A & P 2 – Chapter 23 – The Urinary System

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How do the kidneys regulate blood volume and blood?

By regulating water output

Which of the following describes the location of the kidneys?

Retroperitoneal at the level of T12 to L3

What is the order of urine-collecting structures found within the kidney?

Minor calyx, major calyx, renal pelvis, ureter

Which blood vessel carries blood into a glomerulus?

Afferent arteriole

When there is a drop in blood pressure, the juxtaglomerular cells respond by secreting which of the following?

Renin

In the kidney, tubular reabsorption refers to the movement of fluid and solutes where?

From the tubular fluid into the blood

What is tubular secretion?

The movement of water and solutes from the blood into the tubular fluid

The primary function of the nephron loop is to generate a medullary ECF osmotic gradient that allows for what?

The concentration of urine

Filtration is a ________________ process that depends on a ___________________ gradient.

passive; pressure

When systemic blood pressure decreases, the result is that the ___________ arterioles change diameter by undergoing ______________.

afferent; vasodilation

If both the glomerular and capsular hydrostatic pressures remain unchanged, an increase in the blood colloid osmotic pressure results in a(n) _____________ in the net filtration pressure.

decrease

Which of the following forces oppose glomerular filtration?

capsular hydrostatic pressure (HPc) and blood colloid osmotic pressure (OPg)

Glomerulosclerosis results in a ____________________ of the basement membrane

thickening

Proteinuria occurs when the filtration membrane becomes leaky, allowing proteins to cross. This impacts the blood colloid osmotic pressure by ____________________ the osmolarity gradient between the blood and filtrate, thereby ________________ the strength of this pressure.

decreasing; reducing

An increase in the NFP would result in a(n) _______________ in the GFR.

increase

Renin is released in response to ________________________ stimulation.

sympathetic

Angiotensin II triggers the __________________________ of the intraglomerular mesangial cells which results in a(an) _______________________________ of the filtration surface area.

contraction; decrease

ACE inhibitors are prescribed to control blood pressure. These drugs work by reducing _____________________.

the conversion of angiotensin I to angiontensin II

Tubular reabsorption and tubular secretion differ in that __________________________.

tubular secretion adds materials to the tubular filtrate while tubular reabsorption removes materials from the tubular filtrate

Which of the following substances utilizes paracellular transport in order to cross the basolateral membrane of the tubule cell during the process of reabsorption?

potassium

The majority of sodium reabsorption occurs at the proximal convoluted tubule. During this process sodium enters the tubule cells at the ___________________ and exits the tubule cells at the ____________________.

luminal membrane by facilitated diffusion; basolateral membrane through the sodium potassium pump

Glucose that is reabsorbed into tubular cells travels __________ its concentration gradient through sodium-glucose symport channels at the luminal membrane. Glucose in tubular cells exits the basolateral membrane into interstitial fluid through the process of ______________________.

against; facilitated diffusion

Under normal conditions the majority of uric acid reabsorption occurs at the _______________________.

proximal convoluted tubule

Treatment with Probenecid® results in _________________ levels of uric acid in the urine and __________________ levels of uric acid in the blood.

increased; decreased

The interstitial fluid within the medulla has a __________________ osmolarity than the interstitial fluid within the cortex.

higher

Individuals with Bartter syndrome have a defective gene coding for Na+/K+/2Cl- symport (NKCC2) that disables it from functioning. These individuals are expected to have ___________ than normal blood potassium levels. This response is the ___________ what is expected from individuals taking prescribed loop diuretics.

lower; same as

The nephron loop is responsible for approximately 25% of the reabsorption of sodium. Loop diuretics cause an overall __________________ in the reabsorption of sodium in this region resulting in a(n) ________________________ in the osmolarity of the tubular filtrate.

decrease; increase

Decreased Na+ and water reaborption due to the use of loop diuretics and thiazides __________ the concentration gradient of the interstitial fluid, thereby _____________ the osmotic force at the collecting tubule and duct.

lowers; reducing

Aldosterone enhances the reabsorption of sodium through the upregulation of the sodium-potassium pump found at the ________________.

basolateral membrane

In addition to enhancing the reabsorption of sodium, aldosterone also enhances the __________________ of potassium.

secretion

Antidiuretic hormone enhances water ______________ by _______________ the number of aquaporins at the tubular cell membrane.

reabsorption; increasing

Pendrin is found in __________ intercalated cells where it allows for the ________________ of bicarbonate

type B; secretion

The expected response to metabolic alkalosis is the ___________________ of Pendrin. Type _____________ also assist in buffering the alkaline blood through its transport of H+.

upregulation; B

Inactivating the sodium-glucose symport SGLT2 inhibits the reabsorption of glucose by ____________________________.

preventing glucose from entering the tubular cells

Inhibiting the sodium-glucose symport SGLT2 is expected to cause a(n) __________________________ in the osmolarity of the tubular filtrate, and would thus _____________________ the risk of dehydration.

increase; increase

Match each nitrogenous waste with the substance from whose catabolism it results.

1. Urea
2. Uric Acid
3. Creatinine

A. Proteins
B. Creatine Phosphate
C. Nucleic Acids

Urea – Proteins Uric Acid – Nucleic Acids Creatinine – Creatine Phosphate

The process of separating wastes from the body fluids and eliminating them is called __________.

excretion

If a patient presents with a Streptococcus viridans infection, his doctor may prescribe oral penicillin taken four times daily. Why does he have to take the penicillin so often?

The renal tubules extract penicillin from the blood and secrete it into the urine.

Aldosterone

Effect on water excretion.

Stimulates sodium ion retention

Natriuretic Peptides

Effect on water excretion.

Inhibits NaCl reabsorption by the collecting duct

Antidiuretic hormone

Effect on water excretion.

Causes water to reenter the bloodstream via the collecting duct

Parathyroid hormone

Effect on water excretion.

