Chapter 42: Urinary System
Autoregulation of glomerular filtration by tubuloglomerular feedback helps protect the kidney: a. from rapid systemic arterial pressure variations that would otherwise cause large glomerular filtration rate changes. b. from rapid systemic venous pressure variations that would otherwise cause large glomerular filtration rate changes. c. by contracting the walls of the efferent arterioles, thus increasing systemic blood pressure. d. by relaxing the walls of the efferent arterioles, thus reducing systemic blood pressure.
ANS: A
If a person becomes dehydrated, which hormone would you expect to find in high concentration in the blood? a. Antidiuretic hormone (ADH) b. Atrial natriuretic hormone (ANH) c. Para-aminohippurate acid (PAH) d. Prolactin (PRL)
ANS: A
If the glomerular hydrostatic pressure is 67 mm Hg, the glomerular osmotic pressure is 28 mm Hg, the capsular hydrostatic pressure is 17 mm Hg, and the capsular osmotic pressure is 0 mm Hg, the effective filtration pressure (EFP) would be _____ mm Hg. a. 22 b. 56 c.78 d. There is not enough information to determine the EFP.
ANS: A
In the average bladder, what amount of urine would cause a moderately distended sensation and the desire to void? a. 250 ml b. 100 ml c. 600 ml d. 150 ml
ANS: A
Of all the blood pumped per minute by the heart, approximately ____ goes through the kidneys. a. 1/5 b. 1/3 c. 1/2 d. 3/4
ANS: A
Reabsorption, as performed in the kidney, may be defined as the: a. movement of molecules out of the tubule and into the peritubular blood. b. movement of molecules out of the peritubular blood and into the tubule for excretion. c. movement of water and solutes from the plasma in the glomerulus, across the glomerular-capsular membrane, and into the capsular space of the glomerular capsule. d. volume of plasma from which a substance is removed by the kidney per minute.
ANS: A
Terry has lupus erythematosus and has been complaining of feelings of urgency, pain in urination, and the appearance of blood in the urine. More than likely, Terry is suffering from: a. interstitial cystitis. b. renal calculi. c. renal ptosis. d. renal sarcoma.
ANS: A
The mechanism for voiding begins with: a. the relaxation of the internal sphincter. b. the contraction of the muscles of the bladder. c. the relaxation of the external sphincter. d. a parasympathetic impulse sent to the bladder.
ANS: A
The microvilli on the luminal surface of each epithelial cell in the proximal tubule wall will: a. form a brush border that increases absorptive surface area of the entire inner surface of the proximal tubule. b. form an electrical gradient that drives the diffusion of negative ions from the filtrate into the interstitial fluid. c. participate in the countercurrent mechanism, which allows the contents to flow in opposite directions. d. increase the secretory surface area of the entire inner surface of the proximal tubule.
ANS: A
The movement of substances out of the _____ best describes secretion in the formation of urine. a. blood into the tubule b. blood into the glomerular capsule c. tubules into interstitial fluids d. glomerulus into the tubules
ANS: A
The shape of the kidney could best be described as _____-shaped. a. bean b. pear c. pea d. potato
ANS: A
The substance most often measured to determine normal kidney function is: a. creatinine. b. glucose. c. sodium. d. potassium.
ANS: A
Under normal conditions, most nutrients are reabsorbed in which portion of the nephron? a. Proximal tubule b. Ascending nephron loop c. Distal tubule d. Collecting tubule
ANS: A
What effect on the treatment of secondary hypertension would you expect from angiotensin-converting enzyme (ACE) inhibitor drugs? a. When secondary hypertension occurs, the cells of the juxtaglomerular apparatus secrete renin, which in turn results in angiotensin production and increased blood pressure, so giving ACE inhibitors may reduce the production of angiotensin and lower the blood pressure. b. Secondary hypertension is caused by stenosis of the renal artery, so ACE inhibitors will relax the vessel, thus reducing blood pressure. c. Secondary hypertension is caused by stenosis of the renal artery, so ACE inhibitors will decrease atherosclerotic plaque and result in a lower blood pressure. d. ACE inhibitors will not have any effect on secondary hypertension.
