Urinary System Review

In French, it's "faire de pipi," in Spanish, it's "hacer pipí," in English, it's "I have to pee." What's the medical term for this universal urge to pass urine?

micturition

Which hormone(s) is released by cardiac muscle cells in response to increased atrial distension?

natriuretic peptides

Which segment of the nephron is solely involved in the reabsorption of water and sodium and chloride ions?

nephron loop

Countercurrent multiplication takes place in the

nephron loop.

The U-shaped segment of the nephron is the

nephron loop.

The functional unit of the kidney is the

nephron.

When water is lost, but electrolytes are retained,

osmosis moves water from the intracellular fluid to the extracellular fluid.

All of the following factors are consistent with hyperkalemia except

overuse of diuretics.

What effect would a decrease in the Na+ concentration of filtrate have on the pH of tubular fluid?

pH would increase because fewer hydrogen ions could be secreted by countertransport.

The ________ delivers urine to a minor calyx.

papillary duct

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

peritubular

Tubular reabsorption involves all of the following except

phagocytosis.

Identify the body's three major buffer systems.

phosphate buffer system, protein buffer system, and the carbonic acid-bicarbonate buffer system

The principal cation in cytoplasm is

potassium.

Each of the following is a normal constituent of urine except

proteins

Which solid component makes up most of the body mass?

proteins

The filtrate first passes from the glomerular capsule to the

proximal convoluted tubule.

An X-ray image of the urinary system is called a

pyelogram

Hyperventilation will ________ pH.

raise (increase)

The primary function of the proximal convoluted tubule is

reabsorbing nutrients.

Autoregulation of the rate of glomerular filtration does not depend on

release of renin by the juxtaglomerular complex.

Trace the pathway of blood from the renal artery to the renal vein.

renal artery, segmental arteries, interlobar arteries, arcuate arteries, cortical radiate arteries, afferent arterioles, glomerulus, cortical radiate veins, arcuate veins, interlobar veins, renal vein

Which structure is a conical mass within the renal medulla that ends at the papilla?

renal pyramid

Describe filtrate.

similar to blood plasma without proteins

Triangular or conical structures located in the renal medulla are called

renal pyramids

Hypoventilation leads to

respiratory acidosis

Consuming a meal high in salt will

result in a temporary increase in blood volume.

Regarding kidney function, in ________, solutes are transported from the peritubular fluid across the tubular epithelium and into the tubular fluid.

secretion

Which of the following formulas will allow you to calculate the net filtration pressure (FP)? (Hint: GHP = glomerular hydrostatic pressure, BCOP = blood colloidal osmotic pressure, CsHP = capsular hydrostatic pressure.)

FP = GHP - (CsHP + BCOP)

Define hypokalemia and hyperkalemia.

Hypokalemia is defined as blood K+ levels below 3.5 mEq/L and hyperkalemia is defined as blood K+ levels above 5.0 mEq/L.

Which fluids are buffered by the phosphate buffer system?

ICF, urine

What effect does an increase in ADH levels have on the DCT?

Increased ADH will increase the number of aquaporins in the DCT which increases water reabsorption and reduces urine volume.

Substances larger than ________ do not pass through the filtration membrane.

albumin

Which substance plays a central role in determining the rate of sodium reabsorption?

aldosterone

The amount of potassium excreted by the kidneys is regulated mainly by

aldosterone.

When the pH rises above 7.45, a state of ________ exists.

alkalosis

The renal sinus is

an internal cavity lined by the fibrous capsule

Which of the tubules is impermeable to water?

ascending limb of the nephron loop

At which point is the osmotic concentration of filtrate highest?

at the deepest point of the nephron loop between the descending and ascending limbs of the nephron loop

The hemoglobin buffer system exists in

both intracellular fluid and extracellular fluid.

When the level of ADH (antidiuretic hormone) decreases,

both more urine is produced and the osmolarity of the urine decreases.

The ability to form concentrated urine depends on the functions of

both the distal convoluted tubule and the collecting duct.

A chemical that minimizes changes in the pH of a body fluid by releasing or binding hydrogen ion is called a(n)

buffer

A(n) ________ consists of a combination of a weak acid and its associated anion.

buffer system

Renal columns are

bundles of tissue that extend between pyramids from the cortex.

