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2012-04-22 18:11:00

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  1. What are 5 functions of the kidneys?
    • filter blood
    • regulate blood volume (water and salt)
    • regulate blood chemistry (acids and bases)
    • regulate BP by producing renin
    • produce erythropoetin to stimulate production of RBCs
  2. How many liters of blood are filtered through both kidneys?
    200 liters (only ~5L of blood in one person)
  3. What 3 things are filtered out of the body into urine?
    • toxins
    • metabolic wastes
    • excess ions
  4. Which kidney is lower than the other?
    right is lower than left
  5. Where are the kidneys found in reference to the peritoneum?
    • behind peritoneum
    • retroperitoneal
  6. What are the 3 supportive tissue layers of the kidney?
    • renal fascia
    • fibrous capsule
    • fat capsule
  7. What supportive tissue of the kidney is the outer, dense connective tissue that anchors the kidney?
    renal fascia
  8. Which supportive tissue layer of the kidney prevents kidney infection?
    fibrous capsule
  9. What supportive tissue layer of the kidney cushions the kidney?
    fat capsule
  10. What are the 3 regions of the kidney?
    • cortex
    • medulla
    • pelvis
  11. What region of the kidney contains glomerulus and convoluted tubules?
  12. Which region of the kidney contains the pyramids with Loops of Henle and collecting ducts?
  13. What do the columns of the renal medulla contain?
    blood vessels
  14. What 3 structures are found in the renal pelvis?
    • major calyx
    • minor calyx
    • pelvis
  15. From the papilla to urethra, what are 7 steps to the flow of urine?
    • papilla
    • minor calyx
    • major calyx
    • pelvis
    • ureter
    • bladder
    • urethra
  16. What structure in the kidney does ADH act on to conserve water and raise BP?
  17. From abdominal aorta to glomerulus, what are 8 steps for the flow of blood in the kidney?
    • abdominal aorta
    • renal artery
    • segmental artery
    • interlobar artery
    • arcuate artery
    • cortical radiate artery
    • afferent arteriole
    • glomerulus
  18. From the glomerulus to the inferior vena cava, what are 8 steps for the flow of blood out of the kidney?
    • glomerulus
    • efferent arteriole
    • capillary beds (peritubular or vasa recta)
