiotensin mechanism, the renal cells produce other chemicals. Name four, and briefly give the main function of each
Answer: Renal cells also produce chemicals, some of which act locally as signaling molecules. These chemicals include prostaglandins (vasodilators and vasoconstrictors), which probably regulate GFR; nitric oxide, a potent vasodilator produced by the vascular endothelium; adenosine, which constricts renal vasculature; and endothelin, a vasoconstrictor that inhibits renin release.
7) A 58-year-old woman complains of loss of urine when coughing and sneezing, and during exercise. She has had three children. Describe the possible causes of urinary incontinence in this patient
Answer: Stress incontinence is found most commonly in women with relaxed pelvic musculature deprived of estrogen. Stress incontinence may occur with a sudden increase in intra-abdominal pressure such as coughing or sneezing, which forces urine through the external sphincter
Peritubular capillaries
Arise from efferent arterioles draining in the glomeruli.
Afferent arterioles
Arise from the cortical radiate arteries that run through the renal cortex. Arterioles are high-resistance vessels & the afferent has a larger diameter than the efferent
13) The fatty tissue surrounding the kidneys is important because ________. A) it ensures adequate energy for the adrenal glands to operate efficiently B) it stabilizes the position of the kidneys by holding them in their normal position C) it is necessary as a barrier between the adrenal glands and kidneys D) it produces vitamin D
B
2) Urine passes through the ________. A) renal hilum to the bladder to the ureter B) pelvis of the kidney to ureter to bladder to urethra C) glomerulus to ureter to renal tubule D) hilus to urethra to bladder
B
22) The mechanism of water reabsorption by the renal tubules is ________. A) active transport B) osmosis C) solvent drag D) cotransport with sodium ions
B
29) A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________. A) diabetes mellitus B) diabetes insipidus C) diabetic acidosis D) coma
B
3) A Bowmanʹs capsule does not contain ________. A) a podocyte B) a vasa recta C) a fenestrated capillary D) an efferent arteriole
B
30) An important characteristic of urine is its specific gravity or density, which is ________. A) 1.041-1.073 B) 1.001-1.035 C) 1.030-1.040 D) 1.000-1.015
B
33) What would happen if the capsular hydrostatic pressure were increased above normal? A) Net filtration would increase above normal. B) Net filtration would decrease. C) Filtration would increase in proportion to the increase in capsular pressure. D) Capsular osmotic pressure would compensate so that their filtration would not change.
B
35) Tubular reabsorption ________. A) includes substances such as creatinine B) by active mechanisms usually involves movement against an electrical and/or chemical gradient C) by passive processes requires ATP to move solutes from the interior of the tubule to the blood D) is a way for the body to get rid of unwanted waste
B
4) An increase in the permeability of the cells of the collecting tubule to water is due to ________. A) a decrease in the production of ADH B) an increase in the production of ADH C) an increase in the production of aldosterone D) a decrease in the concentration of the blood plasma
B
41) The factor favoring filtrate formation at the glomerulus is ________. A) the colloid osmotic pressure of the blood B) the glomerular hydrostatic pressure C) the capsular hydrostatic pressure D) the myogenic mechanism
B
44) Excretion of dilute urine requires ________. A) relative permeability of the distal tubule to water B) impermeability of the collecting tubule to water C) transport of sodium and chloride ions out of the descending loop of Henle D) the presence of ADH
B
47. Secretion of atrial natriuretic peptide A. decreases sodium excretion. B. increases sodium excretion. C. decreases potassium excretion. D. increases potassium excretion. E. has no effect on either sodium or potassium excretion
B
54. The ________ is the tube that conveys urine outside the body. A. ureter B. urethra C. collecting duct D. afferent arteriole E. nephron loop
B
55. The ureter extends downward A. behind the parietal peritoneum and joins the urinary bladder from above. B. behind the parietal peritoneum and joins the urinary bladder from below. C. in front of the parietal peritoneum and joins the urinary bladder from above. D. in front of the parietal peritoneum and joins the urinary bladder from below. E. and then loops up around the bladder.
B
58. The trigone is A. a group of three neighboring nephrons in a kidney. B. a triangular area on the floor of the urinary bladder. C. a region where the glomerulus meets the glomerular capsule. D. part of the Balkans where people developed kidney failure. E. a muscle layer that surrounds each kidney.
B
9) The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) lobar B) arcuate C) interlobar D) cortical radiate
B
Calculate the net filtration pressure if blood pressure in the glomerulus is unusually high, around 68 mm Hg. A) 83 mm Hg B) 23 mm Hg C) 113 mm Hg D) 15 mm Hg
B) 23 mm Hg
How much water is generated per day from cellular metabolism? A) 750 ml B) 250 ml C) 1500 ml D) 2500 ml
B) 250 ml
The renal corpuscle is made up of ________. A) the renal pyramid B) Bowman's capsule and glomerulus C) the descending loop of Henle D) the renal papilla
B) Bowman's capsule and glomerulus
Which of the following is not true regarding tubular reabsorption? A) It involves hormonal signals in the collecting ducts. B) It is a purely passive transport process. C) It occurs via transcellular or paracellular routes. D) It is a reclamation process.
B) It is a purely passive transport process.
What would happen if the capsular hydrostatic pressure were increased above normal? A) Filtration would increase in proportion to the increase in capsular pressure. B) Net filtration would decrease. C) Capsular osmotic pressure would compensate so that filtration would not change. D) Net filtration would increase above normal.
B) Net filtration would decrease.
Which hormone raises blood calcium levels? A) aldosterone B) PTH C) ADH D) calcitonin
B) PTH
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? A) Proteinuria is when there are excessive levels of protein in the blood, resulting in an increased osmotic pressure. The increased osmotic pressure forces fluid into the tissues, resulting in edema. B) 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. C) Proteinuria is when there are excessive levels of protein in the blood, resulting in an increased osmotic pressure. This does not relate to the edema seen in this case. D) Proteinuria is a condition in which proteins are actively secreted into the kidneys at the DCT. This decreases the osmotic pressure, causing more fluid to leave the blood into the tissues in the body, resulting in edema. E) Proteinuria is when the liver does not make enough plasma proteins, resulting in a decreased osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema.
B) 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.
Respiratory acidosis can occur when ________. A) a runner has completed a very long marathon B) a person's breathing is shallow due to obstruction C) the kidneys secrete hydrogen ions D) a person consumes excessive amounts of antacids
B) a person's breathing is shallow due to obstruction
Which of the following is not associated with the renal corpuscle? A) a fenestrated capillary B) a vasa recta C) an efferent arteriole D) a podocyte
B) a vasa recta
Which of the following is not associated with the renal corpuscle? A) a podocyte B) a vasa recta C) a fenestrated capillary D) an efferent arteriole
B) a vasa recta
The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) lobar B) arcuate C) interlobar D) cortical radiate
B) arcuate
In what part of the renal tubule are aquaporins scarce or absent so that water CANNOT be reabsorbed? A) collecting duct B) ascending limb of the nephron loop C) descending limb of the nephron loop D) proximal convoluted tubule (DCT)
B) ascending limb of the nephron loop
The term alkaline reserve is used to describe the ________ buffer system. A) protein B) bicarbonate C) phosphate D) hemoglobin
B) bicarbonate
The primary buffer of the extracellular fluid (ECF) is the __________. A) protein buffer system B) bicarbonate buffer system C) phosphate buffer system D) sodium-potassium buffer system
B) bicarbonate buffer system
Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH? A) by producing new bicarbonate ions B) by secreting sodium ions C) by secreting hydrogen ions into the filtrate D) by reabsorbing filtered bicarbonate ions
B) by secreting sodium ions
The __________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the __________. A) renal pyramids; renal pelvis B) calyces; renal pelvis C) renal pyramids; calyces D) renal pelvis; calyces
B) calyces; renal pelvis
Which structure is the first to collect the urine? A) pelvis B) calyx C) ureter D) urethra
B) calyx
The function of angiotensin II is to ________. A) decrease water absorption B) constrict arterioles and increase blood pressure C) decrease the production of aldosterone D) decrease arterial blood pressure
B) constrict arterioles and increase blood pressure
Which of the following is not reabsorbed by the proximal convoluted tubule? A) Na+ B) creatinine C) glucose D) K+
B) creatinine
Which of the following is not a method for regulating the hydrogen ion concentration in blood? A) chemical buffer systems B) diet C) renal mechanism D) respiratory changes
B) diet
Which of the following is not a disorder of water balance? A) hypotonic hydration, in which sodium content is normal but water content is high B) excessive hydration due to excess ANP secretion C) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure D) excess water in interstitial spaces due to a low level of plasma proteins
B) excessive hydration due to excess ANP secretion
What type of capillaries make up the glomerulus? A) continuous B) fenestrated C) vasa recta D) sinusoids
B) fenestrated
Which of the choices below is a function of the nephron loop? A) form a large volume of very concentrated urine or a small volume of very dilute urine B) form a large volume of very dilute urine or a small volume of very concentrated urine C) absorb electrolytes actively and water by osmosis in the same segments D) absorb water and electrolytes into the tubular network
B) form a large volume of very dilute urine or a small volume of very concentrated urine
Which of the following is the volume of filtrate formed each minute by all of the glomeruli of the kidneys? A) hydrostatic pressure in the capsular space (HPcs) B) glomerular filtration rate (GFR) C) hydrostatic pressure in glomerular capillaries (HPgc) D) net filtration pressure (NFP)
B) glomerular filtration rate (GFR)
Each nephron contains a __________, which is a tuft of capillaries, and a __________. A) renal plexus; renal tubule B) glomerulus; renal tubule C) glomerulus; renal plexus D) renal plexus; glomerulus
B) glomerulus; renal tubule
Which of the following abnormalities would not be observed in a patient who has Addison's disease? A) elevated plasma potassium level B) hypertension C) hyponatremia D) decreased plasma chloride level
B) hypertension Hypertension (abnormally high blood pressure) is typically caused by restricting blood flow by vasoconstriction or abnormally high fluid volume in the blood. Water balance is regulated by anti-diuretic hormone secreted from the posterior pituitary.