Decreases hydrostatic pressure in the peritubular capillaries

This urinary system organ removes waste products from the body and helps regulate blood pressure:

a. liver
b. heart
c. kidney
d. lungs

c. kidney

This is the basic histological and functional unit of the kidney:

a. glomerulus
b. filtration membrane
c. nephron
d. podocyte
e. renal corpuscle

c. nephron

The major calyces of the kidney converge to form this enlarged channel:

a. renal fascia
b. renal pelvis
c. renal pyramids
d. renal papillae
e. renal sinus

b. renal pelvis

The juxtaglomerular cells of the _____________ and the macula densa cells of the _____________ form the juxtaglomerular apparatus.

a. afferent arteriole, distal tubule
b. afferent arteriole, proximal tubule
c. efferent arteriole, proximal tubule
d. efferent arteriole, distal tubule

a. afferent arteriole, distal tubule

Arrange the parts in order as fluid flows from the filtration membrane through the nephron. Given these parts of a nephron:

1. renal corpuscle
2. collecting duct
3. loop of Henle
4. distal tubule
5. proximal tubule

a. 1,5,3,4,2
b. 2,4,1,3,5
c. 2,1,4,5,3
d. 4,2,3,5,1

a. 1,5,3,4,2

This process of urine production is the active transport of solutes across the walls of the nephron into the filtrate:

a. filtration
b. tubular reabsorption
c. tubular secretion
d. filtration fraction

c. tubular secretion

These substances normally cannot pass through the filtration membrane:

a. hemoglobin
b. water
c. sodium ions
d. bicarbonate ions
e. glucose

a. hemoglobin

By the time the filtrate reaches this, the glucose is usually completely reabsorbed:

a. the end of the proximal tubule
b. the tip of the loop of Henle
c. the end of the distal tubule
d. the end of the collecting duct
e. Bowman’s capsule

a. the end of the proximal tubule

A decrease in systemic blood pressure results in dilation of the afferent arterioles which prevents a decrease in renal blood flow and filtration pressure.

True/False

True

Drinking a large amount of beer results in this:

a. increased aldosterone secretion
b. increased permeability of the collecting ducts of the nephrons
c. decreased urine osmolality
d. increased urine volume
e. both c and d

e. both c and d

AnswerThis hormone secreted by the kidney triggers a cascade that regulates blood Na+ and blood pressure:

a. erythropoietin
b. vasopressin
c. renin
d. angiotensin

c. renin

This effect is caused by increased aldosterone levels:

a. increased reabsorption of Na+
b. decreased blood volume
c. decreased reabsorption of Cl-
d. increased permeability of the distal tubule to water
e. increased volume of urine

a. increased reabsorption of Na+

Diuretics affect the urine in this manner:

a. decrease the urine flow
b. increase the urine flow
c. increase the cellular composition of the urine
d. none of the above

b. increase the urine flow

This statement best describes principal cells in the distal tubules and collecting duct:

a. secrete renin
b. respond to ADH and aldosterone
c. respond to ADH only
d. respond to aldosterone only

b. respond to ADH and aldosterone

Putting a patient with hypertension on a low-sodium diet would have this effect:

a. reduces the osmolality of blood
b. ADH secretion is inhibited
c. produces dilute urine and eliminates water
d. reduces blood volume and blood pressure
e. all of these

e. all of these

This small tube leads from the floor of the urinary bladder to the exterior of the body:

a. renal pelvis
b. ureter
c. urethra
d. calyx

c. urethra

This is the principal function of the ureter:

a. transport blood to the efferent arterioles
b. transport urine from the renal pelvis into the urinary bladder
c. transport glucose and protein into the renal pelvis
d. none of the above

b. transport urine from the renal pelvis into the urinary bladder

The urinary bladder can contain 1 L of urine, but discomfort becomes noticeable when the volume exceeds 500mL.

True/False

True

The urinary bladder is lined with this tissue:

a. simple cuboidal epithelium
b. simple columnar epithelium
c. smooth muscle
d. transitional epithelium

d. transitional epithelium

This triangular area of the urinary bladder is between the two ureters posteriorly and the urethra anteriorly:

a. external urinary sphincter
b. internal urinary sphincter
c. smooth muscle
d. transitional epithelium
e. trigone

e. trigone

Blood vessels, lymphatic vessels and nerves enter and exit the kidney through this:

a. renal hilus
b. renal sinus
c. renal calyces
d. adrenal glands

a. renal hilus

The cortex of the kidney contains this:

a. hilus
b. glomeruli
c. perirenal fat
d. renal pyramids
e. renal pelvis

b. glomeruli

Water leaves the nephron by this mechanism:

a. active transport
b. filtration into the capillary network
c. osmosis
d. facilitated diffusion
e. cotransport

c. osmosis

This condition reduces filtration pressure in the glomerulus:

a. elevated blood pressure
b. constriction of the afferent arterioles
c. decreased plasma protein in the glomerulus
d. dilation of the afferent arterioles
e. decreased capsule pressure

b. constriction of the afferent arterioles

Arrange the vessels in the order in which a drop of blood from the interlobular artery passes through them. Given these vessels:

1. arcuate vein
2. afferent arteriole
3. efferent arteriole
4. interlobular vein
5. peritubular capillaries

a. 1,2,4,5,3
b. 2,3,5,4,1
c. 4,2,5,3,1
d. 5,2,4,1,3

b. 2,3,5,4,1

Prednisone is a steroid that reduces inflammation and is used to treat autoimmune diseases. It has some aldosterone-like effects on the kidney and has this effect on the body:

a. increases Na+ absorption
b. increases blood volume
c. increases blood pressure
d. causes edema
e. all of these

e. all of these

Parathyroid hormone increases phosphate excretion by the proximal convoluted tubule as well as promotes synthesis of calcitriol.

True/ False

True

The ureters pass anterior to the bladder and enter it from below.

True/ False

False

Glomerular capillaries suffer little damage from hypertension because of the protective influence of the afferent arterioles.

True/ False

False

Which is not a function of the kidneys?

a. They regulate osmolarity of the body fluids.
b. They fight osteoporosis by synthesizing vitamin D.
c. They help control blood pressure.
d. They release waste into the bloodstream.
e. They indirectly increase oxyhemoglobin.

d. They release waste into the bloodstream.

Angiotensin-converting enzyme is found only in the kidneys and converts angiotensinogen to angiotensin I.

