BIOS 256: Week 4 - The Urinary System

Which solution contains more electrolytes per volume of water?​ 700 milliosmoles (mOsm​) 1200 milliosmoles (mOsm​) 300 milliosmoles (mOsm​) 800 milliosmoles (mOsm​) 500 milliosmoles (mOsm​)

1200 milliosmoles (mOsm​) The correct answer is 1200 milliosmoles (mOsm​). Osmolarity is a measure of electrolytes dissolved per unit volume. The larger the number, the more electrolytes there are per volume of water.

How much filtrate is produced on a daily basis in a healthy adult? 2.5 milliliters (mL) 2.5 liters (L) 1800 liters (L) 180 liters (L) 180 milliliters (mL)

180 liters (L)

How much urine would a healthy adult human produce each day?​ 2 L/day 0.5 L/day 900 mL/day 2 mL/day 100 mL/day

2 L/day On a normal daily basis, a healthy adult human will produce 1.0-2.0 L of urine per day.​

Approximately how much urine does a healthy adult human produce each day? 2 milliliters (mL)/day 10 milliliters (mL)/day 800 milliliters (mL)/day 10 liters (L)/day 2 liters (L)/day

2 liters (L)/day On a normal daily basis, a healthy adult human will produce 1.0-2.0 liters (L) of urine per day.​

Which hormone is the primary determinant if urine will be concentrated or dilute? Atrial natriuretic peptide Antidiuretic hormone Aldosterone Adrenocorticotropic hormone Androstenedione

Antidiuretic hormone Antidiuretic hormone (ADH) is the primary determinant of the concentration of urine as it influences the permeability of the renal membranes to water. If water is driven into the interstitial space, urine becomes concentrated. If it stays in the tubule, the urine becomes dilute. Aldosterone is responsible for the reabsorption of sodium, but not water directly. Atrial natriuretic peptide (ANP) is responsible for excretion of sodium into the nephron tubule, leading to water staying in the tubule. Androstenedione is a precursor steroid hormone made in the gonads and adrenal glands that will eventually become estrogen or testosterone. Adrenocorticotropic hormone (ACTH) is produced by the anterior pituitary gland and is responsible for regulating the secretion of glucocorticoids from the adrenal cortex.

Antidiuretic hormone (ADH) activates which proteins in the distal convoluted tubule (DCT) and collecting duct when present? Water transport pump Aquaporin-1 Aquaporin-2 Glucose transporter type 4 (GLUT4) Aquaporin-3

Aquaporin-2 Antidiuretic hormone (ADH) increases the amount of aquaporin-2 in the distal convoluted tubule (DCT) and collecting duct, increasing the permeability of water. Aquaporin-1 is found in the proximal convoluted tubule (PCT). Aquaporin-3 is found in the epidermis. GluT4 aids in glucose transport. There are no water transport pumps in the kidneys.

Which structure is impermeable to water? Collecting duct Descending nephron loop Ascending nephron loop Distal convoluted tubule (DCT) Proximal convoluted tubule (PCT)

Ascending nephron loop The ascending duct is impermeable to water, allowing it to aid in countercurrent multiplication. The other regions are permeable to water.

Which region of the nephron is impermeable to water? Ascending nephron loop Glomerulus Descending nephron loop Distal convoluted tubule Proximal convoluted tubule

Ascending nephron loop. Water is able to pass through all of these structures with the exception of the ascending nephron loop. Water can be filtered through the glomerulus and reabsorbed in the proximal convoluted tubule (PCT), distal convoluted tubule (DCT), and descending nephron loop.

Which hormone would result in an increased urinary output?​ Renin Atrial natriuretic peptide Antidiuretic hormone Angiotensin II Aldosterone

Atrial natriuretic peptide Atrial natriuretic peptide (ANP) secretes sodium into the renal tubules, leading to a greater osmotic pressure. This will cause an increase in the volume of urine.​ ADH, aldosterone, renin, and angiotensin II would all lead to a decreased urinary output.

Which are not potential triggers of antidiuretic hormone secretion? Select all that apply. Decreased blood pressure Decreased blood viscosity Decreased vasodilation Decreased blood volume Increased blood osmolarity

Decreased blood viscosity Decreased vasodilation Antidiuretic hormone will be secreted in response to increased blood osmolarity, decreased blood volume, and decreased blood pressure. Decreased blood viscosity and decreased vasodilation will not stimulate the release of ADH.

Which would result in an increase in the glomerular filtration rate (GFR)? Increased parasympathetic activity A decrease in the availability of nitric oxide Decreased sympathetic activity Increased levels of adenosine triphosphate (ATP) Increased levels of angiotensin II

Decreased sympathetic activity. To increase glomerular filtration rate (GFR), blood flow must increase to the glomerulus and the endothelium of the glomerulus must become more permeable. Nitric oxide is a vasodilator and inhibiting it would prevent dilation. Adenosine triphosphate (ATP) is converted into adenosine to activate the juxtaglomerular apparatus and decrease GFR. Angiotensin II is a vasopressor and causes the blood vessels to constrict, not dilate. Parasympathetic activity does not seem to affect the kidneys, but if sympathetic innervation is decreased, it would increase GFR.

