Anatomy of the Urethra and Urinary Bladder
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Anatomy of the Urethra and Urinary Bladder

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Questions and Answers

Which part of the male urethra is the shortest?

  • Prostatic Urethra
  • Membranous Urethra (correct)
  • Spongy Urethra
  • External Urethra

    • What function does the internal urethral sphincter serve during male ejaculation?

  • It relaxes to allow urine flow.
  • It remains inactive during ejaculation.
  • It dilates to facilitate semen passage.
  • It contracts to prevent semen backflow. (correct)

    • Which of the following is the location of the ejaculatory ducts in males?

  • Located at the base of the bladder.
  • Connects directly to the prostatic urethra.
  • Opens into the verumontanum. (correct)
  • Surrounds the membranous urethra.

    • What is a homologous structure to the prostatic utricle in females?

    <p>Vagina</p> Signup and view all the answers

    Which of the following describes the spongy or penile urethra?

    <p>It is the longest segment of the male urethra.</p> Signup and view all the answers

    What is the characteristic of the membranous urethra compared to other parts of the male urethra?

    <p>It is the least dilatable.</p> Signup and view all the answers

    Where is the internal urethral sphincter located?

    <p>Near the bladder neck.</p> Signup and view all the answers

    During orgasm in females, which process occurs in the urethra?

    <p>The internal urethra contracts.</p> Signup and view all the answers

    What is the approximate length of the female urethra?

    <p>4 cm</p> Signup and view all the answers

    Which statement about the female urethra is true?

    <p>It passes posterior and inferior to the pubic symphysis.</p> Signup and view all the answers

    Which types of nephrons are classified according to their location?

    <p>Cortical and juxtamedullary nephrons</p> Signup and view all the answers

    What glands are homologous to the prostate glands in males, found in females?

    <p>Paraurethral glands</p> Signup and view all the answers

    What primarily supplies arterial blood to the female urethra?

    <p>Internal pudendal artery and vaginal artery</p> Signup and view all the answers

    What is the average length of the male urethra?

    <p>18 - 22 cm</p> Signup and view all the answers

    Which part of the male urethra is the widest and most dilatable?

    <p>Prostatic urethra</p> Signup and view all the answers

    Where does the male urethra terminate?

    <p>At the external urethral meatus</p> Signup and view all the answers

    What type of epithelium lines the proximal part of the urethra?

    <p>Transitional epithelium</p> Signup and view all the answers

    Which layer of the urinary bladder is directly surrounded by the lamina propria?

    <p>Mucosa</p> Signup and view all the answers

    What encloses the penile urethra?

    <p>Corpus spongiosum</p> Signup and view all the answers

    What happens to the internal urethral orifice during bladder filling?

    <p>It becomes small and high</p> Signup and view all the answers

    What is the main function of the distal part of the urethra, which is lined by stratified squamous epithelium?

    <p>Protection from the external environment</p> Signup and view all the answers

    During which week of development do indications of the pronephros disappear?

    <p>End of the 4th week</p> Signup and view all the answers

    Which area of the male urethra enlarges into the Fossa Navicularis?

    <p>Penile urethra</p> Signup and view all the answers

    What is the length of the prostatic urethra?

    <p>3 cm</p> Signup and view all the answers

    What defines the appearance of the empty bladder wall as shown in micrographs?

    <p>Folded muscularis layer</p> Signup and view all the answers

    Which lymph nodes drain the posterior/fundus part of the male urethra?

    <p>Internal iliac lymph nodes</p> Signup and view all the answers

    Which part of the urethra in males is lined by transitional epithelium?

    <p>Prostatic urethra</p> Signup and view all the answers

    The intramural part of the male urethra is primarily located in which area?

    <p>Within the urinary bladder</p> Signup and view all the answers

    The lumen of the urethra is described as being what shape?

    <p>Stellate</p> Signup and view all the answers

    During which phase is the internal urethral orifice wide and low?

    <p>Bladder emptying</p> Signup and view all the answers

    What embryological structure is the urinary bladder derived from?

    <p>Intermediate mesoderm</p> Signup and view all the answers

    What role do nephrotomes play in embryological development?

    <p>Development of vestigial structures</p> Signup and view all the answers

    What is the primary characteristic of the mesonephros in fetal development?

    <p>It functions for a short time only.</p> Signup and view all the answers

    What type of epithelium initially lines the spongy urethra?

    <p>Stratified columnar and pseudostratified epithelium</p> Signup and view all the answers

    Which type of epithelium replaces the stratified columnar epithelium as the spongy urethra approaches its opening?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    What type of epithelium lines the proximal part of the female urethra?

    <p>Transitional epithelium</p> Signup and view all the answers

    What is the lining of the distal part of the female urethra composed of?

