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CH27

Urinary

QuestionAnswer
Urine is produced continuously & can be stored for convenience. The urinary bladder is expandable and stores as much as __ of urine. 1L
Excretion of urine is through the ___. urethra
The urinary system regulates blood ___. Under direction of certain hormones, it controls blood and interstitial fluid and directly affects ___ ___. volume, blood pressure
Function of the urinary system: works by regulation of ___ production, also measures O2 in blood, secretes erythropoietin if necessary. erythrocyte
Function of the urinary system: works by regulation of ion balance/acid-base balance: helps control the inorganic ion balance and acid/base balance by altering ___ ___ and ___ secretion. hydrogen ion, ammonium
The urinary system is comprised of the following structures: ___, ___, ___ ___, ___ kidneys, ureters, urinary bladder, urethra
The kidneys ___ blood, process ___ into tubular fluid, then urine. filter, filtrate
The ___ transport urine from kidneys to bladder via ___. ureters, peristalsis
The urinary bladder is a reservoir for urine until ___ occurs. micturition
The ___ transports urine from bladder to outside of body. urethra
The kidneys are located retroperitoneal on the ___ ___ wall. posterior abdominal
Each kidney weighs about ___ gr. and measures 12 x 6.5 x 2.5 cm 100
The superior pole of the ___ kidney is at the level of T___, whereas the superior pole of the right kidney is about ___cm lower to accommodate the large size of the liver. left, 12, 2
The kidneys have a concave medial border called the ___, where vessels, nerves, and the ureter connect with the kidney. hilum
The hilum is continuous with an internal space called the ___ ___. renal sinus
Each kidney is surrounded and supported by several tissue layers (from deepest to most superficial): ___ ___, ___ fat, ___ ___, ___ fat. fibrous capsule, perinephric, renal fascia, paranephric
The ___ ___ comes in direct contact with the outer surface of the kidney, protects it from trauma and prevents infections. fibrous capsule
___ fat provides cushioning and insulation to the kidney. Perinephric
The ___ ___ anchors kidney to posterior abdominal wall. renal fascia
The ___ fat is the outermost layer surrounding the kidney between renal fascia and peritoneum. paranephric
The kidney is divided into an outer renal ___ and an inner renal ___. cortex, medulla
The medulla of the kidney looks ___ than the cortex. darker
Extensions of the renal cortex, called ___ ___, project into the renal medulla and subdivide the medulla into renal pyramids or ___ pyramids. renal columns, medullary
A typical kidney contains ___ to ___ renal pyramids 8–15
The wide base of the renal pyramid makes contact with the cortex in a region called the ___ ___. corticomedullary junction
The apex (tip) of the renal pyramid is called the ___ ___. renal papilla
Functions of urinary system: ___ of urine, ___ of urine, regulation of blood volume, regulation of ___ production, regulation of ion balance/___-___ balance. storage, excretion, erythrocyte, acid-base
Each renal papilla projects into a hollow funnel-shaped structure called the ___ ___. There are 8 to 15 of them. minor calyx
Several minor calyces fuse to form a ___ ___. There are 2 to 3 of them. major calyx
The major calyces fuse to form the ___ ___, which collects the total urine output from one kidney and transports it into the ___. renal pelvis, ureter
A typical kidney contains 8 to 15 renal lobes that consist of a ___ ___ and some ___ substance. medullary pyramid, cortical
20 – 25% of cardiac output enters kidneys by the renal arteries. The renal artery rises from the ___ ___ ___ between 1st and 2nd lumbar vertebra. descending abdominal aorta
Within the renal sinus, the renal arteries branch into ___ ___. Segmental arteries branch into ___ ___, still inside the renal sinus. segmental arteries, interlobar arteries
Interlobar arteries branch into ___ ___ in the ___ junction. arcuate arteries, corticomedullary
Arcuate arteries branch into ___ ___ that project to the cortex. interlobular arteries
Arcuate arteries branch into ___ ___ that project to the cortex. interlobular arteries
