Urinary

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Question

Answer

Urine is produced continuously & can be stored for convenience. The urinary bladder is expandable and stores as much as __ of urine.

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Excretion of urine is through the ___.

urethra

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The urinary system regulates blood ___. Under direction of certain hormones, it controls blood and interstitial fluid and directly affects ___ ___.

volume, blood pressure

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Function of the urinary system: works by regulation of ___ production, also measures O2 in blood, secretes erythropoietin if necessary.

erythrocyte

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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

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The urinary system is comprised of the following structures: ___, ___, ___ ___, ___

kidneys, ureters, urinary bladder, urethra

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The kidneys ___ blood, process ___ into tubular fluid, then urine.

filter, filtrate

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The ___ transport urine from kidneys to bladder via ___.

ureters, peristalsis

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The urinary bladder is a reservoir for urine until ___ occurs.

micturition

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The ___ transports urine from bladder to outside of body.

urethra

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The kidneys are located retroperitoneal on the ___ ___ wall.

posterior abdominal

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Each kidney weighs about ___ gr. and measures 12 x 6.5 x 2.5 cm

100

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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

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The kidneys have a concave medial border called the ___, where vessels, nerves, and the ureter connect with the kidney.

hilum

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The hilum is continuous with an internal space called the ___ ___.

renal sinus

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Each kidney is surrounded and supported by several tissue layers (from deepest to most superficial): ___ ___, ___ fat, ___ ___, ___ fat.

fibrous capsule, perinephric, renal fascia, paranephric

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The ___ ___ comes in direct contact with the outer surface of the kidney, protects it from trauma and prevents infections.

fibrous capsule

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___ fat provides cushioning and insulation to the kidney.

Perinephric

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The ___ ___ anchors kidney to posterior abdominal wall.

renal fascia

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The ___ fat is the outermost layer surrounding the kidney between renal fascia and peritoneum.

paranephric

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The kidney is divided into an outer renal ___ and an inner renal ___.

cortex, medulla

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The medulla of the kidney looks ___ than the cortex.

darker

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Extensions of the renal cortex, called ___ ___, project into the renal medulla and subdivide the medulla into renal pyramids or ___ pyramids.

renal columns, medullary

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A typical kidney contains ___ to ___ renal pyramids

8–15

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The wide base of the renal pyramid makes contact with the cortex in a region called the ___ ___.

corticomedullary junction

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The apex (tip) of the renal pyramid is called the ___ ___.

renal papilla

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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

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Each renal papilla projects into a hollow funnel-shaped structure called the ___ ___. There are 8 to 15 of them.

minor calyx

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Several minor calyces fuse to form a ___ ___. There are 2 to 3 of them.

major calyx

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The major calyces fuse to form the ___ ___, which collects the total urine output from one kidney and transports it into the ___.

renal pelvis, ureter

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A typical kidney contains 8 to 15 renal lobes that consist of a ___ ___ and some ___ substance.

medullary pyramid, cortical

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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

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Within the renal sinus, the renal arteries branch into ___ ___. Segmental arteries branch into ___ ___, still inside the renal sinus.

segmental arteries, interlobar arteries

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Interlobar arteries branch into ___ ___ in the ___ junction.

arcuate arteries, corticomedullary

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Arcuate arteries branch into ___ ___ that project to the cortex.

interlobular arteries

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Arcuate arteries branch into ___ ___ that project to the cortex.

interlobular arteries

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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

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Efferent arterioles branch into one of two capillary networks: ___ capillaries and ___ ___.

peritubular, vasa recta

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Peritubular capillaries surround ___ ___ and reside primarily in the ___.

convoluted tubules, cortex

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The vasa recta are associated mainly with the ___ ___ and primarily reside in the ___.

nephron loop, medulla

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The peritubular capillaries and vasa recta drain into a network of ___.

veins

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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

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Arcuate veins merge to form the interlobar veins. They merge in the renal sinus to form the ___ ___ in each kidney.

renal vein

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Blood filtration in the kidney occurs at the ___ and remains oxygenated till it reaches the peritubular capillaries and ___ ___.

glomerulus, vasa recta

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The ___ is the functional filtration unit of the kidney.

nephron

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There are approximately ___ million nephrons in each kidney.

1.25

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The nephrons form urine through three interrelated processes: ___, ___ ___, and ___ ___

filtration, tubular reabsorption, tubular secretion

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Water and dissolved solutes enter the renal capsule by pressure differences during ___.

filtration

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Substances move across the wall of the renal tubules during ___ ___.

tubular reabsorption

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___ ___ is the active transport of solutes into the tubular fluid.

Tubular secretion

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There are 2 types of nephrons : ___ and ___

cortical, juxtamedullary

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___ 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

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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

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The nephron is comprised of the following components: the ___ ___, ___ ___ tubule, ___ ___ and ___ ___ tubule.

renal corpuscle, proximal convoluted, nephron loop, distal convoluted

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The renal corpuscle is composed of two structures: the ___ and the ___ ___

glomerulus, glomerular capsule

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The glomerulus is a thick tangle of ___ ___.

fenestrated capillaries

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The glomerular capsule is an ___ covering over the glomerulus.

epithelial

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The renal corpuscle has a ___ ___, where the afferent arteriole enters and the efferent arteriole exits.

vascular pole

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The renal corpuscle has a tubular pole, where the ___ ___ tubule exits.

proximal convoluted

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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

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The glomerular capsule is also called the ___ ___.

