Chapter 26 Urinary System

The prominent indentation on the medial surface of the kidney is the

hilum

Where does the ureter penetrate the kidney?

hilum

What is the primary driving force (pressure) that produces glomerular filtration? hydrostatic pressure of blood (blood pressure) colloid osmotic pressure of blood gravity

hydrostatic pressure of blood (blood pressure)

Prolonged aldosterone stimulation of the distal convoluted tubule may result in alkalosis. hypercalcemia. hypocalcemia. hypokalemia. hyperkalemia.

hypokalemia

An important structure for blood pressure regulation is the papillary duct. collecting duct. juxtaglomerular complex. nephron loop. proximal convoluted tubule.

juxtaglomerular complex

The macula densa forms part of the __________.

juxtaglomerular complex

Nephrons located close to the medulla with long nephron loops are called ________ nephrons.

juxtamedullary

The excretory functions of the urinary system are performed by the

kidneys

What structure connects the proximal convoluted tubule to the distal convoluted tubule?

nephron loop

Some patients with kidney failure regularly undergo a procedure called hemodialysis to cleanse their blood. This procedure thus effectively simulates which of the following kidney components. collecting ducts nephrons ureters All of the listed responses are correct.

nephrons

The functional units of kidneys where blood is filtered and urine produced are called

nephrons

If the osmotic pressure in the glomerular capillaries increased from 28 mm Hg to 35 mm Hg, would net filtration increase or decrease?

net filtration would decrease

The efferent arteriole of a nephron divides to form a network of capillaries within the cortex called the ________ capillaries.

peritubular

Capillaries that surround the proximal convoluted tubules are

peritubular capillaries

Reabsorbed water and solutes enter into the tubular fluid. efferent arteriole. afferent arteriole. peritubular fluid. glomerulus.

peritubular fluid

In the renal corpuscle, the visceral layer is a layer of specialized cells called

podocytes

Blood colloid osmotic pressure (BCOP) in the glomerulus is generated by presence of albumin proteins in blood plasma. constriction of the efferent arteriole. blood pressure. protein in the filtrate. filtrate in the capsular space.

presence of albumin proteins in blood plasma

Which substance would be found in higher concentration if the membrane were damaged? chloride creatinine protein glucose

protein

Which of the following substances should not be filtered? proteins fatty acids water amino acids glucose

proteins

In which of the structures does reabsorption of organic substrates occur?

proximal convoluted tubule

The majority of water is reabsorbed by osmosis in the proximal convoluted tubule. papillary duct. collecting duct. nephron loop. distal convoluted tubule.

proximal convoluted tubule

Where does most nutrient reabsorption occur?

proximal convoluted tubule

The primary function of the proximal convoluted tubule is reabsorption of ions, organic molecules, vitamins, and water. adjusting the urine pH. secretion of acids and ammonia. secretion of drugs. filtration.

reabsorption of ions, organic molecules, vitamins, and water

Aldosterone-sensitive portions of the distal convoluted tubule and collecting duct allow for the exchange of which ions? (Figure 26-13) reabsorption of potassium ions in exchange for sodium ions reabsorption of bicarbonate ions in exchange for hydrogen ions reabsorption of sodium ions in exchange for potassium ions reabsorption of hydrogen ions in exchange for chloride ions reabsorption of chloride ions in exchange for hydrogen ions

reabsorption of sodium ions in exchange for potassium ions

Each of the following organs is part of the urinary system except the urethra. kidney. ureter. rectum. urinary bladder.

rectum

The process that transports solutes, including many drugs, into the tubular fluid is called

secretion

Which of the following activities occurs at the proximal convoluted tubule? reabsorption of water reabsorption of 99 percent of organic nutrients secretion of hydrogen ions All of the listed activities occur at the proximal convoluted tubule.

all of the listed activities occur at the proximal convoluted tubule

The detrusor muscle functions as the internal urinary sphincter. surrounds the renal pelvis. compresses the urinary bladder and expels urine through the urethra. functions as the external urinary sphincter. moves urine along the ureters by peristalsis.

compresses the urinary bladder and expels urine through the urethra.