Interlobular arteries enter kidney cortex, extend small branches, ___ ___. Afferent arterioles enter ___ ___, form capillary ball, ___. ___ filtered from capillaries to renal corpuscle. Remaining blood exits glomerulus & renal corpuscle as the ___ ___. afferent arterioles, renal corpuscle, glomerulus, Plasma, efferent arteriole
Efferent arterioles branch into one of two capillary networks: ___ capillaries and ___ ___. peritubular, vasa recta
Peritubular capillaries surround ___ ___ and reside primarily in the ___. convoluted tubules, cortex
The vasa recta are associated mainly with the ___ ___ and primarily reside in the ___. nephron loop, medulla
The peritubular capillaries and vasa recta drain into a network of ___. veins
Blood supply to the kidney - the smallest veins are the interlobular veins. They travel alongside with the interlobular arteries and then merge to form ___ ___. arcuate veins
Arcuate veins merge to form the interlobar veins. They merge in the renal sinus to form the ___ ___ in each kidney. renal vein
Blood filtration in the kidney occurs at the ___ and remains oxygenated till it reaches the peritubular capillaries and ___ ___. glomerulus, vasa recta
The ___ is the functional filtration unit of the kidney. nephron
There are approximately ___ million nephrons in each kidney. 1.25
The nephrons form urine through three interrelated processes: ___, ___ ___, and ___ ___ filtration, tubular reabsorption, tubular secretion
Water and dissolved solutes enter the renal capsule by pressure differences during ___. filtration
Substances move across the wall of the renal tubules during ___ ___. tubular reabsorption
___ ___ is the active transport of solutes into the tubular fluid. Tubular secretion
There are 2 types of nephrons : ___ and ___ cortical, juxtamedullary
___ nephrons account for 85% of all nephrons; the bulk of the nephron structures reside in the kidney cortex and only a relatively small component enters the kidney medulla. Cortical
Juxtamedullary nephrons make up 15% of all nephrons; their renal corpuscle lies near the ___ junction and their long nephron loops extend deep into the ___. Associated with vasa recta. corticomedullary, medulla
The nephron is comprised of the following components: the ___ ___, ___ ___ tubule, ___ ___ and ___ ___ tubule. renal corpuscle, proximal convoluted, nephron loop, distal convoluted
The renal corpuscle is composed of two structures: the ___ and the ___ ___ glomerulus, glomerular capsule
The glomerulus is a thick tangle of ___ ___. fenestrated capillaries
The glomerular capsule is an ___ covering over the glomerulus. epithelial
The renal corpuscle has a ___ ___, where the afferent arteriole enters and the efferent arteriole exits. vascular pole
The renal corpuscle has a tubular pole, where the ___ ___ tubule exits. proximal convoluted
The glomerular capsule is comprised of 2 layers. The visceral layer directly overlies and comes in contact with the glomerulus and is comprised of specialized cells called ___. The parietal layer is formed from ___ ___ epithelium podocytes, simple squamous
The glomerular capsule is also called the ___ ___. Bowman capsule
A capsular space between the visceral and parietal layers of the renal corpuscle is filled with filtered products from the ___. glomerulus
The visceral layer of the glomerular capsule is composed of podocytes that have long processes called ___. They wrap around the glomerular capillaries to support the capillary wall, but do not completely ensheathe it. pedicels
The pedicels in the visceral layer of the glomerular capsule are separated from each other by thin spaces called ___ ___. filtration slits
The filtration slits and the fenestrated capillary wall make up the ___ ___, which leaks indiscriminate contents from the plasma into the capsule. filtration membrane
The ___ ___ ___ begins at tubular pole of renal corpuscle. proximal convoluted tubule
The proximal convoluted tubule walls are comprised of ___ ___ epithelium with tall microvilli that increase reabsorption capacity. There are abundant ___ in these cells. simple cuboidal, mitochondria
The cells of the ___ ___ ___ reabsorb almost all nutrients (glucose, amino acids, ions, vitamins, plasma proteins) leaked through the filtration membrane. proximal convoluted tubule
