EXAM 5

by active mechanisms usually involves movement against an electrical and/or chemical gradient

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

True

Tubular secretion is effective in controlling blood pH

False

Urea is reabsorbed in the loop of Henle.

renal calculi

Urine crystals in the renal pelvis are called ________.

True

Urine is 95% water by volume.

pelvis of the kidney to ureter to bladder to urethra

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

True

Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration

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

Weak acids are able to act as chemical buffering systems for the body because they partially dissociate.

Aquaporins are water-filled pores in water-permeable portions of the convoluted tubules such as the PCT.

What are aquaporins?

This patient would have a much higher glomerular hydrostatic pressure and would therefore lose more fluids than normal. Because of the threat of dehydration, the staff should make sure the patient drinks plenty of water.

What clinical effects would high blood pressure have on the kidneys of a bedridden patient?

atrial natriuretic peptide

What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) ADH B) aldosterone C) atrial natriuretic peptide D) thyroxine

the placenta allows the mother's urinary system to clear the waste from fetal blood

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 mother's 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

Intracellular

Fluid compartments located within the cell.

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.

Freshly voided urine has very little smell, but shortly after voiding it can give off a very strong smell. Why?

False

Glomerular filtration is an ATP-driven process.

sodium

Newborn infants have a relatively higher ________ content in their ECF than do adults. A) iron B) sodium C) magnesium D) bicarbonate

True

Obligatory water reabsorption involves the movement of water along an osmotic gradient.

a rise in plasma osmolality

One of the major physiological factors that triggers thirst is ________. A) a dry mouth from high temperatures B) becoming overly agitated C) drinking caffeinated beverages D) a rise in plasma osmolality

True

One of the most powerful and plentiful sources of buffers is the protein buffer system.

intracellular fluid

Phosphate ions are highest in ________.

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 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

Hyperkalemia

Potassium excess.

intracellular fluid

Potassium ions are highest in ________.

True

Premenstrual edema may be due to enhanced reabsorption of sodium chloride.

True

Pressure diuresis decreases blood volume and blood pressure.

inefficient kidneys

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________. A) inefficient kidneys B) comparatively low metabolic rates C) low rate of insensible water loss D) low daily rate of fluid exchange

True

Prolonged hyperventilation can cause alkalosis.

intracellular fluid

Proteins are highest in ________.

It is possible that Rachael has cystitis, a condition in which the mucous membrane lining the bladder becomes swollen and bleeding occurs. This condition is caused by bacterial invasion of the bladder or by chemical or mechanical irritation.

Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms?

secondary active transport

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

progesterone

The female hormone ________ seems to decrease sodium reabsorption, thus promoting sodium and water loss by the kidney.

renal fascia

The filtration membrane includes all except ________. A) glomerular endothelium B) podocytes C) renal fascia D) basement membrane

Extracellular

The fluid compartments outside the cell

pyuria

The presence of pus in the urine is a condition called ________.

False

The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.

It is not uncommon for anorexics who are chronically fluid depleted to develop a compensatory increased production of aldosterone, which causes the kidneys to conserve sodium and water.

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. Explain these symptoms.

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.

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.

Hyponatremia

A condition due to excessive water intake that results in net osmosis into tissue cells. This leads to severe metabolic disturbances

Hypoproteinemia

A condition of unusually low levels of plasma proteins resulting in tissue edema.

diabetes insipidus

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

Addison's disease

A disorder entailing deficient mineralocorticoid hormone production by the adrenal cortex.

respiratory acidosis

A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) respiratory acidosis B) respiratory alkalosis C) metabolic acidosis D) metabolic alkalosis

Escherichia coli are normal residents of the digestive tract and generally cause no problems there, but these bacteria account for 80% of all urinary tract infections. The nurse can instruct the patient on proper hygiene measures. The nurse should also explain that sexually transmitted infections can also inflame the urinary tract, clogging some of its ducts

A patient is 18 years old and has a complaint of painful urination, fever, chills, and back pain. This is her second urinary tract infection (UTI) within 5 months. How can the RN instruct the patient on prevention of another UTI?