    <p>Stratified squamous non-keratinized epithelium</p> Signup and view all the answers

    Which layer is outer to the inner longitudinal muscle layer of the muscularis externa?

    <p>Circular muscle layer</p> Signup and view all the answers

    What kind of epithelium is commonly found in the vagina, similar to that of the distal female urethra?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    Which epithelial type is present in both the proximal female urethra and the bladder?

    <p>Transitional epithelium</p> Signup and view all the answers

    What structure encloses the spongy urethra?

    <p>Erectile tissue of the penis</p> Signup and view all the answers

    What is the role of the non-keratinized stratified squamous epithelium near the opening of the spongy urethra?

    <p>Protective barrier</p> Signup and view all the answers

    What serves as a barrier against the spread of infection in relation to the kidneys?

    <p>Fibrous renal capsule</p> Signup and view all the answers

    Which organ is NOT closely associated with the right kidney?

    <p>Spleen</p> Signup and view all the answers

    What anatomical structure surrounds the kidneys and adrenal glands, providing cushion?

    <p>Perirenal fat</p> Signup and view all the answers

    What is the primary anterior relation of the left kidney?

    <p>Tail of pancreas</p> Signup and view all the answers

    Which of the following accurately describes the renal fascia?

    <p>It separates the kidney from the surrounding peritoneum.</p> Signup and view all the answers

    What happens to pus or blood from the kidney during infection or injury?

    <p>It can travel inferiorly toward the pelvic area.</p> Signup and view all the answers

    What structure is found at the level of the omental foramen?

    <p>Right suprarenal gland</p> Signup and view all the answers

    Which statement is true regarding the posterior relations of the kidneys?

    <p>Upper parts are related to the diaphragm and 12th rib.</p> Signup and view all the answers

    What is the earliest nephric stage in kidney development?

    <p>Pronephros</p> Signup and view all the answers

    What type of epithelium lines the distal part of the male urethra?

    <p>Stratified squamous epithelium</p> Signup and view all the answers

    What is the sequence of systems from which the kidneys develop?

    <p>Pronephros, Mesonephros, Metanephros</p> Signup and view all the answers

    During which week of development does the pronephros begin to appear?

    <p>Beginning of the 4th week</p> Signup and view all the answers

    Which structure is described as being rudimentary and non-functional in kidney development?

    <p>Pronephros</p> Signup and view all the answers

    What spinal cord segments are primarily involved in transmitting pain from the renal pelvis and ureters?

    <p>T11-L2</p> Signup and view all the answers

    Referred pain from the renal pelvis commonly occurs in which regions?

    <p>Lumbar and inguinal regions</p> Signup and view all the answers

    Pain from the renal pelvis can extend to which additional area through the genito-femoral nerve?

    <p>Proximal anterior thigh</p> Signup and view all the answers

    In males, referred pain can also be perceived in which anatomical structures?

    <p>Penis and scrotum</p> Signup and view all the answers

    Which statement describes the organization of pain sensation from the renal pelvis?

    <p>Pain is felt in areas supplied by T11-L2 dermatomes.</p> Signup and view all the answers

    The visceral afferent fibers from the renal pelvis mainly transmit pain to which segments of the spinal cord?

    <p>T11-L2</p> Signup and view all the answers

    In females, which area can be associated with referred pain from the renal pelvis?

    <p>Labia majora</p> Signup and view all the answers

    What is the significance of the T11-L2 dermatomes in relation to renal pain?

    <p>They are the areas where pain is often referred.</p> Signup and view all the answers

    Which nerve is involved in projecting pain from the renal pelvis to the proximal anterior thigh?

    <p>Genito-femoral nerve</p> Signup and view all the answers

    Pain referred from the renal pelvis is most commonly felt in which of the following areas?

    <p>Lumbar and inguinal regions</p> Signup and view all the answers

    What is contained within the cortex of the kidney?

    <p>Nephrons</p> Signup and view all the answers

    What is the primary function of the vesical venous plexus?

    <p>To drain blood from the bladder</p> Signup and view all the answers

    What is the function of the renal hilum?

    <p>Transmitting renal vessels</p> Signup and view all the answers

    Which veins are primarily responsible for draining the bladder in males?

    <p>Inferior vesical veins</p> Signup and view all the answers

    Which structure is formed by the apex of the medullary pyramids?

    <p>Minor calyx</p> Signup and view all the answers

    Which ligament supports the bladder and is associated with the perivesical plexus?

    <p>Median umbilical ligament</p> Signup and view all the answers

    Which statement accurately describes the renal vein in relation to the renal artery?

    <p>The renal vein is anterior to the renal artery</p> Signup and view all the answers

    What is a unique feature of the vesical venous plexus in males?

    <p>It is continuous with the prostatic venous plexus</p> Signup and view all the answers

    What do the renal columns of Bertin separate?

    <p>Renal pyramids</p> Signup and view all the answers

    What structures serve to drain urine from the kidney?