Eighty percent of nephrons in the human kidney are located in the ________ and have short nephron loops.

cortex

Part complete The proximal convoluted tubule cells are cuboidal cells without microvilli. squamous cells. columnar cells with microvilli. columnar cell without microvilli. cuboidal cells with microvilli.

cuboidal cells with microvilli

where does secretion mostly occur?

distal convoluted tubule

Which area(s) allow variable water reabsorption and is/are sensitive to the hormone ADH?

distal convoluted tubule and collecting duct

Blood leaves the glomerulus through a blood vessel called the

efferent arteriole

What is the function of the renal pelvis?

collects newly formed urine

Calculate the net filtration pressure if capillary hydrostatic pressure is 60 mm Hg, capillary osmotic pressure is 25 mm Hg, and capsular hydrostatic pressure is 10 mm Hg.

60-(25+10) = 25 mmHg

As the filtrate passes through the renal tubules, approximately what percentage is reabsorbed and returned to the circulation?

99 percent

Identify the correct direction of urine flow from formation to exiting the kidney. Cortex, medulla, renal pelvis, ureter Medulla, cortex, renal pelvis, ureter Ureter, renal pelvis, medulla, cortex Cortex, medulla, ureter, renal pelvis

Cortex, medulla, renal pelvis, ureter

The urinary system does all of the following except excreting excess albumin molecules. regulating plasma concentrations of electrolytes. helping to stabilize blood pH. regulating blood volume. eliminating organic waste products.

EXCEPT excreting excess albumin molecules

Which of the following formulas will allow you to calculate correctly the net filtration pressure (NFP)? (Hint: CsHP is capsular hydrostatic pressure.) FP = BCOP + (GHP - CsHP) FP = GHP + CsHP - BCOP FP = BCOP - GHP + CsHP FP = CsHP + GHP - BCOP FP = GHP - (CsHP + BCOP)

FP = GHP - (CsHP + BCOP)

true or false? The medullary pyramids contain collecting tubules (ducts) that travel towards the RENAL CORTEX carrying urine to exit the kidney.

False: The medullary pyramids contain collecting tubules that travel towards the RENAL PAPILLAE, carrying urine to exit the kidney.

In the event of a severe increase in systemic blood pressure, what mechanism would increase GFR? release of ANP and BNP constriction of afferent arterioles due to myogenic mechanism increased autonomic stimulation of afferent arterioles dilation of efferent arterioles

Release of ANP and BNP ~ANP and BNP are released from the heart when an increase in blood pressure or volume stretches the walls of the heart. Both ANP and BNP increase GFR, which increases urine production and reduces blood volume and pressure.

Which of the choices below best describes the autonomic mechanism for regulating GFR? View Available Hint(s) Sympathetic fibers override local controls to decrease the GFR. Sympathetic fibers trigger release of an enzyme to decrease the GFR. Sympathetic fibers trigger the release of hormones from the heart. Sympathetic fibers initiate the myogenic response to decrease the GFR.

Sympathetic fibers override local controls to decrease the GFR. ~Sympathetic activity causes vasoconstriction of afferent arterioles to decrease GFR when there is an acute fall in blood pressure.

Which statement best describes the relationship between Type 2 diabetes and the transport maximum (Tm)? The oscillations in blood glucose between hyperglycemia and hypoglycemia associated with Type 2 diabetes will cause the nephron membranes to inappropriately engage in transport maximum, leading to the inability to respond due to unpredictable glucose levels. Transport maximum of glucose is quite low. Therefore, when glucose transporters are all engaged, the amount of glucose transported is reduced due to the increased concentration of glucose available. The continued high concentration of glucose in blood could cause the chronic transport maximum to be exceeded. This may result in membrane damage that affects glucose reabsorption as well as an inability to regulate blood glucose to normal levels. The major problem with Type 2 Diabetes is the loss of all other ions, such as Na, Cl, K, Ca2+, etc. As these ions are lost, the glucose is transported out with them, causing the Tm to be reached and an upregulation in tubular glucose to occur.

The continued high concentration of glucose in blood could cause the chronic transport maximum to be exceeded. This may result in membrane damage that affects glucose reabsorption as well as an inability to regulate blood glucose to normal levels.

Which of the following statements about filtrate is INCORRECT? The filtrate has the same osmotic pressure as blood plasma. The filtrate is produced within the proximal convoluted tubule. The filtrate is similar to blood plasma. The filtrate is collected within the renal cortex.