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

cortex

Chloride ion is reabsorbed in the thick ascending limb by

cotransport with Na ions.

The ability to consciously control urination depends on your ability to control which muscle?

external urethral sphincter

Homeostatic mechanisms that monitor and adjust the composition of body fluids respond to changes in the

extracellular fluid.

What three elements form the filtration membrane?

fenestrated endothelium, basement membrane, and foot processes of the podocyte

The outermost layer of the kidney is the

fibrous capsule

Identify the three distinct processes of urine formation in the kidney.

filtration, reabsorption, and secretion

Which of the following descriptions best matches the term calyx?

final urine enters here

A(n) ________ acid is an acid that cannot leave solution and enter the atmosphere.

fixed

Small amounts of ________ acids are generated during the catabolism of amino acids and compounds that contain phosphate groups

fixed

Rapid water movement between the extracellular fluid and the intracellular fluid is termed

fluid shift.

Identify the structures of the renal corpuscle.

glomerular capsule and glomerulus

One mechanism the kidney uses to raise systemic blood pressure is to

increase secretion of renin by the juxtaglomerular complex.

Increased sympathetic tone can do all of the following except increase the glomerular filtration rate increase cardiac output produce venoconstriction of blood reservoirs increase systemic blood pressure stimulate peripheral vasoconstriction.

increase the glomerular filtration rate.

Secretion of potassium into the urine is

increased by aldosterone.

Antidiuretic hormone

increases the permeability of the collecting ducts to water by increasing the number of aquaporins.

About two-thirds of the body's fluid is within cells and is termed ________ fluid.

intracellular

What has to happen to the external urethral sphincter to allow urination?

it must be consciously stimulated to relax

Which type of nephron is essential for water conservation and concentrated urine production?

juxtamedullary nephrons

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

juxtamedullary nephrons.

Name the major excretory organs of the urinary system.

kidneys

Which organs are primarily responsible for regulating the potassium ion concentration in the ECF?

kidneys

Major calyces are

large tributaries of the renal pelvis

The primary role of the carbonic acid-bicarbonate buffer system is to

limit pH changes caused by organic and fixed acids.

All of the following are true of the kidneys except that they are covered by peritoneum held in place by the renal fascia.surrounded by a fibrous capsule located in a position that is retroperitoneal located partly within the pelvic cavity

located partly with pelvic cavity

If the kidneys are conserving HCO3- and eliminating H+ in acidic urine, which is occurring: metabolic alkalosis or metabolic acidosis?

metabolic acidosis

A person who consumes large amounts of sodium bicarbonate ("baking soda") to settle an upset stomach risks

metabolic alkalosis.

Prolonged vomiting can result in

metabolic alkalosis.

The left kidney lies ________ to the right kidney.

slightly superior

The thick ascending limb of the nephron loop actively pumps what substances into the peritubular fluid?

sodium and chloride ions

Identify the electrolytes absorbed by active transport.

sodium, calcium, magnesium, iron, phosphate, and sulfate

Intracellular fluid is found only within

the cells of the body.

In response to increased levels of aldosterone, the kidneys produce

urine with a lower concentration of sodium ions.

The ________ is a capillary plexus that parallels the nephron loop.

vasa recta

A(n) ________ acid is an acid that can leave solution and enter the atmosphere.

volatile

Regarding kidney function, in reabsorption,

water and solutes are transported from the tubular fluid, across the tubular epithelium, and into the peritubular fluid.

Metabolic water is

water produced through catabolic processes.

When does urine production end?

when the fluid enters the renal pelvis

When is your body in acid-base balance?

when the production of hydrogen ions is precisely offset by their loss and pH remains within normal limits

The ureters and urinary bladder are lined by ________ epithelium.

transitional

The area of the urinary bladder bounded by the openings of the two ureters and the urethra is called the

trigone.

True or false? The micturition reflex is controlled by the parasympathetic nervous system.

true

the most abundant waste solute in urine

urea

Urine is transported by the ________, stored within the ________, and eliminated through the ________.

ureters; urinary bladder; urethra

Urine is temporarily stored in the

urinary bladder

The inability to urinate is termed

urinary retention.