    <p>Renal pelvis and calices</p> Signup and view all the answers

    What additional structure contributes to the drainage of the bladder in males?

    <p>Deep dorsal vein of the penis</p> Signup and view all the answers

    What is the appearance of the kidney's outer surface in infants?

    <p>Marked with renal lobules</p> Signup and view all the answers

    Which of the following drains into the internal iliac veins?

    <p>Inferior vesical veins</p> Signup and view all the answers

    What is the role of medullary rays in the kidney?

    <p>Representing bundles of tubules</p> Signup and view all the answers

    Which structure envelops the fundus of the bladder and prostate in males?

    <p>Prostatic venous plexus</p> Signup and view all the answers

    Through which veins might blood from the bladder also be drained indirectly?

    <p>Sacral veins</p> Signup and view all the answers

    Which part of the kidney is dark brown and grainy?

    <p>Cortex</p> Signup and view all the answers

    What is the relationship between the inferior vesical veins and the bladder?

    <p>They drain venous blood from the bladder</p> Signup and view all the answers

    What does each medullary pyramid plus the cortical tissue at its base constitute?

    <p>Renal lobe</p> Signup and view all the answers

    What role does the perivesical plexus play in the venous drainage of the bladder?

    <p>It surrounds the bladder before draining into the inferior vesical vein</p> Signup and view all the answers

    What are the two types of nephrons found in the kidney?

    <p>Juxtamedullary and cortical nephrons</p> Signup and view all the answers

    Which part of the nephron is responsible for the filtration of blood?

    <p>Glomerulus</p> Signup and view all the answers

    What features differentiate the cortex from the medulla in the kidney?

    <p>Arrangement of nephrons</p> Signup and view all the answers

    What type of epithelium lines the collecting tubules of the nephron?

    <p>Simple cuboidal epithelium</p> Signup and view all the answers

    Which component is considered part of the juxtaglomerular apparatus?

    <p>Macula densa</p> Signup and view all the answers

    What is the function of the ligaments supporting the urinary bladder?

    <p>To maintain bladder position</p> Signup and view all the answers

    What type of drainage system do the ureters utilize?

    <p>Both blood supply and lymphatic drainage</p> Signup and view all the answers

    What is a clinical significance of identifying normal constrictions in the ureters?

    <p>It assists in diagnosing kidney stones.</p> Signup and view all the answers

    Which organ is located beside the inferior vena cava?

    <p>Right kidney</p> Signup and view all the answers

    What is the primary function of the kidneys?

    <p>Process blood filtrate to form urine</p> Signup and view all the answers

    What anatomical structure lies between the left and right kidneys?

    <p>Celiac plexus</p> Signup and view all the answers

    What is the average weight of a kidney?

    <p>120-170g</p> Signup and view all the answers

    During fetal development, which structure is involved in forming different parts of the urinary system?

    <p>Metanephros</p> Signup and view all the answers

    What is the function of erythropoietin released by the kidneys?

    <p>Stimulate red blood cell production</p> Signup and view all the answers

    What is the approximate length of a kidney?

    <p>10-12 cm</p> Signup and view all the answers

    What is the role of the ureters in the urinary system?

    <p>Conduct urine from kidney to bladder</p> Signup and view all the answers

    Which part of the urinary system serves as a passageway for urine to be voided?

    <p>Urethra</p> Signup and view all the answers

    What anatomical relation is superior to the kidneys?

    <p>Diaphragm</p> Signup and view all the answers

    What does the left renal vein receive that the right renal vein does not?

    <p>Left suprarenal vein</p> Signup and view all the answers

    What is the length range of the ureters?

    <p>20 – 25 cm</p> Signup and view all the answers

    Which region is the suprarenal cortex derived from?

    <p>Mesoderm</p> Signup and view all the answers

    What is a primary function of the suprarenal cortex?

    <p>Secrete corticosteroids</p> Signup and view all the answers

    What anatomical relationship do the renal veins have to the renal arteries?

    <p>Anterior</p> Signup and view all the answers

    What type of cells are found in the suprarenal medulla?

    <p>Chromaffin cells</p> Signup and view all the answers

    How do the ureters convey urine to the urinary bladder?

    <p>Using peristaltic contractions</p> Signup and view all the answers

    Where are the kidneys located in relation to the peritoneum?

    <p>Retroperitoneal</p> Signup and view all the answers

    In terms of anatomical position, where does the left kidney sit in relation to the right kidney?

    <p>Higher than the right kidney</p> Signup and view all the answers

    Which layer surrounds the kidneys and adrenal glands and provides support?

    <p>Perinephric fat</p> Signup and view all the answers

    Which organ is the right kidney NOT in close proximity to?

    <p>Spleen</p> Signup and view all the answers

    What serves as a barrier against the spread of infection related to the kidneys?

