________ ______________ main function is to keep the body in homeostasis by controlling the composition and volumes of the blood

Urinary System

__________________ means external or posterior to the peritoneum

Retroperitoneal

The Kidneys lie in a ______________ position (between the dorsal body wall and the parietal peritoneum).

Retroperitoneal

Kidneys ...

• _________ and ______________ selected amounts of water and solutes.
• __________ selected amounts of varios wastes (________, __________)

• Remove
• Restore
• Excrete
• Urea and creatinine

Kidneys...

• Help to regulate blood pressure by balancing __________ levels.

• water

• Because their position next to ____________, right kidneys is __________ than the left.
• Both are protected by the ________ and __________ pairs of ribs.

• liver
• lower
• 11th
• 12th pair of ribs

The kidneys are _______ -shaped, as they are retroperitoneal; ______ layers of tissue protect and support the kidneys.

• _________________ is a fibrous coat.
• _________________ fat deposits around the kidney (12% body fat).
• _________________ fibrous C.T. which anchors the kidneys to the dorsal wall

• bean
• three
• Fibrous Capsule
• Parietal Fat Capsule or Adipose capsule
• Renal Fascia

Kidneys are sectioned in:

• Hilum
• Renal Sinus
• Renal Cortex
• Renal Medulla

__________ is the indentation where the blood vessels enter and exit from the kidneys , and the ureters ________ from the renal pelvis.

• Hilum
• exit

Renal __________ is a cavity in the Kidney in which the renal pelvis can be found.

• Sinus

____________ is the area or the kidneys from the base of the renal pyramid to the renal capsule

• Cortex

________________ is the area which contains the renal pyramids.

Medulla

• ________________ ______________ is a "Funnel-shaped tube", continuous with the ureter leaving the hilium.
• It is a large central urine collecting area.
• Branching extensions of this structure form the _________.

• Renal Pelvis
• Calyxes

__________________ are the triangular-shaped structures in the medulla which appear _______ due to the presence of collecting ducts and blood vessels.

• Renal Pyramids
• striated

_____ __________ is the tip of the pyramid; the collecting ducts opening is located here.

• Renal Papella

_______ __________ are long portions of the cortex between the pyramids, located in the medullar area

• Renal Collumns

____________ are cup-like extensions of the renal pelvis which encompass each of the renal papillae.

Calyxes

These last areas or structures form part of the __________________ , and are here listed again:

• Renal Pyramid
• Renal papillae
• Renal Column
• Renal Pelvis
• Renal Calyxes (major and minor)

Renal Medulla

_______________ are the functional portion of the kidneys which contains the nephrons (cortex and renal pyramids)

Parenchyma

Which is the functional UNIT of the kidney

The Nephrons

A nephron functions are:

• Filtration
• Reabsorption
• Secretion

Filtration takes place in the _____________ and processes a cell-free and protein-free __________.

• corpuscle
• fitrate

Reabsorption (reclaims what the body needs to keep) is the process of selectively moving substances from the filtrate back into the _________. It takes place in the renal ___________ and collecting __________. Reclaims almost everything from the Filtrate:

• Water
• Salts
• glucose
• AAs

What happens with what is not reabsorbed:

Becomes URINE

Secretion is the process of selectively moving substances from the ___________ into the ______________. It also takes place in the renal ___________ and collecting __________.

• blood
• filtrate
• tubule
• ducts

Nephrons consist of two portions:

• Renal Corpuscle
• Renal Tubule

Renal Corpuscle consists of

• Glomerular capsule
• Glomerulus

Renal Tubule consists of...

• Proximal convoluted tubules
• Distal convoluted tubules
• Loop of Henle

What it the other name for Loop of Henle:

Loop of Nephron

• Glomerular Capsule, also known as _________ ___________ is composed of:
  • parietal layer composed of ____________ ___________ epithelium; which invaginates and becomes _____________ _________

• Bowman's capsule
• simple squamous epithelium
• Visceral layer

• _______________ is a capillary tuft within the spherical glomerular capsule.
• Differs from all other capillary beds in the body in that it is both fed and drained by _____________
• BLOOD enters via the ____________ arteriole, and exits via the ___________ arteriole.

• Glomerulus
• Arterioles
• Afferent
• Efferent

• ________ _________ are wider than _______ _________
• This arrangements maintain the ________ __________ in the glomerulus that is needed for filtration.