When ADH levels in the DCT decrease, what happens to the urine osmotic concentration?

urine osmotic concentration decreases and urine volume increases

A healthy adult typically produces ________ of urine per day.

1200mL

Approximately ________ liters of glomerular filtrate enter glomerular capsules each day.

180

Typical renal blood flow is about ________ percent of cardiac output under resting conditions.

25

From deep to superficial, put the following layers of the kidney in order: 1) renal capsule 2) perinephric fat 3) cortex 4) renal fascia

3,1,2,4

Put the following urinary structures in order as urine is produced and eliminated from the body 1) liver 2) urinary bladder 3) kidney 4) ureter 5) urethra.

3,4,2,5

Normal K+ concentration in extracellular fluid is ________ mEq/L.

3.5-5.0

The following is a list of the blood vessels that carry blood to the kidney. 1. afferent arteriole 2. arcuate artery 3. interlobar artery 4. renal artery 5. glomerulus 6. cortical radiate artery 7. efferent arteriole 8. peritubular capillary What is the proper order in which blood passes through these vessels?

4, 3, 2, 6, 1, 5, 7, 8

Put the following urinary structures in order to represent the flow of newly produced urine: 1) minor calyx 2) renal pelvis 3) ureter 4) major calyx 5) renal papilla

5,1,4,2,3

In an adult female, the body consists of about ________ percent water.

50

In an adult male, the body consists of about ________ percent water.

60

The normal pH range for extracellular fluid is

7.35-7.45.

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

99

What percentage of nutrients (glucose, amino acids, etc.) is reabsorbed in the PCT?

99

Describe a fluid shift.

A fluid shift is the rapid movement of water between the ECF and ICF in response to an osmotic gradient.

Which hormone stimulates the thirst mechanism?

ADH

What effect does ADH have on the apical plasma membranes lining the DCT and collecting ducts?

ADH increases the aquaporins in the apical plasma membranes lining the DCT and collecting ducts.

Define acidemia and alkalemia.

Acidemia is when pH decreases below 7.35 and alkalemia is when pH increases above 7.45

________ is/are an immediately life-threatening condition. However, if an individual survives the incident, full recovery is often possible.

Acute renal failure

What effect does aldosterone have on sodium ion concentration in the ECF?

Aldosterone increases urinary sodium retention and therefore increases sodium ion concentration in ECF.

Which body system is not involved in fluid, electrolyte, and acid-base balance?

All systems produce metabolic wastes and therefore are involved in fluid and electrolyte balance.

Summarize the relationship between PCO2 levels and pH.

An inverse relationship occurs between the levels of PCO2 and pH.

In the PCT, ions and organic substrates are actively removed, thus causing what to occur?

An osmotic flow of water out of the tubular fluid.

What is a pyelogram?

An x-ray image of the urinary system taken after a radiopaque dye was administered.

Angiotensin II has what effect on the CNS?

Angiotensin II triggers CNS responses including increasing thirst, increasing ADH production and increasing sympathetic motor tone.

Describe autoregulation at the kidneys.

Autoregulation is the process of maintaining GFR despite changes in local blood pressure and blood flow by changing local responses in the kidney.

What would happen to the blood PCO2 of a patient who has an airway obstruction?

Blood PCO2 would increase, resulting in respiratory acidosis.

Describe how blood enters and leaves the glomerulus.

Blood enters by the afferent arteriole and leaves by the efferent arteriole.

Explain why blood pressure is higher in glomerular capillaries than in other systemic capillaries.

Blood pressure is higher in glomerular capillaries because the efferent arteriole has a smaller diameter than the afferent arteriole.

Briefly explain the difference between chronic and acute renal failure.

Chronic renal failure is a gradual loss of renal function, whereas acute renal failure is a sudden loss of renal function.

Explain dehydration and its effect on the osmotic concentration of blood.

Dehydration occurs when water losses outpace water gain causing the osmotic concentration of blood plasma to increase.

Define dialysis.

Dialysis is the process of using an artificial semipermeable membrane to remove wastes and retain plasma proteins in the blood of a person whose kidneys are not functioning properly.

In which direction do fluids and solutes move in each of the three kidney processes?