True/ False

False

The countercurrent multiplier mechanism for water conservation was discovered by limiting studies to humans and thus hypothesizing how form determines function.

True/ False

False

Albuminuria is a common sign of diabetes mellitus.

True/ False

False

Human urine can have as much as __________ times the osmolarity of the blood plasma, which is why it is called hypertonic.

a. 1.5
b. 2.6
c. 4.0
d. 5.8

4.0

The most toxic of our metabolic wastes are nitrogenous wastes.

True/ False

True

Cells in the cleft between the afferent and efferent arterioles and among capillaries of the glomerulus are known as mesangial cells.

True/ False

True

Diseases that affect the descending corticospinal tracts may limit inhibition of the sacral somatic motor neurons and thus could result in urinary incontinence

True/ False

True

Ethyl (drinking) alcohol stimulates the secretion of ADH, thereby reducing reabsorption by the collecting duct.

True/ False

False

The thick segment of the nephron loop is impermeable to water.

True/ False

True

Glomerular filtration occurs because glomerular oncotic pressure overrides glomerular blood pressure.

True/ False

False

The fenestrated endothelium of the capillary has pores small enough to exclude blood cells from the filtrate.

True/ False

True

In life-threatening starvation, the kidneys synthesize glucose by

a. secreting erythropoietin.
b. secreting renin.
c. deaminating amino acids.
d. contributing to calcium homeostasis.
e. producing uric acid.

c. deaminating amino acids

This byproduct of protein catabolism constitutes approximately one-half of all nitrogenous waste.

a. urea
b. creatinine
c. uric acid
d. azotemia
e. ammonia

a. urea

Which organ system does not excrete waste?

a. the urinary system
b. the cardiovascular system
c. the integumentary system
d. the digestive system
e. the respiratory system

b. the cardiovascular system

Which of the following is not an organ of the urinary system?

a. urethra
b. ureter
c. urinary bladder
d. kidney
e. collecting duct

e. collecting duct

A patient enters a hospital after a motorcycle accident. He complains of mid-back pain. X-rays reveal both rib and pelvic fractures. His emergency room examination includes urinalysis. Which of the following findings from the urinalysis would most likely suggest trauma to the kidneys from the accident, but not to the urinary bladder?

a. pyuria
b. hematuria
c. albuminuria
d. uremia
e. phenylketonuria

c. albuminuria

The innermost connective tissue layer protecting the kidney and assisting in staving off infection is known as
the perirenal fat capsule.

a. the renal fascia.
b. the hilum.
c. the fibrous capsule.
d. the renal medulla.
e. the fibrous capsule.

c. the fibrous capsule.

A single lobe of a kidney is comprised of

a. two calyces and a renal pelvis.
b. one pyramid and the overlying cortex.
c. one major calyx and all of its minor calyces.
d. a renal medulla and two renal columns.
e. one collecting duct and all nephrons that drain into it.

b. one pyramid and the overlying cortex.

A renal pyramid voids urine into:

a. the minor calyx.
b. the major calyx.
c. the renal medulla.
d. the renal papilla.
e. the ureter.

a. the minor calyx.

Which of these correctly traces blood flow from the renal artery into the renal cortex?

a. arcuate a. → interlobar a. → afferent arteriole → interlobular a.
b. interlobar a. → interlobular a. → segmental a. → arcuate a.
c. segmental a. → interlobar a. → arcuate a. → interlobular a.
d. afferent arteriole → interlobular a. → arcuate a. → interlobar a.
e. segmental a. → arcuate a. → interlobar a. → interlobular a.

c. segmental a. → interlobar a. → arcuate a. → interlobular a.

The transition from an afferent arteriole to an efferent arteriole occurs in the

a. glomerulus.
b. medulla.
c. cortical radiate veins.
d. peritubular capillaries.
e. vasa recta.

a. glomerulus.

The average person has approximately _______ nephrons per kidney.

a. 1.2 million
b. 2.4 million
c. 3.6 million
d. 4.8 million
e. 5.6 million

a. 1.2 million

Which of these correctly traces blood flow from the renal cortex to the renal vein?

a. interlobular v. → interlobar v. → segmental v. → renal v.
b. arcuate v. → interlobar v. → segmental v. → renal v.
c. interlobar v. → interlobular v. → arcuate v. → renal v.
d. segmental v. → arcuate v. → interlobar v. → renal v.
e. interlobular v. → arcuate v. → interlobar v. → renal v.

e. interlobular v. → arcuate v. → interlobar v. → renal v.

Blood plasma is filtered in:

a. the renal tubule.
b. the renal corpuscle.
c. the renal capsule.
d. the renal column.
e. the renal calyx.

b. the renal corpuscle

Which of these form the inner layer of the glomerular capsule and wrap around the capillaries of the glomerulus?

a. macula densa cells
b. mesangial cells
c. nephrocytes
d. podocytes
e. monocytes

d. podocytes

All of the following are composed of cuboidal epithelium with the exception of:

a. the thin segment of the nephron loop.
b. the thick segment of the nephron loop.
c. the collecting duct.
d. the proximal convoluted tubule.
e. the distal convoluted tubule.

a. the thin segment of the nephron loop.

Which are primarily responsible for maintaining the salinity gradient of the renal medulla?

a. cortical nephrons
b. juxtamedullary nephrons
c. collecting ducts
d. proximal convoluted tubules
e. distal convoluted tubules

b. juxtamedullary nephrons

In the nephron, the fluid that immediately precedes urine is known as:

a. plasma.
b. glomerular filtrate.
c. tubular fluid.
d. renal filtrate.
e. medullary filtrate.

c. tubular fluid.

Glucose and amino acids are reabsorbed from the glomerular filtrate by:

a. the renal corpuscle.
b. the proximal convoluted tubule.
c. the distal convoluted tubule.
d. the glomerular capillaries.
e. the collecting duct.

b. the proximal convoluted tubule.

