LSB258 Lecture 7: Renal Physiology

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7 Nov 2018

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The primary function of the urinary system is the formation of urine. Urine a filtrate of blood plasma, and a vehicle for secretion of waste products. Function of the kidneys: elimination of waste products, reabsorption of nutrients/water, regulation of blood pressure, regulation of fluid composition, regulation of fluid ph, hormone secretion renin and erythropoietin, activation of vitamin d. Salt concentration: high salt concentration 4 x more concentrated than plasma. High salt concentration results from reabsorption of water. Has the ability to recycle water is a major advantage. Able to go without water for extended periods of time. The urine is transported from the kidneys via the ureter, where it is stored by the bladder prior to excretion. Cross section of a kidney blood vessels of the kidney. The nephron is the functional unit of the kidney, with each nephron being comprised of the following components:

Related Questions

. The kidneys contain millions of _________, which are the smallest functional units of the kidneys since each one can make urine from blood.

2. There are 3 stages in urine formation. The first stage is called____________; during this stage, blood pressure pushes water and small solutes out of a ball of capillaries called the __________ into the first part of the renal tubule called the _________ _________.

3. The second stage of urine formation is called _________. Cells lining the proximal convoluted tubules (PCTs) have special projections called _________ which increase their surface area, thus enabling the PCTs to transport about 70% of filtrate back into blood.

4. When a person is dehydrated, their blood volume and blood pressure are too low. Two hormones reduce the loss of sodium and water from the body during dehydration by concentrating urine to prevent further water loss. The first hormone is secreted by the adrenal cortex and is called __________; this hormone stimulates sodium retention by nephrons. The second hormone is released by the posterior pituitary gland and is called _________; this hormone cause water retention by nephrons.

5. ___________is the waste product of cellular respiration (ATP synthesis). This waste product must be eliminated from the body because it becomes toxic at high levels. This waste product combines with water in blood to form carbonic acid, which is then converted into bicarbonate ions (HCO3-) and hydrogen ions (H+). Hydrogen ions lower blood pH, causing it to become too acidic. Kidneys are able to sense high H+ levels in blood and actively transport hydrogen ions (and other toxic blood borne chemicals) from blood into urine during ___________, the third stage of urine formation.

6. Urine and blood differ in composition. In a healthy person, blood contains _________ , __________, and _________ but urine DOES NOT these materials.

7. Urine moves from the kidneys down the ureters into the bladder due to __________, a form of motility wherein _________ muscle tissue in the ureteral walls undergoes rhythmic waves of contractions.

8. The kidneys are located in the ___________ cavity; ureters conduct urine to the urinary bladder which is located in the pelvic cavity behind the symphysis joint of the _________ bones.

9. The three major systems which participate in the excretion of cellular wastes from blood include: the __________ system which eliminates urea and excess electrolytes like sodium; the ___________ system which eliminates water and salt; and the ____________ system, which eliminates carbon dioxide.

10. When the bladder is full, the _____________ reflex is initiated. During this reflex, the bladder walls contract and the ________ ________ sphincter, a circular structure made of _______ ______tissue, relaxes. Upon sensing an urge to urinate, a person can consciously contract their _______ _______ sphincter, a circular structure made of ________ ________ tissue - this stops the flow of urine out of the bladder and into the urethra until the time is convenient to urinate.

REFERENCE CITATIONS: _______________________________

amaranthantelope72

1. Which hormone responsible for calcium absorption is synthesized by the kidneys?
a. Calcitriol b. Glucagon c. Erythropoietin d. Antidiuretic hormone

2. Which of the following regulations is not performed by the kidney?
a. acid-base balance b. blood pressure c. glycolysis d. blood production

3. The hormone require for blood pressure regulation and release by the kidney is _____.
a. erythropoietin b. renin c. calcitriol

4. Almost all nutrients and about 65% of sodium are actively reabsorbed in this part of the nephron, transported from the filtrate back to the plasma.
a. proximal tubule b. descending limb c. ascending limb d. collecting duct

5. Which site is where most regulation happens?
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

amaranthfrog191

1) A drop of urine would follow this path

a) renal pyramid/major calyx/minor calyx/renal pelvis/ureter

b) minor calyx/major calyx/renal pyramid/renal pelvis/ureter

c) renal pelvis/minor calyx/major calyx/renal pyramid/ureter

d) renal pyramid/minor calyx/major calyx/renal pelvis/ureter

2) The production of filtrate starts at

a) Loop of Henle

b) capsular space

c) distal convoluted tubule

d) proximal convoluted tubule

3) Major reabsorption of water happens by ____at the _____

a) contransport, distal convoluted tubules

b) Cl- shift, nephron loop

c) countercurrent, nephron loop

d) countercurrent, ureter

4) Angiotensin II causes production of ____to increase Na + reabsorption in the _________

a) renin; collecting duct

b) aldosterone; PCT

c) ADH; nephron loop

d) aldosterone; collecting duct

5) Most of the reabsorbed compounds from the filtrate end up in the

a) peritubular capillary

b) urine

c) nephron loop

d) DCT

6) Reabsorption of urea happens by

a) transcellular movement

b) by paracellular movement

c) by cotransport with glucose

d) by HCO3- movement

7) Transport Maximum, in urinary system terms, refers to

a) proteins performing âtransportâ out of the filtrate at maximum rate

b) the reason why a diabetic produces large volumes of diluted urine

c) excess filtrate components being urinated out of the body

d) All choices are correct

8) Urine does not drop below pH 4.5 because

a) proteins that move H+ into filtrate stop working when too much H+ builds up in filtrate

b) proteins in urine neutralize acid

c) H+ are always buffered

d) the buffering system in urine does not run out

9) Hyperkalemia will

a) activate adrenal cells to secrete aldosterone

b) can stop the heart

c) No choices are correct

d) cause reduced excitability of neurons

e) All choices are correct

10)In your body, chloride (Cl-) can be found in its highest concentration in

a) extracellular fluid

b) intracellular fluid

c) Neither choice is correct

11) Diuretic abuse leads to

a) All choices are correct

b) two choices are correct

c) No choice is correct

d) dehydration

e) athletes being accused of doping

f) hypotonic hydration

12) Long diffusion distance, low blood pressure, and impaired circulation are the result of

a) hypernatremia

b) edema

c) hyperkalemia

d) water toxicity

13) In males FSH is under feedback control by _____ and is down regulated when _________reaches high concentrations

a) inhibin, testosterone/sperm #s

b) testosterone, inhibin/sustentocyte #s

c) ADH, inhibin/sustentocyte #s

d) LH, testosterone/sperm #s

14) Testosterone production is done by ____-cells

a) posterior pituitary

b ) interstitial endocrine

c) anterior pituitary

d) sustentocytes

15) Upon _____of estrogen/progesterone, the ____phase of the uterine cycle begins

a) increase; menstrual

b) decrease; menstrual

c) increase; proliferative

d) decrease; secretory

16) Progesterone

a) All choices are correct

b) is low in the luteal phase

c) No choices are correct

d) raises in the follicular phase

e) is high along with estrogen during the follicular phase

17) Which nephron is most responsible for urine concentration?

a) cortical nephrons

b) Juxtamedullary nephrons

c) Neither

carminesalmon877

LSB258 Lecture 7: Renal Physiology

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