During filtration, fluids move from the glomerular capillaries into the capsular space; during reabsorption, fluids move from the tubular fluid into the peritubular fluid; during secretion, fluids move from the peritubular fluid into the tubular fluid.

What does the juxtaglomerular complex do in response to decreased filtration pressure?

It increases renin production and release.

What effect would increased amounts of aldosterone have on the K+ concentration in urine?

It would increase the K+ concentration in urine because Na+ is retained.

________ nephrons are essential to water conservation and the production of concentrated urine.

Juxtamedullary

Describe metabolic acidosis.

Metabolic acidosis occurs when pH decreases due increased numbers of fixed and metabolic acids, from bicarbonate loss, or from depletion of bicarbonate reserve when hydrogen ions are not adequately excreted by the kidneys.

Describe metabolic alkalosis.

Metabolic alkalosis occurs when pH increases due to the removal of hydrogen ions when bicarbonate ion concentrations are elevated.

Define mineral balance.

Mineral balance occurs when ion gains are equal to ion losses.

During the micturition reflex, the external sphincter is unconsciously relaxed the internal sphincter is consciously relaxed sympathetic motor neurons that control the detrusor muscle become active stimulation of stretch receptors in the bladder wall sends impulses to the lumbar spinal cord.

None of the answers is correct.

Compare obligatory water reabsorption with facultative water reabsorption.

Obligatory water reabsorption cannot be prevented, whereas facultative water reabsorption can be precisely controlled.

Identify factors that cause potassium excretion.

Potassium excretion is caused by an increase in aldosterone stimulation and when the pH of the ECF increases.

How does the urethra differ between males and females?

The male urethra is longer and also transports semen.

How would a decrease in the pH of body fluids affect the respiratory rate?

Respiratory rate would increase.

Describe the carbonic acid-bicarbonate buffer system.

The carbonic acid-bicarbonate buffer system uses the hydrogen ions created by the metabolic and fixed acids to generate carbonic acid which dissociates into H2O and CO2, which can be eliminated by the lungs

Name the specialized smooth muscle of the urinary bladder, and describe its function.

The detrusor muscle compresses the bladder and expels the urine into the urethra.

Which of the following connections is not true relating the urinary system and other body system?

The endocrine, specifically the hypothalamus producing renin, acts on the kidneys to produce more urine.

Define countercurrent multiplication as it occurs in the kidneys.

The exchange of substances in the adjacent limbs of the nephron loop containing fluid moving in opposite directions.

What would happen to a kidney's position if the perinephric fat layer were depleted and the collagen fibers of the fibrous capsule were to become detached?

The kidneys would fall inferiorly.

Compare the minor and major calyces.

The minor calyces collect urine from a single lobe and the major calyces collect urine from 4-5 minor calyces.

What is the primary challenge to acid-base homeostasis?

The primary challenge is that the body generates a variety of acids during normal metabolic operations causing a decrease in pH.

________ play(s) a key role in maintaining acid-base homeostasis by eliminating carbon dioxide.

The respiratory system

Blood colloid osmotic pressure tends to draw water out of the filtrate and into the plasma. Why does this occur?

The solute concentration in the blood exceeds that within the filtrate.

Define the vasa recta

The vasa recta are long, straight capillaries that that parallel the nephron loop.

Identify routes of fluid loss from the body.

Water can be lost during urination, evaporation at skin and lungs, and in feces.

An increase in sodium and chloride ions in the peritubular fluid affects the descending thin limb in what way?

When the osmotic concentration around the peritubular fluid increases around the descending limb the result is an increased osmotic outflow of water.

All of the following structures are subject to a urinary tract infection except

a calyx.

A glomerulus is

a knot of capillaries within the renal corpuscle.

A patient excretes a large volume of very dilute urine on a continuing basis. This is may be due to

absence of ADH.

When the blood pH falls below 7.35, ________ results.

acidemia

Where does filtration exclusively occur in the kidney?

across the filtration membrane in the renal corpuscle

Each of the following organs is part of the urinary system except the: urinary bladder kidney urethra adrenal glands ureter

adrenal glands

What intermediate compound formed from water and carbon dioxide directly affects the pH of the ECF?

carbonic acid

The afferent arteriole in the kidney

carries blood to the glomerulus.

Antidiuretic hormone does not

cause water to shift out of the ICF.