    <p>Renal capsule</p> Signup and view all the answers

    What is the role of perirenal fat?

    <p>Protects the kidneys from direct contact with organs</p> Signup and view all the answers

    Which structure is located at the level of the omental foramen?

    <p>Right suprarenal gland</p> Signup and view all the answers

    Which list correctly identifies anterior relations of the left kidney?

    <p>Tail of pancreas, stomach, jejunum</p> Signup and view all the answers

    What anatomical feature separates the right kidney from the liver?

    <p>Hepatorenal recess</p> Signup and view all the answers

    Which statement about the posterior relations of the kidneys is incorrect?

    <p>The 12th rib is associated with the lower third of the kidney.</p> Signup and view all the answers

    What is a significant clinical implication during an infection/injury of the kidney?

    <p>Pus or blood can travel inferiorly toward the pelvic area</p> Signup and view all the answers

    Which of the following best describes the true renal capsule?

    <p>It encloses the renal parenchyma.</p> Signup and view all the answers

    Which organ is NOT a posterior relation of the left kidney?

    <p>Spleen</p> Signup and view all the answers

    Which embryonic structure gives rise to the uteric bud?

    <p>Metanephric</p> Signup and view all the answers

    What is the role of the inferior suprarenal artery in relation to the adrenal gland?

    <p>It supplies blood to the adrenal gland.</p> Signup and view all the answers

    Which part of the male urethra has the specific function of being the shortest?

    <p>Membranous urethra</p> Signup and view all the answers

    Which nerves innervate the internal urethral sphincter?

    <p>Hypogastric plexus</p> Signup and view all the answers

    Which embryonic nephric system is responsible for forming the longitudinal collecting duct?

    <p>Pronephros</p> Signup and view all the answers

    What is the length of the male urethra typically?

    <p>18 - 22 cm</p> Signup and view all the answers

    Which part of the male urethra is the widest and most dilatable?

    <p>Prostatic urethra</p> Signup and view all the answers

    Where does the male urethra terminate?

    <p>External urethral meatus</p> Signup and view all the answers

    Which part of the male urethra varies in diameter and length based on bladder filling?

    <p>Intramural part</p> Signup and view all the answers

    What anatomical feature is prominent in the prostatic urethra?

    <p>Urethral crest</p> Signup and view all the answers

    What lymph nodes drain the anterior/superolateral wall of the male urethra?

    <p>External iliac lymph nodes</p> Signup and view all the answers

    Which structure surrounds and protects the spongy urethra?

    <p>Corpus spongiosum</p> Signup and view all the answers

    What area of the male urethra enlarges into the Fossa Navicularis?

    <p>Spongy urethra</p> Signup and view all the answers

    What is the role of the ureteric bud during kidney development?

    <p>It penetrates metanephrogenic tissue to give rise to tubules.</p> Signup and view all the answers

    At which stage of development does the metanephros appear?

    <p>5th week</p> Signup and view all the answers

    Which component is formed by the mesonephric duct in males?

    <p>Wolffian duct</p> Signup and view all the answers

    What structure is formed around the glomerulus during kidney development?

    <p>Bowman's capsule</p> Signup and view all the answers

    What is a characteristic of the mesonephric tubules during their development?

    <p>They lengthen rapidly and form an S-shaped loop.</p> Signup and view all the answers

    What is the primary function of the distal convoluted tubule?

    <p>Reabsorption of electrolytes</p> Signup and view all the answers

    Which hormone regulates sodium absorption in the distal convoluted tubule?

    <p>Aldosterone</p> Signup and view all the answers

    What type of epithelium lines the distal convoluted tubule?

    <p>Simple cuboidal epithelium</p> Signup and view all the answers

    Which of the following describes the appearance of the lumen of the distal convoluted tubule?

    <p>Wider and more empty</p> Signup and view all the answers

    Where does the distal convoluted tubule transport urine to?

    <p>Collecting duct</p> Signup and view all the answers

    How does the distal convoluted tubule contribute to urine concentration?

    <p>By allowing further water reabsorption regulated by ADH</p> Signup and view all the answers

    What characterizes the principal cells in the distal convoluted tubule?

    <p>Presence of aquaporins</p> Signup and view all the answers

    Which part of the distal convoluted tubule is located in the cortex?

    <p>Pars convoluta</p> Signup and view all the answers

    Which statement accurately describes the distal convoluted tubule's relationship with the loop of Henle?

    <p>It has an ascending thick straight part from the loop of Henle</p> Signup and view all the answers

    What is true about the Na+ absorption in the distal convoluted tubule?

    <p>It is influenced predominantly by aldosterone</p> Signup and view all the answers

    What type of epithelium lines the urinary bladder?

    <p>Transitional epithelium</p> Signup and view all the answers

    What is the muscular layer of the urinary bladder primarily composed of?