Which of the following is NOT involved in triggering the thirst mechanism? A) decrease in blood volume B) increase in blood pressure C) dry mouth D) osmoreceptors detect increased osmolality
B) increase in blood pressure
An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________. A) decrease in the production of ADH B) increase in the production of ADH C) increase in the production of aldosterone D) decrease in the concentration of the blood plasma
B) increase in the production of ADH
An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________. A) decrease in the concentration of the blood plasma B) increase in the production of ADH C) increase in the production of aldosterone D) decrease in the production of ADH
B) increase in the production of ADH
Which of the following is NOT a risk factor for dehydration? A) a high rate of insensible water loss B) increased muscle mass C) vomiting D) inefficient kidneys
B) increased muscle mass
Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________. A) low daily rate of fluid exchange B) inefficient kidneys C) comparatively low metabolic rates D) low rate of insensible water loss
B) inefficient kidneys
The compound used to assess the function of the kidney at the level of the glomerulus is _____. A) creatinine B) inulin C) para-aminohippuric acid D) creatine
B) inulin
The regulation of potassium balance ________. A) includes renal secretion, but never absorption B) involves aldosterone-induced secretion of potassium C) is not linked to sodium balance D) is accomplished mainly by hepatic mechanisms
B) involves aldosterone-induced secretion of potassium
The body's water volume is closely tied to a powerful water "magnet." What magnet is referred to here? A) water level in the intracellular compartment B) ionic sodium C) ionic potassium D) water level in the extracellular compartment
B) ionic sodium
The movement of fluids between cellular compartments ________. A) requires ATP for the transport to take place B) is regulated by osmotic and hydrostatic forces C) involves filtration D) requires active transport
B) is regulated by osmotic and hydrostatic forces
Which of the choices below is the salt level-monitoring part of the nephron? A) vasa recta B) macula densa C) loop of Henle D) principal cell
B) macula densa
Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely? A) respiratory acidosis B) metabolic acidosis C) respiratory alkalosis D) metabolic alkalosis
B) metabolic acidosis
Which of the following is NOT a major urine formation process? A) tubular secretion B) micturition C) glomerular filtration D) tubular reabsorption
B) micturition
The functional and structural unit of the kidneys is the ________. A) nephron loop B) nephron C) glomerular capsule D) capsular space
B) nephron
Urine passes through the ________. A) renal hilum to the bladder to the ureter B) pelvis of the kidney to ureter to bladder to urethra C) glomerulus to ureter to renal tubule D) hilum to urethra to bladder
B) pelvis of the kidney to ureter to bladder to urethra
Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. A) chloride B) potassium C) iron D) bicarbonate
B) potassium
Which buffer system is the most abundant in the body? A) hydrogen B) protein C) phosphate D) carbonic acid-bicarbonate
B) protein
Which of the following are NOT found in the glomerular filtrate? A) glucose B) protein C) uric acid D) creatinine
B) protein
The filtration membrane includes all except ________. A) glomerular endothelium B) renal fascia C) podocytes D) basement membrane
B) renal fascia
The most common cause of acid-base imbalance is __________. A) metabolic acidosis B) respiratory acidosis C) respiratory alkalosis D) metabolic alkalosis
B) respiratory acidosis
What is the most common cause of acid-base imbalance? A) metabolic acidosis B) respiratory acidosis C) metabolic alkalosis D) respiratory alkalosis
B) respiratory acidosis
The fatty tissue surrounding the kidneys is important because it ________. A) ensures adequate energy for the adrenal glands to operate efficiently B) stabilizes the position of the kidneys by holding them in their normal position C) is necessary as a barrier between the adrenal glands and kidneys D) produces vitamin D
B) stabilizes the position of the kidneys by holding them in their normal position
In the ascending limb of the loop of Henle the ________. A) thin segment is freely permeable to water B) thick segment moves ions out into interstitial spaces for reabsorption C) thick segment is permeable to water thin segment is not permeable to sodium and chloride
B) thick segment moves ions out into interstitial spaces for reabsorption
Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________. A) nerve damage B) tissue edema C) confusion D) extreme weight loss
B) tissue edema
The urinary bladder is composed of ________ epithelium. A) pseudostratified columnar B) transitional C) stratified squamous D) simple squamous
B) transitional
Which of the following does NOT impact how much sodium is reabsorbed? A) aldosterone B) transport maximum of the renal proximal tubule C) estrogen D) atrial natriuretic peptide
B) transport maximum of the renal proximal tubule
Under normal circumstances, most water is lost in __________. A) feces B) urine C) sweat D) insensible losses via skin and lungs
B) urine
74. The new parents are stunned at the state of their newborn's soiled diaper - it is blue! What might be the cause of the odd diaper stain? A. ADH deficiency B. A defect in transport of the amino acid tryptophan in the small intestine C. A buildup of uric acid in the blood. D. The baby ate a crayon. E. E. coli poisoning
B. A defect in transport of the amino acid tryptophan in the small intestine
40. Which of the following is not a diuretic? A. Caffeine B. Chocolate C. Alcohol D. Tea E. A water pill
B. Chocolate
3. Athletes might abuse which of the following chemicals made in the urinary system to improve performance by increasing red blood cell production? A. ADH B. Erythropoietin (EPO) C. Glomerular filtrate D. Urea E. ATP
B. Erythropoietin (EPO)
20. Which of the following would increase the rate of glomerular filtration? A. Decreased blood pressure B. Increased blood pressure C. A constricted afferent arteriole D. A dilated efferent arteriole E. Drinking water
B. Increased blood pressure
4. Which of the following is correct concerning the location of the kidneys? A. The right kidney is usually higher than the left one. B. They are located behind the parietal peritoneum. C. Their upper borders are about at the level of the third lumbar vertebra. D. They are against the anterior wall of the abdominal cavity. E. None of the above.
B. They are located behind the parietal peritoneum.
62. Nocturnal enuresis is A. a type of hormone made in the heart. B. bedwetting. C. kidney damage from a toxin that E. coli produces. D. a form of kidney cancer. E. an infection.
B. bedwetting
41. Linda drinks a 28-ounce venti sugar-free vanilla nonfat caffe latte on her way to work, and has to urinate about a half hour later. This is most likely because A. a venti is a very large drink. B. caffeine is a diuretic. C. the vanilla inhibits ADH secretion. D. walking quickly rushes fluid through the urinary system. E. all of the above.
B. caffeine is a diuretic.
34. A decrease in the glomerular hydrostatic pressure of a glomerular capsule will _____ the rate of glomerular filtration. A. increase B. decrease C. not change D. have a variable effect on E. stop
B. decrease
73. As a consequence of widespread edema, blood volume A. increases and blood pressure drops. B. decreases and blood pressure drops. C. increases and blood pressure rises. D. decreases and blood pressure rises. E. remains the same.
B. decreases and blood pressure drops.
72. During a kidney transplant procedure, the renal artery and vein of the donor kidney are connected to the recipient's A. renal artery and vein. B. iliac artery and vein. C. aorta and inferior vena cava. D. aorta and portal vein. E. bladder.
B. iliac artery and vein.
67. Kidney shrinkage with age is due to A. spooling of collecting ducts. B. loss of glomeruli. C. merging of proximal and distal convoluted tubules. D. proliferating nephron loops. E. loss of fat and muscle.
B. loss of glomeruli.
16. When sodium ions are reabsorbed through the wall of the renal tubule by active transport, chloride ions are A. reabsorbed by active transport. B. reabsorbed by passive transport. C. secreted by active transport. D. secreted by passive transport. E. none of the above.
B. reabsorbed by passive transport.
35. The composition of glomerular filtrate differs from that of plasma by including A. many different substances that are absent from plasma. B. the same substances as plasma except for larger protein molecules. C. less water and electrolytes than does plasma. D. much more uric acid and creatinine than plasma. E. DNA and RNA.
B. the same substances as plasma except for larger protein molecules.
43. A by-product of amino acid catabolism in the liver is A. uric acid. B. urea. C. ammonia. D. water. E. phenylalanine.
B. urea.
Three major chemical buffer systems
Bicarbonate buffer system Phosphate buffer system Protein buffer system
In dehydration, what would be the levels of ADH & aldosterone?
Both would be HIGH
The renal corpuscle is made up of ________.
Bowman's capsule and glomerulus
How do high levels of aldosterone increase sodium reabsorption?
By increasing the # of Na+/K+ ATPase pumps in the basolateral membrane
How does ADH increase water reabsorption?
By inserting water channels in the luminal membrane
10) The glomerulus differs from other capillaries in the body in that it ________. A) has a basement membrane B) is impermeable to most substances C) is drained by an efferent arteriole D) has a blood pressure much lower than other organ systems
C
12) Select the correct statement about the ureters. A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine. B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. C) The ureters are capable of peristalsis like that of the gastrointestinal tract. D) The ureter is innervated by parasympathetic nerve endings only.
C
17) The chief force pushing water and solutes out of the blood across the filtration membrane is ________. A) the design and size of the podocytes B) the thickness of the capillary endothelium C) glomerular hydrostatic pressure (glomerular blood pressure) D) the size of the pores in the basement membrane of the capillaries
C
19) The first major branch of the renal artery is ________. A) arcuate B) interlobular C) segmental D) cortical radiate
C
21) The filtration membrane includes all except ________. A) glomerular endothelium B) podocytes C) renal fascia D) basement membrane
C
23) Most electrolyte reabsorption by the renal tubules ________. A) is not Tm limited B) is in the distal convoluted tubule C) is hormonally controlled in distal tubule segments D) is completed by the time the loop of Henle is reached
C
34) Which of the following is not a part of the juxtaglomerular apparatus? A) granular cells B) macula densa C) podocyte cells D) mesanglial cells
C
36) Which statement is true about urine? A) Urine is usually slightly alkaline. B) Urine has an ammonialike odor when fresh. C) Urine has nitrogenous waste such as urea and uric acid. D) Urine has a yellow color due to the presence of hemoglobin.
