Urinary System

Almira Coleen · 28問 · 1年前

通報

問題一覧

Where urine is formed by filtration of blood?

Kidney

Carry urine to the bladder

Ureters

Stores the urine produced

Bladder

Delivers the urine for EXCRETION

Urethra

Kidney's function is to maintain

Homeostasis

• Maintaining homeostasis • Excretion of waste products • Concerned with the maintenance of blood pressure and erythropoiesis

Kidney

The functional unit of the kidney

Nephron

The nephron has approximately __________ each kidney

1.5 Million

Site of Filtration

Renal Corpuscle

Consists of a coil of approximately eight capillary lobes (capillary tuft)

Glomerulus

The glomerulus consists of a coil of approximately eight ________ (capillary tuft)

Capillary Lobes

A cluster of small arteries that bring blood to and from the glomerulus in the kidneys

Afferent Arteriole

A blood vessel in the urinary system that brings filtered blood from the glomerulus to the rest of the kidney and back to the general circulation.

Efferent Arteriole

Surround the proximal and distal convoluted tubules, the immediate reabsorption of essential substances from the fluid

Peritubular Capillaries

Located adjacent to the ascending and descending of Loop of Henle

Vasa Recta

• 85% • Removal of waste products • Reabsorption of filtered nutrients

Cortical

• 15% • Longer of loops of Henle • Urine concentration

Juxtamedullary

The kidneys receive a large blood flow

25%

Supplies blood to the kidney

Renal Artery

Renal Blood Flow based on average body size of ______

1.73m²

Total renal blood flow: approx.

1200mL/min

Total renal plasma flow:

600 to 700 mL/min

Glomerulus is located in the

Bowman's Capsule

• Endothelial cells have pores (Fenestrated) • Large molecules and cells are blocked

Capillary Wall

Further restriction of large molecules

Basement Membrane

• Intertwining podocytes • Membrane covered filtration slits • Protest glomerulus

Bowman's capsule inner layer

Presence of Hydrostatic Pressure cause by (size of afferent and efferent arteriole)

Glomerular Pressure

• Larger afferent and smaller efferent • Prevents decreased blood flow

Low Systemic Blood Pressure

• Smaller Afferent Arteriole • Prevents overfiltration and glomerular damage

High Systemic Blood Pressure

Are necessary to overcome the opposition of pressure from the fluid from the Bowman's Capsule

Hydrostatic Pressure

Pressure of unfiltered plasma protein

Oncotic Pressure

• Regulates blood flow • Responds to blood pressure and plasma sodium changes

RAAS System

Juxtaglomerular apparatus: Afferent Arteriole

Juxtaglomerular Cells

Juxtaglomerular Apparatus: Efferent Arteriole

Macula Densa

Initiates RAAS in response to blood pressure changes

Macula Densa

• Dilates afferent arteriole • Constricts efferent arteriole • Stimulate sodium reabsorption in PCT • Trigger release of Aldosterone • Trigger release of ADH

Angiotensin II

Normal glomerular filtrate

120 mL/min

Glomerular Filtrate Composition: Ultrafiltrate of ______

Plasma

Ultrafiltrate specific gravity

1.010

Cellular energy and carrier proteins needed for transport back to blood

Active Transport

In Active Transport _______, ______, ______ in PCT

Glucose, Salts, Amino Acids

In Active Transport, _______ in ascending loop of Henle

Chloride

In Active Transport, ______ in DCT

Sodium

Controlled by substance concentration gradients on sides of a membrane

Passive Transport

In passive transport, water reabsorption occurs throughout the _______

Nephron

The water in Passive Transport accompanies high amount of sodium reabsorption in

Proximal Convoluted Tubule

In passive transport, _____ in PCT and ascending loop of Henle

Urea

In passive transport, ______ the ascending loop of Henle

Sodium

• Maintains concentration in the medulla • Medulla is diluted by the water from the descending loop of Henle • Reconcentrated by sodium and chloride from the filtrate in the ascending loop

Countercurrent Mechanism

In tubular concentration, DCT has ______ controlled and ______ reabsorption of needed by the body

Aldosterone, Sodium

Plasma level at which active transport ceases

Maximal Reabsorptive Capacity

Plasma level causing active transport to cease • Normally reabsorbed substance appears in urine

Renal Threshold

Glucose threshold

160-180 mg/dL

Normal blood sugar, urine glucose =

Tubular Damage

• Final filtrate concentration • Water reabsorption controlled by ADH in response to body hydration

Collecting Duct Reabsorption

• Controls permeability of DCT and CT walls to water

Antidiuretic Hormone

Amount of ADH produced by _______ determines permeability

Hypothalamus

Filtrate to blood

Reabsorption

Blood to Filtrate

Secretion

• Eliminate non-filtered wastes • Protein-bound substance • Regulate acid-balance

Tubular Secretion

• Secrete ______ to return filters buffers to the blood • Excretion of excess _____

H+ ions

Is produced and secreted by the DCT

Ammonia

Additional ammonia is produced from the metabolism of _______ in PCT

Glutamine

Measure rate at which the kidneys can remove a filterable substance from the blood

Clearance Tests

Inulin Clearance Test

Priming Dose: ______ of _____ Inulin solution

25mL, 10%

Continuous Infusion: ____ of ____ inulin solution

500mL, 1.5%

Inulin Clearance Test! Reference Test: Male

127mL/min

Inulin Clearance Test Reference Values: Female

118mL/min

Current routine test substance

Creatinine

• Most commonly used clearance test • Screening method of GFR

Creatinine Clearance Test

Principle: To determine the amount of creatinine completely removed from the _____ during 1 minute

Plasma

Report in milliliters per minute

Creatinine Clearance Test

Creatinine Clearance Test: GFR

Glomerular Filtration Rate

Is produced as a result of muscle destruction; therefore, normal values are based on size; the larger the person, the more creatinine produced

Creatinine

Are available to adjust for size

Nomograms

Glomerular Filtration Rate

MDRD

Modification of Diet in Renal Disease

Modification of Diet in Renal Disease (MDRD)

Beta² Microglobulin

Small protein produced by all nucleated cells; filtered by glomerulus

Cystatin C

Radioisotopes

Tubular Reabsorption Tests

Has replaced specific gravity as the tests to asses renal concentration

Osmolarity

Osmolarity's ___________ includes number of size of molecules

Specific Gravity

Patients were deprived of fluids for 24 hrs prior to measuring specific gravity.

Fishberg Test

Compare the volume and specific gravity of urine of day and night urine samples.

Mosenthal Test

Osmolarities clinical unit of measure is the

Milliosmole

Colligative Properties

Freezing Point Osmometers

Vapor Osmometers Actual measure is _______ (Temperature at which water vapor condenses to liquid)

Dew Point

Temperature lowered, vapor condenses, _________ measures heat of condensation that raised temperature to dew point.

Thermocoupler

• Decreased ADH production • Inability of tubules to respond to ADH

Diabetes Insipidus

Ultrafiltrate has some _______ as plasma

Osmolarity

Indicates if enough water is excreted to remove wastes and the kidneys response to body hydration

Free Water Clearance

• Test for renal blood flow • Exogenous Procedure

P-Aminohippuric Acid (PAH)

PAH is secreted in _______, not by glomerular filtration

Proximal Convoluted Tubule

Is completely removed from the blood each time it comes in contact with functional renal tissue

PAH

100

Is inability to produce an acid urine = metabolic acidosis

Renal Tubular Acidosis

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