In a healthy kidney, very little ___ is filtered by the glomerulus.

a. amino acids
b. electrolytes
c. glucose
d. vitamins
e. protein

e. protein

Which of the following would reduce the glomerular filtration rate?

a. vasoconstriction of the efferent arteriole
b. a drop in oncotic pressure
c. vasodilation of the afferent arteriole
d. vasoconstriction of the afferent arteriole
e. an increase in osmotic pressure in the glomerular capsule

a. vasoconstriction of the afferent arteriole

The mechanism of stabilizing the GFR based on the tendency of smooth muscle to contract when stretched is known as what?

a. renal autoregulation
b. the myogenic mechanism
c. tubuloglomerular feedback
d. sympathetic control
e. the renin-angiotensin-aldosterone mechanism

b. the myogenic mechanism

In response to a drop in overall blood pressure, ___ stimulates constriction of the glomerular inlet and even greater constriction of the outlet.

a. azotemia
b. sodium chloride
c. parathyroid hormone
d. aldosterone
e. angiotensin II

e. angiotensin II

Assuming all other values are normal, calculate the net filtration pressure in a patient with a drop in capsular hydrostatic pressure to 8 mmHg.

a. 10 mm Hg out
b. 20 mm Hg out
c. 30 mm Hg out
d. 40 mm Hg out
e. 50 mm Hg out

b. 20 mm Hg out

Renin hydrolyzes angiotensinogen released from the ________ to form angiotensin I.

a. lungs
b. kidneys
c. liver
d. heart
e. spleen

c. liver

Because of the great deal of active transport that occurs here, the _________ of all the nephrons collectively account for about 6% of one’s daily resting ATP and caloric consumption.

a. proximal convoluted tubules
b. distal convoluted tubules
c. loops of Henle
d. collecting ducts
e. glomeruli

a. proximal convoluted tubules

PCTs are responsible for reabsorbing all of the following except:

a. potassium.
b. sodium chloride.
c. hydrogen ions.
d. urea.
e. water.

c. hydrogen ions.

Total saturation of protein transporters for a given solute in the renal tubules would result in:

a. reabsorption of all the solute.
b. a renal clearance of zero.
c. a net filtration pressure of 1.0.
d. appearance of that solute in the urine.
e. absence of that solute from the urine.

d. appearance of that solute in the urine.

Which of the following is a direct result of antidiuretic hormones?

a. decreased urine volume
b. decreased urine molarity
c. increased urine volume
d. increased urine salinity
e. increased urine acidity

a. decreased urine volume

Aldosterone acts on:

a. the proximal convoluted tubule.
b. the medullary portion of the collecting duct.
c. the descending limb of the nephron loop.
d. the distal convoluted tubule.
e. the glomerulus.

d. the distal convoluted tubule

Atrial natriuretic peptide reduces blood volume and pressure by all of the following means except

a. increasing glomerular filtration rate.
b. inhibiting renin and aldosterone secretion.
c. inhibiting the action of ADH on the kidney.
d. inhibiting NaCl reabsorption by the collecting duct.
e. preventing sodium loss in the urine.

e. preventing sodium loss in the urine.

Hypocalcemia stimulates:

a. a decrease in aldosterone production.
b. secretion of parathyroid hormone.
c. secretion of renin.
d. an increase in blood urea nitrogen.
e. vasoconstriction of the afferent arterioles

b. secretion of parathyroid hormone.

Which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass through?

a. glomerulus
b. proximal convoluted tubule
c. distal convoluted tubule
d. collecting duct
e. nephron loop

d. collecting duct

The urine is most likely to be hypotonic when:

a. the body’s water volume is high.
b. the body’s pH is low.
c. the output of antidiuretic hormone is high.
d. the output of natriuretic peptides is high.
e. a person is lost and deprived of drinking water.

a. the body’s water volume is high.

Which of the following does not contribute to water conservation?

a. the collecting duct
b. the countercurrent multiplier
c. the countercurrent exchange system
d. diuretics
e. the length of the nephrons

d. diuretics

The countercurrent multiplier recaptures ______ and is based on fluid flowing in ______ direction in two adjacent tubules.

a. potassium; the same
b. calcium; the opposite
c. calcium; the same
d. sodium; the opposite
e. sodium; the same

d. sodium; the opposite

The overall purpose of the countercurrent exchange system is:

a. to supply salt and urea to the renal medulla.
b. to supply nutrients and oxygen to the renal cortex.
c. to supply nutrients and oxygen to the renal medulla.
d. to remove metabolic wastes from the renal cortex.
e. to remove metabolic wastes from the renal medulla.

c. to supply nutrients and oxygen to the renal medulla.

Which of these induces renin secretion, constricts afferent arterioles, and reduces GFR and urine volume?

a. aldosterone
b. antidiuretic hormone
c. parathyroid hormone
d. norepinephrine
e. angiotensin II

d. norepinephrine

Normal urine from a healthy person can be expected to contain all of the following except:

a. creatinine
b. urobilin
c. glucose
d. ammonia
e. magnesium

c. glucose

What is the term for the pigment responsible for the color of urine?

a. monochrome
b. urochrome
c. cyanochrome
d. multichrome
e. pyuria

b. urochrome

The minimum daily output of urine to meet the definition of polyuria is:

a. 0.5 L.
b. 1.0 L.
c. 1.5 L.
d. 2.0 L.
e. 3.0 L.

d. 2.0 L.

Prior to chemical tests for glycosuria, clinicians checked for sweetness of the urine as a sign of:

a. diabetes insipidus.
b. acute glomerulonephritis.
c. diabetes mellitus.
d. renal calculus.
e. pyelitis.

c. diabetes mellitus.

Loop diuretics reduce body water content by acting on
the feedback loop between the kidney and posterior pituitary gland.

a. the countercurrent multiplier system.
b. the countercurrent exchanger system.
c. aquaporins of the collecting duct.
d. the thirst mechanism and water intake.

a. the countercurrent multiplier system.