    <p>Smooth muscle</p> Signup and view all the answers

    What occurs to the mucosa of the bladder when it is full?

    <p>It appears smooth</p> Signup and view all the answers

    Which structure covers the upper part of the urinary bladder?

    <p>Serous peritoneum</p> Signup and view all the answers

    What information about the lamina propria is correct?

    <p>It is rich in blood vessels</p> Signup and view all the answers

    How many layers of muscle are there in the muscularis mucosae of the bladder?

    <p>Three</p> Signup and view all the answers

    What happens to the umbrella cells of the bladder when it is full?

    <p>They become flatter</p> Signup and view all the answers

    What is the composition of the muscularis mucosae in the bladder?

    <p>Circular and longitudinal smooth muscle layers</p> Signup and view all the answers

    What happens to the bladder's appearance when it is empty?

    <p>It is highly folded</p> Signup and view all the answers

    Which type of blood vessels supply the bladder?

    <p>Interlobar veins</p> Signup and view all the answers

    What type of epithelium is found in the proximal part of the female urethra?

    <p>Transitional epithelium</p> Signup and view all the answers

    Which epithelium lines the distal part of the female urethra?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    What type of epithelium is initially found lining the spongy urethra?

    <p>Stratified columnar epithelium</p> Signup and view all the answers

    As the spongy urethra approaches its opening, which type of epithelium replaces the initial lining?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    What is the primary characteristic of the muscularis externa in the urinary system?

    <p>Inner longitudinal and outer circular layers</p> Signup and view all the answers

    What type of epithelium is found in the distal part of the male urethra near the opening?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    Which feature distinguishes the spongy urethra in males?

    <p>It is enclosed within erectile tissue of the penis.</p> Signup and view all the answers

    What modification occurs to the epithelium of the spongy urethra as it nears its opening?

    <p>It becomes non-keratinized stratified squamous epithelium.</p> Signup and view all the answers

    What type of epithelium is lining the proximal part of the male urethra?

    <p>Pseudostratified columnar epithelium</p> Signup and view all the answers

    What is the purpose of the non-keratinized stratified squamous epithelium near the opening of the spongy urethra?

    <p>To provide protection.</p> Signup and view all the answers

    Where is the bladder located in infants compared to adults?

    <p>Within the abdominal cavity</p> Signup and view all the answers

    Which part of the urinary bladder is connected to the anterior abdominal wall?

    <p>Apex</p> Signup and view all the answers

    How is the prostate gland related to the bladder in males?

    <p>It is attached directly to the base of the bladder</p> Signup and view all the answers

    What structure separates the fundus of the bladder from the rectum in males?

    <p>Fascial rectovesical septum</p> Signup and view all the answers

    What is the relationship between the bladder and the uterus in females?

    <p>The bladder lies inferior to the uterus</p> Signup and view all the answers

    Which connective tissue surrounds the bladder?

    <p>Loose connective tissue</p> Signup and view all the answers

    What anatomical relationship exists between the bladder and the anterior vaginal wall in females?

    <p>The bladder is anterior to the vaginal wall</p> Signup and view all the answers

    What is the function of the median umbilical ligament in relation to the bladder?

    <p>To connect the apex of the bladder to the abdominal wall</p> Signup and view all the answers

    What does the fundus of the bladder represent?

    <p>Central and superior-posterior part of the bladder</p> Signup and view all the answers

    What is the function of intercalated cells in the urinary system?

    <p>Maintaining acid-base balance</p> Signup and view all the answers

    Which type of epithelium lines the lumen of the ureters?

    <p>Transitional epithelium</p> Signup and view all the answers

    What is a characteristic of umbrella cells in the urinary system?

    <p>They protect underlying cells from hypertonic urine</p> Signup and view all the answers

    Which feature is NOT associated with intercalated cells?

    <p>Function in urine filtration</p> Signup and view all the answers

    What is the appearance of the lumen of the ureters?

    <p>Stellate-shaped lumen</p> Signup and view all the answers

    What is the characteristic length of the male urethra?

    <p>18 - 22 cm</p> Signup and view all the answers

    Which part of the male urethra is described as the widest and most dilatable?

    <p>Prostatic urethra</p> Signup and view all the answers

    Where does the male urethra begin?

    <p>Internal urethral orifice</p> Signup and view all the answers

    Which lymph nodes drain the anterior/superolateral wall of the male urethra?

    <p>External iliac lymph nodes</p> Signup and view all the answers

    What change occurs to the internal urethral orifice during bladder emptying?

    <p>Becomes wide and low</p> Signup and view all the answers

    Which part of the male urethra traverses through the prostate gland?

    <p>Prostatic urethra</p> Signup and view all the answers

    What is the main anatomical feature of the prostatic urethra?