Edema is an atypical accumulation of fluid in the interstitial space, leading to tissue swelling. Heart failure is one cause of edema.

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. A symptom of heart failure is generalized edema. Explain the finding of generalized edema in heart failure. Answer: Edema is an atypical accumulation of fluid in the interstitial space, leading to tissue swelling. Heart failure is one cause of edema.

The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. With a pH below 7.0, the patient will go into a coma and death soon follows.

A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. What diagnosis would you give and what prognosis? A medical history reveals that this patient is a chronic alcoholic.

metabolic alkalosis

A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) respiratory acidosis B) metabolic acidosis C) metabolic alkalosis D) respiratory alkalosis

Instructing the patient to breathe more slowly will increase the patient's blood level of CO2. Having the patient breathe into a paper bag would also increase blood CO2 levels.

A patient's anxiety caused her to develop respiratory alkalosis. The nurse instructs the patient to take some slow deep breaths. Explain why this would be effective.

She is showing edema, an atypical accumulation of fluid in the spaces between cells (interstitial spaces). This is caused by her pregnancy due to a high blood volume that increases capillary hydrostatic pressure and enhances capillary permeability. She should be monitored for the edema during the pregnancy, but it should clear up at the end of the pregnancy.

A pregnant woman complains to her doctor that her ankles and feet stay swollen all of the time. She is very worried about this. As her doctor, what would you tell her?

False

Adipose tissue is one of the most hydrated of all tissues in the human body.

Respiratory alkalosis is always caused by hyperventilation. Claire is experiencing the effect of the high altitude and was overcompensating or trying to do too much the first day in Denver.

After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. The clinic's diagnosis is respiratory alkalosis. What has caused this problem?

inhibits the release of ADH

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

True

Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.

False

Aldosterone is secreted in response to low extracellular potassium.

True

Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.

True

Although the sodium content of the body may be altered, its concentration in the ECF remains stable because of immediate adjustments in water volume.

Edema

An atypical accumulation of fluid in the interstitial space.

False

An excessive urine output is called anuria

1.001-1.035

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

Hypocalcemia

Calcium depletion

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 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

The symptoms indicate a kidney stone that has been passed into the ureter. Treatment would be IV therapy to flush the stone out, surgery, or ultrasound waves to shatter the calculi. The prognosis is for complete recovery. There is a possibility of kidney stones forming again

An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. X rays indicate a shadow on his right ureter. Diagnose his problem. Give suggested treatment and prognosis.

False

Angiotensin II is a substance made by the body to lower blood pressure during stress

There will be a temporary increase in blood volume.

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) It will increase the osmolality of the blood. B) There will be a temporary increase in blood volume. C) She will experience hypotension. D) There will be a shift in the pH of her body fluids to the higher side of the pH scale.

acidemia/acidosis

Arterial blood pH below 7.35 is called ________.

True

As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases

reduce blood pressure and blood volume by inhibiting sodium and water retention

Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) enhance atrial contractions B) activate the renin-angiotensin mechanism C) prevent pH changes caused by organic acids D) reduce blood pressure and blood volume by inhibiting sodium and water retention

False

Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events that promote vasodilation and potassium and water retention.

True

Atrial naturetic peptide inhibits sodium reabsorption.

interstitial fluid

Bicarbonate ions are highest in ________.

True

Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS.

metabolic acidosis

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) metabolic alkalosis D) respiratory alkalosis

True

Blood in the urine may be a symptom of bladder cancer.

False

Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water.

Peritubular capillaries.

Blood supply that directly receives substances from the tubular cells.

Falsee

Calcitonin targets the bones and causes the release of calcium from storage when serum levels are low

True

Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus.

Parathyroid hormone (PTH) activates osteoclasts that break down the bone matrix, resulting in the release of Ca2+ and PO43- to the blood. PTH enhances intestinal absorption of Ca2+ indirectly by stimulating the kidneys to transform vitamin D to its active form, which is necessary for calcium absorption by the small intestine. PTH increases the reabsorption of calcium by the renal tubules, which simultaneously decreases phosphate ion reabsorption.