Which metabolic condition is the most likely to result in kidney damage? Hyperthyroidism Cushing's syndrome Addison's disease Diabetes mellitus

Diabetes mellitus Diabetes mellitus is a condition that results in body-wide effects including kidney neuropathy and potentially renal failure. Addison's disease and Cushing's syndrome are associated with damage to the suprarenal (adrenal) glands. Hyperthyroidism is a condition of the thyroid.

Which nephron structure is responsible for the filtration of blood? Renal corpuscle Distal convoluted tubule Proximal convoluted tubule Nephron loop

Distal convoluted tubule

Which regions of the nephron can reabsorb water? Select all that apply. Ascending nephron loop Distal convoluted tubule Descending nephron loop Proximal convoluted tubule Glomerulus

Distal convoluted tubule Descending nephron loop Proximal convoluted tubule Water reabsorption can be done in the proximal convoluted tubule (PCT), distal convoluted tubule (DCT), and descending nephron loop. The glomerulus is responsible for filtration and not reabsorption. The ascending nephron loop is impermeable to water.

A 34-year-old client who has recently been diagnosed with polycystic kidney disease asks you to explain what complications might occur. Which is the most serious complication that can occur with this disease? Kidney stones Bladder cancer End-stage renal disease (ESRD) Cystitis Urethritis

End-stage renal disease (ESRD) End-stage renal disease (ESRD) is the most serious complication that can occur with polycystic kidney disease as this may require dialysis or transplant. Though cystitis, urethritis, and kidney stones can be a result of polycystic kidney disease, these are not as serious as ESRD. The rate of bladder cancer is unaffected by polycystic kidney disease.

Which bacteria is a common cause of urinary tract infections? Plasmodium vivax Escherichia coli Salmonella spp. Streptococcus spp. Heliobacter pylori

Escherichia coli The most common bacterium that causes urinary tract infections (UTIs) is Escherichia coli (E. coli), a bacterium typically found in the gut flora. Other bacteria that can cause this condition are Klebsiella pneumoniae, Enterococcus faecalis, Proteus mirabilis, and Staphylococcus saprophyticus.

What is the major function of the glomerular capillaries within the renal corpuscle? Reabsorption Secretion Filtration Digestion Excretion

Filtration The glomerular capillaries are responsible for the filtration of blood. If anything damages them, it can influence the efficiency of filtration. Reabsorption and secretion occur in other structures of the nephron. Excretion refers to the disposal of substances outside the body. Digestion does not occur in the glomerular capillaries.

Which of the choices is a function of the nephron loop?​​ Generates osmotic gradient that enables the formation of a large volume of very dilute urine or a small volume of very concentrated urine​ Generates osmotic gradient that enables the formation of a large volume of very concentrated urine or a small volume of very dilute urine​ Absorbs electrolytes actively and water by osmosis in the same segments​ Directly forms a large volume of very dilute urine or a small volume of very concentrated urine​

Generates osmotic gradient that enables the formation of a large volume of very dilute urine or a small volume of very concentrated urine​ The nephron loop enables the generation of osmotic gradient and plays a critical role in the regulation of urine concentration. This will make a large volume of dilute urine or a small volume of concentrated urine. Electrolytes are not actively absorbed in the nephron loop.

Which is a procedure to eliminate kidney stones? Cytoscopy Cystectomy Lithotripsy Nephroscopy Nephrostomy

Lithotripsy Lithotripsy is the use of sound waves to break apart kidney stones. The suffix -scopy is used to describe exploratory procedures. The suffix -ectomy is used to describe the surgical removal of a structure. The suffix -stomy refers to the formation of a hole.

If one says that the clearance value of glucose is nearly zero, what does this mean?​ The clearance value of glucose is relatively high in a healthy adult. The glucose molecule is too large to be filtered out of the blood.​ The client has diabetes. Nearly 100% of glucose is reabsorbed.​ Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules.​

Nearly 100% of glucose is reabsorbed.​ When a substance has a clearance rate of 0 or near 0, then the majority of the substance was either reabsorbed or never entered the nephron in the first place. Glucose is small enough to enter the filtrate initially and, thus, it has to have been nearly completely reabsorbed. The clearance value of glucose should be relatively low in healthy adults and if it is elevated (glucosuria), then the client may have diabetes.

Which are symptoms of glomerulonephritis? Select all that apply. Oliguria Hypotension Hematuria Edema Lipuria

Oliguria Hematuria Edema Lipuria and hypotension are symptoms of nephrotic syndrome.