• Afferent arterioles
• Efferent artrioles
• High Pressure

The walls of __________ ____________ tubule are formed by cuboidal epithelial cells with dense microvilli. Just as the intestine, this brush border increases the surface area and capacity for REABSORBING water and solutes from the filtrate and secreting substances into it.

• Proximal Convoluted Tubule (PCT)

The U-shape __________ loop, also known as The Loop of ________, has _________ and ___________ limbs. Cells have microvilli also (true or false)

• Nephron
• Henle
• descending and
• ascending
• True

• The proximal part of the descending limb is continuous with the ____________ tubule. The rest of the descending limb (the thin limb) consists of _________ ___________ epithelium.

• Proximal
• simple squamous epithelium

_________ ______________ Tubule is made of ____________ cells, almost entirely lack of microvilli.

• Distal Convoluted Tubule
• Cuboidal

___________ duct is a duct where many distal convoluted tubules join and deposit their __________ secretion.

• Collective Duct
• urine

____________ duct is the end of the collecting duct as it terminates at the end of the renal papilla

• Papillary Duct

Nephrons are generally divided into 2 major groups, or there are 2 type of Nephrons :

1. Cortical Nephron
2. Juxtamedullary Nephron

Cortical Nephron, account _____% of the nephrons. They have their glomerulus in the portion of the _______ and its loop of Henle penetrates into the _________.

• 25%
• Cortex
• Medulla

Juxtamedullary Nephrone originate its glomerulus deep in the ________ and its loop of Henle penetrates the ________ almost to the renal __________.

• Cortex
• Medulla
• Renal Papillae

HISTOLOGY OF THE NEPHRON

1- The endothelial is make of ________ ___________ epithelium which comprises the glomerural ________ ______. This capillary has ___________ or pores ___ or ____ microns in the diameter. These pores are too _______ for blood cells to pass through.

• simple squamous epithelium
• capillary tuft
• finestra
• .5 to 1.0 microns
• small

2- ____________________ is an extracellular fibours glycoprotein matrix which acts as a ______________ membrane. It functions to ________ _____ large molecules from leaving the plasma.

• Basement membrane
• dialyzing membrane (purification)
• screen out

3- _____________ _________ is formed by the protocytes of the visceral layer of the ____________ ____________.

• Extensions from podocytes called ______________, which mean _________ __________ form filtration slits.
• A slit membrane extends across the filtration slits and restricts the passage of ___________ ___________.

• Filtration Slits
• Glomerulus Capsule
• pedicels
• little feet
• medium-size molecules

• Blood circulation to the kidneys is under ____________ control which regulates the ____________ of the capillaries
• _______ __________ transport ____% of the cardiac output (______) to the kidkeys per minute, which represents about _________ ml/min to be cleanse.

• Motor
• diameter
• Renal Arteries
• 25
• blood
• 1,200 ml/min

Blood Pathway through Kidneys

1. Renal arteries branch into
2. __________ ________ which in the turn branch into
3. Interlobal arteries (between pyramids) which branch to form the...
4. _________ _________ (at base of the pyramids) which branch to form the
5. __________ ________ _________ (in the cortex)

1. Renal Artery
2. Segment arteries
3. Interlobal Arteries
4. Arcuate Arteries
5. Cortical Radiate Arteries

6- The __________ branch off and enter the glomerular capsule to form the ...

7- ________________ where filtration happens

8- The efferent arteriole now leaves the _____________ and branches into a capillary network called the _____________ ____________

6-Afferent arteries

7-Glomerulus

8-Glomerulus

1. Peritubular Capillaries (surrounding the proximal and distal convoluted tubules)
2. Vasa Recta (surrounding the loop of the nephrones)

9- Peritubular Capillaries and Vasa Recta unite to form the ___________ ___________ vein.

10- then the _____________ veins

11- Interlobal veins

12- Segmental Vens

13- Renal Veins

9- Cortical Radiate Vein

10- Arcuate veins

11- Interlobal veins

12- segmental veins

13-Renal Veins

In the _______________ apparatus the fluid in the DCT are thought to play a role in controlling blood flow through the afferent arterioles (__________)

• Juxtaglomerulus Apparatus
• feedback

• Afferent arterioles are made of _______________ cells.
• Which contain granules called ___________.
• Its release causes formation of _____________ which constricts the afferent arteriole, there-by controlling blood flow to the nephrone.