Describe the influence of rising PTH levels on bone, the small intestine, and the kidneys.

Virtually all of the H+ that leaves the body in urine is secreted into the filtrate. The tubule cells, including collecting ducts, appear to respond directly to the pH of the ECF and to alter their rate of H+ secretion accordingly. The secreted H+ ions are obtained from the dissociation of carbonic acid within the tubule cells. For each H+ ion actively secreted into the tubule lumen, one sodium ion is reabsorbed into the tubule cell from the filtrate, thus maintaining the electrochemical balance.

Describe the mechanisms by which the kidneys remove hydrogen ions from the body.

Electrolytes

Dissociate in water

Nonelectrolytes

Do not dissociate

True

Electrolytes determine most of the chemical and physical reactions of the body.

Harry is showing the symptoms of kidney inflammation. The smoky brown color of the urine indicates the presence of blood or bile. Kidney inflammations usually result from infections either of the lower urinary tract or, in Harry's case, from his earlier infection of a sore throat. The kidney inflammation is called either pyelitis (involves only the renal pelvis and calyces) or pyelonephritis (affects the whole kidney).

Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harry's signs and symptoms, diagnose his condition and indicate the relationship (if any) between his present condition and his earlier sore throat.

Proteinuria is a condition in which the permeability of the glomerular capillaries is increased to such an extent that large amounts of plasma proteins (mostly albumin) pass into the glomerular filtrate and are excreted in the urine. If the condition is severe, the loss of plasma proteins may decrease osmotic pressure substantially. When this happens there is a tendency for fluid to leave the systemic blood vessels and enter the tissue space. This is the reason for Ellen's swollen limbs.

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?

impermeability of the collecting tubule to water

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

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

Explain how an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as an antihypertensive.

The glomerular capillaries are fenestrated, allowing fairly large molecules to pass through. The substances must pass through the basement membrane, where they are further selected for size by the filtration slits of the podocytes

Explain how filtration works in the glomerular capillaries.

Aldosterone targets the distal tubule and collecting duct and enhances sodium ion reabsorption so that very little leaves the body in urine. Aldosterone also causes increased water reabsorption because, as sodium is reabsorbed, water follows it back into the blood

Explain the role of aldosterone in sodium and water balance.

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

Explain what is meant by the terms cotransport process and transport maximum.

glucose

Extracellular fluid in the human body is composed of all of the following except ________. A) lymph and interstitial fluid B) blood plasma C) cerebrospinal fluid D) glucose

False

Having a kinked ureter is called renal ptosis.

True

Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal.

Helen is suffering from respiratory acidosis because she is retaining too much carbon dioxide. Her shallow breathing, due to the damage to her lungs from the disease, is the cause. In order to release the carbon dioxide, one must be able to breathe normally (deep breathing would be optimal).

Helen is a 62-year-old smoker. Her physician has diagnosed her as having emphysema that has caused her to hypoventilate. She is tired and sedentary. Besides having difficulty breathing, what other condition is contributing to her tiredness?

The respiratory system maintains a constant bicarbonate level in the bloodstream by outgassing carbon dioxide. In the event of a respiratory problem the bicarbonate system might not be a constant.

How does the respiratory system influence the buffer systems of the body?

Facultative water reabsorption depends on the presence of antidiuretic hormone. In the presence of ADH, the pores of the collecting tubule enlarge and the filtrate loses water by osmosis as it passes through the medullary regions of increasing osmolarity. Consequently, water is conserved and urine becomes concentrated. The water that passes through these regions is reabsorbed by the body in order to prevent dehydration.

Humans can survive for a period of time without water thanks to the ability of the kidneys to produce concentrated urine. Briefly explain the factors that allow this to happen.

False

Hypercalcemia causes muscle tetany

tissue edema

Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________. A) tissue edema B) extreme weight loss C) extreme weight gain D) nerve damage

Falsee

Hypoproteinemia reflects a condition of unusually high levels of plasma proteins and causes tissue edema.