C
38) While the kidneys process about 180 L of blood-derived fluids daily, the amount that actually leaves the body is ________. A) 50%, or 90 L B) all of the 180 L C) 1%, or 1.8 L D) 100 L
C
39) Fetal kidneys do not have to work very hard because ________. A) fetuses do not have any waste to excrete B) there are no functional nephrons until after birth C) the placenta allows the motherʹs urinary system to clear the waste from fetal blood D) there is no way a fetus could excrete urine until the seventh month of development
C
42) 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 ________. A) will be actively secreted into the filtrate B) will be completely reabsorbed by the tubule cells C) will appear in the urine D) will be reabsorbed by secondary active transport
C
43) If one says that the clearance value of glucose is zero, what does this mean? A) The glucose molecule is too large to be filtered out of the blood. B) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules. C) Normally all the glucose is reabsorbed. D) The clearance value of glucose is relatively high in a healthy adult
C
48) The disruption in homeostasis known as pyelitis is ________. A) a virus that appears only in children because of poor hygiene B) the aftermath of a severe upper respiratory infection C) an infection of the renal pelvis and calyces D) more prevalent in the elderly
C
52. Extracorporeal shock-wave lithotripsy is used to treat A. kidney failure. B. a urinary tract infection. C. kidney stones. D. incontinence. E. gout.
C
6) The kidneys are stimulated to produce renin ________. A) when the peritubular capillaries are dilated B) when the pH of the urine decreases C) by a decrease in the blood pressure D) when the specific gravity of urine rises above 1.10
C
7) Blood vessels of the renal columns are called ________. A) lobar B) segmental C) interlobar D) cortical radiate
C
In a given day, what is the typical value for water intake? A) 250 mL B) 1500 ml C) 2500 ml D) 750 ml
C) 2500 ml
PTH (parathyroid hormone) acts on the __________ to __________ Ca2+ reabsorption. A) liver; decrease B) bones; decrease C) DCT; increase D) large intestine; increase
C) DCT; increase
This chemical equation shows the reaction of a strong acid and weak base in the bicarbonate buffer system. Provide the products of the following reaction. HCl + NaHCO3 --> A) NaOH + NaH2PO4 B) NaHCO3 + H2O C) H2CO3 + NaCl D) NaH2PO4 + NaCl
C) H2CO3 + NaCl
What is the most abundant intracellular anion? A) Na+ B) Cl- C) HPO4 2- D) K+
C) HPO4 2-
What is the most abundant intracellular cation? A) Na+ B) Cl- C) K+ D) HPO42-
C) K+
Select the correct statement about urinary system development. A) The metanephric ducts will become the urethras. B) The mesonephros will develop into the kidneys. C) Kidneys develop from urogenital ridges. D) The pronephros (first tubule system) develops during the tenth week of gestation.
C) Kidneys develop from urogenital ridges.
Which of the following is the only logical explanation for why hypocalcemia increases neuromuscular excitability and causes muscle tetany? A) Low plasma calcium ion concentration decreases the release of calcium ions from the sarcoplasmic reticulum. B) Low plasma calcium ion concentration decreases the rate of exocytosis of synaptic vesicles. C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated. D) Low plasma calcium ion concentration increases the likelihood of acetic acid and choline being formed in the synaptic cleft when a neuron is stimulated to the threshold level.
C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated. Sodium and calcium are cations, and so loss of positive charge in the extracellular fluid would increase membrane permeability to all cations, including sodium. Recall that the efflux (outward movement) of sodium causes depolarization.
Which of the following is NOT characteristic of the cortical nephrons? A) The efferent arteriole of the cortical nephrons supplies the peritubular capillaries. B) Cortical nephrons have a short nephron loop. C) The glomerulus of the cortical nephron is closer to the cortex-medulla junction. D) Cortical nephrons form the majority of nephrons in the kidney.
C) The glomerulus of the cortical nephron is closer to the cortex-medulla junction.
A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why? A) The nurse instructed the patient to breathe faster and deeper. This will increase the patient's blood levels of carbon dioxide by eliminating less carbon dioxide from the lungs, resulting in a decrease in the blood pH. B) The nurse instructed the patient to breathe more shallowly. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH. C) The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease. D) The nurse instructed the patient to breathe faster and deeper. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH.
C) The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.
Select the correct statement about the ureters. A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine. B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. C) The ureters are capable of peristalsis like that of the gastrointestinal tract. D) The ureter is innervated by parasympathetic nerve endings only.
C) The ureters are capable of peristalsis like that of the gastrointestinal tract.
One of the major physiological factors that triggers thirst is ________. A) becoming overly agitated B) a dry mouth from high temperatures C) a rise in plasma osmolality D) drinking caffeinated beverages
C) a rise in plasma osmolality
Which of the following does NOT serve as a source of acids in the body? A) CO2 in the blood B) fat metabolism C) aerobic breakdown of glucose D) ingested foods
C) aerobic breakdown of glucose
Vigorous exercise could release high amounts of _____ into the urine. A) glucose B) uric acid C) albumin D) ascorbic acid
C) albumin
Which of the choices below exerts primary control over sodium levels in the body? A) glucocorticoids B) water levels C) aldosterone D) ADH
C) aldosterone
Which of the following regulates the secretion of K+ into the filtrate? A) atrial natriuretic peptide (ANP) B) parathyroid hormone (PTH) C) aldosterone D) antidiuretic hormone
C) aldosterone
A decrease in blood CO2 levels leads to __________. A) a drop in blood pH B) an increase in carbonic acid C) an increase in blood pH D) an increased respiratory rate
C) an increase in blood pH
What hormone helps to maintain extracellular fluid (ECF) osmolality when concentrations become too high? A) parathyroid hormone (PTH) B) angiotensin II C) antidiuretic hormone (ADH) D) aldosterone
C) antidiuretic hormone (ADH)
Which chemical buffer system is the only important system in the extracellular fluid (ECF) that resists short-term changes in pH? A) phosphate buffer system B) protein buffer system C) bicarbonate buffer system D) physiological buffering systems
C) bicarbonate buffer system
Which of the following substances is not normally found in filtrate? A) nitrogenous waste particles, such as urea B) water and small solutes C) blood cells and large particles D) ions, such as sodium and potassium
C) blood cells and large particles
The kidneys are stimulated to produce renin ________. A) when the peritubular capillaries are dilated B) when the pH of the urine decreases C) by a decrease in the blood pressure D) when the specific gravity of urine rises above 1.10
C) by a decrease in the blood pressure
The macula densa cells respond to ________. A) antidiuretic hormone B) changes in pressure in the tubule C) changes in solute content of the filtrate D) aldosterone
C) changes in solute content of the filtrate
Which of the following promotes the formation of dilute urine? A) increased osmolality of extracellular fluids B) large amounts of antidiuretic hormone (ADH) released from the posterior pituitary C) decreased osmolality of extracellular fluids D) increased number of aquaporins present in the collecting duct
C) decreased osmolality of extracellular fluids
Which process is most affected by blood pressure? A) tubular secretion B) tubular reabsorption C) glomerular filtration D) loop of Henle diffusion
C) glomerular filtration
Where is filtrate produced in the nephron? A) vasa recta B) juxtaglomerular complex C) glomerulus D) peritubular capillaries
C) glomerulus
What two structures constitute the renal corpuscle? A) proximal convoluted tubule and nephron loop B) glomerulus and renal tubule C) glomerulus and glomerular (Bowman's) capsule D) renal tubule and collecting duct
C) glomerulus and glomerular (Bowman's) capsule
The entrance into the kidney is called the _____. A) sinus B) renal column C) hilum D) pyramid
C) hilum
Excretion of dilute urine requires ________. A) the presence of ADH B) relative permeability of the distal tubule to water C) impermeability of the collecting tubule to water D) transport of sodium and chloride ions out of the descending loop of Henle
C) impermeability of the collecting tubule to water
What results from increased levels of aldosterone? A) decreased Na+ reabsorption B) increased K+ reabsorption C) increased Na+ reabsorption D) increased Ca2+ reabsorption
C) increased Na+ reabsorption
The fluid that bathes the cells found in tissues is called __________. A) plasma B) intracellular fluid C) interstitial fluid D) electrolytic fluid
C) interstitial fluid
The glomerulus differs from other capillaries in the body in that it ________. A) has a basement membrane B) is impermeable to most substances C) is drained by an efferent arteriole D) has a blood pressure much lower than other organ systems
C) is drained by an efferent arteriole
Overall, which of the following pressures is ultimately responsible for glomerular filtration? A) blood colloid osmotic pressure B) capsular hydrostatic pressure C) net filtration pressure D) glomerular hydrostatic pressure
C) net filtration pressure
Which of the following is not a chemical buffer system? A) bicarbonate B) phosphate C) nucleic acid D) protein
C) nucleic acid
What causes urine to flow from the kidneys to the bladder? A) gravity B) hydrostatic pressure C) peristalsis D) osmotic pressure
C) peristalsis
Which part of the brain controls the micturition reflex? A) medulla oblongata B) cerebrum C) pons D) hypothalamus
C) pons
Which of the following is an electrolyte? A) glucose B) cholesterol C) potassium D) phospholipid
C) potassium
Where in the nephron does most solute reabsorption occur? A) collecting duct B) glomerulus C) proximal convoluted tubule D) distal convoluted tubule
C) proximal convoluted tubule
What is the most important trigger for aldosterone release? A) increased osmolality of the extracellular fluids (ECF) B) decreased K+ concentration in the extracellular fluids (ECF) C) renin-angiotensin-aldosterone mechanism D) decreased sodium ion concentration in the extracellular fluids (ECF)
C) renin-angiotensin-aldosterone mechanism
What is the effect of hyperventilation on pH? A) metabolic acidosis B) metabolic alkalosis C) respiratory alkalosis D) respiratory acidosis
C) respiratory alkalosis
Which vessel is present in the arterial pathway as blood flows into the kidney but NOT present in the venous pathway exiting the kidney? A) interlobar B) cortical radiate C) segmental D) arcuate
C) segmental
Hypersecretion of aldosterone results in hypokalemia, which causes hyperpolarization of neurons; this in turn results in ______. A) increased speed of sodium-potassium pump activity in order to compensate for the reduced concentration of potassium ions B) decreased plasma membrane permeability to potassium ions C) the need for a stronger than normal stimulus in order to trigger an action potential D) a craving for more salt in the diet
C) the need for a stronger than normal stimulus in order to trigger an action potential To trigger an action potential cells must reach threshold (critical electrical value required to open voltage-gated ion channels). If the membrane potential is hyperpolarized and falls below normal resting membrane potential, then more cations must enter the cytoplasm for the cell to reach threshold.