The filtrate is produced within the proximal convoluted tubule. ~The filtrate is produced in the renal corpuscle of the nephron, which consists of the glomerular capillaries and the renal capsule.

Besides being very painful, a blockage in a ureter due to kidney stones or external pressure is serious because it leads to an increase in capsular hydrostatic pressure. What is the consequence of this increase in pressure? The glomerular filtration rate increases to the point where damage to the filtration membrane occurs. The glomerular filtration rate increases to the point where the nephrons do not have sufficient time to reabsorb vital nutrients and ions. The glomerular filtration rate decreases because the blood colloid osmotic pressure increases. The glomerular filtration rate decreases because the net filtration pressure is a negative value.

The glomerular filtration rate decreases because the net filtration pressure is a negative value.

Imagine a situation in which the number of urea leak channels increased dramatically in the ascending limb of the loop of Henle. What could be one likely consequence of this situation? The increased solute concentration in the vasa recta would stimulate additional water reabsorption. Aldosterone-regulated Na+ pump activity would increase dramatically to stabilize the osmotic concentration gradient. The concentration gradient of the renal medulla would remain unaffected. The final urine output would increase greatly because of the increase in ADH-regulated water reabsorption.

The increased solute concentration in the vasa recta would stimulate additional water reabsorption Urea permeability is tightly controlled to maintain an appropriate concentration gradient in the renal medulla together with the vasa recta. The concentration in the renal medulla usually reaches 1200 mOsm/L and ensures the most efficient filtrate adjustment associated with the countercurrent multiplication of the loop of Henle and the vasa recta.

Mike's injury is going to impact his urinary system significantly. Which of the following is NOT a function of the urinary system? Regulate plasma concentration of ions like sodium, potassium, and chloride by controlling the amounts excreted in the urine. Stabilize blood pH by controlling the loss of hydrogen ions and bicarbonate ions in urine. Assist the liver in detoxifying poisons and generate amino acids for metabolic use during starvation by deaminating amino acids. The kidney releases erythropoietin, a hormone that functions in the maturation of white blood cells.

The kidney releases erythropoietin, a hormone that functions in the maturation of white blood cells. ~This is the best answer! While it is true that the kidneys produce erythropoietin, erythropoietin functions in the maturation of red blood cells.

Damage to the glomerular filtration membrane allowing proteins into the capsular space would result in all of the following except an increase in capsular colloid osmotic pressure. a decrease in capsular hydrostatic pressure. a decrease in blood colloid osmotic pressure. an increase in net filtration pressure. an increase in GFR and fluid loss.

a decrease in capsular hydrostatic pressure

A glomerulus is the source of erythropoietin. the expanded end of a nephron. the horseshoe-shaped segment of the nephron. attached to the collecting duct. a knot of capillaries within the renal corpuscle.

a knot of capillaries within the renal corpuscle

Excess release of natriuretic peptides would cause a large volume of concentrated urine. a small volume of dilute urine. a large volume of dilute urine. a small volume of concentrated urine. a small volume of urine void of sodium.

a large volume of dilute urine

A transport mechanism that can move a substance against a concentration gradient by using cellular energy is bulk transport. osmosis. facilitated diffusion. active transport. simple diffusion.

active transport

The myogenic mechanism of renal autoregulation primarily involves smooth muscle in which blood vessels? afferent arterioles efferent arterioles glomerulus systemic arterioles

afferent arterioles ~By regulating afferent arteriole diameter, the myogenic mechanism affects pressure inside the glomerulus, and therefore GFR. Under normal physiological conditions, this mechanism works to maintain GFR despite moderate changes in systemic blood pressure.

Substances larger than ________ are normally not allowed to pass through the filtration membrane.

albumin

Immediate local responses of the kidney to changes in blood flow to maintain GFR occur via

autoregulation

What is the primary regulatory mechanism that maintains glomerular filtration rate (GFR)? natriuretic peptides autoregulation renin-angiotensin system autonomic regulation

autoregulation ~Autoregulation (local blood flow regulation) by myogenic mechanisms maintains an adequate GFR despite changes in local blood pressure and blood flow.