The bicarbonate buffer system (carbonic acid plus sodium bicarbonate) acts to tie up the hydrogen ions released by a strong acid, thus converting it to a weaker acid, which lowers the pH only slightly. For a strong base, the carbonic acid will be forced to donate more H+ to tie up the OH- released by the base, with the net result of replacement of a strong base by a weak one. The pH rise is very small. The phosphate buffer system, composed of the sodium salts of dihydrogen phosphate and monohydrogen phosphate, acts in a similar fashion to the bicarbonate system. NaH2PO4 acts as a weak acid; Na2HPO4 acts as a weak base. Hydrogen ions released by strong acids are tied up in weak acids; strong bases are converted to weak bases. Amino acids of the protein buffer system release H+ when the pH begins to rise by dissociating carboxyl groups, or bind hydrogen ions with amine groups to form NH3+ when the pH falls.

Identify and describe the operation of the three major chemical buffers of the body.

Normally all the glucose is reabsorbed.

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.

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.

appear in the urine

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) be actively secreted into the filtrate B) be completely reabsorbed by the tubule cells C) appear in the urine D) be reabsorbed by secondary active transport

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.

In addition to the renin-angiotensin mechanism, the renal cells produce other chemicals. Name four, and briefly give the main function of each.

True

In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water

thick segment moves ions out into interstitial spaces for reabsorption

In the ascending limb of the loop of Henle the ________. A) thin segment is freely permeable to water B) thick segment is permeable to water C) thin segment is not permeable to sodium and chloride D) thick segment moves ions out into interstitial spaces for reabsorption

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.

Falseee

It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions.

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.

List and describe three pressures operating at the filtration membrane, and explain how each influences net filtration pressure.

Abnormal urinary constituents include the following (the clinical term for each is listed in parentheses): glucose (glycosuria), proteins (proteinuria or albuminuria), ketone bodies (ketonuria), hemoglobin (hemoglobinuria), bile pigments (bilirubinuria), erythrocytes (hematuria), and leukocytes (pyuria)

List three substances that are abnormal urinary constituents and provide the proper clinical term for such abnormalities.

Hypermagnesemia

Magnesium excess.

amphoteric

Molecules that can act reversibly as acids or bases depending upon the pH of their environment are called ________

True

Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism

hormonally controlled in distal tubule segments

Most electrolyte reabsorption by the renal tubules is ________. A) not Tm limited B) in the distal convoluted tubule C) hormonally controlled in distal tubule segments D) completed by the time the loop of Henle is reached

Alex may be suffering from Addison's disease, a disorder entailing deficient mineralocorticoid hormone production by the adrenal cortex. Sometimes when the necessary electrolytes are deficient, people crave strange substances such as chalk, clay, starch, or burnt match tips. This unusual habit is called pica.

Recently Alex's family noticed that he is craving salt to the point where he uses it excessively on his food. He also has a need to consume strange substances such as clay and burnt match tips. What might be the cause of this strange behavior?

Aldosteron

Regulates sodium ion concentrations in the extracellular fluid.

False

Regulation of the acid-base system is accomplished mainly through respiratory control, and the kidneys also play a small role.

a person's breathing is shallow due to obstruction

Respiratory acidosis can occur when ________. A) a person consumes excessive amounts of antacids B) a person's breathing is shallow due to obstruction C) a runner has completed a very long marathon D) the kidneys secrete hydrogen ions

True

Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.

True

Salts are lost from the body in perspiration, feces, and urine

Kidney tubule cells are able to synthesize bicarbonate ion.

Select the correct statement about renal mechanisms of acid-base balance. A) The kidneys are not able to excrete phosphoric acid. B) Excreted hydrogen ions are unbound in the filtrate. C) Kidney tubule cells are able to synthesize bicarbonate ion. D) The kidneys are the most important mechanism for eliminating all bicarbonate ions.

The parietal layer of the glomerular capsule is simple squamous epithelium.