• Juxtaglomerular cells
• Renin
• angiotensin

• If the flow rate is too slow, the Macula Densa will signal the afferent arteriole to _____________
• If the flow rate is too FAST, the Macula Densa will signal the afferent arteriole to _____________

• Dialate
• Constrict

Physiology of the Nephrons

Nephrons functions are 3:

1. Control blood concentration and volume by removing selected amounts of water and solutes.
2. Helps to regulate blood pH
3. Removes toxic waste from the blood

The main 3 processes require for Urine Formation are:

1. Glomerular Filtration
2. Tubular resorption
3. Tubular secretion

• _________________ occurs by forcing the fluids and dissolved substances through a membrane by an outside pressure.
• Filtration occurs in _________-______ membrane.
• The pressure is because _________ pressure
• The fluid is called _________________

• Filtration
• Endothelial-capsular membrane
• Blood
• Filtrate

• _______________ of renal corpuscles for filtering blood occurs because of:
  • A capsule of highly __________ glomerular capillaries presents a vast surface area for filtration.
  • The _________-_________ membrane receives from afferent arterioles __________.
  • efferent arteriole is ________ in diameter that the afferent; which brings _________ to outflow of blood from the glomerulus.

• The adaptation
• coiled
• Endothelial-capsule membrane
• blood
• smaller
• resistance

• The glomerular capillaries have the _______ Blood Pressure of all capillaries (_________).
• The endothelial-capsular membrane is very thin (___________) and separates __________ and ___________ from water and smaller solutes to form _____________.

• Highest
• 40-60 mm Hg
• .1 micrometers
• blood cells
• large proteins
• Filtrate

To find the levels of filtration according to hydrostatic pressure, we need to consider these different types of Pressures:

• NFP
• CHP
• BOP
• BGHP

NFP stands for

Net (effective) Filtration Pressure

NFP tells the ____________ which causes filtrate to be formed (to leave the capillary and enter into the glomerular space).

Pressure

CHP stands for

Capsular Hydrostatic Pressure

CHP is the __________ or ___________ which a fluid under pressure exerts on the walls of a container (capsular wall)

force or resistance

BOP stands for

Blood Colloidal Osmotic Pressure

The pressure which develops from water movement into a contained solution. It walways develops in the solution with the higher concentration of solutes.

Blood Colloidal Osmotic Pressure

Since blood has more proteins than the filtrate. Then, water moves _________ the filtrate and _________ the blood vessels.

• out of
• back into

GHP stands for

Glomerular Hydrostatic Pressure

The blood pressure in the glomerulus. This pressure is pushing _________ the walls of the capsule and the filtrate which is already there.

• Glomerular Hydrostatic Pressure

• Tubular Resorption is the movement of the _________ back into the ____________ of the _________ capillaries or ____________ Recta.
• Some of the materials reabsorbed are:
  • ___
  • ___
  • ___

• Filtrate
• Blood
• Peritubular capillaries
• Vasa Recta
• water, glucose, AAs, Na+, K+, Ca+, Cl-

Tm stands for ____________

Tubular Max

• Tubular Max is the _______ amount that can be ______, and the rest is _________.
• This allows the body to ___________ most of its nutrients.

• Maximum
• reabsorbed
• voided
• retain

Keeping the plasma proteins in the capillaries maintains the________ ___________, which prevents the _______ of all its water to the capsular space.

Colloid osmotic (oncotic) Pressure.

The presence of proteins or ______ _______ cells indicate

• Red Blood C.
• A problem with the filtration membrane.

___________ is only partially resorbed, and is derived from the normal breakdowns of amino acids.

Urea

Water accounts for about ____% of urine volume; the remaining ___% consists of solutes.

• The largest component of urine by weight , apart from water is ___________

• 95%
• 5%
• Urea

• ___________ reabsorption probably involves a carrier system
• Na+ ions are resorbed actively from the __________ _________ Tubules back into the ____________ capillaries.

• Glucose
• proximal convoluted
• peri-tubular

• _____________- ____________ tubules contain ___________ which increase the surface area approximately 20x.

• Proximal Convoluted T.
• microvilli

• As Na+ is actively transported through the cells, and into the ___________ capillaries; now that Na+ ion concentrations inside the cell is ______ than in the lumen, so a Na+ ion diffusion gradient is established from the _______ to the insid________ of the cell. Reason why the blood now is slightly more electropositive than the filtrate.