ANS: A
Which hormone tends to increase the amount of urine produced? a. ANH b. Aldosterone c. ADH d. Both B and C
ANS: A
Which of the following is not a part of the glomerular-capsular membrane? a. Parietal layer of the glomerular capsule b. Visceral layer of the glomerular capsule Glomerular endothelium d. Basement membrane
ANS: A
Which of the following structures does not enter or leave through the hilum of the kidney? a. Calyx b. Renal artery c. Renal vein d. Ureter
ANS: A
Which statement best explains why the insertion of a urinary catheter would be an ineffective treatment for renal suppression? a. Renal suppression occurs when effective filtration pressure falls to zero and the kidneys shut down, so a urinary catheter would not help this situation. b. Renal suppression occurs when effective filtration pressure is elevated and urine production is increased, thus allowing free-flowing urine. A urinary catheter isn't needed in this situation. c. Renal suppression occurs when there is a disruption of nervous input to the bladder, resulting in loss of control of voiding. A urinary catheter would not be a treatment for the condition. d. Renal suppression is caused by a urinary tract infection, and a urinary catheter would not be effective in treating this condition.
ANS: A
Which statement identifies two blood indicators of renal dysfunction and best explains why they can be as such? a. Increased urea and creatinine levels in the blood indicate the inability of the kidney to filter creatinine and urea. b. Glucose in urine and complete blood count elevations indicate the kidney's inability to produce red blood cells. c. pH and specific gravity elevation indicate kidney dysfunction because an increase in solutes prevents the kidney from filtering correctly. d. Albumin and acetone decreases indicate that the kidney is unable to reabsorb these in the loop of Henle.
ANS: A
A drop in systemic blood pressure would cause the filtration rate to: a. increase. b. decrease. c. stay the same. d. vary depending on the level of AHD in the blood.
ANS: B
Cells called podocytes make up the: a. parietal layer of the glomerular capsule. b. visceral layer of the glomerular capsule. c. glomerulus. d. proximal tubule.
ANS: B
If the Tmax for glucose in the nephron was 300 mg/100 ml and a person had blood glucose level of 380 mg/100 ml, there would be: a. 300 mg/100 ml of glucose in the urine. b. 80 mg/100 ml of glucose in the urine. c. 80 mg/100 ml of glucose in the blood leaving the kidney. d. both A and C.
ANS: B
In which parts of the nephron do all of the following functions occur: passive reabsorption, active reabsorption, passive secretion, and active secretion? a. Proximal tubule and the renal corpuscle b. Collecting duct and the distal tubule c. Collecting duct and the ascending nephron limb d. Collecting duct and the descending nephron limb
ANS: B
One difference between the male urethra and the female urethra is the male urethra is: a. shorter. b. part of two different body systems. c. unique in that there are no additional ducts that merge with it. d. both B and C.
ANS: B
Regarding reabsorption in the proximal tubules, which of the following statements is not true? a. Sodium is actively transported out of the tubule fluid and into the blood. b. Chloride ions are actively transported into the blood plasma. c. Glucose and amino acids are transported with sodium and passively move out of the tubule fluid by means of the sodium cotransport mechanism. d. About half of the urea present in the tubule fluid passively moves out of the tubule, leaving half the urea to move on to the nephron loop.
ANS: B
Urine formation involves all the following processes except: a. filtration. b. catabolism. c. reabsorption. d. secretion.
ANS: B
Which best explains why a person who has uncontrolled diabetes mellitus voids a large amount of urine? a. Excess glucose "spills over" into urine, thereby decreasing the solute concentration of urine (and decreasing the solute concentration of plasma), which in turn leads to diuresis. b. Excess glucose "spills over" into urine, thereby increasing the solute concentration of urine (and decreasing the solute concentration of plasma), which in turn leads to diuresis. c. Low levels of insulin stimulate the kidney to not reabsorb water in the tubules. d. Decreased glucose is caused by withdrawal of sugar from urine, causing an increase in urine production.
ANS: B
Which blood vessels empty into the glomerulus? a. Interlobar arteries b. Afferent arterioles c. Lobar arteries d. Arcuate arteries
ANS: B
Which nitrogenous waste is the most abundant found in urine? a. Uric acid b. Urea c. Ammonia d. Creatinine
ANS: B
Which of the following is not a normal function of the kidneys? a. Synthesize prostaglandins b. Regulate blood sugar c. Produce hormones d. Regulate blood electrolytes
ANS: B
Which of the following is not a primary function of the nephron loop? a. The nephron loop reabsorbs water from the tubule fluid in its descending limb. b. In addition to reabsorption, the nephron loop secretes hydrogen ions. c. By reabsorbing salt from its ascending limb, it makes the tubule fluid hypoosmotic. d. Reabsorption of salt in the ascending limb also creates and maintains a high osmotic pressure.