Which of the following substances is not normally found in filtrate? nitrogenous waste particles, such as urea ions, such as sodium and potassium water and small solutes blood cells and large particles

blood cells and large particles

Sheila has been exercising at peak performance for about 60 minutes. She did not hydrate as effectively as she should have and as a result, her urine is deep yellow and low in volume. Which of the following is the most likely mechanism affecting this?

blood colloid osmotic pressure

There are multiple pressures involved in controlling glomerular filtration and the formation of filtrate. Which is the pressure that opposes the formation of filtrate by drawing water out of the filtrate and back into the plasma? net filtration pressure (NFP) blood colloid osmotic pressure (BCOP) capsular colloid osmotic pressure glomerular hydrostatic pressure (GHP)

blood colloid osmotic pressure (BCOP) ~The BCOP is the pressure that opposes filtration. Over the entire length of the glomerular capillary bed, the BCOP averages about 25 mm Hg.

The main force(s) opposing glomerular filtration is (are) __________. capsular hydrostatic pressure blood colloid osmotic pressure and capsular hydrostatic pressure glomerular (blood) hydrostatic pressure glomerular hydrostatic pressure and capsular hydrostatic pressure

blood colloid osmotic pressure and capsular hydrostatic pressure

The process of filtration is driven mainly by solvent drag. blood hydrostatic pressure. renal pumping. active transport. blood osmotic pressure.

blood hydrostatic pressure

A decrease in blood albumin level will cause a decrease in blood colloid osmotic pressure. This will lead to a rise in the net glomerular filtration pressure. Are these two statements true or false?

both statements are true

Which of these is NOT considered to be part of the excretory system? cardiovascular system respiratory system integumentary system urinary system

cardiovascular system

The region of the nephron containing intercalated cells primarily associated with pH balance is the

collecting duct

Chronic and acute renal failure impairs all of the functions carried out by the kidneys and, as a consequence, the functions of most other body systems. Which of the following renal functions is matched incorrectly? calcitriol, calcium metabolism erythropoietin, digestion renin, blood pressure None of the listed responses is correct.

erythropoietin, digestion

true or false? The fibrous capsule is a layer of adipose tissue that surrounds the kidney.

false The fibrous capsule is a strong sheet of dense fibrous connective tissue. There is a layer of adipose tissue superficial to the fibrous capsule, called the perirenal fat capsule.

true or false: the collecting duct is considered to be a part of a nephron

false: it is depicted in "off white" in order to represent the separation

During filtration, anything that is small enough to pass through all three layers of the filtration membrane will become part of the filtrate. Sometimes, the least porous layer of this membrane becomes clogged and then glomerulonephritis may occur. What is the name of the most porous layer of the filtration membrane?

fenestrated endothelium

The filtration barrier in the renal corpuscle consists of which three layers? podocyte filtration slits, matrix cells in the glomerulus, and extraglomerular mesangial cells filtration slits, foot processes, and slit pores basement membrane of glomerulus, foot processes, and capsular outer layer fenestrated endothelium of glomerulus, basement membrane of glomerulus, and podocyte filtration slits fenestrations, matrix, and foot processes

fenestrated endothelium of glomerlulus, foot processes, and membrane of glomerulus, and podocyte filtration slits

Name the strong transparent covering that encases the kidney.

fibrous capsule

The outermost layer of the kidney is the

fibrous capsule

The step in kidney function in which fluid is forced out of the blood includes moving fluid __________. from glomerular capsule to PCT from PCT to DCT from afferent arteriole to glomerulus from glomerulus to glomerular capsule

from glomerulus to glomerular capsule

The first step in the formation of urine is the generation of filtrate from the blood plasma by filtration. In what part of the nephron does the formation of filtrate occur? proximal convoluted tubule glomerular capsule loop of Henle distal convoluted tubule

glomerular capsule ~Filtrate is formed when blood pressure forces water and solutes, which are small enough to pass through the filtration membrane, across the wall of the glomerular capillaries and into the capsular space.