Which mechanism is used to transport water across the tubule membrane? Symport transport Simple diffusion Antiport transport Osmosis Adenosine triphosphate (ATP)-powered pumps

Osmosis Osmosis is the diffusion of water across a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration. This passive transport mechanism will allow water to follow the different concentrations of solute in the filtrate or in the interstitial space. Active transport would require the use of energy such as ATP. Symport refers to the movement of different substances moving in the same direction. Antiport refers to the movement of different substances in opposing directions. Water is not transported using simple diffusion.

Which statement is true of osmosis? Osmosis is the movement of solute from an area of low concentration of solute to an area of high concentration of solute​. Osmosis is the movement of solute from an area of high concentration of solute to an area of low concentration of solute​. Osmosis is the movement of water from an area of low concentration of solute to an area of high concentration of solute. Osmosis is the movement of water from an area of high concentration of solute to an area of low concentration of solute.​

Osmosis is the movement of water from an area of low concentration of solute to an area of high concentration of solute. Osmosis is the movement of water which is driven by the concentration of solutes. Areas with a higher concentration of solutes have a pulling force that drives water toward them.

Which symptom is the most common clinical finding associated with bladder cancer? Suprapubic pain Painless hematuria Kidney stone Dysuria Urinary retention

Painless hematuria Painless hematuria is the most common clinical finding, but other symptoms include dysuria, polyuria, and back pain. Bladder cancer does not induce suprapubic pain, urinary retention, or kidney stones.

Which is a term that refers to a kidney infection? Urethritis Hepatitis Cystitis Pylonephritis Glomerulonephritis

Pylonephritis The suffix "-itis" refers to an inflammation or infection, "nephron" means kidney, and "pyelo" refers to [renal] pelvis. Thus, a kidney infection is pylonephritis.​ Cystitis is inflammation of the bladder. Hepatitis is inflammation of the liver. Urethritis is inflammation of the liver. Urethritis is inflammation of the urethra. Glomerulonephritis is inflammation specifically of the glomerular capsules.

A new diuretic is introduced to the market. Which mechanism would allow for the induction of diuresis? Dilation of the urethra Constriction of the afferent arterioles Promotion of antidiuretic hormone (ADH) secretion Blocking of salt channels in the ascending limb Inhibition of the thirst centers of the hypothalamus

Blocking of salt channels in the ascending limb. Increased antidiuretic hormone (ADH) would promote water reabsorption, not excretion. Inhibiting the thirst centers would prevent more fluid from entering the system. Constriction of the afferent arterioles would lead to a decrease in glomerular filtration rate (GFR) and, thus, urine output. Dilation of the urethra would have no effect on diuresis.

Which body fluid is filtered by the kidneys?​ Bile Blood Cerebrospinal fluid Saliva Feces

Blood

Which pressure is the driving force for fluid to enter the glomerular capsule? Blood colloid osmotic pressure Capsular colloid osmotic pressure Capsular hydrostatic pressure Blood hydrostatic pressure Interstitial fluid hydrostatic pressure

Blood hydrostatic pressure The driving force of fluid into the glomerular capsule is blood hydrostatic pressure. The blood colloid osmotic pressure and capsular hydrostatic pressure (technically could also be called the interstitial fluid hydrostatic pressure) would resist this movement. Though there is some capsular colloid osmotic pressure present, it would not be the driving force for the fluid.

Which are targets of angiotensin II? Select all that apply.​ Skeletal muscle Blood vessels Adrenal glands Hypothalamus​ Kidney

Blood vessels Adrenal glands Hypothalamus Kidney Angiotensin II will trigger the release of ADH from the hypothalamus and posterior pituitary gland, the release of aldosterone from the adrenal glands, constriction in the blood vessels, and a decrease in GFR in the kidneys. Skeletal muscle is non-reactive to angiotensin II.

Which is a correct statement regarding the ureters? The epithelium is stratified squamous like the skin, which allows a great deal of stretch.​ Ureters allow for the direct voiding of urine into the environment. The ureter does not have a smooth muscle layer. The ureters are capable of peristalsis like that of the gastrointestinal tract.​ Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.​

The ureters are capable of peristalsis like that of the gastrointestinal tract. The ureters are muscular tubes that are lined with transitional endothelium that lacks any sphincters. They connect the kidneys to the bladder, not the bladder to the outside (urethra). Finally, somatic nerve endings are used to regulate skeletal muscle, but the ureters only have smooth muscle, requiring autonomic regulation.

Which is not true of the kidneys? They are surrounded by a fibrous capsule. ​ They consist of a renal cortex, medulla, and pelvis. They are held in place by the renal fascia. They are located retroperitoneal. They are located partly within the pelvic cavity. ​

They are located partly within the pelvic cavity. The kidneys are retroperitoneal organs located in the upper abdominal quadrants. Externally, they have several fibrotic layers including the renal fascia, adipose capsule, and renal capsule aiding in anchoring and support. Internally, they consist of the renal cortex, medulla, and pelvis. ​ These organs are not found in the pelvic cavity.