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.

The ureters are capable of peristalsis like that of the gastrointestinal tract.

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.

Kidneys develop from urogenital ridges.

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

False

Severe damage to the respiratory system rarely will result in acid-base imbalances.

Proximal convoluted tubule.

Site at which most of the tubular reabsorption occurs.

Glomerulus

Site of filtrate formation.

Collecting duct

Site that drains the distal convoluted tubule

Hyponatremia

Sodium depletion

Hypernatremia

Sodium excess

blood plasma

Sodium ions are highest in ________.

True

Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.

obligatory

Sodium-linked water flow across a membrane is called ________ water reabsorption.

False

Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients.

Interstitial

Spaces between cells.

arcuate

The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) lobar B) arcuate C) interlobar D) cortical radiate

myogenic

The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched.

True

The act of emptying the bladder is called voiding.

trigone

The area between the ureters and urethra is called the ________ in a bladder.

sodium ions

The body's water volume is closely tied to the level of which of the following ions? A) calcium ions B) potassium ions C) hydrogen ions D) sodium ions

phosphoric

The breakdown of phosphorus-containing proteins releases ________ acid.

vasa recta

The capillary bed that surrounds the descending and ascending loop of Henle of juxtamedullary nephrons is called the ________.

glomerular hydrostatic pressure (glomerular blood pressure)

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

False

The collecting duct is impermeable to water in the presence of ADH.

contains fluid that becomes more concentrated as it moves down into the medulla

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

True

The entire responsibility for urine formation lies with the nephron.

glomerular hydrostatic pressure

The factor favoring filtrate formation at the glomerulus is the ________. A) colloid osmotic pressure of the blood B) glomerular hydrostatic pressure C) capsular hydrostatic pressure D) myogenic mechanism

stabilizes the position of the kidneys by holding them in their normal position

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

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) glucose B) hormones C) electrolytes D) plasma protein

plasma

The fluid link between the external and internal environment is ________. A) plasma B) intracellular fluid C) interstitial fluid D) cerebrospinal fluid

constrict arterioles and increase blood pressure

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

nephron

The functional and structural unit of the kidneys is the ________. A) nephron B) loop of Henle C) glomerular capsule D) basement membrane of the capillaries

is drained by an efferent arteriole

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

regulating the rate of filtrate formation and controlling systemic blood pressure

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

by a decrease in the blood pressure

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

False

The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate

changes in solute content of the filtrate

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

True

The main way the kidney regulates potassium ions is to excrete them.

the control of respiratory ventilation

The maintenance of the proper pH of the body fluids may be the result of ________. A) the control of respiratory ventilation B) the operation of the various buffer systems in the stomach C) the active secretion of OH- into the filtrate by the kidney tubule cells D) control of the acids produced in the stomach

osmosis

The mechanism of water reabsorption by the renal tubules is ________. A) active transport B) osmosis C) solvent drag D) cotransport with sodium ions

loop of Henle

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

False

The most abundant cation in intracellular fluid is sodium.

sodium bicarbonate

The most important ECF buffer of HCl is ________.

hydrostatic pressure of capillary blood

The most important force causing net water flow across capillary walls is ________. A) osmotic pressure of plasma proteins B) hydrostatic pressure of capillary blood C) hydrostatic pressure of interstitial fluid D) intracellular hydrostatic pressure

PTH (parathyroid hormone)

The most important hormone that regulates calcium ions in the body is ________.

is regulated by osmotic and hydrostatic forces

The movement of fluids between cellular compartments ________. A) requires active transport B) is regulated by osmotic and hydrostatic forces C) requires ATP for the transport to take place D) involves filtration

False

The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.

nocturia

The need to get up in the middle of the night to urinate is called ________.

True

The normal pH of blood is 7.35-7.45

True

The phosphate buffer system is relatively unimportant for buffering blood plasma.