Bowman capsule

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A capsular space between the visceral and parietal layers of the renal corpuscle is filled with filtered products from the ___.

glomerulus

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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

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The pedicels in the visceral layer of the glomerular capsule are separated from each other by thin spaces called ___ ___.

filtration slits

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The filtration slits and the fenestrated capillary wall make up the ___ ___, which leaks indiscriminate contents from the plasma into the capsule.

filtration membrane

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The ___ ___ ___ begins at tubular pole of renal corpuscle.

proximal convoluted tubule

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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

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The cells of the ___ ___ ___ reabsorb almost all nutrients (glucose, amino acids, ions, vitamins, plasma proteins) leaked through the filtration membrane.

proximal convoluted tubule

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Reabsorbed nutrients and water enter the ___ capillaries and are returned to the general circulation in the vascular system.

peritubular

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Nephron loop or ___ ___ ___ originates at the proximal convoluted tubule and projects into the medulla.

loop of Henle

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Each nephron loop has two limbs: ___ and ___

descending, ascending

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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

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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)

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Both the ascending and descending limbs of the nephron loop facilitate reabsorption of ___ and ___.

water, solutes

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The distal convoluted tubule is found in renal cortex and contacts the afferent arteriole wall at the ___ ___.

vascular pole

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The distal convoluted tubule is lined with simple cuboidal epithelium (just like the proximal convoluted tubule), but has fewer, sparse ___ and fewer mitochondria.

microvilli

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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

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ADH is secreted by the posterior pituitary in response to low ___ ___ or low ___ ___ in tubular fluid in the kidney.

blood volume, solute concentration

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Aldosterone is secreted by the ___ ___ and responds to low ___ ___ or low ___ ___ in tubular fluid in the kidney.

adrenal cortex, blood volume, solute concentration

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Both ADH and aldosterone cause the distal convoluted tubule to increase ___ and ___ absorption from tubular fluid.

H20, Na

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Tubular fluid...collecting tubules...___ ___.

collecting ducts

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The ___ ___ are the last structures able to modify content of tubular fluid, under the influence of ADH and aldosterone.

collecting ducts

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In a dehydrated individual, water conservation occurs and urine is more ___.

concentrated

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Once tubular fluid leaves the collecting duct, it becomes ___.

urine

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The juxtaglomerular apparatus is important in regulation of blood pressure and is comprised of: ___ ___ and ___ ___

juxtaglomerular cells, macula densa

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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

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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

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Juxtaglomerular apparatus structures work together to regulate blood pressure, monitoring ___ ___ in tubular fluid.

ion concentration

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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

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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

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Sympathetic innervation of the kidney: T10-T12. Vessel constriction and decreased glomerular flow and ___ formation. Excess may also stimulate the juxtaglomerular cells.

filtrate

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Parasympathetic innervation of the kidney: CN ___. No known effect.

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Pain from kidneys is usually referred to dermatomes T___-T___.

10, 12

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The urinary tract is composed of the following components: ___, ___ ___, ___

ureters, urinary bladder, urethra

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____ are fibromuscular tubes that conduct urine from the kidney to the urinary bladder. Average: 25cm in length and retroperitoneal.

ureters

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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

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The wall of ureter has three layers: ___, ___, and ___

mucosa, muscularis, adventitia

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Mucosa wall of ureter is composed of transitional epithelium. It is both ___ and ___.

distensible, impermeable

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Muscularis wall of ureters have an inner longitudinal layer and an outer circular layer. The presence of urine produces ___ waves.

peristaltic

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Adventitia, some extensions of ureter connective tissue anchor them to the ___ ___ wall.

posterior abdominal

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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

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Each ureter segment receives blood from a segment of the nearest ___.

artery

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Parasympathetic innervation of ureters: CN X and the ___ ___ nerves.

pelvic splanchnic

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Sympathetic innervation of ureters: T11-L2. Pain is referred to these dermatomes “___ to ___”.

loin, groin

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The urinary bladder is an expandable, muscular container. Its main function is as a ___ for urine.

reservoir

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The urinary bladder is located immediately posterior to the ___.

pubic symphysis

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In females, the urinary bladder lies anteroinferior to the uterus and directly ___ to the vagina.

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In males, the urinary bladder lies anterior to the rectum and ___ to the prostate gland.

superior

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The urinary bladder is a ___ organ.

retroperitoneal

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The median umbilical ligament is actually remnant of the ___.

urachus

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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

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Four tunics form the wall of the urinary bladder: ____, ____, ____, and ____

mucosa, submucosa, muscularis, adventitia

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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

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The submucosa of the urinary bladder supports urinary bladder ___.

wall

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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

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The adventitia of the urinary bladder has an outer layer of ___ ___ tissue.

areolar connective

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___ iliac artery and veins supply the urinary bladder.

Internal

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___ is expulsion of urine from the bladder and is initiated by the ___ ___.

Micturition, micturition reflex

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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

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Sympathetic axons from T11-L2 cause contraction of the sphincter, inhibit contraction of detrusor muscle and inhibit ___.

micturation

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The male urethra is partitioned into three segments: ___, ___, and ___ urethras.

prostatic, membranous, spongy

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The urethra is a fibromuscular tube that originates at the neck of the urinary bladder and conducts urine to the ___ of the body.

exterior

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Two sphincters control the release of urine from the urinary bladder in to the urethra: the internal and external ___ ___.

urethral sphincters

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The female urethra has the single function of transporting urine to the exterior of the body and is ___ to ___cm long.

3, 5

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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

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The membranous urethra is the shortest and least ___ portion. It is surrounded by ___ muscle fibers that form the external urethral sphincter.

dilatable, striated

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Luminal lining of the urethra has a protective ___ membrane with mucin cells and ___ glands.

mucous, urethral

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The prostatic urethra is 3-4 cm and is the most ___ portion. Internal longitudinal muscle and external circular muscle.

dilatable

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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

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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.

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