ANS: B
Which of the following is the approximate threshold level for the reabsorption of glucose? a. 100 mg/100 ml b. 300 mg/100 ml c. 200 mg/100 ml d. 250 mg/100 ml
ANS: B
Which of the following statements is not true? a. The right kidney is slightly lower than the left kidney. b. The right kidney is often slightly larger than the left kidney. c. The kidneys extend above the level of the twelfth rib. d. The kidneys are retroperitoneal.
ANS: B
Which structure of the kidney narrows as it exits the kidney to become the ureter? a. Renal pyramids b. Renal pelvis c. Renal columns d. Hilum
ANS: B
Approximately how much blood flows through the kidneys per minute? a. 500 ml b. 750 ml c. 1200 ml d. 3500 ml
ANS: C
As the amount of sodium reabsorbed by the distal convoluted tubule increases, the amount of _____ increases. a. potassium ions absorbed also b. hydrogen ions absorbed also c. potassium ions secreted d. Both A and B are correct.
ANS: C
At the beginning of the "plumbing system" of the urinary system, urine leaving the renal papilla is collected in the cuplike structures called: a. renal columns. b. renal pyramids. c. calyces. d. ureters.
ANS: C
Filtrate in which part of the nephron tubule has the highest osmolality? a. Proximal tubule b. Ascending nephron loop c. Descending nephron loop d. Distal tubule
ANS: C
In the kidney, blood flows from the interlobular artery into the: a. glomerulus. b. efferent arteriole. c. afferent arteriole. d. peritubular capillaries.
ANS: C
Substances travel from the glomerulus into the glomerular capsule by the process of: a. diffusion. b. active transport. c. filtration. d. osmosis.
ANS: C
The calyces of the kidney join together to form a large collection reservoir called the: a. renal columns. b. renal pyramids. c. renal pelvis. d. hilum.
ANS: C
The portion of the nephron that empties into a calyx is the: a. distal tubule. b. nephron loop. c. collecting tubule. d. proximal tubule.
ANS: C
There are how many openings in the urinary bladder? a. One b. Two c. Three d. Four
ANS: C
What effect do aldosterone and antidiuretic hormone (ADH) have on urine volume? a. Because water reabsorption in the distal and collecting tubules doesn't require ADH, the aldosterone mechanism must work separately from the ADH mechanism to maintain homeostasis of the fluid content in the body. b. Both aldosterone and ADH decrease distal and collecting tubule absorption of sodium, which in turn causes an osmotic imbalance that drives the reabsorption of water from the tubule. c. Because water reabsorption in the distal and collecting tubules requires ADH, the aldosterone mechanism must work in concert with the ADH mechanism if homeostasis of the fluid content in the body is to be maintained. d. Both aldosterone and ADH increase distal and collecting tubule absorption of sodium, which in turn causes an osmotic imbalance that stops the reabsorption of water from the tubule.
ANS: C
What is the first branch of the segmental artery? a. Interlobar arteries b. Afferent arterioles c. Lobar arteries d. Arcuate arteries
ANS: C
When aldosterone is released, secretion of _____ occurs. a. ammonium b. hydrogen c. potassium d. sodium
ANS: C
Which of the following is not true of the proximal tubule? a. Highly convoluted b. Nearest to the glomerular capsule c. Second part of the renal tubules d. Contains microvilli
ANS: C
Which of the following statements is not true of the ureter? a. The ureter is approximately 28 cm long. b. The ureter conducts urine inferiorly from the kidney to the bladder. c. The ureter is composed of two layers of tissue—an inner mucous layer and an outer fibrous layer. d. All of the above are true of the ureter.
ANS: C
A good description of the urinary system function is that it: a. produces urine. b. balances blood plasma. maintains the dynamic c. consistency of the internal fluid environment. d. does all of the above.
ANS: D
A portion of the nephron that can lie within the medulla is the: a. proximal tubule. b. glomerular capsule. c. distal tubule. d. nephron loop.
ANS: D
ADH has the greatest effect on the reabsorption of water in the: a. proximal tubule. b. ascending nephron loop. c. descending nephron loop. d. distal tubule.