True

The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.

hydrogen phosphate

The preferred intracellular negative ion is ________.

involves aldosterone-induced secretion of potassium

The regulation of potassium balance ________. A) is not linked to sodium balance B) includes renal secretion, but never absorption C) is accomplished mainly by hepatic mechanisms D) involves aldosterone-induced secretion of potassium

is linked to blood pressure

The regulation of sodium ________. A) is due to specific sodium receptors in the hypothalamus B) is linked to blood pressure C) involves aldosterone, a hormone that increases sodium excretion in the kidneys D) involves hypothalamic osmoreceptor detection of ion concentration

Bowman's capsule and glomerulus

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

True

The single most important blood buffer system is the bicarbonate buffer system.

potassium ion concentration in blood plasma

The single most important factor influencing potassium ion secretion is ________. A) the potassium ion content in the renal tubule cells B) the pH of the ICF C) intracellular sodium levels D) potassium ion concentration in blood plasma

bicarbonate

The term alkaline reserve is used to describe the ________ buffer system. A) phosphate B) hemoglobin C) bicarbonate D) protein

a condition that may result from renal insufficiency or drinking extraordinary amounts of water

The term hypotonic hydration refers to ________. A) the feeling one might have after a long swim B) the unpleasant feeling people have after drinking too much liquor C) a condition that may result from renal insufficiency or drinking extraordinary amounts of water D) a condition that is caused by high levels of sodium in the extracellular fluid compartment

True

The thirst center in the brain is located in the hypothalamus.

False

The trigone is so named because of the shape of the urinary bladder.

False

The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin

True

The ureter transports urine from the kidney to the urinary bladder.

True

The urethra contains an internal sphincter of smooth muscle.

transitional

The urinary bladder is composed of ________ epithelium. A) transitional B) simple squamous C) stratified squamous D) pseudostratified columnar

False

Thirst is always a reliable indicator of body water need.

True

To remain properly hydrated, water intake must equal water output.

When the body is in acute acidosis, the nervous system becomes so severely depressed that the person goes into a coma and death soon follows. Alkalosis causes overexcitement of the nervous system. Characteristic signs include muscle tetany, extreme nervousness, and convulsions. Death often results from respiratory arrest.

What is the effect of acidosis on the body? Of alkalosis?

help regulate blood pressure and the rate of blood filtration by the kidneys

What is the function of the juxtaglomerular apparatus? A) help regulate blood pressure and the rate of blood filtration by the kidneys B) help regulate blood pressure and the rate of excretion by the kidneys C) help regulate urea absorption by the kidneys D) help regulate water and electrolyte excretion by the kidneys

Chemical buffers act within a fraction of a second to resist a pH change. The longest-term mechanism is the kidney system, which ordinarily requires from several hours to a day or more to effect changes in blood pH.

What provides the shortest-term mechanism for preventing acid-base imbalances in the body? The longest-term mechanism?

Net filtration would decrease.

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 filtration would not change.

True

When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the collecting tube.

A person experiences greater thirst during periods when ADH release is elicited.

When does a person experience greater thirst, during periods when ADH release is elicited or during periods when aldosterone release is elicited?

The release of ADH causes the kidney tubules to reabsorb excess water, resulting in the excretion of concentrated urine

When the blood becomes hypertonic (too many solutes), ADH is released. What is the effect of ADH on the kidney tubules?

potassium

Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. A) iron B) chloride C) potassium D) magnesium

macula densa cells

Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate? A) juxtaglomerular cells B) mesangial cells C) macula densa cells D) podocytes

adrenal

Which gland sits atop each kidney? A) adrenal B) thymus C) pituitary D) pancreas

angiotensin II and aldosterone

Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion? A) angiotensin II and ADH B) angiotensin II and aldosterone C) angiotensin I and epinephrine D) angiotensin I and atrial natriuretic peptide

ridding the body of bicarbonate ions

Which of the choices below does not describe the importance of tubular secretion? A) disposing of substances not already in the filtrate, such as certain drugs B) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes C) ridding the body of bicarbonate ions D) ridding the body of excessive potassium ions

aldosterone

Which of the choices below exerts primary control over sodium levels in the body? A) ADH B) aldosterone C) water levels D) glucocorticoids