Which mechanisms will regulate the glomerular filtration rate (GFR)? Select all that apply. Tubuloglomerular feedback Sympathetic innervation Parasympathetic innervation Myogenic feedback Antidiuretic hormone

Tubuloglomerular and myogenic feedback are autoregulatory mechanisms of the kidney. Antidiuretic hormone (ADH) is a hormone that affects the permeability of the nephron to water. Sympathetic innervation will regulate the amount of filtrate that can be produced. Parasympathetic innervation has not been determined to have any effect on the kidneys and, thus, it will not affect the glomerular filtration rate (GFR).

The nitrogenous waste, ammonia, is usually converted to a less toxic substance known as​ amino acids urea fatty acids sodium chloride crystals uric acid

Urea Ammonia and uric acid are both incredibly toxic substances and thus, these need to be converted into the less toxic urea in the kidneys. Amino acids carry nitrogen, but they are required for protein synthesis and are not inherently toxic. Fatty acids are organic molecules but do not contain nitrogenous groups. Finally, sodium chloride is an inorganic salt, and thus, would not have nitrogen either.

Which are typical nitrogenous waste in urine?​ Select all that apply. Urea Glucose Urobilin Calcium Uric acid

Urea Urobilin Uric acid

Which structure will deliver urine from the kidneys to the bladder? Uterus Urethra Umbilicus Ureters

Ureters

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

Urine with a lower concentration of sodium ions Aldosterone prompts sodium ion reabsorption and potassium secretion and thus, reduces sodium concentration in urine. For a larger volume of urine, ADH would have to be inhibited. Glucose should not be present in urine.

Which of the following would be a typical component of urine? Glucose Water Ketone bodies Bacteria

Water

Match each form of diuresis to its description. Excess water intake leads to an increase in volume of dilute urine. Filtration of solutes such as glucose and mannitol increase, leading to an increase in volume of concentrated urine. Excessive urination of small volumes of fluid. Water diuresis Polyuria Osmotic diuresis

Water diuresis: Excess water intake leads to an increase in volume of dilute urine. Polyuria: Excessive urination of small volumes of fluid. Osmotic diuresis: Filtration of solutes such as glucose and mannitol increase, leading to an increase in volume of concentrated urine.

Which area of the suprarenal glands secrete aldosterone?​ Zona glomerulosa​ Suprarenal capsule​ Zona reticularis​ Zona fasciculata Chromaffin cells​

Zona glomerulosa​ The zona glomerulosa is responsible for the secretion of mineralocorticoids such as aldosterone in the suprarenal glands. The zona reticularis will secrete glucocorticoids. The zona fasciculata will secrete androgens. The chromaffin cells secrete norepinephrine and epinephrin. The suprarenal capsule does not secrete hormones.

The urinary system does all the following, except that it excretes excess albumen molecules regulates blood volume contributes to stabilizing blood pH eliminates organic waste products regulates plasma concentrations of electrolytes

excretes excess albumen molecules The urinary system performs a variety of roles, including regulation of blood volume, blood pH, nitrogenous wastes, and electrolytes. However, albumen is an important protein that the blood requires to maintain its colloid osmotic pressure and thus, it should not be excreted with the urine.

Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by facilitated diffusion passive transport​ antiport transport​​ symport transport simple diffusion.

symport transport For the reabsorption of glucose and amino acids, these will require a form of active transport due to their size and polarity. While glucose is absorbed as secondary active transport with sodium, amino acids are absorbed via symport with sodium. Simple diffusion would require the diffusing substance to be both small and non-polar to penetrate through membranes. Facilitated diffusion can only work if the diffusion substance is not moving against its gradient, but protein levels are already high within the cell, and absorbing more would allow active transport.

Chloride ions are reabsorbed in the ascending nephron loop via simple diffusion facilitated diffusion active transport symport transport with Na+ and K+ ions antiport transport for bicarbonate ion proton pump.

symport transport with Na+ and K+ ions Chloride ions are reabsorbed in the ascending nephron loop via symport transport with sodium and potassium ions.​ They do not follow any of the other mechanisms of transport.