The amount of filtrate produced by the kidneys each minute is called the plasma volume. kidney filtrate volume. glomerular filtration rate. colloid pressure. net filtration pressure.

glomerular filtration rate

name for the blood pressure in the glomerular capillaries

glomerular hydrostatic pressure (GHP)

Which of the following best describes the passive force that creates filtrate? glomerular filtration rate (GFR) autonomic regulation glomerular hydrostatic pressure (GHP) vasoconstriction

glomerular hydrostatic pressure (GHP) ~Filtration throughout the cardiovascular capillaries, including those in the kidney, is passively driven by hydrostatic pressure (i.e., blood pressure).

You have been diagnosed with lupus erythematosus, a very severe autoimmune disorder with a wide variety of associated organ-related problems. Your doctor is particularly worried about how this will affect your kidney function. He says that you are susceptible to ________ because of the lupus. diabetes polycystic kidney glomerulonephritis renal calculi cystitis

glomerulonephritis

________ is/are an inflammatory disorder of the glomeruli that affects the filtration mechanism of the kidneys.

glomerulonephritis

Sympathetic stimulation of the kidney can do all of the following except reduce blood flow to kidneys. increase the glomerular filtration rate. produce powerful vasoconstriction of the afferent arterioles. trigger renin release. produce renal ischemia.

increase the glomerular filtration rate

A drug that inhibits angiotensin converting enzyme (ACE) may lead to all of the following except reduction of blood pressure. decreased sodium reabsorption. less secretion of aldosterone. increased fluid retention. increased urinary loss of sodium.

increased fluid retention

Which of these effects is NOT produced by sympathetic activation? increased glomerular filtration rate vasoconstriction of the afferent arteriole altered regional blood flow renin release

increased glomerular filtration rate

What four factors shown result in an increased blood volume? (Figure 26-11) increased sodium retention, increased fluid consumption, increased fluid retention, and constriction of systemic veins increased sodium excretion, increased potassium retention, decreased fluid consumption, increased fluid retention decreased cardiac output, decreased fluid retention, decreased sodium retention, and systemic vasodilation decreased glomerular hydrostatic pressure, decreased blood colloid osmotic pressure, increased capsular hydrostatic pressure, increased capsular colloid osmotic pressure increased glomerular hydrostatic pressure, increased blood colloid osmotic pressure, decreased capsular hydrostatic pressure, decreased capsular colloid osmotic pressure

increased sodium retention, increased fluid consumption, increased fluid retention, and constriction of systemic veins

Which of these is NOT a property of countercurrent multiplication? It creates a hyperosmotic peritubular fluid in the kidney medulla. It exploits the structure of the nephron loop. It depends on active ion transport to function. It is opposed by the vasa recta.

it is opposed by the vacta reta

Modified smooth muscle cells in the wall of the afferent arteriole that secrete renin are called

juxtaglomerular cells

Part complete Which structure is found separating the renal pyramids?

renal columns

Where does the kidney filter the blood?

renal corpuscle

In which region of the kidney is a glomerulus located?

renal cortex

Where does filtration of the blood occur within the kidneys?

renal cortex

Which of the following regions of the kidney is in contact with the fibrous capsule?

renal cortex

Which region of the kidney is the most superficial?

renal cortex

renal corpuscles are found in which structure of the kidney?

renal cortex

The inability of the kidneys to excrete adequately to maintain homeostasis is renal failure. hematuria. calculi. glomerulonephritis. polycystic kidney disease.

renal failure

Where are the renal columns located?

renal medulla

A major calyx is a component of which of the following anatomical structures?

renal pelvis

The ________ is the plasma concentration at which a specific compound will begin appearing in the urine.

renal threshold

What enzyme is released by the juxtaglomerular complex to regulate GFR? View Available Hint(s) angiotensin II angiotensin-converting enzyme (ACE) renin angiotensin I

renin ~Renin catalyzes the conversion of angiotensinogen to angiotensin I, a critical first step in the hormonal regulation of GFR during a low pressure event.

Which of the following GFR-regulating mechanisms is initiated by cells of the juxtaglomerular complex? myogenic mechanism natriuretic peptides renin-angiotensin system autonomic regulation

renin-angiotensin system ~`Renin is secreted by cells in the juxtaglomerular complex in response to a decrease in glomerular blood pressure, ultimately resulting in angiotensin II circulating in the blood. Activation of the renin-angiotensin system increases GFR.