    <p>Urethral crest</p> Signup and view all the answers

    Which part of the male urethra enlarges into the Fossa Navicularis?

    <p>Spongy urethra</p> Signup and view all the answers

    What characterizes the segmental arteries in regards to their function?

    <p>They independently supply areas of the kidney.</p> Signup and view all the answers

    Which segmental artery is NOT associated with the anterior branch of the renal artery?

    <p>Posterior Segmental Artery</p> Signup and view all the answers

    What shape is the right suprarenal gland?

    <p>Pyramid shaped</p> Signup and view all the answers

    What is the primary relationship of the suprarenal glands?

    <p>Attached to the crura of the diaphragm.</p> Signup and view all the answers

    Which statement correctly identifies one of the left suprarenal gland's characteristics?

    <p>It is crescent shaped.</p> Signup and view all the answers

    What is the key anatomical feature of the right renal artery?

    <p>It passes posterior to the IVC.</p> Signup and view all the answers

    Which of these arteries is NOT part of the segmental arteries supplied by the renal artery?

    <p>Anterior Segmental Artery</p> Signup and view all the answers

    What anatomical relationship is accurate regarding the inferior segmental artery?

    <p>It supplies the inferior pole of the kidney.</p> Signup and view all the answers

    What is the characteristic of segmental arteries in the context of renal surgery?

    <p>Their areas of supply can be surgically resected independently.</p> Signup and view all the answers

    The adrenal glands have a significant amount of what substance surrounding them?

    <p>Perinephric fat</p> Signup and view all the answers

    What is the primary artery supplying the bladder in females?

    <p>Internal iliac artery</p> Signup and view all the answers

    Which vein receives blood from the dorsal vein of the clitoris in females?

    <p>Vaginal venous plexus</p> Signup and view all the answers

    What is the function of the sympathetic innervation to the bladder?

    <p>Inhibit detrusor muscle contraction</p> Signup and view all the answers

    Which artery supplies the fundus of the bladder in males?

    <p>Inferior vesical artery</p> Signup and view all the answers

    What does the hypogastric plexus primarily inhibit?

    <p>Detrusor muscle relaxation</p> Signup and view all the answers

    Which artery in females sends branches to the postero-inferior parts of the bladder?

    <p>Vaginal artery</p> Signup and view all the answers

    What role do the vesical venous plexus and prostatic sinuses play in males?

    <p>Envelop the bladder neck and urethra</p> Signup and view all the answers

    Which structure contains the utricle that opens into the urethra?

    <p>Seminal colliculus</p> Signup and view all the answers

    What is the main arterial supply to the male urethra?

    <p>Inferior vesical artery</p> Signup and view all the answers

    Which segment of the spinal cord contributes to the visceral (pelvic) plexuses for bladder innervation?

    <p>Sacral spinal cord</p> Signup and view all the answers

    What is indicated by oliguria in a patient?

    <p>Severely reduced urine production</p> Signup and view all the answers

    Which condition is characterized by excessive urine production?

    <p>Polyuria</p> Signup and view all the answers

    What type of incontinence involves the involuntary leakage of urine due to increased abdominal pressure?

    <p>Stress incontinence</p> Signup and view all the answers

    Increased urinary frequency or urgency can be caused by which of the following?

    <p>Urethral irritation</p> Signup and view all the answers

    What does anuria indicate about a patient's renal function?

    <p>It indicates severely reduced urine production.</p> Signup and view all the answers

    Urinary retention in males primarily results from which condition?

    <p>Enlarged prostate gland</p> Signup and view all the answers

    Which term describes a condition where there is an inability to control urination voluntarily?

    <p>Incontinence</p> Signup and view all the answers

    Frequent urination that does not involve significant urine output might indicate which condition?

    <p>Cystitis</p> Signup and view all the answers

    What is the capacity of the urinary bladder in an adult human?

    <p>1 liter</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with urinary disorders?

    <p>Increased thirst</p> Signup and view all the answers

    What type of incontinence occurs when urine leaks due to increased abdominal pressure?

    <p>Stress incontinence</p> Signup and view all the answers

    What is a common clinical sign of renal disorders related to urine output?

    <p>Decreased urine output</p> Signup and view all the answers

    What urinary frequency abnormality involves the need to urinate more than eight times within 24 hours?

    <p>Polyuria</p> Signup and view all the answers

    What occurs as a result of the active removal of ions and organic substrates in the proximal convoluted tubule (PCT)?

    <p>Decrease in osmotic concentration of tubular fluid</p> Signup and view all the answers

    Which part of the nephron loop is responsible for actively transporting sodium and chloride out of the tubule?

    <p>Ascending limb</p> Signup and view all the answers

    What effect does hormonal control have on the distil convoluted tubule (DCT) and the collecting system?

    <p>Regulates solute reabsorption and water reabsorption</p> Signup and view all the answers

    How does renal failure primarily affect urine production?