Which of the following is not a portion of the elongated urethra? Prostatic urethra testis urethra Intermediate urethra Penile urethra Spongy urethra

testis urethra

A patient excretes a large volume of very dilute urine on a continuing basis. What may be the cause of this? Absence of ADH Overproduction of aldosterone Excessive ADH secretion Hematuria Constriction of the afferent arterioles

Absence of ADH Without ADH, fluid remains in the tubules and will form larger volumes of dilute urine. Aldosterone and ADH work together to absorb more water and salt, leading to low amounts of concentrated urine. Constriction of the afferent arterioles would lead to a lower GFR, decreasing urinary output. Hematuria refers to blood in the urine, and this implies there is damage somewhere along the tract but does not necessarily create dilute urine.​

Identify whether each characteristic is associated with acute renal failure or chronic renal failure. Acute Renal Failure Chronic Renal Failure Potentially reversible Causes permanent damage Can be caused by hypertension, diabetes myelitis, polycystic kidney disease, or lupus erythematosus Can be caused by shock, myocardial infarction, glomerulonephritis, or medications Symptoms may include fever, muscle weakness, hemorrhage, fatigue, rashes, or bloody stool Symptoms can include polyuria, anuria, urinary incontinence, malaise, hearing deficit, and a metallic taste in the mouth

Acute Renal Failure Potentially reversible Can be caused by shock, myocardial infarction, glomerulonephritis, or medications Symptoms may include fever, muscle weakness, hemorrhage, fatigue, rashes, or bloody stool Chronic Renal Failure Causes permanent damage Can be caused by hypertension, diabetes mellitus, polycystic kidney disease, or lupus erythematosus Symptoms can include polyuria, anuria, urinary incontinence, malaise, hearing deficit, and a metallic taste in the mouth

Which hormone is responsible for the reabsorption of sodium? Parathyroid hormone Antidiuretic hormone Calcitriol Epinephrine Aldosterone

Aldosterone Aldosterone is a corticosteroid that is responsible for the regulation of sodium in the body. When it is present in the nephron, sodium is reabsorbed rather than excreted. Antidiuretic hormone is responsible for the reabsorption of water in the nephron. Parathyroid hormone and calcitriol are responsible for the reabsorption of calcium in the nephron. Epinephrine is not associated with reabsorption.

Which hormone is the primary regulator of sodium homeostasis in the body?​ Aldosterone Angiotensin II​ Parathyroid hormone​ Antidiuretic hormone​ Erythropoietin

Aldosterone Aldosterone is the primary regulator of sodium in the body by increasing the reabsorption of sodium. Its counterpart, atrial natriuretic peptide, aids in decreasing blood sodium levels. ADH will regulate reabsorption of water in the kidneys. PTH will regulate calcium homeostasis. Erythropoietin will regulate the production of red blood cells. Angiotensin II can regulate sodium, but not as much as aldosterone.

What hormone is responsible for the activation of aquaporin 2? Aldosterone Anti-diuretic hormone Angiotensin II Atrial natriuretic peptide

Anti-diuretic hormone

Which of the following is not a hormone produced by the kidneys? Anti-diuretic hormone Renin Calcitriol Erythropoietin

Anti-diuretic hormone

Gallstones can be made from which compound? Calcium carbonate Calcium nitrate Calcium phosphate Calcium sulfate Calcium oxalate

Calcium carbonate Gallstones are a combination of calcium carbonate and cholesterol. Stones made in other organs may utilize different calcium compounds.

Kidney stones can be made from which compounds? Select all that apply. Calcium carbonate Calcium oxalate Calcium sulfate Calcium nitrate Calcium phosphate

Calcium oxalate Calcium phosphate Kidney stones are typically made of either calcium oxalate or calcium phosphate. Gallstones are typically made of calcium carbonate and cholesterol. Calcium sulfate and nitrate are not found in kidney stones.

Determine if the statement is describing the ureter or the urethra. Carries urine between the kidney and the bladder: urethra or ureter Carries urine between the bladder and the environment: urethra or ureter

Carries urine between the kidney and the bladder: Ureter Carries urine between the bladder and the environment: Urethra The ureter and urethra are two structures that are commonly confused due to their similarity in spelling. The ureters are paired muscular tubes that will carry urine from the kidney to the bladder. The urethra is a single tube that will carry urine out of the bladder towards the environment.

Place the locations of urine flow in the correct order, from first to last. Bladder Ureter Collecting duct Urethra Renal pelvis

Collecting duct Renal pelvis Ureter Bladder Urethra

Which is not reabsorbed by the proximal convoluted tubule (PCT)?​ Water Creatinine Sodium (Na+​) ion Glucose​ Potassium (K+​) ion

Creatinine Creatinine is secreted as a metabolic waste product in the proximal convoluted tubule (PCT) using the antiport mechanism and is not reabsorbed by the PCT. The other substances are reabsorbed by the PCT.