In order to buffer a strong acid into a weak acid, which has a less dramatic effect on pH, what chemical should be used as the buffer? A) salt B) weak acid C) weak base D) water
C) weak base
6. Which of the following indicates the parts of a renal tubule in the correct sequence from beginning to end? A. Proximal convoluted tubule, ascending limb, descending limb, distal convoluted tubule B. Distal convoluted tubule, ascending limb, descending limb, proximal convoluted tubule C. Proximal convoluted tubule, descending limb, ascending limb, distal convoluted tubule D. Collecting duct, proximal convoluted tubule, descending limb, ascending limb, distal convoluted tubule E. Ascending convoluted tubule, proximal limb, descending convoluted tubule, distal limb.
C. Proximal convoluted tubule, descending limb, ascending limb, distal convoluted tubule
23. Which choice describes the countercurrent mechanism of the nephron loop? A. Water moves out of the ascending limb; sodium moves in the ascending limb B. Water moves in the ascending limb; sodium moves out of the ascending limb C. Water moves out of the descending limb; sodium moves out of the ascending limb D. Water moves in the descending limb; sodium moves out of the descending limb E. Water moves out of the descending limb; calcium moves out of the ascending limb
C. Water moves out of the descending limb; sodium moves out of the ascending limb
19. Most hydrogen ions are secreted A. passively into the proximal convoluted tubule. B. passively from the distal convoluted tubule. C. actively into the entire renal tubule. D. actively from the distal convoluted tubule. E. endocytotically in the nephron loop.
C. actively into the entire renal tubule.
39. Water channels in cell membranes formed by __________ are a result of ADH signaling in the kidneys. A. podocytes B. cytopores C. aquaporins D. pyrogens E. ring proteins
C. aquaporins
61. Conscious control of micturition inhibits the micturition reflex by using nerve centers in the A. medulla oblongata. B. spinal cord. C. brainstem and cerebral cortex. D. pons and hypothalamus. E. kidneys and bladder.
C. brainstem and cerebral cortex.
63. The micturition reflex can be voluntarily controlled by the A. person controlling contraction and relaxation of the pyloric sphincter valve. B. sympathetic impulses stimulating the internal urethral sphincter valve. C. cerebral cortex stimulating or inhibiting the external urethral sphincter valve. D. voluntary contractions or inhibition of the prostate gland. E. spinal cord
C. cerebral cortex stimulating or inhibiting the external urethral sphincter valve
65. Kidney stones are least likely to be composed of A. uric acid. B. calcium oxalate. C. cholesterol. D. magnesium phosphate. E. calcium phosphate
C. cholesterol.
27. Aldosterone from the adrenal cortex causes sodium ions to be A. excreted and water to be conserved. B. excreted and water to be excreted. C. conserved and water to be conserved. D. conserved and water to be excreted. E. unchanged in concentration.
C. conserved and water to be conserved.
37. An increase in urine volume is termed A. anuresis. B. dialysis. C. diuresis. D. urinary edema. E. plasmaphoresis.
C. diuresis.
70. Chronic glomerulonephritis is inflammation of the A. glomerular capsule. B. peritubular capillaries. C. glomerular capillaries. D. collecting ducts. E. bladder.
C. glomerular capillaries
28. Michael is 26 years old. He becomes dehydrated after a long run if he has not drunk enough. His infant son Sean, however, becomes dehydrated fairly frequently. This difference in susceptibility to dehydration is because A. adults drink more liquid. B. infants grow rapidly. C. infant kidneys are less able to conserve water. D. the infant thirst mechanism is underdeveloped. E. Sean has inherited a kidney disease from his father.
C. infant kidneys are less able to conserve water.
42. After work Linda relaxes by drinking two beers, and soon has to urinate. The alcohol is a diuretic because it A. activates distal tubular sodium secretion. B. inhibits aldosterone secretion. C. inhibits ADH secretion. D. activates chloride ion reabsorption. E. promotes ADH secretion.
C. inhibits ADH secretion.
14. The reabsorption of glucose occurs primarily through the walls of the A. glomerular capsule. B. nephron loop. C. proximal convoluted tubule. D. distal convoluted tubule. E. renal duct.
C. proximal convoluted tubule.
29. A renal clearance test determines the rate at which the kidneys can A. excrete water. B. reabsorb ions. C. remove a particular substance from the blood. D. restore the correct pH of the blood. E. add a substance to the blood.
C. remove a particular substance from the blood.
13. Once in the glomerulus, the filtrate moves into the A. renal pelvis. B. renal calyx. C. renal tubule. D. ureter. E. bladder.
C. renal tubule.
32. The juxtaglomerular apparatus regulates the filtration rate by _____ and by ____. A. vasodilation of the afferent arteriole; increasing osmotic pressure in the glomerular capsule B. vasoconstriction of the peritubular capillary; dilation of the collecting duct C. vasodilation of the afferent arteriole; renin-angiotensin II vasoconstricting the renal artery D. vasoconstriction of the afferent arteriole; vasoconstriction of the ureters. E. all of the above; depending on conditions.
C. vasodilation of the afferent arteriole; renin-angiotensin II vasoconstricting the renal artery
In an exercising individual, the afferent arteriole will
CONSTRICT to avoid excess fluid loss
Perirenal Fat Capsule
Cushions against blows
11) The descending limb of the loop of Henle ________. A) is not permeable to water B) is freely permeable to sodium and urea C) pulls water by osmosis into the lumen of the tubule D) contains fluid that becomes more concentrated as it moves down into the medulla
D
16) The juxtaglomerular apparatus is responsible for ________. A) the secretion of drugs B) the secretion of acids and ammonia C) reabsorption of organic molecules, vitamins, and water D) regulating the rate of filtrate formation and controlling systemic blood pressure
D
24) The macula densa cells respond to ________. A) aldosterone B) antidiuretic hormone C) changes in pressure in the tubule D) changes in solute content of the filtrate
D
25) Which of the following is not reabsorbed by the proximal convoluted tubule? A) Na+ B) K+ C) glucose D) creatinine
D
26) The fluid in the glomerular (Bowmanʹs) capsule is similar to plasma except that it does not contain a significant amount of ________. A) glucose B) hormones C) electrolytes D) plasma protein
D
27) Alcohol acts as a diuretic because it ________. A) is not reabsorbed by the tubule cells B) increases the rate of glomerular filtration C) increases secretion of ADH D) inhibits the release of ADH
D
31) 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 A) 3, 1, 2, 6, 5, 4 B) 6, 3, 2, 1, 5, 4 C) 2, 1, 3, 6, 5, 4 D) 3, 6, 2, 1, 5, 4
D
37) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________. A) facilitated diffusion B) passive transport C) countertransport D) secondary active transport
D
40) Which of the following best describes kidney function in older adults (70 years or older)? A) Kidney function remains the same throughout life, regardless of age. B) Only about 3% of older adults have any loss of kidney function. C) Only obese and diabetic older adults have any kidney dysfunction. D) Kidney function decreases due to kidney atrophy.
D
46) In the ascending limb of the loop of Henle ________. A) the thin segment is freely permeable to water B) the thick segment is permeable to water C) the thin segment is not permeable to sodium and chloride D) the thick segment moves ions out into interstitial spaces for reabsorption
D
49. Shigatoxin is associated with A. Balkan endemic nephropathy. B. urinary tract infection. C. edema. D. hemolytic uremic syndrome. E. hair loss.
D
51. Marvin goes on vacation to Maine and for a week eats nothing but seafood. The next week, he experiences intense pain in his big toe. He probably has A. Balkan endemic nephropathy. B. diuresis. C. edema. D. gout. E. an ingrown toenail.
D
57. Which of the following is not part of the male urethra? A. Prostatic urethra B. Membranous urethra C. Penile urethra D. Ductus deferens E. Mucous membrane
D
59. The detrusor muscle is in the A. ureter. B. urethra. C. brain. D. urinary bladder. E. kidneys.
D
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 A) 2, 1, 3, 6, 5, 4 B) 3, 1, 2, 6, 5, 4 C) 6, 3, 2, 1, 5, 4 D) 3, 6, 2, 1, 5, 4
D) 3, 6, 2, 1, 5, 4
Which of the following creates the greatest osmotic pressure? A) NaCl B) MgCl2 C) glucose D) H3PO4
D) H3PO4
What is the most common cation found in the interstitial fluid? A) K+ B) HPO42- C) Cl- D) Na+
D) Na+
Which of the following is NOT one of the things that must happen for micturition to occur? A) The detrusor muscle must contract. B) The internal urethral sphincter must open. C) The external urethral sphincter must open. D) The extrusor muscle must relax.
D) The extrusor muscle must relax. There is no "extrusor" muscle; only the detrusor muscle.
A nonfasting urine sample from an individual who has previously ingested 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? A) Some glucose is always present in the urine. B) The individual has diabetes mellitus. C) The individual is glucose intolerant. D) The individual exceeded the transport maximum.
D) The individual exceeded the transport maximum.
What is the function of the macula densa cells of the juxtaglomerular complex (JGC)? A) The macula densa cells produce filtrate. B) The macula densa cells pass regulatory signals between other cells of the juxtaglomerular complex. C) The macula densa cells sense blood pressure in the afferent arteriole. D) The macula densa cells monitor the NaCl content of the filtrate entering the distal convoluted tubule.
D) The macula densa cells monitor the NaCl content of the filtrate entering the distal convoluted tubule.
A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema? A) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the pulmonary circulation, leading to edema. B) The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the pulmonary circulation, leading to edema. C) The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the systemic circulation, leading to edema. D) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
D) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
Select the correct statement about the ureters. A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine. B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. C) The ureter is innervated by parasympathetic nerve endings only. D) The ureters are capable of peristalsis like that of the gastrointestinal tract.
D) The ureters are capable of peristalsis like that of the gastrointestinal tract.
Annie has just eaten a large order of heavily salted french fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology? A) There will be a shift in the pH of her body fluids to the higher side of the pH scale. B) She will experience hypotension. C) It will cause a prolonged increase in the osmolality of the blood. D) There will be a temporary increase in blood volume.