ADH creates a (small or large) volume of (dilute or concentrated) urine. (Figure 26-15)

small and concentrated

The majority of cotransporters and countertransporters are linked to the reabsorption of what ion? hydrogen chloride bicarbonate sodium potassium

sodium

The majority of renal innervation is by the

sympathetic nervous system

Mike's injury caused his ureter to be torn away at the hilum of the kidney. What internal kidney structures funnel the urine into the renal pelvis of the ureter? renal tubules renal pyramids the calyces juxtamedullary nephrons

the calyces ~The minor calyces drain into the major calyces that then empty into to the renal pelvis and ureter.

Which of these is NOT an aspect of the micturition reflex arc? It is stimulated by mechanoreceptors. CNS processing occurs in the sacral cord. The effector is the detrusor muscle. The diameter of the urethra increases.

the diameter of the urethra increases

The region known as the macula densa is part of

the distal convoluted tubule

The region known as the macula densa is part of the collecting duct. the nephron loop (loop of Henle). the proximal convoluted tubule. glomerular (Bowman's) capsule. the distal convoluted tubule.

the distal convoluted tubule

If the micturition reflex is primarily controlled by parasympathetic innervation, then how is it that you have voluntary control of when you choose to urinate? Interneurons in the CNS relay signals to the parasympathetic preganglionic motor fibers in the pelvic nerves. The external urethral sphincter is under skeletal muscle control. When it is voluntarily relaxed, the internal urethral sphincter will open, allowing the flow of urine. The parasympathetic preganglionic motor fibers in the pelvic nerves innervate the skeletal muscle sphincters. Distortion of stretch receptors in the urinary bladder signal contraction of the smooth muscle layers in the bladder wall.

the external urethral sphincter is under skeletal muscle control. When it is voluntarily relaxed, the internal urethral sphincter will open, allowing the flow of urine.

Which structure of the kidney functions to reabsorb nutrients from the filtrate?

the proximal convoluted tubule: the product is called tubular fluid

Which of the choices below best describes the glomerular filtration rate (GFR)? the blood pressure within the glomerulus the volume of filtrate created by the kidneys per minute the volume of urine that leaves the kidneys per minute the volume of blood flowing through the glomerular capillaries per minute

the volume of filtrate created by the kidneys per minute ~Fluid and small solutes that leave the glomerulus are collectively termed filtrate. Glomerular filtration produces approximately 125 ml of filtrate per minute.

What type of epithelium is found lining the ureters, the urinary bladder, and the proximal portion of the urethra? simple squamous stratified cuboidal transitional stratified squamous

transitional

true or false? the podocyte is contained in the visceral epithelium of the glomerular capsule

true

true or false: The ureter, blood vessels, and nerves penetrate the kidney on its medial surface.

true (medial surface at the HILUM)

The concentration at which all of the carriers in renal tubules for a given substance are saturated is the

tubular maximum

________ is the most abundant organic waste.

urea

The (ureter or urethra) transports urine to the bladder. urethra ureter

ureter

The urinary function of elimination occurs through the

urethra

Urine is carried from the urinary bladder to the outside of the body by the

urethra

Which of the following is NOT associated with the renal hilum? urethra renal artery ureter renal nerves

urethra

Urine is temporarily stored in the trigone. urethra. kidney. ureter. urinary bladder.

urinary bladder

In response to increased levels of aldosterone, the kidneys produce a larger volume of urine. urine with a lower concentration of sodium ions. urine with less glucose. urine with a lower concentration of potassium ions. urine with a higher concentration of sodium ions.

urine with a lower concentration of sodium ions.

How is the proximal convoluted tubule different from the distal convoluted tubule? The proximal convoluted tubule empties directly into the collecting duct, just like the distal convoluted tubule. Water reabsorption is always obligatory in the proximal convoluted tubule but not in the distal convoluted tubule. The proximal convoluted tubule has numerous aldosterone-regulated solute-transport mechanisms, just like the distal convoluted tubule. The proximal convoluted tubule is parallel to the vasa recta, just like the distal convoluted tubule.

water reabsorption is always obligatory in the proximal convoluted tube but not in the distal convoluted tubule ~The active removal of ions and organic nutrients creates an osmotic gradient that draws water out of the tubules. This gradient is particularly steep in the proximal convoluted tubule, where the largest amount of solutes is reabsorbed.