Which of the following would refer to the presence of red blood cells (RBCs) in urine? Nocturia​ Polyuria Albuminuria Hematuria Ketonuria

Hematuria Albumin: Albuminuria is a sign of kidney disease and abnormal glomerular filtration that has allowed this protein into the urine.​ Glucose: Glucosuria is a sign of hyperglycemia. As glucose is unable to move back into blood after being filtered due to higher concentration in blood, hence it will be excreted in urine.​ Red blood cells: Hematuria can be a sign of urinary tract infection (UTI), kidney disease, or liver disease.​ Ketone bodies: Ketonuria is a sign that the blood is too acidic, and the individual is breaking down more fats and proteins for energy.​ Microbes: Any microbe found in the urine can potentially mean UTI or kidney disease.​

The secretion of which ion will allow the nephrons to increase blood pH?​ Calcium Bicarbonate Phosphate Hydrogen Ammonia

Hydrogen The two primary ions associated with the blood potential of hydrogen (pH) are hydrogen and bicarbonate. However, it is the secretion of hydrogen into the renal tubule that will result in a net increase in the pH of blood.

Which is not a symptom of polycystic kidney disease? Hypotension Urinary tract infections Headache Kidney stones Hematuria

Hypotension With a blockage by the cysts, less filtrate will move through the nephron, causing fluid to back up into the blood, leading to hypertension, not hypotension. Other symptoms associated with this disease include kidney stone formation, headaches, hematuria, and urinary tract infections.

Which structure produces antidiuretic hormone (ADH)?​ Posterior pituitary gland​ Suprarenal glands​ Anterior pituitary gland​ Kidneys Hypothalamus

Hypothalamus Though the posterior pituitary gland stores excess antidiuretic hormone, it is initially produced in the neurosecretory cells of the hypothalamus.​ ADH is not produced by the anterior or posterior pituitary gland​, the kidneys, or the suprarenal glands.

Excretion of dilute urine requires relative permeability of the distal tubule to water​​ impermeability of the collecting tubule to water ​transport of sodium and chloride ions out of the descending nephron loop the presence of ADH the presence of aldosterone​.

Impermeability of the collecting tubule to water To form dilute urine, permeability to water must be minimized. This will generate an increased volume.​ ADH, aldosterone, and permeability to water would lead to concentrated urine formation. The movement of sodium and chloride out of the descending loop is associated with both dilute urine and concentrated urine.

Which cells produce renin?​ Glomerular endothelial cells​ Macula densa​ Aquaporin cells​ Absorptive cells​ Juxtaglomerular cells​

Juxtaglomerular cells​ Though the macula densa begins the signaling cascade, it does not produce the renin. The signaling cascade must reach the juxtaglomerular cells in the afferent arteriole in order to secrete renin.​ The other listed cells do not produce renin.

The renal veins drain into the ​ renal arteries inferior vena cava​ segmental arteries superior vena cava abdominal aorta

Inferior vena cava Veins do not drain into the arteries but rather into other veins until the blood reaches the heart. The superior vena cava drains structures from above the heart whereas the kidneys are found in the abdominal cavity.

Which is true of antidiuretic hormone (ADH)? It can cause the kidneys to produce a larger volume of very dilute urine. It increases the permeability of the collecting ducts to water. Its release is insensitive to the osmolarity of interstitial fluid. It is secreted by the anterior pituitary. It is secreted in response to low potassium ion in the blood.

It increases the permeability of the collecting ducts to water Antidiuretic hormone (ADH) inserts aquaporin channels into the collecting duct, thus increasing water permeability. It is a hormone that is secreted by the posterior pituitary gland in response to an increase in osmolarity of the interstitial fluids. This will result in the conserving of water from the kidneys, leading to a small volume of concentrated urine.

What is true of antidiuretic hormone (ADH)?​ Its release is insensitive to the osmolarity of interstitial fluid. It causes the kidneys to produce a larger volume of very dilute urine. It increases the permeability of the collecting ducts to water. It is secreted by the anterior pituitary. It is secreted in response to low potassium ion in the blood.

It increases the permeability of the collecting ducts to water. ADH acts directly on the collecting duct and increases its permeability to water. It is secreted by the hypothalamus and posterior pituitary in response to angiotensin II and when the osmolarity of the interstitial fluid is too high (potassium levels would be elevated).

While at a clinical site, several of your peers mentioned that they had been diagnosed with urinary tract infections over the last few weeks. Based on your knowledge of UTIs, which should you remind your peers of? It is important to remember that UTIs cannot be caused by gut bacteria. It is important to decrease fluid consumption during the nursing shift to decrease the need to void.​ It is important to drink more energy drinks to acquire more caffeine. It is important to not ignore the urge to void. It is important to avoid cranberry juice because it can cause UTIs.

It is important to not ignore the urge to void. In this scenario, the nursing students want to make a good impression, but ignoring the urge to void urine is likely to lead to urinary tract infections. Caffeine is not a recommended treatment for UTI. UTIs are commonly caused by gut bacteria.