D) There will be a temporary increase in blood volume.
The term hypotonic hydration refers to ________. A) the feeling one might have after profuse sweating with exertion B) the unpleasant feeling people have after drinking too much liquor C) a condition that is caused by high levels of sodium in the extracellular fluid compartment D) a condition that may result from renal insufficiency or drinking extraordinary amounts of water
D) a condition that may result from renal insufficiency or drinking extraordinary amounts of water
What hormone promotes active tubular secretion of potassium ions in the late distal convoluted tubule (DCT) and collecting ducts? A) antidiuretic hormone (ADH) B) atrial natriuretic peptide (ANP) C) parathyroid hormone (PTH) D) aldosterone
D) aldosterone
Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) renin B) erythropoietin C) antidiuretic hormone D) aldosterone
D) aldosterone
Which of the following does not depend on the presence of electrolytes? A) membrane polarity B) neuromuscular excitability C) maintenance of osmotic relations between cells and ECF D) amount of body fat
D) amount of body fat
Which of the choices below is not an essential role of salts in the body? A) secretory activity B) membrane permeability C) neuromuscular activity D) anabolism of lipids
D) anabolism of lipids
A patient is discovered to have a strange craving for iron objects. To try to determine the cause, her physician decides to order tests to determine if this patient might have some type of ______. A) hypothyroidism B) diabetes C) acidosis D) anemia
D) anemia Anemia is a condition where red blood cells have an abnormally low oxygen carrying capacity. This capacity depends on the iron content within the hemoglobin molecule.
Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion? A) angiotensin I and epinephrine B) angiotensin I and atrial natriuretic peptide C) angiotensin II and ADH D) angiotensin II and aldosterone
D) angiotensin II and aldosterone
Where does antidiuretic hormone (ADH) exert its effects to promote water reabsorption? A) descending limb of the nephron loop B) distal convoluted tubule (DCT) C) ascending limb of the nephron loop D) collecting duct
D) collecting duct
The descending limb of the loop of Henle ________. A) is not permeable to water B) is freely permeable to sodium and urea C) pulls water by osmosis into the lumen of the tubule D) contains fluid that becomes more concentrated as it moves down into the medulla
D) contains fluid that becomes more concentrated as it moves down into the medulla
Which muscle metabolism waste product is eliminated by the kidneys? A) urea B) uric acid C) creatine D) creatinine
D) creatinine
A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________. A) diabetic acidosis B) coma C) diabetes mellitus D) diabetes insipidus
D) diabetes insipidus
Upon reaching what point in the nephron is reabsorption (1) dependent upon the body's needs at the time, and (2) regulated by hormones? A) ascending limb of the loop of Henle B) proximal convoluted tubule C) descending limb of the loop of Henle D) distal convoluted tubule
D) distal convoluted tubule
In what part of the renal tubule does parathyroid hormone (PTH) promote the reabsorption of calcium ions? A) proximal convoluted tubule (PCT) B) descending limb of the nephron loop C) collecting duct D) distal convoluted tubule (DCT)
D) distal convoluted tubule (DCT)
What solute in body fluids determines most of their chemical and physical reactions? A) glucose B) nonelectrolytes C) water D) electrolytes
D) electrolytes
Which of the choices below is not a function of the urinary system? A) regulates blood glucose levels and produces hormones B) maintains blood osmolarity C) helps maintain homeostasis by controlling the composition, volume, and pressure of blood D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
Which of the choices below is not a function of the urinary system? A) helps maintain homeostasis by controlling the composition, volume, and pressure of blood B) regulates blood glucose levels and produces hormones C) maintains blood osmolarity D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
What is the most direct function of the juxtaglomerular apparatus? A) help regulate blood pressure and the rate of excretion by the kidneys B) help regulate water and electrolyte excretion by the kidneys C) help regulate urea absorption by the kidneys D) help regulate blood pressure and the rate of blood filtration by the kidneys
D) help regulate blood pressure and the rate of blood filtration by the kidneys
Which age group most commonly has fluid, electrolyte, and acid-base balance issues? A) growing children B) young adults C) the elderly D) infants
D) infants
Which blood vessel conveys blood out of the nephron? A) efferent arteriole B) vasa recta C) peritubular capillary D) interlobular vein
D) interlobular vein
The glomerulus differs from other capillaries in the body in that it ________. A) has a blood pressure much lower than other organ systems B) is impermeable to most substances C) has a basement membrane D) is drained by an efferent arteriole
D) is drained by an efferent arteriole
The regulation of sodium ________. A) involves hypothalamic osmoreceptor detection of ion concentration B) involves aldosterone, a hormone that increases sodium excretion in the kidneys C) is due to specific sodium receptors in the hypothalamus D) is linked to blood pressure
D) is linked to blood pressure
Which of these could appear in the urine from dieting or the utilization of excess lipids? A) urea B) uric acid C) glycine D) ketone
D) ketone
What receptors does the brain use to detect changes in osmolality? A) chemoreceptors B) thermoreceptors C) baroreceptors D) osmoreceptors
D) osmoreceptors
Renal secretion of a compound usually occurs from the _____ into the distal convoluted tubule. A) loop of Henle B) glomerulus C) vasa recta D) peritubular capillaries
D) peritubular capillaries
The fluid link between the external and internal environment is ________. A) intracellular fluid B) cerebrospinal fluid C) interstitial fluid D) plasma
D) plasma
Which of the following is not a part of the juxtaglomerular apparatus? A) macula densa B) mesangial cells C) granular cells D) podocyte cells
D) podocyte cells
The single most important factor influencing potassium ion secretion is ________. A) intracellular sodium levels B) the potassium ion content in the renal tubule cells C) the pH of the ICF D) potassium ion concentration in blood plasma
D) potassium ion concentration in blood plasma
Which of the three parts of the renal tubule is formed by cuboidal epithelial cells bordered by dense microvilli? A) distal convoluted tubule B) nephron loop C) collecting duct D) proximal convoluted tubule
D) proximal convoluted tubule
In which kidney region are all renal corpuscles located? A) renal columns B) renal medulla C) renal pelvis D) renal cortex
D) renal cortex
The kidneys are located in the _____ space. A) pelvic cavity B) peritoneal cavity C) abdominal D) retroperitoneal
D) retroperitoneal
Which of the choices below is the least important role of tubular secretion? A) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes B) ridding the body of excessive potassium ions C) disposing of substances not already in the filtrate, such as certain drugs D) ridding the body of bicarbonate ions
D) ridding the body of bicarbonate ions
An important characteristic of urine is its specific gravity or density, which is ________. A) the same as water B) much higher than water C) less than water D) slightly higher than water
D) slightly higher than water
What is the driving force for water intake? A) ADH B) aldosterone C) glucose concentration D) thirst
D) thirst
What type of epithelial tissue forms the mucosa layer of the urinary bladder? A) pseudostratified columnar epithelium B) simple squamous epithelium C) stratified squamous epithelium D) transitional epithelium
D) transitional epithelium
What is the largest component of urine by weight, other than water? A) creatine B) phosphates C) salt D) urea
D) urea
36. Glomerular filtration produces about ________ liters of fluid in twenty-four hours. A. 40 B. 96 C. 144 D. 180 E. 240
D. 180
1. Which of the following is not a function of the kidneys? A. Maintaining volume, pH, and composition of body fluids within normal ranges. B. Removal of excess chemicals. C. Removal of metabolic wastes. D. Synthesis of plasma proteins. E. Removal of drug metabolites.
D. Synthesis of plasma proteins.
31. Filtration rate in the glomerulus is increased by A. vasodilation of the afferent arteriole only. B. vasoconstriction of the efferent arteriole only. C. both vasodilation and vasoconstriction of the efferent arteriole. D. both vasodilation of the afferent arteriole and vasoconstriction of the efferent arteriole. E. none of the above.
D. both vasodilation of the afferent arteriole and vasoconstriction of the efferent arteriole.
25. As a result of very low arterial blood pressure, glomerular hydrostatic pressure A. rises and filtration increases. B. rises and filtration decreases. C. drops and filtration increases. D. drops and filtration decreases. E. does not change
D. drops and filtration decreases.
15. When plasma glucose concentration exceeds the renal plasma threshold, A. the glomerular filtration rate increases. B. the volume of urine decreases. C. glucose is secreted into the peritubular capillary. D. glucose appears in the urine. E. glucose disappears from the urine.
D. glucose appears in the urine.
33. An adaptation of the epithelial cells of the proximal convoluted tubule for reabsorption is A. thin walls. B. rugae folds that increase surface area. C. secreting enzymes that activate absorption of substances. D. microscopic projections called microvilli. E. microscopic invaginations.
D. microscopic projections called microvilli.
17. The countercurrent mechanism functions primarily in the A. renal corpuscle. B. proximal convoluted tubule. C. distal convoluted tubule D. nephron loop. E. ureters.
D. nephron loop.
68. Which of the following does not occur with aging of the urinary system? A. decreased GFR. B. renal tubules become encased in fat. C. fibrous connective tissue accumulates around the kidney capsule. D. nephrons invert. E. decrease in surface area for filtration
D. nephrons invert.
2. The organs of the urinary system are A. the renal cortex, renal pelvis, and renal medulla. B. the glomerular capsule, proximal convoluted tubule, the nephron loop, distal convoluted tubule, and the collecting duct. C. a kidney, a ureter, and paired bladders and urethras. D. paired kidneys, paired ureters, a bladder and a urethra. E. the penis, the vagina, the uterus, and the hilum.
D. paired kidneys, paired ureters, a bladder and a urethra.
9. The renal medulla is composed of _____, whereas the renal cortex is composed of _____. A. renal pyramids; ureters from nephrons B. renal columns; renal pyramids and nephrons C. collecting tubules; peritubular capillaries from nephrons D. renal pyramids; nephron tubules E. strings; strands
D. renal pyramids; nephron tubules
38. If glucose is not reabsorbed in the tubular fluid ___________ increases. A. hydrostatic pressure B. glomerular filtration rate C. the rate of urine production D. the osmotic concentration E. none of the above.