• peri-tubular capillaries
• higher
• tubule
• inside

• Cl- ions follow ______ ions out of the tubule by _________ attraction (also _____ and ______).

• Na+
• electrostatic
• Phosphorus and HCO3- (bicarbonate)

________ follows since the Proximal C.T. are always permeable to it.

H2O

• Due to Na+ being transported ______ ____ the blood, the osmotic pressure of the blood becomes higher than the filtrate.
• Water follows the ______ into the blood to re-establish _________ equilibrium. This is called _______________ Reabsorption.

• back into
• Na+
• Osmotic
• Obligatory

• When blood-water concentration is too low, ______ is released. Which stands for:

• ADH
• Antidiuretic Hormone

• ADH makes the membrane of the _____ and _________ duct _____ permeable to water _______ reabsorption by carrier molecule. This is called _____________ reabsorption.

• DCT
• Collective Ducts
• more
• Facultative

About _____ - ______ ml (volume) are eliminated per day and is influenced by:

• 1000-1800
• Blood Pressure
• Blood Concentrations
• Diet
• Temperature
• Diuretics
• Mental state
• general health

• Tubular secretion is a process which adds materials from the blood in peritubular capillary to the filtrate:___________________________,
• It moves ____________ substances

K+, H+, ammonium ions, urea, creatinine, penicillin, etc.

Selectively

Tubular secretion functions to ______ the body of certain materials as well as help to control the ____________

• rid
• blood pH

The body tries to maintain a pH of ___________

7.35 to 7.45

Normal urine has a pH of

6 pH

To raise the blood in renal tubules secrete _____ ions and _____________ into the filtrate.

• H+
• ammonium ions

Which is the main site of secretion:

PCT

Urine eventually excreted contain both __________ and _____________ substances. With one major exception.

• filtrrated
• secreted
• K+

____________ ________________ is a process which allows the kidneys to secrete hypertonic urine or hypotonic urine.

Countercurrent Multiplier Mechanism

____________ deliver urine from the kidneys to the urinary bladder.

Ureters

• Ureters are aprox. ___ to ___ inches long.
• ___________, hydrostatic pressure and __________ help move urine

• 10 to 12
• Peristalsis
• gravity

In a cross-sectional view of ureters we find different layers of:

• Mucosa
• Muscularis
• Fibrous

Mucosa in the ureter is formed of:

• Transitional epithelium
• Lamina propia

Muscularis is formed of

• longitudinal layer
• circular layer

Fibrous

which holds tu ureters with Adventitia

______________ is a hollow muscular organ held in place by the peritoneum.

Urinary bladder

Urinary bladder consists of 4 coats

• Mucosa
• Submucosa
• Muscularis or Detrusor muscle
• Peritoneum

1- Mucosa is composed of ___________ ______________, contains folds called ______________ which allow the urinary bladder to _____________ as it fills with urine.

• Transitional epithelium
• ragae
• stretch

2- Submucosa is a ____ layer which holds the _______ layer to the ______ coat.

• Connective Tissue
• Mucosa
• Muscular

3- Muscularis or _________ ________ consists of __ layers of ________:

1. _____ Longitudinal, ____ -________ and outer __________.
2. _________ urethral sphincter
3. _________ urethral sphincter

• Detrusor muscle
• 3 layers of
• muscles
• Inner
• middle circular
• longitudinal
• Internal
• External

4- Peritoneum is the external ___________ covering

Serous

________________ is the expulsion of urine from the urinary bladder; urination; voiding.

Micturition

The average urinary bladder capacity is _______

400 to 800 ml

_______________ a smooth mucosal layer; the ureters drain into the urinary bladder at the base corners of this layer (at top)

Trigone

________________ is a tube extending from the urinary bladder to the external urethral orifice through which urine is expelled.

Urethra

_____________ is only partially resorbed, and is derived from the normal breakdowns of amino acids.

Urea

_________ occurs when toxic levels of urea in the blood due to the kidneys not functioning correctly

Uremia

____________ is an infection in renal pelvis and calyxes

Pyelitis

_____________ is an infection or inflammation the entire kidney

Pyelonephritis

______ ________ when rapid weight loss removes fat causing the kidney to fall to a lower position

Renal Ptosis

________________ is the back up of urine from ureter obstruction.

Hydronephrosis