A hospital patient produces 4 mL/min of urine with a urea concentration of 8 mg/mL. Venous blood draw reveals urea concentration of .4 mg/mL. What is the percentage of cleared urea from glomerular filtrate?

a. 40%
b. 56%
c. 64%
d. 72%
e. 80%

c. 64%

Which two substances are most useful for determining a patient’s glomerular filtration rate?

a. insulin and glucose
b. insulin and creatinine
c. sodium and water
d. albumin and inulin
e. insulin and urea

b. insulin and creatinine

Creatinine has a renal clearance of 140 mL/min due to the fact that:

a. it is absorbed by the loop of Henle.
b. it is secreted by the glomerulus.
c. it is absorbed by the renal tubules.
d. it is secreted by the renal tubules.
e. it is produced in the pulmonary tissue.

d. it is secreted by the renal tubules.

Which of the following is not found in the ureter?

a. adventitia
b. two layers of smooth muscle
c. three layers of smooth muscle
d. transitional epithelium
e. skeletal muscle

e. skeletal muscle

A renal calculus can be up to 2 cm wide, but even then, it would not obstruct:

a. the major calyx.
b. the ureter.
c. the urethra.
d. the urinary bladder.
e. the renal pelvis.

d. the urinary bladder.

Which muscle is located in the bladder?

a. detrusor
b. distractor
c. pubococcygeus
d. corpus spongiosum
e. corpus cavernosum

a. detrusor

Which is not a portion of the urethra?

a. external urethral orifice
b. internal urethral sphincter
c. prostatic urethra
d. membranous urethra
e. spongy urethra

b. internal urethral sphincter

Micturition is another term for:

a. the production of nitrogenous wastes.
b. glomerular filtration.
c. the countercurrent multiplier process.
d. inflammation of the urinary bladder.
e. the elimination of urine.

e. the elimination of urine.

Which of the following urinary tract disorders seems most likely to occur in someone who frequently participates in marathon runs?

a. osmotic diuresis
b. renal hypertension
c. cystitis
d. hematuria
e. renal calculi

d. hematuria

Lithotripsy is a medical procedure used to treat:

a. acute glomerulonephritis.
b. nephrotic syndrome.
c. renal calculi.
d. hydronephrosis.
e. prostatic hypertrophy.

c. renal calculi

What is the most common urinary symptom of diabetes mellitus?

a. pyuria
b. glycosuria
c. hematuria
d. albuminuria
e. urobilinuria

b. glycosuria

Removal of the posterior pituitary will immediately cause:

a. a decrease in urine volume.
b. an increase in urine volume.
c. no change in urine volume.

a. a decrease in urine volume.

Which of the following events would increase filtration pressure?

a. increase in capsular pressure
b. constriction of the efferent arteriole
c. increase in colloid osmotic pressure
d. decrease in renal blood flow
e. dilation of the efferent arteriole

a. increase in capsular pressure

Trace the path of a red blood cell from the renal artery to the glomerulus:

(1) interlobar artery
(2) interlobular artery
(3) segmental artery
(4) arcuate artery
(5) afferent arteriole

a. 1, 2, 3, 4, 5
b. 1, 4, 2, 3, 5
c. 1,3, 2, 4, 5
d. 2, 1, 3, 5, 4
e. 1, 4, 3, 2

a. 1, 2, 3, 4, 5 (1) interlobar artery (2) interlobular artery (3) segmental artery (4) arcuate artery (5) afferent arteriole

Choose the one that does not belong.

a. loop of Henle
b. glomerulus
c. distal convoluted tubule
d. proximal convoluted tubule
e. Bowman’s capsule

b. glomerulus

If the following hypothetical conditions exist in the nephron, calculate the net filtration pressure.

glomerular capillary pressure = 80 mmHg
blood colloid osmotic pressure = 20 mmHg
capsular hydrostatic pressure = 10 mmHg

a. 110 mmHg
b. 90 mmHg
c. 50 mmHg
d. 30 mmHg
e. 20 mmHg

c. 50 mmHg

In which of the following locations is filtrate osmolality highest?

a. end of proximal convoluted tubule
b. tip of the loop of Henle
c. end of distal convoluted tubule
d. beginning of distal convoluted tubule
e. descending loop of Henle

b. tip of the loop of Henle

Decreased blood pressure in the afferent arterioles results in:

a. increased renin secretion.
b. decreased ADH secretion.
c. suppression of thirst.
d. stimulation of the parasympathetic nervous system.
e. decreased renin secretion.

a. increased renin secretion

Put the following in the correct order after the blood pressure increases.

(1) decreased sympathetic stimulation
(2) increase in glomerulus filtration rate
(3) increase in arterial blood pressure
(4) increase in urine production
(5) afferent arterioles dilate

a. 1, 3, 5, 2, 4
b. 3, 2, 1, 5, 4
c. 2, 3, 5, 1, 4
d. 3, 1, 5, 2, 4
e. 3, 2, 5, 4, 1

d. 3, 1, 5, 2, 4 (3) increase in arterial blood pressure (1) decreased sympathetic stimulation (5) afferent arterioles dilate (2) increase in glomerulus filtration rate (4) increase in urine production

Which of the following is NOT an effect of aging on the kidneys?

a. decrease in kidney size
b. loss of nephrons
c. decreased response to hormonal control of urine volume
d. a marked decrease in the ability to maintain homeostasis

d. a marked decrease in the ability to maintain homeostasis

Arrange the following in the sequence in which filtrate moves through them.

(1) loop of Henle
(2) Bowman’s capsule
(3) distal convoluted tubule
(4) proximal convoluted tubule

a. 1, 2, 3, 4
b. 4, 2, 1, 3
c. 2, 4, 3, 1
d. 2, 4, 1, 3
e. 3, 4, 1, 2

c. 2, 4, 3, 1 (2) Bowman’s capsule (4) proximal convoluted tubule (3) distal convoluted tubule (1) loop of Henle

When macula densa cells experience increased Na+ concentration in the filtrate, they respond by:

a. increasing afferent arteriole constriction.
b. decreasing urine production.
c. decreasing renin secretion.
d. increasing aldosterone secretion.
e. increasing renin secretion

c. decreasing renin secretion.

Starting from the collecting duct, indicate the order in which urea molecules move to
maintain the medullary concentration gradient.