D. the osmotic concentration
The osmolarity of the filtrate
DECREASES as it flows through the distal convoluted tubule
Drinking a lrg amount of beer results in:
Decreased urine osmolality & Increased urine volume
Total water content ____ throughout life.
Decreases
What happens tot he osmolarity of the filtrate as it moves up the ascending limb of the loop of Henle?
Decreasing osmolarity
Low osmolarity in the ascending limb of the loop of Henle will cause the afferent arteriole to:
Dilate
Which statement best describes the effect diuretics have?
Diuretics increase urinary output.
A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Why did she get these symptoms? A) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing fluid correctly. B) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing electrolytes correctly. C) The abuse of laxatives and self-induced vomiting caused her to be chronically electrolyte depleted. She developed a compensatory increased production of aldosterone. D) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid depleted. She developed a compensatory increased production of ADH. E) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.
E) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.
A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. A medical history reveals that this patient is a chronic alcoholic. What diagnosis would you give, and what prognosis? A) The pH and bicarbonate levels and the history of alcoholism indicate metabolic alkalosis. The patient will require dialysis to remove the bicarbonate ions. B) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will require dialysis to remove the bicarbonate ions. C) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will go into a coma and death soon follows. D) The pH and bicarbonate levels and the history of alcoholism indicate respiratory alkalosis. The patient will require dialysis to remove the bicarbonate ions. E) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.
E) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.
21. In which of the following regions of the nephron is water actively transported? A. Proximal convoluted tubule B. Descending limb of the nephron loop C. Collecting duct D. Peritubular capillaries. E. None of the above
E. None of the above
22. Which of the following is an abnormal constituent of urine? A. Urea B. Uric acid C. Creatinine D. Water E. None of the above
E. None of the above
8. A biochemical important in glomerulus formation in the embryo is A. ADH. B. ADP. C. renin. D. aquaporin. E. VEGF
E. VEGF
11. Podocytes and pedicels are part of the A. collecting duct. B. distal convoluted tubule. C. urethra. D. peritubular capillaries. E. glomerular capsule.
E. glomerular capsule.
Made up of 2 compartments.
ECF and ICF
Efferent arterioles
Exit; smaller diameter than afferent
Skeletal muscle that surrounds the urethra as it extends through the pelvic floor is the
External urinary sphincter
Aldosterone, angiotensin II, and ADH all work toward lowering blood pressure. True or False
False
An excessive urine output is called anuria.
False
Angiotensin II is a substance made by the body to lower blood pressure during stress.
False
Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water.
False
Both the male and female urethras serve the urinary and the reproductive systems.
False
Fetal kidneys have the primary responsibility of clearing wastes from the fetal blood.
False
Glomerular filtration is an ATP-driven process.
False
Having a kinked ureter is called renal ptosis.
False
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
Major calyces are large branches of the renal column.
False
The collecting duct is impermeable to water in the presence of ADH.
False
The descending limb of the loop of Henle is permeable to both solutes and water.
False
The functional unit of the kidney is the renal column.
False
The glomerular filtration rate is approximately 350 ml/min.
False
The kidney consumes about 15% of all oxygen used by the body at rest.
False
The leading cause of chronic renal disease is hypertension.
False
The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate.
False
The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.
False
The path urine takes after it is formed until it leaves the body is the urethra, urinary bladder, and finally the ureter.
False
The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.
False
The trigone is so named because of the shape of the urinary bladder.
False
The two fluid compartments of the body are the plasma and interstitial fluid. True or False
False
Urea is reabsorbed in the loop of Henle.
False
Ureters, like the urethra, are lined only with transitional epithelium.
False
Name the tubular components of a nephron in the order that filtrate passes through them
Filtrate is formed in the glomerular capsule and then passes through the proximal convoluted tube, the descending & ascending limbs of the loop of Henle and the distal convoluted tubule
If a vasoconstrictor is released as a result of high osmolarity of the filtrate sensed at the macula densa, what happens to GFR?
GFR decreases
In periods of extreme stress
GFR decreases
List several substances that are secreted into the kidney tubules:
H+, K+, NH4+, creatine, urea, uric acid
In dehydration, what would be the level of ADH
HIGH
In severe dehydration or blood loss, what would the level of ADH be?
HIGH
The kidneys
Help regulate blood volume Help control blood pressure Help control pH
Anuria
Homeostatic imbalance indicative that glomerular blood pressure is too low to cause filtration
ECFs: Sodium is the chief cation Chloride is the major anion Exception = plasma proteins What is ICFs?
ICF Potassium is the chief cation Phosphate is the chief anion
The ascending loop of Henle is
IMPERMEABLE to water
The osmolarity of the filtrate
INCREASES as it flows through the proximal convoluted tubule
Angiotensin II causes
Increased ADH secretion Increased thirst Increased salt appetite Increased peripheral resistance
Extrinsic & intrinsic controls of GFR serve 2 different purposes: what are they?
Intrinsic controls serve to maintain a nearly constant GFR in spite of changes in systemic blood pressure. Extrinsic controls serve to maintain systemic blood pressure.
Which of the following is not true regarding tubular reabsorption?
It is a purely passive transport process.
Which of the following does not describe the juxtaglomerular complex?
Its macula densa cells produce aldosterone.
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.
In diabetes insipidus, what would be the level ADH be
LOW
In overhydration, what would be the levels of ADH
LOW
Where is the locationof the external urethral sphincter in the male
Membranous urethra
Slightly basic pH
NOT a physical characteristic of freshly voided urine
Large Proteins
NOT filtered at the glomerular capillaries
Which is reabsorbed by the proximal convoluted tubule cells?
Na+ K+ amino acids
What portion of the nephron extends into the medulla?
Nephron loop
Juxtamedullary Nephrons
Nephrons with well-developed loops of Henle that extend deeply into the renal medulla.
What would happen if the capsular hydrostatic pressure were increased above normal? A) Capsular osmotic pressure would compensate so that filtration would not change. B) Filtration would increase in proportion to the increase in capsular pressure. C) Net filtration would increase above normal. D) Net filtration would decrease.
Net filtration would decrease
What would happen if the capsular hydrostatic pressure were increased above normal?
Net filtration would decrease.
If one says that the clearance value of glucose is zero, what does this mean?
Normally all the glucose is reabsorbed.
Bottom of the loop of Henle
Osmolaity of the filtrate is the highest
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 colloid osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema.
Cortical Nephrons
Represent 85% of the nephrons in the body. Except for small parts of their loops of Henle that dip into the outer medulla, they are located entirely in the cortex.
Where is the micturation center
Sacra spinal cord
What increases the osmolarity of the interstitium
Sodium is transported form the tubular cell into the interstitium
How does glucose move through the luminal membrane into the proximal tubule cell?
Sodium/glucose cotransport carrier
The NFP is the chief force pushing water & solutes out of the blood & across the filtration membrane
TRUE
The opposing flow of filtrate in the ascending & descending limbs of the loop of Henle forms and maintains an osmotic gradient in the medulla, which is essential for what?
The ability to concentrate the urine
Which of the following is NOT one of the things that must happen for micturition to occur?
The extrusor muscle must relax.
Which of the following is NOT characteristic of the cortical nephrons?
The glomerulus of the cortical nephron is closer to the cortex-medulla junction.
A nonfasting urine sample from an individual who has previously ingested 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.
What is the function of the macula densa cells of the juxtaglomerular complex (JGC)?
The macula densa cells monitor the NaCl content of the filtrate entering the distal convoluted tubule.
Select the correct statement about the nephrons.
The parietal layer of the glomerular capsule is simple squamous epithelium.
Select the correct statement about the ureters.
The ureters are capable of peristalsis like that of the gastrointestinal tract.
Which statement best describes the function of the urethra?
The urethra transports urine from the bladder to the outside of the body.
Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.
True
Atrial naturetic factor inhibits sodium reabsorption.
True
Atrial naturetic peptide inhibits sodium reabsorption.
True
Blood in the urine may be a symptom of bladder cancer.
True
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
ECF and ICF are connected via the plasma. True or False
True
Glomerular hydrostatic pressure (HPg) is the chief force pushing water and solutes out of the blood and across the filtration membrane.
True
In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water.
True
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
Incontinence is the inability to control voluntary micturition.
True
Insensible water loss involves direct diffusion through skin and vaporization via the lungs. True or False
True
Obligatory water reabsorption involves the movement of water along an osmotic gradient.
True
Particles smaller than 3 nanometers are passed into the filtrate.
True
Potassium is the major cation of the intercellular fluid. True or False
True
The act of emptying the bladder is called voiding.
True
The buffer systems of the body include proteins, bicarbonate and phosphates. True or False
True
The entire responsibility for urine formation lies with the nephron.
True
The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.
True
The terminal portion of the urinary system is the urethra.
True
The ureter transports urine from the kidney to the urinary bladder.
True
The urethra contains an internal sphincter of smooth muscle.
True
Tubular secretion is effective in controlling blood pH.
True
Under normal conditions, the large renal arteries deliver one-fourth of the total cardiac output (about 1200 ml) to the kidneys each minute.
True
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
Urine is 95% water by volume.