Reabsorbed nutrients and water enter the ___ capillaries and are returned to the general circulation in the vascular system. peritubular
Nephron loop or ___ ___ ___ originates at the proximal convoluted tubule and projects into the medulla. loop of Henle
Each nephron loop has two limbs: ___ and ___ descending, ascending
The descending limb of the nephron loop extends from the ___ into the ___. It is lined with simple cuboidal epithelium (thick segment) and then ___ ___ epithelium (thin segment). cortex, medulla, simple squamous
The ascending limb of the nephron loop returns from the ___ into the ___. It is lined with simple squamous epithelium (thin segment) and then simple cuboidal epithelium (thick segment). ___ and ___ ions are mostly reabsorbed. medulla, cortex, Na (sodium), Cl (chloride)
Both the ascending and descending limbs of the nephron loop facilitate reabsorption of ___ and ___. water, solutes
The distal convoluted tubule is found in renal cortex and contacts the afferent arteriole wall at the ___ ___. vascular pole
The distal convoluted tubule is lined with simple cuboidal epithelium (just like the proximal convoluted tubule), but has fewer, sparse ___ and fewer mitochondria. microvilli
The primary function of the distal convoluted tubule is to secrete K+ (potassium) and H+ (hydrogen) from peritubular capillaries into tubular fluid. Also reabsorption of H2O under the influence of ___ ___ and ___. antidiuretic hormone, aldosterone
ADH is secreted by the posterior pituitary in response to low ___ ___ or low ___ ___ in tubular fluid in the kidney. blood volume, solute concentration
Aldosterone is secreted by the ___ ___ and responds to low ___ ___ or low ___ ___ in tubular fluid in the kidney. adrenal cortex, blood volume, solute concentration
Both ADH and aldosterone cause the distal convoluted tubule to increase ___ and ___ absorption from tubular fluid. H20, Na
Tubular fluid...collecting tubules...___ ___. collecting ducts
The ___ ___ are the last structures able to modify content of tubular fluid, under the influence of ADH and aldosterone. collecting ducts
In a dehydrated individual, water conservation occurs and urine is more ___. concentrated
Once tubular fluid leaves the collecting duct, it becomes ___. urine
The juxtaglomerular apparatus is important in regulation of blood pressure and is comprised of: ___ ___ and ___ ___ juxtaglomerular cells, macula densa
Juxtaglomerular cells are modified smooth muscle cells of the afferent arteriole located at the vascular pole of the renal corpuscle. They release ___ that makes afferent arteriole vasodilate and vasoconstrict. renin
The ___ ___ is a group of modified epithelial cells with receptors in the distal convoluted tubule that come in contact with the juxtaglomerular cells. macula densa
Juxtaglomerular apparatus structures work together to regulate blood pressure, monitoring ___ ___ in tubular fluid. ion concentration
Blood volume or solute concentration reduced, the ___ ___ senses this in the tubular fluid. Stimulation of ___ ___. Production of ___. Activation of RAAS. ___ production. macula densa, juxtaglomerular cells, renin, aldosterone
The juxtaglomerular apparatus is innervated by a mass of sensory and autonomic fibers collectively called the ___ ___, which enters the kidney at the hilum. renal plexus
Sympathetic innervation of the kidney: T10-T12. Vessel constriction and decreased glomerular flow and ___ formation. Excess may also stimulate the juxtaglomerular cells. filtrate
Parasympathetic innervation of the kidney: CN ___. No known effect. X
Pain from kidneys is usually referred to dermatomes T___-T___. 10, 12
The urinary tract is composed of the following components: ___, ___ ___, ___ ureters, urinary bladder, urethra
____ are fibromuscular tubes that conduct urine from the kidney to the urinary bladder. Average: 25cm in length and retroperitoneal. ureters
Ureters originate at the renal pelvis as they exit the hilum of the kidney then enter the ___ wall of the base of the urinary bladder. posterolateral
The wall of ureter has three layers: ___, ___, and ___ mucosa, muscularis, adventitia