Which does not describe the juxtaglomerular apparatus (JGA)?​​ Its juxtaglomerular cells produce renin.​ It can be found in the ascending nephron loop. It regulates the rate of filtrate formation.​ Its macula densa cells produce aldosterone. It helps control systemic blood pressure.​

Its macula densa cells produce aldosterone. The macula densa cells do not produce aldosterone, but rather renin. Aldosterone is produced in the adrenal glands. The JGA regulates the filtration rate, regulates systemic blood pressure, and is found in the ascending nephron loop.​

Which would be abnormal if found in urine? Select all that apply. Water ​ Microbes Albumin​ Glucose Ketone bodies

Microbes Albumin Glucose Ketone bodies

Match each form of dialysis to its appropriate description. Performed by placing an access tube into the lining of the abdominal wall, and the process can be conducted at home or any other clean place. Performed by creating an access port in the arm in any available artery or vein, and the client is hooked up to a dialysis machine.​ Peritoneal dialysis Hemodialysis

Peritoneal dialysis: Performed by placing an access tube into the lining of the abdominal wall, and the process can be conducted at home or any other clean place. Hemodialysis: Performed by creating an access port in the arm in any available artery or vein, and the client is hooked up to a dialysis machine.

Which term would best describe an increase in the frequency of urination? Polyuria Glucosuria Anuria Dysuria Nocturia

Polyuria Polyuria refers to an increased frequency of urination. Anuria refers to a lack of urination. Nocturia is urination that occurs at night. Dysuria refers to abnormal urination patterns. Glucosuria refers to the presence of glucose in the urine.

Which nervous structure is associated with the micturition reflex? Pons Thalamus Medulla oblongata Hypothalamus

Pons

Where are the kidneys located? Posterior thoracic ​cavity Anterior abdominal​ cavity Posterior abdominal cavity Inferior pelvic cavity​ Inferior abdominal cavity

Posterior abdominal cavity.

Which urinalysis result suggests a deviation from homeostasis? Specific gravity of 1.0​2 Potential of hydrogen (pH) of 4.3 Pale yellow in color No glucose in the urine Osmolarity of 800 milliosmole/liter (mOsm/L)

Potential of hydrogen (pH) of 4.3 The potential of hydrogen (pH) of urine will typically fall in the range of 4.5-8.2 and thus, 4.3 is outside this range. The other findings of the urinalysis are within normal parameters.

Which of the following is not a common component of urine? Water Sodium Protein Urea

Protein

Which substance is not normally found in the filtrate? Glucose Urea ​ Water ​ Chloride ions Protein

Protein The filtrate is formed via passage of substances through the filtration membranes of the renal corpuscle. Anything smaller than proteins (water, chloride ions, glucose, urea) can pass through, but most proteins are stopped from entering the tubule. Thus, of these options, only protein cannot pass through.

Which nephron structure is responsible for most of the reabsorption? Proximal convoluted tubule (PCT)​ Glomerular capsule Ascending nephron loop Distal convoluted tubule (DCT)​ Descending nephron loop

Proximal convoluted tubule (PCT). Most of the reabsorption in the nephron occurs in the proximal convoluted tubule. Filtration occurs in the renal corpuscle, which consists of the glomerular capillaries and capsule. The nephron loop has a reabsorption role, but it will not reabsorb as much as the PCT. The DCT will be the portion of the nephron that will finish determining the final concentration of the urine.

Which would not occur when a person is overhydrated?​ Release of antidiuretic hormone Decrease in mean arterial pressure (MAP) Production of up to 20 liters of urine in a single day Release of atrial natriuretic peptide Reabsorption of water in the DCT and collecting duct

Release of antidiuretic hormone Antidiuretic hormone (ADH) release would result in the reabsorption of water from the renal tubule, leading to a further increase in blood volume and subsequently blood pressure. With overhydration, the body will attempt to excrete large amounts of urine (up to 20 liters in a day) to bring down blood volume and pressure. It will do this by secreting atrial natriuretic peptide (ANP).​ All other factors will lead to increased fluid volume in the body.

Which vessel delivers oxygen-rich blood through the renal hilum? Renal veins Renal arteries Arcuate arteries Interlobar veins Segmental arteries

Renal arteries. Oxygen-rich blood enters the renal hilum through the renal arteries. Once in the kidney, it will branch off into the segmental, interlobar, and arcuate arteries. The interlobar veins carry deoxygenated blood towards the renal veins which will leave through the renal hilum.

Which component of the kidney is responsible for the filtration of blood plasma? Nephron tubule Nephron loop Renal capsule Collecting duct Renal corpuscle

Renal corpuscle The renal corpuscle consists of three filtration membranes: the fenestrated endothelium of the glomerular capillaries, the basal lamina, and the filtration slits created by the podocytes of the glomerular capsule. The nephron tubule, nephron loop, and collecting duct will participate in reabsorption and excretion. The renal capsule acts as a protective structure around the outside of the kidney.