(1) ascending limb
(2) distal convoluted tubule
(3) interstitial fluid
(4) collecting duct
(5) descending limb

a. 2, 5, 1, 4, 3
b. 1, 3, 5, 2, 4
c. 3, 5, 1, 2, 4
d. 4, 2, 1, 3, 5
e. 4, 3, 5, 1, 2

e. 4, 3, 5, 1, 2 (4) collecting duct (3) interstitial fluid (5) descending limb (1) ascending limb (2) distal convoluted tubule

Why is the external urinary sphincter under conscious control?

a. It is made of smooth muscle.
b. It is part of the detrusor muscle.
c. It is made of skeletal muscle.
d. It is made of adventitia.

c. It is made of skeletal muscle

The organs that function to remove metabolic waste material by filtering the blood plasma are the:

kidneys

Starting at the renal papilla, place the structures to which urine will follow in order.

Renal Pelvis
Minor Calyx
Ureter
Major Calyx

Minor Calyx Major Calyx Renal Pelvis Ureter

Which solids are reabsorbed by the nephron loop?
Select all that apply.

Sodium ions
Potassium ions
Chloride
Water
Glucose and amino acids

Sodium ions Potassium ions Chloride

Which nephrons have long nephron loops that extend deep into the medulla?

Juxtamedullary
Medullary
Cortical

Juxtamedullary

The kidneys play a major role in which of the following?
Select all that apply.

Acid-base balance
Electrolytes
Body temperature
Cholesterol levels

Acid-base balance Electrolytes

Smooth muscle cells within wall of afferent arteriole.

Juxtaglomerular cells

Epithelial cells at the end of a nephron loop.

Macula dense cells

Cells between the arterioles and amongst the glomerular capillaries.

Mesangial cells

Which variables affect the filtration coefficient?
Select all that apply.

Permeability of the filtration membrane
The amount of sodium in the blood
The surface area available for filtration
The level of hydration

Permeability of the filtration membrane The surface area available for filtration

Which describes the urethra?

It conveys urine from the renal papillae tot he renal pelvis.
It conveys urine from the kidneys to the bladder.
It conveys urine from the bladder out of the body.

It conveys urine from the bladder out of the body.

Place in order, from the blood side to the capsular space, the structures through which any filtered substance must pass in glomerular filtration.

Filtration slit
Basement membrane
Fenestrated endothelium

Fenestrated endothelium Basement membrane Filtration slit

The kidney parenchyma consists of two regions: an outer ________ and an inner _______.

cortex medulla

What are two examples of nitrogenous wastes that are excreted by the kidneys?

Bicarbonate
Creatinine
Urea
Phosphates

Creatinine Urea

Renal Autoregulation

Dilate/ constrict arterioles; release renin

Juxtaglomerular cells

Renal Autoregulation

Dilate/ constrict glomerular capillaries

Mesangial cells

Renal Autoregulation

Monitor tubular fluid

Macula densa

What is the amount of filtrate formed per minute by the two kidneys called?

Minute urine volume
Glomerular filtration rate
Renal clearance

Glomerular filtration rate

Aspirin, penicillin and other drugs are cleared from the blood via the kidneys by which of the following processes?

Tubular excretion
Tubular reabsorption
Tubular filtration
Tubular secretion

Tubular secretion

Which can pass through the glomerular filtration membrane? Select all that apply.

Blood cells
Electrolytes
Albumin
Glucose
Water

Electrolytes Glucose Water

The renal pyramids make up the layer of the kidney called the renal ________.

medulla

Name the plasma protein that is converted by renin to angiotensin I.

angiotensinogen

From deepest to most superficial, list the layers of connective tissue that surround the kidney.

Fibrous capsule
Renal fascia
Perirenal fat capsule

Fibrous capsule Perirenal fat capsule Renal fascia

How does activation of the angiotensin mechanism affect blood pressure?

it increases the blood pressure.

Running from the glomerular capsule to the tip of the medullary pyramid is a series of ducts that, together, are referred to as what?

Glomerulus
Renal tubule
Vasa recta
Collecting duct

Renal tubule

In glomerular filtration , blood is filtered to form glomerular __________.

filtrate

The filtration pressure in the glomerulus is determined by the balance in which two pressures?

Colloid Osmotic Blood Hydrostatic

The glomerulus is surrounded by _______________________.

Glomerular capsule

Starting from the renal artery, place the arteries carrying blood in to the renal cortex in order.

Cortical radiate artery/ Interlobular artery
Segmental artery
Interlobar artery
Arcuate artery
Renal artery

Renal artery Segmental artery Interlobar artery Arcuate artery Cortical radiate artery/ Interlobular artery

Glomerular filtrate is similar to blood plasma except that it contains little or no proteins.

True/ False

True Other than plasma proteins, small substances can pass through the filtration membrane.

The renal pelvis of each kidney funnels urine into a tube called a ___________.

Ureter

What are the two components of the renal corpuscle?

Nephron loop
Glomerular capsule
Juxtaglomerular apparatus
Afferent arteriole
Glomerulus

Glomerular capsule Glomerulus

A nephron consists of what two parts?

Renal corpuscle Renal tubule

Plasma angiotensin II levels would be higher when mean arterial blood pressure is _____________.

decreased.

Name the steroid hormone secreted in response to decreased blood sodium or increased blood potassium. It alters tubular handling of these electrolytes.

aldosterone

Renal clearance is the net effect of which of the following?
Select all that apply.

Dietary intake
Glomerular filtration
Tubular reabsorption
Metabolic deactivation
Tubular secretion

Glomerular filtration Tubular reabsorption Tubular secretion

The collecting duct receives fluid from the _______________________.

Distal convoluted tubule

Which of the following is true of the collecting ducts?

They drain the glomerular capsule.
They carry fluid from multiple nephrons to renal papillae.
They drain the nephron loop.
They carry fluid deep into the medulla then back up to the cortex.

The _________________ of the nephron acts as a countercurrent multiplier.

nephron loop

Which hormones regulate the amount of water and salt reabsorbed by the DCT and collecting duct?
Select all that apply.

Epinephrine
Atrial natriuretic peptide
Angiotensin converting enzyme
Antidiuretic hormone
Aldosterone

Atrial natriuretic peptide Antidiuretic hormone Aldosterone

What are the three protective layers of the kidney?