    <p>Decreases urine production</p> Signup and view all the answers

    What role do the vasa recta play in the renal system?

    <p>Absorb solutes and water from the tubules into systemic circulation</p> Signup and view all the answers

    What symptoms may indicate central nervous system problems associated with renal failure?

    <p>Sleeplessness, seizures, and delirium</p> Signup and view all the answers

    What is one potential consequence of a decline in erythropoietin production due to renal failure?

    <p>Anemia</p> Signup and view all the answers

    What could be a physiological response when kidneys cannot maintain homeostasis?

    <p>Rise in blood pressure</p> Signup and view all the answers

    Which of the following conditions is NOT a common characteristic of renal failure?

    <p>Increased immunity</p> Signup and view all the answers

    What primarily happens to the osmotic concentration of tubular fluid in the ascending limb of the nephron loop?

    <p>Decreases as Na+ and Cl– are actively transported out</p> Signup and view all the answers

    What effect does restricted water intake have on urinary volume in chronic renal failure?

    <p>Decreases urine production</p> Signup and view all the answers

    Which condition is characterized by rapid deterioration of kidney function?

    <p>Acute renal failure</p> Signup and view all the answers

    Which management strategy is NOT typically involved in controlling chronic renal failure?

    <p>Increasing protein intake</p> Signup and view all the answers

    What is a common problem with both acute and chronic renal failure?

    <p>Acidosis</p> Signup and view all the answers

    What is the survival rate for patients with acute renal failure receiving supportive treatment?

    <p>Approximately 50 percent</p> Signup and view all the answers

    Which dialysis method uses an artificial membrane for filtration?

    <p>Hemodialysis</p> Signup and view all the answers

    Which of the following factors can lead to acute renal failure?

    <p>Obstruction of urinary tract</p> Signup and view all the answers

    How does the dialysis process regulate blood composition?

    <p>Through passive diffusion across a membrane</p> Signup and view all the answers

    What is the primary purpose of ingesting bicarbonate ions in renal failure management?

    <p>To combat acidosis</p> Signup and view all the answers

    Which component of hemodialysis connects blood vessels with the dialysis machine?

    <p>Shunts</p> Signup and view all the answers

    What type of pain is associated with urinary bladder disorders?

    <p>Pain in the superior pubic region</p> Signup and view all the answers

    Which condition is most commonly linked to dysuria?

    <p>Cystitis</p> Signup and view all the answers

    What clinical sign is often a result of renal disorders leading to proteinuria?

    <p>Edema</p> Signup and view all the answers

    Which type of urinary obstruction is considered more dangerous?

    <p>At the urethra</p> Signup and view all the answers

    What typically causes fever in urinary system infections?

    <p>Infection with pathogens</p> Signup and view all the answers

    Which region experiences pain associated with kidney infections?

    <p>Superior lumbar region</p> Signup and view all the answers

    What is a common presentation of proteinuria in terms of appearance?

    <p>Foamy urine</p> Signup and view all the answers

    Which urinary disorder can lead to painful urination due to blockage?

    <p>Urethritis</p> Signup and view all the answers

    What is a common effect of pyelonephritis on body temperature?

    <p>Low-grade fever</p> Signup and view all the answers

    Which symptom is NOT typically associated with urinary disorders?

    <p>Night sweats</p> Signup and view all the answers

    What is the primary function of the perinephric fat layer surrounding the kidney?

    <p>To provide structural support and cushioning</p> Signup and view all the answers

    Which part of the kidney is primarily involved in anchoring it to surrounding structures?

    <p>Renal fascia</p> Signup and view all the answers

    What is the significance of the renal columns within the kidney structure?

    <p>They separate adjacent renal pyramids</p> Signup and view all the answers

    How many lobes does an average kidney contain?

    <p>6–18</p> Signup and view all the answers

    What structural feature lines the renal sinus within the kidney?

    <p>Fibrous capsule</p> Signup and view all the answers

    What might occur to a kidney’s position if the perinephric fat layer is depleted?

    <p>The kidney may drop or migrate downward</p> Signup and view all the answers

    What is the inner region of the kidney called?

    <p>Renal medulla</p> Signup and view all the answers

    What is the tip of a renal pyramid known as?

    <p>Renal papilla</p> Signup and view all the answers

    What is the function of the specialized smooth muscle in the urinary bladder?

    <p>It helps in the propulsion of urine out of the bladder.</p> Signup and view all the answers

    During urination, what happens to the external urethral sphincter?

    <p>It voluntarily relaxes to allow urination.</p> Signup and view all the answers

    What are the two reflexes that coordinate the process of urination?

    <p>Micturition reflex and storage reflex</p> Signup and view all the answers

    What role does the pontine micturition center play during urination?