True
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
The urinary system is the principal system responsible for
Water & Electrolyte balance & Excretion of toxic nitrogenous compounds
If a freshly voided urine sample contains excessive amounts of urochrome it has
a dark yellow color
If a freshly voided urine sample contains excessive amounts of urochrome, it has
a dark yellow color
Glomerular filtration
a passive process in which hydrostatic pressure forces fluids and solutes through a membrane
What is the juxtaglomerular apparatus?
a system that regulates the rate of filtrate formation and systemic blood pressure
Perirenal Fat Capsule
a transparent capsule that prevents infections in surrounding regions from spreading to the kidney
Which of the following is not associated with the renal corpuscle?
a vasa recta
pH of intracellular fluid is a. 7 b. 7.3 c. 7.5 d. 7.35
a. 7
Two ions produced during catabolism of glutamine a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
a. ammonium ions b. bicarbonate
Two substances secreted into the proximal convoluted tubules in exchange for sodium ions a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
a. ammonium ions e. hydrogen ions
Which of the following factors will enhance ADH release? a. decrease in ECF volume b. increase in ECF volume c. increase in ECF osmolality d. decrease in ECF osmolality
a. decrease in ECF volume c. increase in ECF osmolality
Potassium, magnesium, and phosphate ions are the predominant electrolytes in a. intracellular fluid b. interstitial fluid c. plasma
a. intracellular fluid
In an individual with metabolic acidosis, a clue that the respiratory system is compensating is provided by a. rapid, deep breathing b. slow, shallow breathing c. high blood bicarbonate levels d. low blood bicarbonate levels
a. rapid, deep breathing
12% of newborns have
abnormalities of the urinary system
Tubular Secretion
active transport of substances from the blood into the nephron
What vessel directly feeds into the glomerulus?
afferent arteriole
What hormone promotes active tubular secretion of potassium ions in the late distal convoluted tubule (DCT) and collecting ducts?
aldosterone
Renal Fascia
an outer layer of dense fibrous connective tissue that anchors the kidney and the adrenal gland to surrounding structures
Urinary incontinence may occur if a person has ______.
an overactive detrusor muscle
Urea diffuses out of the COLLECTING DUCT
and into the DESCENDING limb of the loop of Henle
Water moves out of the nephron
and solutes move into the nephron (in the loop of Henle)
Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion?
angiotensin II and aldosterone
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
The ________ artery lies on the boundary between the cortex and medulla of the kidney.
arcuate
H+ ions
are actively transported into the filtrate in the proximal & distal tuble
Macula densa cells
are chemoreceptors that respond to changes in the NaCl.
K+ ions & Cl- ions
are cotransported across the apical membrane in the ascending limb of the loop of Henle
The glomerular capillaries differ from other capillary networks in the body because they
are derived from and drain into arterioles
Microscopic AFFERENT glomerular arterioles
arise from branches of the interlobular arteries & lead to the glomeruli
In what part of the renal tubule are aquaporins scarce or absent so that water CANNOT be reabsorbed?
ascending limb of the nephron loop
pH of venous blood and interstitial fluid is a. 7 b. 7.35 c. 7.55 d. 7.45
b. 7.35
Release of ____ triggers the reabsorption of water in the renal collecting ducts. a. cortisol b. ADH c. ANP d. aldosterone
b. ADH
Part of an important chemical buffer system in plasma a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
b. bicarbonate
The radio show that held the "Hold your wee for a Wii" contest, put individuals in danger of a. hypertonic hydration b. hypotonic hydration
b. hypotonic hydration
Body water content is greatest in a. young adults b. infants c. elderly adults
b. infants
Water balance is regulated by control of amount(s) a. lost in feces b. ingested c. excreted in urine d. lost in perspiration
b. ingested c. excreted in urine
The ultimate acid-base regulatory organs are the ______ a. lungs b. kidneys c. heart
b. kidneys
Vasa Recta
bundles of long straight vessels; extend deep into the medulla paralleling the longest loops of Henle
The kidneys are stimulated to produce renin ________.
by a decrease in the blood pressure
Describe 2 main ways in which angiotensin II increases blood pressure & blood volume:
by causing vasoconstriction and by causing aldosterone release
Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?
by secreting sodium ions
Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH? A) by secreting hydrogen ions into the filtrate B) by secreting sodium ions C) by producing new bicarbonate ions D) by reabsorbing filtered bicarbonate ions
by secreting sodium ions
The pH of blood varies directly with a. PCO2 b. H+ c. HCO3 d. none of the above
c. HCO3
Two substances regulated by parathyroid hormone a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
c. calcium g. phosphate
Sodium balance is regulated primarily by control of amount(s) a. lost in feces b. ingested c. excreted in urine d. lost in perspiration
c. excreted in urine
The __________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the __________.
calyces; renal pelvis
Hemoglobin
cannot pass through the filtration membrane
Filtration membrane is formed by:
capillary epithelium, basement membrane & podocytes
Filtration at the glomerulus is inversely related to
capsular hydrostatic pressure
The macula densa cells respond to ________.
changes in solute content of the filtrate
Where does antidiuretic hormone (ADH) exert its effects to promote water reabsorption?
collecting duct
Damage to the renal medulla would interfere first with the functioning of the
collecting ducts
The function of angiotensin II is to ________.
constrict arterioles and increase blood pressure
The function of angiotensin II is to ________. A) decrease the production of aldosterone B) constrict arterioles and increase blood pressure C) decrease water absorption D) decrease arterial blood pressure
constrict arterioles and increase blood pressure
ADH
controls the permeability of the distal tubule & collecting duct
What arteries branch off the arcuate arteries?
cortical radiate (interlobular) arteries
Which vessels supply the cortical tissue of the kidney with blood?
cortical radiate arteries
Which of the following is not reabsorbed by the proximal convoluted tubule?
creatinine
Which of the following is not reabsorbed by the proximal convoluted tubule? A) K+ B) Na+ C) glucose D) creatinine
creatinine
Physiological acidosis occurs at pH < ____ a. 7.45 b. 7.5 c. 7 d. 7.35
d. 7.35
pH of arterial blood is a. 6 b. 7.0 c. 7.5 d. 7.4
d. 7.4
_______ is the most common cause of acid base imbalance. a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory alkalosis d. Metabolic acidosis
d. Metabolic acidosis
High aldosterone = _____ Na+ is actively reabsorbed a. some b. none c. half d. all
d. all
Renal Medulla
darker, brown area of kidney, cone shaped tissue masses called pyramids
A decrease in plasma proteins results in:
decreased colloid osmotic pressure
Which of the following promotes the formation of dilute urine?
decreased osmolality of extracellular fluids
Renal Arteries
deliver 1/4 of the total cardiac output to the kidneys each minute
A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________.
diabetes insipidus
GFR
directly proportional to the net filtration pressure and is about 125 ml/min (180 L/day)
Upon reaching what point in the nephron is reabsorption (1) dependent upon the body's needs at the time, and (2) regulated by hormones?
distal convoluted tubule
In what part of the renal tubule does parathyroid hormone (PTH) promote the reabsorption of calcium ions?
distal convoluted tubule (DCT)
Intercalated cells
distal tubule & collecting duct cells secrete hydrogen ions into the filtrate
Chemicals that enhance urinary output are called __________.
diuretics
Which of the choices below is not a glomerular filtration rate control method?
electrolyte levels
Which of the choices below is not a glomerular filtration rate control method? A) hormonal regulation B) renal autoregulation C) neural regulation D) electrolyte levels
electrolyte levels
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
Water intake must ____ water output
equal
4 kidney functions that maintain body homeostasis
excretory functions regulators of volume & chemical makeup of the blood maintain proper balance between water & salts maintain proper balance between acids & bases
Angiotensin II is a substance made by the body to lower blood pressure during stress
false
Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water
false
Glomerular filtration is an ATP-driven process
false
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
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
The collecting duct is impermeable to water in the presence of ADH.
false
The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct
false
The trigone is so named because of the shape of the urinary bladder.
false
Urea is reabsorbed in the loop of Henle
false
Blood hydrostatic pressure
favors filtration at the glomerulus
What type of capillaries make up the glomerulus?
fenestrated
What is the type of capillaries are the glomerular capillaries? What is theri function?
fenestrated capillaries, function is to filter large amounts of plasma into the glomerular capsule
Renal Capsule
fibrous connective tissue that surrounds each kidney
Which of the choices below is a function of the loop of Henle? A) form a large volume of very dilute urine or a small volume of very concentrated urine B) form a large volume of very concentrated urine or a small volume of very dilute urine C) absorb electrolytes actively with an automatic absorption of water by osmosis D) none of these
form a large volume of very dilute urine or a small volume of very concentrated urine
Which of the choices below is a function of the nephron loop?
form a large volume of very dilute urine or a small volume of very concentrated urine
Granular cells
found in the arteriole walls; also called juxtaglomerular cells, enlarged, smooth muscle cells w/ prominent secretory granules containing renin. Granular cells act as mechanoreceptors that sense the blood pressure in the afferent artriole.
Which of the following is the volume of filtrate formed each minute by all of the glomeruli of the kidneys?
glomerular filtration rate (GFR)
The factor favoring filtrate formation at the glomerulus is the ________.
glomerular hydrostatic pressure
The chief force pushing water and solutes out of the blood across the filtration membrane is ________.
glomerular hydrostatic pressure (glomerular blood pressure)
The chief force pushing water and solutes out of the blood across the filtration membrane is ________. A) glomerular hydrostatic pressure (glomerular blood pressure) B) the thickness of the capillary endothelium C) the size of the pores in the basement membrane of the capillaries D) the design and size of the podocytes
glomerular hydrostatic pressure (glomerular blood pressure)
Where is filtrate produced in the nephron?
glomerulus
Which capillary bed produces filtrate?
glomerulus
What two structures constitute the renal corpuscle?
glomerulus and glomerular (Bowman's) capsule
Each nephron contains a __________, which is a tuft of capillaries, and a __________.
glomerulus; renal tubule
Two main substances regulated by the influence of aldosterone on the kidney tubules. a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
h. potassium I. sodium
What is the most direct function of the juxtaglomerular apparatus?
help regulate blood pressure and the rate of blood filtration by the kidneys
Most electrolyte reabsorption by the renal tubules is ________.
hormonally controlled in distal tubule segments
Which pressure is the chief force pushing water and solutes out of the blood and across the filtration membrane of the glomerulus?
hydrostatic pressure in glomerular capillaries (HPgc)
Which of the following congenital abnormalities of the urinary system is found in male infants only?
hypospadias
Excretion of dilute urine requires ________.
impermeability of the collecting tubule to water
Excretion of dilute urine requires ________. A) the presence of ADH B) impermeability of the collecting tubule to water C) relative permeability of the distal tubule to water D) transport of sodium and chloride ions out of the descending loop of Henle
impermeability of the collecting tubule to water
Na+ ions
in the kidney epithelial cells, solutes are cotransported with
In what part of the nephron does the majority of reabsorption occur?
in the proximal convoluted tube
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
Increased ANP secretion
increases amount of urine produced
Which of the following is the most likely to cause pyelonephritis?
infection of the urinary bladder
Cystitis
infection of urinary bladder
Salts enter the body by ____ and are lost via perspiration, feces, and urine absorption ingestion evaporation vaporization
ingestion
Alcohol acts as a diuretic because it ________.