    • cortical radiate vein
    • arcuate vein
    • interlobar vein
    • renal vein
    • inferior vena cava
  19. What 2 things make the efferent arteriole significant?
    • need an artery for high BP
    • artery leads to more capillary beds
  20. What are the structural and functional units that filter blood and urine?
  21. Approximately how many nephrons are in each kidney?
    1 million
  22. What are 4 nephron pieces?
    • proximal convoluted tubule
    • loop of henle
    • distal convoluted tubule
    • collecting ducts
  23. Which nephron has peritubular capillaries wrapped around it?
    cortical nephron
  24. Which nephron has a long loop of henle and vasa recta wrapped around it?
    juxtamedullary nephron
  25. Which type of nephron is 85% found in the renal cortex?
    cortical nephron
  26. What is the blood pressure in the glomerulus capillaries?
  27. Why is the BP in the glomerulus higher than normal capillary range of 20-40mmHg?
    higher pressure to force out solutes from blood to filtrate
  28. Why are there 2 arterioles leading in and out of the glomerulus?
    to adjust to high pressure
  29. Which nephron is found 15% in the cortex and is used to make more concentrated urine?
    juxtamedullary nephron
  30. What are the 3 capillary beds of the nephron?
    • glomerulus
    • peritubular
    • vasa recta
  31. What kind of capillary bed rises from the afferent arterioles?
  32. What kind of pressure is in the peritubular capillaries?
  33. What capillaries cling to adjacent renal tubes?
    peritubular capillaries
  34. What are the long, straight efferent arterioles wrapped around the juxtamedullary nephrons?
    vasa recta
  35. What are JG cells?
    granular cells
  36. What are the mechanoreceptors that detect changes in pressure in the juxtamedullary apparatus?
    • granular cells
    • JG
  37. What are 2 kinds of cells found in the juxtamedullary apparatus?
    • granular (JG)
    • macula densa
  38. What cells of the juxtamedullary apparatus are embedded in the ascending loop of Henle?
    macula densa cells
  39. What are 2 functions of the macula densa cells?
    • chemoreceptors
    • osmoreceptors
  40. What 2 things do macula densa cells embedded in ascending loop of Henle monitor?
    potassium and salt
  41. What are 3 mechanisms of urine formation?
    • glomerulus filtration
    • tubular reabsorption
    • tubular secretion
  42. What mechanism of formation of urine moves substances from blood to urine only in the glomerulus?
  43. What mechanisms of the formation of urine moves substances from nephron to blood?
  44. What mechanism of the formation of urine moves substances from blood to nephrons?
  45. What 4 substances can pass across the filtration membrane of the glomerulus?
    • water
    • glucose
    • amino acids
    • nitrogenous wastes
  46. What 2 things can not pass through the filtration membrane's fenestrations?
    RBCs and proteins (albumin)
  47. How would RBCs or albumin be able to pass through the fenestrations of the glomerulus's filtration membrane?
    inflammation opens pores up to allow bigger cells to pass into filtrate
  48. What is the glomerular filtration rate?
    total filtrate in mL per minute (by both kidneys)
  49. What is the glomerular filtrate rate of adults normally?
    120-125 mL/min
  50. What is the glomerular filtration rate of adults with chronic(3+ months) renal disease?
    less than 60 mL/min
  51. What is the glomerular filtration rate of adults with renal failure?
    less than 15 mL/min
  52. What 3 pressures does glomerular filtration rate depend on?
    • HPg - glomerular blood hydrostatic pressure (GBHP)
    • OPg - blood colloid osmotic pressure (BCOP)
    • HPc - capsular hydrostatic pressure (CHP)
  53. What pressure is HPg?
    • glomerular blood hydrostatic pressure
    • 55mmHg
  54. What pressure is OPg?
    • blood colloid osmotic pressure
    • 30mmHg
  55. What pressure is HPc
    • capsular hydrostatic pressure
    • 15mmHg
  56. What pressure that glomeruluar filtration rate depends one would decrease if there was less albumin in the blood?
    • OPg
    • blood colloid osmotic pressure
  57. What pressure that glomeruluar filtration rate depends on would be affected if a person had a kidney stone?
    • HPc
    • capsular hydrostatic pressure
  58. What 2 controls regulate glomerular filtration rate?
    intrinsic and extrinsic
  59. What control that helps regulate GFR performs renal autoregulation?
    intrinsic control
  60. What control that helps regulate GFR involves other organ systems besides the kidneys to maintain systemic BP?
    extrinsic controls
  61. What are the blood vessels when kidneys are relaxed?
  62. What mechanisms for regulating GFR prevail when parasympathetic NS is active?
  63. What 3 things does the sympathetic nervous system stimulate in the kidneys?
    • arterioles constrict
    • filtration inhibited
    • renin angiotensin mechanisms activated
  64. What 3 scenarios besides a fight/flight response would trigger extrinsic controls of the kidney to reregulate GFR?
    • drop in BP
    • activated macula densa cells
    • activated sympathetic NS
  65. What kind of cells in the kidney release renin?
  66. What happens after JG/granular cells release renin?
    angiotensin II is released into blood
  67. What 2 things does angiotensin II cause?
    • adrenal cortex to release aldosterone
    • constriction of blood vessels
    • (both raise BP)
  68. Where are most tubule contents put in tubular reabsorption?
    from nephron to blood
  69. Where does 65% of reabsorption occur?
    proximal convoluted tubules
  70. Where does 15% of reabsorption, specifically salt and water, occur?
    loop of henle
  71. Where does about 19% of reabsorption, depending on hormones, occur?
    distal convoluted tubule
  72. What gets reabsorbed in tubular reabsorption?
    all organic nutrients (amino acids and glucose)
  73. What 2 things are reabsorbed depending on certain hormones?
    water and ions (salt, potassium, hydrogen)
  74. What ion provides the means for reabsorbing most other solutes?
    sodium (Na+)