Perirenal fat capsule
Renal fascia
Fibrous capsule
Glomerular capsule
Peritoneum

Perirenal fat capsule Renal fascia Fibrous capsule

Name the hormone that makes the collecting duct more permeable to water thus increasing its reabsorption.

ADH – Antidiuretic hormone

Which leads to an increased secretion of natriuretic peptides?

Decreased blood pressure
Decreased cardiac output
Increased blood sodium
Increased blood pressure

Increased blood pressure.

What is the source of the salts that contribute to the high osmolarity of the medullary ECF?

The active transport of Na+, K+, Cl- from the ascending limb of the nephron loop.

Water is reabsorbed through specialized water channels called?

aquaporins

The color of urine is due to the presence of a pigment called __________, produced during the breakdown of hemoglobin.

urochrome

What are the three segments of the male urethra?

Internal urethra
Prostatic urethra
Spongy urethra
Membranous urethra
External urethra

Prostatic urethra Spongy urethra Membranous urethra

Which segment of the nephron loop actively transports salts?

Thick

What wastes are removed from the blood by tubular secretion?

Urea Ammonia Bile

What is the normal range for the pH of urine?

4.5 – 8.2

The __________ nervous system causes vasoconstriction of the afferent arterioles, reducing glomerular blood flow and the GFR.

sympathetic

As the urethra passes through the pelvic floor, it is encircled by which urethral sphincter?

Internal urethral sphincter

When the transporters within the proximal convoluted tubule are saturated and no additional solute can be reabsorbed, what has been reached?

Transport maximum

Hormones can alter the amount of water reabsorbed during urine production, allowing the production of either concentrated or dilute urine. This is the role of the _____________ duct.

collecting

Angiotensin II stimulates the anterior pituitary gland to secrete ____________________ hormone.

ADH – Antidiuretic

What is a nephron?

functional unit of a kidney

Which can pass through glomerular filtration?

Glucose
Electrolytes
Albumin
Blood cells
Water

Glucose Electrolytes Water

Fluid intake, diabetes and some medications can increase urine output, a condition called diuresis or _____________________.

Polyuria

The ______________ capillaries pick up fluid and solutes that are reabsorbed in the proximal convoluted tubule.

peritubular

The ability of the nephrons to adjust their own blood flow and GFR without nervous or hormonal control is called renal ________________.

autoregulation

Which result from activation of the renin-angiotensin system? Select all that apply.

Vasodilation of afferent arteriole
Increased secretion of aldosterone
Stimulated thirst
Increased release of ADH
Increased secretion of cortisol

Increased secretion of aldosterone Stimulated thirst Increased release of ADH

Which structure is composed of a proximal convoluted tubule, nephron loop, distal convoluted tubule and collecting duct?

Renal tubule
Renal corpuscle
Vasa recta
Juxtaglomerular apparatus

renal tubule

The kidneys play a role in calcium homeostasis by participating in the synthesis of which hormone?

Calcitriol

Which structure acts as a countercurrent exchanger?

Nephron loop
Vasa recta
Collecting duct

Vasa recta

Within the renal corpuscle, the colloid osmotic pressure (COP) is a pressure drawing fluid into what?

Renal capsule
Renal tubule
Glomerular capillaries
Peritubular capillaries

Glomerular capillaries

The blunt tip of a renal pyramid from which urine is collected is a renal _________________.

papilla

Which renal tubule segments are influenced by aldosterone? Select all that apply.

Descending limb of the nephron loop
Ascending limb of the nephron loop
Collecting duct
Distal convoluted tubule
Proximal convoluted tubule

Ascending limb of the nephron loop Collecting duct Distal convoluted tubule

Within the renal corpuscle, blood __________ pressure is the pressure forcing fluid into the glomerular capsular space.

hydrostatic

The process of urination, or voiding urine is called __________________.

micturition

Which result from the activation of the renin-angiotensin system? Select all that apply.

Increased water retention
Increased blood pressure
Decreased water reabsorption
Vasoconstriction
Decreased glomerular filtration

Increased water retention Increased blood pressure Vasoconstriction

Which region of the nephron is adapted for reabsorption, as seen in its length and prominent microvilli?

proximal convoluted tubule

What is the overall pressure found at the glomerulus that determines the amount of filtration called?

Net filtration pressure

The hormone _____________ causes increased reabsorption of sodium (and the water that follows) and secretion of potassium from the later segments of the renal tubule.

aldosterone

What are the leaky junctions between epithelial cells in the proximal convoluted tubule that allow water to move through called?

Tight junctions

If the glomerular filtration rate is too _________, fluid flows through the renal tubules too slowly, urine output will decrease and azotemia may occur.

low

Constriction of the efferent arteriole by angiotensin II lowers blood pressure in the ___________________ capillaries and enhances the reabsorption of sodium and water.

peritubular

The glomerulus is composed of ____________________ capillaries.

fenestrated

Which symptoms are seen with diabetes mellitus?

Anuria
Azotemia
Polyuria
Dehydration
Glycosuria

Polyuria Dehydration Glycosuria

The kidneys help regulate acid-base balance through the tubular secretion of which molecules?

Sodium & Potassium ions
Hydrogen & bicarbonate ions
Sodium & Chloride ions
Glucose and amino acids

Hydrogen & bicarbonate ions

The mechanism by which the glomerulus receives feedback on the status of downstream tubular fluid is called ____________ feedback.

tubuloglomerular

The vasa recta is a network of blood vessels located mostly within?

the medulla

What is the importance of the medullary ECF osmolarity gradient?

It allows for the production of very concentrated urine.
It allows for the reabsorption for a large quantity of salt.
It allows the production of very dilute urine.

It allows for the production of very concentrated urine.

The osmotic and electrical gradients that drive the reabsorption of water and solutes is created by reabsorption of the solute _____________.

Na – Sodium

The micturition center is located in the ____________ of the brain stem.

pons

What is a minor calyx?

A cuplike structure that collects urine.
A structure comprised of glomerular capillaries surrounded by the glomerular capsule.
A region of cortical tissue extending into the medulla between the pyramids.
A series of microscopic tubules that produce urine.