ANS: D
Fluid in the nephron would flow through these structures in which order? a. Proximal tubule, nephron loop, glomerular capsule, distal tubule, collecting duct b. Glomerular capsule, nephron loop, proximal tubule, distal tubule, collecting duct c. Glomerular capsule, proximal tubule, nephron loop, distal tubule, collecting duct d. None of the above are in the correct order.
ANS: D
In the ascending limb of the nephron loop: a. sodium and chloride are reabsorbed from the tubule fluid. b. the tubule fluid becomes dilute (hypotonic). c. antidiuretic hormone causes the cells to become more permeable to water. d. both A and B occur.
ANS: D
The function of the urinary bladder is to: a. serve as a reservoir for urine before it leaves the body. b. expel urine from the body, aided by the urethra. c. help concentrate the urine in periods of dehydration. d. do both A and B.
ANS: D
The ion most likely to be reabsorbed after the reabsorption of sodium ions is: a. potassium. b. chloride. c. phosphate. d. both B and C.
ANS: D
The movement of molecules out of the tubules and into the peritubular blood defines: a. glomerular filtration. b. secretion. c. micturition. d. reabsorption.
ANS: D
The nitrogenous wastes in the urine are usually the result of protein catabolism. They include all except: a. urea. b. ammonia. c. creatinine. d. amino acids.
ANS: D
The normal osmotic pressure of the capsular filtrate is _____ mm Hg. a. 60 b. 32 c. 18 d. 0
ANS: D
The percentage of water in urine is approximately _____%. a. 55 b. 65 c. 80 d. 95
ANS: D
The portion of the nephron tubule that is essentially always impermeable to water is the: a. proximal tubule. b. distal tubule. c. collecting tubule. d. ascending nephron loop.
ANS: D
Urine is conducted from the kidney to the urinary bladder through a tube called the: a. renal column. b. renal pelvis. c. urethra. d. ureter.
ANS: D
Water will move by osmosis only in the presence of ADH in the: a. distal tubule. b. collecting duct. c. ascending nephron limb. d. Both A and B are correct.
ANS: D
Which blood vessel drains the vasa recta? a. Lobar vein b. Arcuate vein c. Interlobular vein d. Both B and C
ANS: D
Which hormone tends to decrease the amount of urine produced? a. ANH b. Aldosterone c. ADH d. Both B and C
ANS: D
Which of the following ions is not normally secreted into the distal or collecting tubules? a. Potassium b. Hydrogen c. Ammonium d. Sodium
ANS: D
Which of the following is not a normal constituent of urine? a. Nitrogenous wastes b. Hormones c. Pigments d. Plasma proteins
ANS: D
Which of the following is(are) classified as an accessory organ of the urinary system? a. Ureters b. Urinary bladder c. Urethra d. All of the above
ANS: D
Which of these statements is not true of the kidney? a. The kidney is usually located next to the vertebrae from T12 to L3. b. The kidney is retroperitoneal. c. The kidney is protected by a heavy layer of fat. d. All of the above are true of the kidney.
ANS: D
Which statement best explains the process of filtration in the nephron? a. Filtration occurs as a result of passive and active transport mechanisms from all parts of the renal tubules; a major portion of reabsorption occurs in the proximal tubule. b. Filtration is the movement of molecules out of peritubular blood and into the tubule for excretion. c. Filtration is the movement of molecules out of the tubule and into peritubular blood. d. Filtration is the movement of water and protein-free solutes from plasma in the glomerulus into the capsular space of the glomerular capsule.
ANS: D
Why would the response of the kidney to arteriosclerosis actually compound the problem of hypertension? a. When the kidney responds to narrowing of a renal artery due to this disease, it will not cause any changes in kidney function or status. b. When the kidney responds to widening of a renal artery due to this disease, it will cause an increase in blood pressure and an increase in kidney perfusion. c. When the kidney responds to narrowing of a renal artery due to this disease, it will cause a decrease in blood pressure and possibly even death. d. When the kidney responds to narrowing of a renal artery due to this disease, it will cause an increase in blood pressure and ischemia of kidney tissues.
ANS: D
Within the male urethra, how is urine prevented from mixing with semen during ejaculation? a. Conscious control of a sphincter muscle guarding the bladder opening b. Contraction of the detrusor muscle of the bladder c. By the urinary meatus d. Reflex closure of sphincter muscles guarding the bladder opening
ANS: D