  75. What 4 things are not reabsorbed, ultimately?
    • urea
    • uric acid
    • creatine
    • some water
  76. What is the difference between filtration and secretion?
    filtration is less specific than secretion, based on size
  77. Where does tubular secretion move substance to and from?
    from peritubular capillaries (blood) to nephron
  78. Where does tubular reabsorption move substance to and from?
    from nephrons to blood
  79. What 4 things are important about tubular secretion?
    • disposes substances
    • eliminates urea/uric acid
    • removes excess potassium
    • controls hydrogen ions
  80. What process controls blood pH by keeping or disposing of hydrogen ions?
    tubular secretion
  81. Where is 65% of filtrate's volume reabsorbed?
    proximal convoluted tubule
  82. What 4 things are actively transported from blood to the proximal convoluted tubule?
    • sodium
    • glucose
    • amino acids
    • other nutrients
  83. What is passively transported from blood to the proximal convoluted tubule?
  84. What is the descending loop of henle permeable to, and what is it not permeable to?
    • permeable to water
    • not permeable to sodium chloride
  85. Where does filtrate become increasingly concentrated because permeable to water but not solutes?
    descending loop of henle
  86. Where in the nephron is it permeable to solutes but not water?
    ascending loop of henle
  87. What consistency is filtrate in the ascending loop of henle?
    more dilute
  88. What hormone regulates how much salt is absorbed in the distal convoluted tubule?
  89. What hormone regulates how much calcium is reabsorbed in the distal convoluted tubule?
    parathyroid hormone
  90. What 2 solutes are reabsorbed in the distal convoluted tubule?
    calcium and sodium
  91. What is water reabsorption regulated by in the collecting duct?
  92. What is sodium and potassium reabsorption regulated by in the collecting duct?
  93. What is the concentration of solutes dissolved in water known as?
  94. What does the osmolality of a solution reflect?
    • the ability to cause osmosis
    • how full of solutes, or concentrated it is
  95. What kind of gradient is present in the renal medulla?
    osmotic gradient
  96. What is blood's osmolality?
    300 milli osmals
  97. What is the osmolality of the renal cortex?
    • 300
    • (close to blood)
  98. What is the osmolality of the renal medulla?
    • 1200
    • 4x more concentrated than blood
  99. Where is filtrate diluted?
    ascending loop of henle
  100. When is ADH secreted?
    during formation of concentrated urine
  101. When is ADH not secreted?
    during formation of dilute urine
  102. What happens to collecting ducts when the formation of more concentrated urine occurs?
    they become more permeable to water
  103. What does aldosterone do during the formation of concentrated urine?
    enhances sodium reabsorption
  104. What are chemicals that enhance the urinary output?
  105. How are high glucose levels a diuretic?
    water follows glucose
  106. What disease causes water to follow glucose in the urine?
    diabetes mellitus
  107. What diuretic inhibits the release of ADH?
  108. What does the inhibition of ADH (by alcohol) cause?
    no change in permeability of collecting ducts
  109. What does caffeine / most diuretic drugs inhibit?
    sodium ion reabsorption
  110. What do Lasix and Duril inhibit?
    sodium transportation
  111. What does urochrome do?
    makes urine yellow
  112. Why is the pH of urine so varied?
    depends on body's needs
  113. What is the specific gravity of urine?
  114. What are 2 normal components found in urine?
    urea and uric acid
  115. What are 4 abnormal components found in urine?
    • RBCs
    • WBCs (albumin)
    • glucose
    • ketones
  116. What 2 places is transitional epithelium found?
    ureters and bladder
  117. What movement do ureters use to move urine to the bladder?
  118. What is the smooth collapsible muscular sac that temporarily stores urine?
  119. What is the trigone?
    base of bladder where ureters and urethra empty
  120. What are the 3 layers of tissue in the bladder?
    • transitional epithelium
    • detrusor muscle
    • adventitia
  121. What is the muscular tube that drains urine from the bladder?
  122. What are 2 other terms for urination?
    • micturition
    • voiding
  123. When are impulses sent to the brain that urine has accumulated to urinate?
    when bladder has 200 mL
  124. What is stimulated to contract by parasympathetic nervous system when urination occurs?
    detrusor muscle of bladder
  125. What is relaxed by the somatic nervous system when micturition occurs?
    external urinary sphincter