A cuplike structure that collects urine.

A decreased GFR results in a(n) ___________ urine volume and ________ blood volume.

decreased; increased

The enzyme __________ converts angiotensinogen to angiotensin I.

renin

During reabsorption from the PCT, water can carry dissolved substances by which process?

solvent drag

The salts in the medullary ECF were transported from which limb of the nephron loop?

Ascending

If the glomerular filtration rate is too _______, fluid flows thought the renal tubules too rapidly. Urine output will increase and electrolyte depletion may occur.

high

The ___________ duct receives fluid draining from several nephrons and carries it through the medulla to the papilla.

collecting

The tubuloglomerular feedback mechanism of GFR regulation relies not the monitoring of tubular fluid by a renal structure called the ___________________________ apparatus.

Juxtaglomerular

Which structures increase the absorptive area of proximal convoluted tubule cells?

microvilli

Fluid and solutes reabsorbed in the PCT are picked up by which capillary bed?

peritubular capillaries

Antidiuretic hormone is secreted in response to ___________________.

dehydration

Within the renal corpuscle colloid osmotic pressure forces fluid _______ the glomerular capillaries.

into

Urine is drained from the renal pyramid into which structure?

Renal column
Renal sinus
Ureter
Minor calyx

Minor calyx

Within the filtration membrane, filtration slits are gaps between which of the following?

Microvilli
Fenestrations
Pedicels
Macula dense cells

Pedicels

Name the condition that develops when blood levels of nitrogenous wastes reach toxic levels. Symptoms include diarrhea, vomiting, dyspnea, and cardiac arrhythmia.

Uremia

What is the action of parathyroid hormone on the kidneys?

Decreases calcium reabsorption & increases phosphate reabsorption.
Decreases phosphate reabsorption & increases calcium reabsorption.
Decreases phosphate & calcium reabsorption.
Increases phosphate & calcium reabsorption.

Decreases phosphate reabsorption & increases calcium reabsorption.

The wall of the proximal convoluted tubule is comprised of ________________ ___________________ epithelium.

simple cuboidal

The nerves and ganglia serving the kidney make up the renal _______________.

Plexus

How does the ascending limb of the nephron loop shift sodium, potassium and chloride into the ECF?

Active transport
Bulk transport
Osmosis
Simple diffusion

Active transport

Sodium is transported into the cells of the PCT by a protein that simultaneously moves it and another solute in the same direction. This type of transport protein is called a __________________.

Symport

How does antidiuretic hormone affect the permeability of the collecting ducts to water?

It increases their permeability.
It does not affect their permeability.
It decreases their permeability.

It increases their permeability.

What are the mechanisms of peritubular capillary absorption?

Osmosis and solvent drag
Active transport and solent drag
Osmosis and bulk transport
Active and passive transport

Osmosis and solvent drag

What effects do fibers from the micturition center in the brain have on the sympathetic neurons that control the internal urethral sphincter?

inhibit
excite

they inhibit them.

The ratio of the density of a substance to the density of water is called its __________________ ___________________.

specific gravity

Gestational diabetes, diabetes insipidus, and diabetes mellitus all are characterized by glycosuria.

True/ False

False. Glycosuria is present in gestation and mellitus, but not insipidus.

A chemical that enhances urine volume is called a __________________.

diurectic

Within the glomerular capsule, podocytes form the________ (inner) layer of the capsule and simple squamous epithelium forms the _______ (outer) layer.

visceral; parietal

Compared to capillary beds in the rest of the body, the hydrostatic pressure within the glomerular capillary bed is:

lower
higher

higher

The kidneys receive about 21% of the cardiac output. This value is called the renal ________.

fraction

What enters at the vascular pole of the renal corpuscle and brings blood to the glomerulus?

afferent arteriole

How does hypertension lead to kidney damage?

It can damage renal tubular walls.
It can rupture glomerular capillaries.
It can decrease renal blood flow.
It can cause hypoxia of renal medullary tissue.

It can rupture glomerular capillaries.

Regarding nitrogenous wastes, the PCT reabsorbs most of the _________, but none of the __________.

uric acid; creatinine.

The presence of which structures in the proximal convoluted tubule cause the lining to be referred to as a brush border?

Microvilli

Patients with poorly controlled diabetes mellitus may have urine with the odor of?

Acetone

Normally very little glucose is reabsorbed from the tubular fluid and is therefore lost in the urine.

True/ False.

False (All the glucose is reabsorbed, unless levels are really high)

To measure glomerular filtration rate, a substance that is neither secreted, reabsorbed or metabolized is needed. The compound ______ is an example of a substance used to measure GFR.

inulin

What is azotemia?

An increased level of blood sodium.
An increased level of blood urea nitrogen.
An increased level of blood acid.
An increased level of blood bicarbonate.

An increased level of blood urea nitrogen.

The accumulation of reabsorbed fluid not the basal side of the epithelial cells creates a high tissue fluid pressure that drives water ____ the peritubular capillaries.

into

The motor fibers of the renal plexus are branches of which nervous system?

Sympathetic

As urine stands, it develops a pungent odor due to the degradation of what?

Creatinine to urea
Ammonia to sulfuric acid
Glucose to lactate
Urea to ammonia

Urea to ammonia

How can hypertension damage the glomerular capillaries?

It can scar them.

Clinically what is the level of nitrogenous waste in the blood typically expressed as?

Blood urea nitrogen
Azoexcretion
Catabolic nitrogen

Blood urea nitrogen

In clinical practice, glomerular filtration rate is estimated by measuring excretion of the compound ____________.

Ammonia
Creatinine
Urea
Phosphate

Creatinine

Podocytes form which of the following?

Parietal layer of the glomerular capsule.
Visceral layer of the glomerular capsule.
Renin-secreting cells of the juxtaglomerular apparatus.
Walls of the collecting ducts.

Visceral layer of the glomerular capsule.

The nephron reabsorbs about how much urea from the tubular fluid?

All
About half
None

About half

The renal fraction is approximately what percent of the cardiac output?

1
83
21
5

21

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