The nephron loop is found predominantly in which portion of the kidney? Renal column Renal pelvis Renal pyramids Renal cortex

Renal pyramids

Which hormones are secreted by the kidneys? Select all that apply. Renin Erythropoietin Calcitriol Aldosterone Angiotensin II

Renin Erythropoietin Calcitriol Aldosterone is secreted by the suprarenal (adrenal) glands. Angiotensin II is a blood pressure-regulating hormone that requires activation of angiotensinogen by renin and angiotensin-converting enzymes.

Which hormones are produced by the kidneys? Select all that apply. Calcitonin Renin Erythropoietin Epinephrine Calcitriol

Renin Erythropoietin Calcitriol The thyroid gland produces calcitonin. The suprarenal glands produce epinephrine.​

Atrial natriuretic peptide is responsible for the excretion of which electrolyte?​ Phosphate Sulfate Sodium Potassium Bicarbonate

Sodium The term natriuretic can be broken down into "natri-" meaning "sodium" and "uretic" meaning "excretion of through the urine". Thus, natriuretic peptides aid in regulating blood pressure through the excretion of sodium.​ It will not be responsible for secreting potassium, phosphate, bicarbonate, or sulfate.

Which bacteria is a common cause of glomerulonephritis? Plasmodium vivax Streptococcus spp. Escherichia coli Heliobacter pylori Salmonella spp.

Streptococcus spp. Poststreptococcal glomerulonephritis occurs when an individual has an untreated infection for Streptococcus spp. H. pylori, E. coli, and Salmonella spp. are associated with gastrointestinal conditions. P. vivax (malaria) is associated with circulatory conditions.

Match each type of urinary incontinence to its description. An individual has a weakened bladder that will expel small amounts of urine during physical activity.​ An individual is suddenly compelled to void their urine.​ An individual's bladder control is normal, but other barriers exist for the individual making it to the bathroom.​ An individual's bladder is always full and some leaks out.​ Stress incontinence Urge incontinence Overflow incontinence Functional incontinence

Stress incontinence: An individual has a weakened bladder that will expel small amounts of urine during physical activity.​ Urge incontinence: An individual is suddenly compelled to void their urine.​ Functional incontinence: An individual's bladder control is normal, but other barriers exist for the individual making it to the bathroom.​ Overflow incontinence: An individual's bladder is always full and some leaks out.

Which organs are associated with the renin-angiotensin-aldosterone (RAA) pathway? Select all that apply. Suprarenal glands​ Liver Spleen Lungs Kidney

Suprarenal glands Liver Lungs Kidney The kidneys will secrete renin. The liver secretes angiotensinogen. The lungs secrete angiotensin-converting enzyme (ACE). With these organs, angiotensin II is formed, which will further activate the suprarenal glands to produce aldosterone.​ The spleen is the only organ on this list that does not play a role in the RAA pathway.

Urine is carried from the kidneys to the urinary bladder by ​ the blood vessels the lymphatics the ureters the urethra the renal cortex

The ureters Note that although the ureters and urethra look similar in name, they are very different. The ureters are muscular tubes that extend from the kidneys and drain urine into the bladder, whereas the urethra carries urine from the bladder to the outside.​ Blood vessels can conduct blood to the kidney, but not the urine. Lymphatic vessels can aid in electrolyte balance, but not urine transport. The renal cortex is an internal structure of the kidneys but does not carry urine.

Which are correct statements regarding the elongated urethra? Select all that apply. The first segment is referred to as the prostatic urethra. The intermediate urethra is the widest segment. The elongated urethra can receive fluids from both the urinary and reproductive systems. The elongated urethra is approximately 20 cm. The external urethral sphincter is found within the spongy urethra.

The elongated urethra is found in individuals that have a prostate and a penis and is approximately 20 cm in length. The first segment is the prostatic urethra, which is directly attached to the bladder and is the widest segment. The second segment is the intermediate urethra, the narrowest segment and it contains the external urethral sphincter. Finally, the spongy urethra is the last segment and allows the voiding of urine out through the external urethral orifice.

Passive membrane transport processes include the movement of a substance down its concentration gradient​ movement of water from an area of high solute concentration to an area of low concentration ​consumption of ATP ​​use of transport proteins when moving substances from areas of low to high concentration use of energy to power pumps.

movement of a substance down its concentration gradient​ Passive membrane transport is a method of transport that allows substances to move down their concentration gradient, or from high concentration to low concentration. Facilitated diffusion is a form of passive transport that requires transport proteins, but not all forms of passive transport require these proteins. Finally, this form of transport does not require energy, hence the "passive" portion of this transport.​

Each of these organs is a component of the urinary system, except the kidney urinary bladder rectum ureter urethra

rectum

When the level of antidiuretic hormone (ADH) decreases, ​a concentrated urine is produced less urine is produced the osmolarity of the urine decreases permeability to water in the collecting system increases water reabsorption increases in the loop of Henle

the osmolarity of the urine decreases With a decrease in ADH, more dilute urine will be produced, decreasing its osmolarity and increasing its volume. Permeability to water is increased when ADH is present.