Mucosa wall of ureter is composed of transitional epithelium. It is both ___ and ___. distensible, impermeable
Muscularis wall of ureters have an inner longitudinal layer and an outer circular layer. The presence of urine produces ___ waves. peristaltic
Adventitia, some extensions of ureter connective tissue anchor them to the ___ ___ wall. posterior abdominal
Ureters project through the posteroinferior bladder wall obliquely. Because of this, the ureters are compressed as the bladder distends decreasing the likelihood of ___ ___. urine reflux
Each ureter segment receives blood from a segment of the nearest ___. artery
Parasympathetic innervation of ureters: CN X and the ___ ___ nerves. pelvic splanchnic
Sympathetic innervation of ureters: T11-L2. Pain is referred to these dermatomes “___ to ___”. loin, groin
The urinary bladder is an expandable, muscular container. Its main function is as a ___ for urine. reservoir
The urinary bladder is located immediately posterior to the ___. pubic symphysis
In females, the urinary bladder lies anteroinferior to the uterus and directly ___ to the vagina. anterior
In males, the urinary bladder lies anterior to the rectum and ___ to the prostate gland. superior
The urinary bladder is a ___ organ. retroperitoneal
The median umbilical ligament is actually remnant of the ___. urachus
The posteroinferior triangular area of the urinary bladder is called the ___. It is defined by the ureteral opening and the urethral opening. This does not move. trigone
Four tunics form the wall of the urinary bladder: ____, ____, ____, and ____ mucosa, submucosa, muscularis, adventitia
The mucosa of the urinary bladder is formed of transitional epithelium that lines the internal surface of the bladder; rugae allow for ___ of bladder and highly vascularized ___ ___. distention, lamina propria
The submucosa of the urinary bladder supports urinary bladder ___. wall
The muscularis of the urinary bladder has three layers of smooth muscle called ___ muscles; an internal urethral sphincter muscle is present at the urethral opening. detrusor
The adventitia of the urinary bladder has an outer layer of ___ ___ tissue. areolar connective
___ iliac artery and veins supply the urinary bladder. Internal
___ is expulsion of urine from the bladder and is initiated by the ___ ___. Micturition, micturition reflex
Parasympathetic axons: micturition reflex center from segments S2-S4. They relax the internal urethral sphincter and stimulate the contraction of the ___ ___ and micturition. detrusor muscle
Sympathetic axons from T11-L2 cause contraction of the sphincter, inhibit contraction of detrusor muscle and inhibit ___. micturation
The male urethra is partitioned into three segments: ___, ___, and ___ urethras. prostatic, membranous, spongy
The urethra is a fibromuscular tube that originates at the neck of the urinary bladder and conducts urine to the ___ of the body. exterior
Two sphincters control the release of urine from the urinary bladder in to the urethra: the internal and external ___ ___. urethral sphincters
The female urethra has the single function of transporting urine to the exterior of the body and is ___ to ___cm long. 3, 5
The male urethra has two functions–___ and ___–because it serves to transport both urine and semen and ends as an opening called the external urethral orifice. urinary, reproductive
The membranous urethra is the shortest and least ___ portion. It is surrounded by ___ muscle fibers that form the external urethral sphincter. dilatable, striated
Luminal lining of the urethra has a protective ___ membrane with mucin cells and ___ glands. mucous, urethral
The prostatic urethra is 3-4 cm and is the most ___ portion. Internal longitudinal muscle and external circular muscle. dilatable
Spongy male urethra: 15 cm. Encased by the ___ ___which is the erectile tissue of the penis and extends to the external urethral orifice. corpus spongiuosum
Bladder fills, stretch receptors activated, micturition reflex.Parasympathetic impulses travel to sphincter/detrusor muscle.Smooth sphincter relaxes, detrusor contracts. Need to urinate=relaxation external urethral sphincter.Urine expelled contraction of detrusor & abdominal wall muscles.
Created by: Falicon