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 loop of Henle? 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 with an automatic absorption of water by osmosis D) none of these

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

electrolyte levels

Which of the choices below is not a glomerular filtration rate control method? A) renal autoregulation B) neural regulation C) electrolyte levels D) hormonal regulation

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 reabsorbing filtered bicarbonate ions C) by producing new bicarbonate ions D) by secreting sodium ions

anabolism of proteins

Which of the choices below is not an essential role of salts in the body? A) neuromuscular activity B) membrane permeability C) secretory activity D) anabolism of proteins

macula densa

Which of the choices below is the salt level-monitoring part of the nephron? A) macula densa B) principal cell C) vasa recta D) loop of Henle

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 pressure of the fluid in the bladder D) the sympathetic efferents

Kidney function decreases due to kidney atrophy.

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.

K+ mainly in the cells, Na+ in the body fluids

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) Na+ mainly in the cells, K+ in the body fluids C) equal amounts of each ion in the cells and body fluids D) little of either in the cells, but large amounts of each in the body fluids

amount of body fat

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

antidiuretic hormone

Which of the following hormones is important in stimulating water conservation in the kidneys? A) aldosterone B) thymosin C) antidiuretic hormone D) atrial natriuretic peptide

aldosterone

Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) antidiuretic hormone B) erythropoietin C) aldosterone D) renin

nucleic acid

Which of the following is not a chemical buffer system? A) bicarbonate B) phosphate C) nucleic acid D) protein

excessive hydration due to excess ADH secretion

Which of the following is not a disorder of water balance? A) excessive hydration due to excess ADH secretion B) hypotonic hydration, in which sodium content is normal but water content is high 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

diet

Which of the following is not a method for regulating the hydrogen ion concentration in blood? A) chemical buffer systems B) diet C) respiratory changes D) renal mechanism

podocyte cells

Which of the following is not a part of the juxtaglomerular apparatus? A) granular cells B) macula densa C) podocyte cells D) mesangial cells

They are extremely complex molecules.

Which of the following is not a reason why substances are either not reabsorbed or are incompletely reabsorbed from the nephron? A) They lack carriers. B) They are not lipid soluble. C) They are too large to pass through the fenestrations. D) They are extremely complex molecules.

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

creatinine

Which of the following is not reabsorbed by the proximal convoluted tubule? A) Na+ B) K+ C) glucose D) creatinine

They are trilayered (mucosa, muscularis, and adventitia)

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

The male urethra serves both the urinary and reproductive systems at the same time.

Which of the following statements is a false or incorrect statement? A) The male urethra serves both the urinary and reproductive systems at the same time. B) The male urethra serves both the urinary and reproductive systems but at different times. C) The male urethra is longer than the female urethra. D) The male urethra is a passageway for both urine and semen.

Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

Which of the following statements is true regarding fluid shifts? A) Nonelectrolytes are the controlling factor in directing fluid shifts. B) Electrolytes are not as important as proteins in regulating fluid shifts in the body. C) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts. D) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.

the lungs and the kidneys

Which of the following two organs function as the most important physiological buffer systems? A) the lungs and the kidneys B) the adrenal glands and the testes C) the thyroid gland and the heart D) the stomach and the liver

ADH

Which of the hormones below is responsible for facultative water reabsorption? A) ADH B) thyroxine C) aldosterone D) atrial natriuretic peptide

Reabsorption of water is hormonally controlled.

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.

If the infant is uncomfortable and cries forcefully for long periods of time, this would be similar to hyperventilation. Hyperventilation would cause respiratory alkalosis because the infant is losing carbon dioxide rapidly.

Why would an infant with colic be suffering from respiratory alkalosis?

Respiratory alkalosis

________ occurs when carbon dioxide is eliminated faster than it is produced.

Atrial natriuretic peptide

________ reduces blood pressure and volume by inhibiting nearly all events that promote vasoconstriction and the retention of sodium ions and water.