inhibits the release of ADH
Alcohol acts as a diuretic because it ________. A) increases secretion of ADH B) increases the rate of glomerular filtration C) is not reabsorbed by the tubule cells D) inhibits the release of ADH
inhibits the release of ADH
What region of the male urethra runs through the urogenital diaphragm, extending about 2 cm from the prostate to the beginning of the penis?
intermediate part of the urethra (membranous urethra)
The __________ keeps the urethra closed when urine is not being passed from the bladder and prevents leaking between voiding.
internal urethral sphincter
When renal calculi obstruct a ureter, pain is perceived to radiate from the lower back to the anterior abdominal wall on the same side. This is an event that ______.
is called referred pain
The glomerulus differs from other capillaries in the body in that it ________.
is drained by an efferent arteriole
Glucose is not normally found in the urine because it
is reabsorbed by the tubule cells
RENIN
is secreted by the juxtaglomerular cells
99%
is the percentage of filtrate that is reabsorbed during urine formation
Polycystic kidney disease always affects both kidneys instead of only the right or left kidney because ______.
it is a genetic disease
ADH
it is secreted in response to an increase in extracellular fluid osmolality
This is TRUE about ADH
it is secreted in response to an increase in extracellular fluid osmolality
Substance regulated by ADH's effects on the renal tubules a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium I. sodium j. water
j. water
What are the structural differences between juxameduallary & cortical nephrons?
juxtamedullary nephrons have long hoops of Henle (with long thin segments) & renal corpuscles that are near the cortex-medulla junction, whereas cortical nephrons have short loops of Henle & renal corpuscles that lie more superficially in the cortex
Conditions such as diabetes and starvation are closely lined to
ketonuria
The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.
loop of Henle
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 cells
Renal pelvis
major calyces of the kidney converge to form an enlarged channel
Juxtaglomerular apparatus
makes renin (regulates BP). Composed of two important structures: Juxtaglomerular cells and the Macula densa
Which of the following is NOT a major urine formation process?
micturition
Which of the following is the least important influence on reabsorption of a substance in the nephron?
molecular complexity
Transcellular Pathway
most solutes use
5) The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched
myogenic
The functional and structural unit of the kidneys is the ________.
nephron
Which of the following is the functional unit of the kidney?
nephron
Overall, which of the following pressures is ultimately responsible for glomerular filtration?
net filtration pressure
3) The need to get up in the middle of the night to urinate is called
nocturia
7) Sodium-linked water flow across a membrane is called ________ water reabsorption
obligatory
Tubular
of glucose and many other substances is a Tm- limited active transport of Na+
The mechanism of water reabsorption by the renal tubules is ________.
osmosis
Kidney Anatomy
paired, retroperitoneal in the superior lumbar region
65%
percentage of filtrate volume reabsorbed in the proximal tubule
The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________.
plasma protein
The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________. A) plasma protein B) glucose C) electrolytes D) hormones
plasma protein
Which of the following is not a part of the juxtaglomerular apparatus?
podocyte cells
Which part of the brain controls the micturition reflex?
pons
Which of the following is NOT a function of the kidneys?
producing the hormones melanin and oxytocin
Which of the following is the correct sequence of kidney development from embryo to fetus?
pronephros, mesonephros, metanephros
Where in the nephron does most solute reabsorption occur?
proximal convoluted tubule
Which of the three parts of the renal tubule is formed by cuboidal epithelial cells bordered by dense microvilli?
proximal convoluted tubule
Most glucose molecules are reabsorbed in the
proximal convoluted tubules
6) The presence of pus in the urine is a condition called ________.
pyuria
RENIN
released by macula densa when osmolarity is low
2) Urine crystals in the renal pelvis are called ________.
renal calculi
In what part of the nephron is plamsa filtered
renal corpuscle
Fluid flows through the kidney
renal corpuscle proximal tubule loop of Henle distal tubule collecting duct
In which kidney region are all renal corpuscles located?
renal cortex
Hydronephrosis may be caused by all EXCEPT which of the following?
renal failure
The filtration membrane includes all except ________.
renal fascia
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 lowest blood concentration of nitrogenous waste occurs in
renal vein
The lowest blood concentration of nitrogenous waste occurs in the
renal vein
SODIUM
responsible for reabsorption of most substances in the nephron
Which of the choices below is the least important role of tubular secretion?
ridding the body of bicarbonate ions
Oliguria
scanty output of urine
Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.
secondary active transport
Which vessel is present in the arterial pathway as blood flows into the kidney but NOT present in the venous pathway exiting the kidney?
segmental
An important characteristic of urine is its specific gravity or density, which is ________.
slightly higher than water
Approximately 80% of the energy used for active transport is devoted to the reabsorption of __________.
sodium
Vasa Recta
specialized portions of the peritubular capillaries that extend deep into the medulla of the kidney
The fatty tissue surrounding the kidneys is important because it ________.
stabilizes the position of the kidneys by holding them in their normal position
Renal tubules are LESS permeable to urea
than they are to water; therefore, urea concentration in the tubules INCREASES
Renal papilla
the apex of the renal pyramid
Nephron
the basic structural and functional unit of the kidney. Its chief function is to regulate the concentration of water and soluble substances like sodium salts by filtering the blood, reabsorbing what is needed and excreting the rest as urine. A nephron eliminates wastes from the body, regulates blood volume and blood pressure, controls levels of electrolytes and metabolites, and regulates blood pH. Regulated by the endocrine system by hormones such as antidiuretic hormone, aldosterone, and parathyroid hormone. In humans, a normal kidney contains 800,000 to 1.5 million nephrons
Nephron
the functional unit of the kidney
What type of capillaries are the glomerular capillaries? What is their function?
the glomerular capillaries are fenestrated capillaries: function is to filter lrge amounts of plasma into the glomerular capsule
Nephron is closed associated with
the glomerulus & the peritubular capillaries (both are capillary beds)
Glomerular filtration is a process of bluk flow driven by:
the hydrostatic pressure of blood
Why does water diffuse from lumen into intersitial space?
the intersitial space has a greater osmolarity
Distal tubule
the juxtaglomerular apparatus is formed where the distal tubule projects between the afferent arteriole and efferent arteriole enxt to Bowman's capsule
Roger is hit in the lower back, what protects his kidneys from trauma
the lower part of the rib cage & the perirenal fat capsule protect his kidneys from blows
The frequency of cystitis in men is lower than in women because ______.
the male urethra is longer than the female urethra
Tubular reabsorption
the movement of substances from the filtrate back into the blood of the peritubular capillaries
Proximal tubule
the part of a nephron between Bowman's capsule & the loop of Henle
Filtration Fraction
the part of the plasma volume that passes through the filration membrane
Renal Fraction
the part of the total cardiac output that passes through the kidneys
65%
the percentage of filtrate that is absorbed in the promixal tube
Fetal kidneys do not have to work very hard because ________. A) fetuses do not have any waste to excrete B) the placenta allows the mother's urinary system to clear the waste from fetal blood C) there are no functional nephrons until after birth D) there is no way a fetus could excrete urine until the seventh month of development
the placenta allows the mother's urinary system to clear the waste from fetal blood
How does the movement of Na+ drive the reabsorption of water & solutes
the reabsorption of of Na+ by primary active transport, in turn, drives reabsorption of amino acids and glucose by secondary active transport. It also drives passive reabsorption of chloride, and reabsorption of water by osmosis. The reabsorpion of water leaves behind other solutes, which become more concentrated and can therefore be reabsorbed by diffusion
Which of the following acts as the trigger for the initiation of micturition (voiding)?
the stretching of the bladder wall
Which of the following acts as the trigger for the initiation of micturition (voiding)? A) the stretching of the bladder wall B) motor neurons C) the sympathetic efferents D) the pressure of the fluid in the bladder
the stretching of the bladder wall
Nephrons
the structural & functional units of the kidneys
Trigone
the triangular area of the urinary bladder between the two ureters posteriorly & the urethra anteriorly
In the ascending limb of the loop of Henle the ________.
thick segment moves ions out into interstitial spaces for reabsorption
In the ascending limb of the loop of Henle the ________. A) thick segment is permeable to water B) thick segment moves ions out into interstitial spaces for reabsorption C) thin segment is not permeable to sodium and chloride D) thin segment is freely permeable to water
thick segment moves ions out into interstitial spaces for reabsorption
ADH
this hormone increqases reabsorption of water in the collecting ducts
The urinary bladder is composed of ________ epithelium.
transitional
What type of epithelial tissue forms the mucosa layer of the urinary bladder?
transitional epithelium
4) The area between the ureters and urethra is called the ________ in a bladder.
trigone
Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.
true
Atrial naturetic peptide inhibits sodium reabsorption
true
In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water
true
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. Answer: TRUE
true
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
Obligatory water reabsorption involves the movement of water along an osmotic gradient.
true
The act of emptying the bladder is called voiding.
true
The entire responsibility for urine formation lies with the nephron.
true
The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.
true
The ureter transports urine from the kidney to the urinary bladder
true
The urethra contains an internal sphincter of smooth muscle
true
Tubular secretion is effective in controlling blood pH.
true
Urine is 95% water by volume
true
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
Glomerulus
tuft of capillaries in the renal corpuslce
What is the largest component of urine by weight, other than water?
urea
What are the 3 nitrogenous wastes excreted in the urine?
urea, uric acid, creatinine
Which urinary structure serves as the temporary storage site for urine?
urinary bladder
Urinary system
urinary bladder ( a temporary storage reservoir for urine) 3 tube-like organs (paired ureters & urethra)
1) The capillary bed that surrounds the descending and ascending loop of Henle of juxtamedullary nephrons is called the ________.
vasa recta
Where does the efferent arteriole of the juxtamedullary nephron carry blood to?
vasa recta
Since most patients with renal failure produce little or no urine, hemodialysis often involves removal of water from the blood. However, side-effects may develop if too much fluid is removed from the blood. Which of the following is NOT one of the potential side-effects?
vasoconstriction of afferent arterioles
Which of the following is NOT a cause of anuria?
vasodilation of afferent arterioles
GFR
volume of filtrate formed each minute by the combined activity of all 2 million glomeruli