The ions in highest concentration in the extracellular fluid are sodium and

chloride.

Which of the following is characterized as a slowly progressing disease that is irreversible?

chronic renal failure

Urine passes, in the order given, through which of the following structures?

collecting duct, renal pelvis, ureter, bladder, urethra

The detrusor muscle

compresses the urinary bladder and expels urine through the urethra.

Which of the following descriptions best fits the acid-base disorder respiratory alkalosis?

consequence of hyperventilation, for example in fever or mental illness

Which of the following descriptions best fits the acid-base disorder metabolic alkalosis?

consequence of prolonged vomiting

Which of the following descriptions best fits the acid-base disorder respiratory acidosis?

consequence of reduced alveolar ventilation, for example due to emphysema

Which of the following is required as a cofactor for hemoglobin synthesis?

copper

The release of natriuretic peptides from the heart will cause the following response

decrease of ADH release.

Increased blood volume will

decrease thirst

What effect does inhibition of osmoreceptors have on ADH secretion and thirst?

decreased ADH secretion and suppressed thirst

With regard to fluid balance, water gains occur primarily in the

digestive tract.

The portion of the nephron that empties into the collecting duct is the

distal convoluted tubule.

The condition called ________ is characterized by painful or difficult urination. This condition can be due to pathologic or benign causes.

dysuria

What is the term for painful or difficult urination?

dysuria

Blood leaves the glomerulus through a blood vessel called the

efferent arteriole.

Which of the following descriptions does not describe a function of the nephron loop?

enables production of hypotonic urine

The filtration membrane in the renal corpuscle consists of what three layers?

endothelium of glomerulus, dense layer of glomerulus, and podocyte filtration slits

The DCT secretes hydrogen ions in exchange for sodium ions by the process of

energy-dependent exchange pump.

Peristaltic contractions, beginning at the renal pelvis, sweep along the ureter, forcing urine toward the urinary bladder. In a normal, healthy person, how often do these contractions occur?

every 30 seconds or so

When the pH of the extracellular fluid drops, the kidneys

excrete more hydrogen ions and reabsorb bicarbonate ions.

Which of the following is not a function of the urinary system? excretes abundant protein molecule seliminates organic waste products contributes to stabilizing blood pH regulates plasma concentrations of electrolytes regulates blood volume

excretes abundant protein molecule

The amount of filtrate produced by the kidneys each minute is called the

glomerular filtration rate.

Under normal conditions, glomerular filtration depends on three main pressures. Which of those pressures is a pressure that favors the filtration pressure?

glomerular hydrostatic pressure

The process of filtration is driven by

glomerular hydrostatic pressure.

The process of filtration occurs at the

glomerulus.

Which of the following substances is not secreted

glucose.

The structure known as the juxtaglomerular complex is located near the

golmerulus

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

hilum.

The glomerular capsule and the glomerulus make up the

renal corpuscle

The inability of the kidneys to excrete adequately to maintain homeostasis is termed

renal failure.

The cavity of the kidney that receives urine from the calyces is called the

renal pelvis

The expanded beginning of the ureter connects to the

renal pelvis

Which of the following is greater? the concentration of solute in the filtrate at the beginning of the nephron loop the concentration of solute in the filtrate at the bottom of the nephron loop the concentrations at the top and bottom are identical.

the concentration of solute in the filtrate at the bottom of the nephron loop

If you have to urinate, but have to "hold it" until you can find a bathroom, what structure are you "holding it" with?

the external urethral sphincter

Excess hydrogen ion is eliminated from the body largely by

the kidneys.

With regard to mineral balance, the primary site of ion loss in the body is

the kidneys.

Which buffers/buffer system exist(s) only in intracellular fluid?

the phosphate buffer system

The mechanism for producing concentrated urine involves all of the following except

the release of natriuretic peptides

What structures enter and exit the kidney at the hilum?

the renal artery and renal nerves enter; the renal vein and ureter exit at the hilum

Urine is carried to the urinary bladder by: the urethra the calyces. the ureters blood vessels lymphatics

the ureters

What are the two reflexes that control urination?

the urine storage reflex and the urine voiding reflex

Which of the following descriptions best matches the term "renal papilla"?

tip of the medullary pyramid