    <p>It signals relaxation of the external urethral sphincter.</p> Signup and view all the answers

    What type of nerve activity increases as the bladder fills to facilitate urine storage?

    <p>Sympathetic nerve activity</p> Signup and view all the answers

    What structure collects fluid from multiple collecting ducts and delivers it to the minor calyx?

    <p>Papillary duct</p> Signup and view all the answers

    Which arterial structure branches directly from the renal artery?

    <p>Segmental arteries</p> Signup and view all the answers

    Which arteries run within the renal columns?

    <p>Interlobar arteries</p> Signup and view all the answers

    What is the function of the visceral layer of the glomerular capsule?

    <p>Covers the glomerular capillaries</p> Signup and view all the answers

    What are the final branches of the cortical radiate arteries that supply each nephron?

    <p>Afferent arterioles</p> Signup and view all the answers

    Which component of the filtration membrane helps to prevent plasma proteins from entering the capsular space?

    <p>Filtration slits from podocytes</p> Signup and view all the answers

    Along which boundary do arcuate arteries arch?

    <p>Between the renal cortex and renal medulla</p> Signup and view all the answers

    What role does glomerular hydrostatic pressure play in the filtration process?

    <p>It pushes water and solutes out of plasma</p> Signup and view all the answers

    Which pressure opposes glomerular filtration by drawing water back into the plasma?

    <p>Blood colloid osmotic pressure</p> Signup and view all the answers

    Which part of the renal arterial system is responsible for supplying blood specifically to a capillary knot known as a glomerulus?

    <p>Afferent arterioles</p> Signup and view all the answers

    What do the gaps between the adjacent pedicels of podocytes form?

    <p>Filtration slits</p> Signup and view all the answers

    What structure delivers fluid collected from the major calyx to the renal pelvis?

    <p>Minor calyx</p> Signup and view all the answers

    What is the result of capsular hydrostatic pressure in the filtration process?

    <p>Opposes glomerular hydrostatic pressure</p> Signup and view all the answers

    Which of the following accurately describes the sequence of blood flow from the renal artery to the glomerulus?

    <p>Renal artery → Segmental arteries → Afferent arterioles → Glomerulus</p> Signup and view all the answers

    What role do segmental arteries play in kidney anatomy?

    <p>They branch from the renal sinus to supply blood to the kidney.</p> Signup and view all the answers

    What characteristic of fenestrated glomerular capillaries contributes to filtration?

    <p>Large diameter pores allowing passage of solutes</p> Signup and view all the answers

    Which layer of the glomerular capsule is responsible for covering the capillaries?

    <p>Visceral layer</p> Signup and view all the answers

    What primarily restricts the passage of large plasma proteins during filtration?

    <p>Podocyte foot processes</p> Signup and view all the answers

    What is the primary effect of blood colloid osmotic pressure on the filtration process?

    <p>Draws water back into the bloodstream</p> Signup and view all the answers

    What is the primary treatment that relieves symptoms of renal failure but is not a cure?

    <p>Dialysis</p> Signup and view all the answers

    Which of the following is considered the only real cure for severe renal failure?

    <p>Kidney transplant</p> Signup and view all the answers

    What typically increases the success rate of a kidney transplant?

    <p>Close relative donor</p> Signup and view all the answers

    Why are immunosuppressive drugs necessary after a kidney transplant?

    <p>To reduce the risk of transplant rejection</p> Signup and view all the answers

    What is the approximate length of the ureters?

    <p>30 cm</p> Signup and view all the answers

    What is the main function of the urinary bladder?

    <p>Storing urine</p> Signup and view all the answers

    Which imaging technique used a radiopaque dye to visualize the urinary tract?

    <p>Pyelogram</p> Signup and view all the answers

    What role does Epogen or Procrit serve for patients on dialysis?

    <p>Stimulate red blood cell production</p> Signup and view all the answers

    What organ is responsible for urine transport from the kidneys to the bladder?

    <p>Ureters</p> Signup and view all the answers

    Which of the following statements about kidney transplants is true?

    <p>Patient survival exceeds 90 percent at 2 years</p> Signup and view all the answers

    What symptom is primarily associated with urinary bladder disorders?

    <p>Dysuria</p> Signup and view all the answers

    Which condition is likely to cause pain in the superior lumbar region radiating to the upper quadrants?

    <p>Pyelonephritis</p> Signup and view all the answers

    What clinical sign may occur as a result of renal disorders leading to protein in the urine?

    <p>Facial swelling</p> Signup and view all the answers

    Which urinary infection is characterized by potentially causing high fevers?

    <p>Pyelonephritis</p> Signup and view all the answers

    What is the term used to describe painful urination that often occurs with cystitis or urethritis?

    <p>Dysuria</p> Signup and view all the answers

    What happens to water reabsorption in the distal convoluted tubule when ADH is not present?

    <p>No water is reabsorbed.</p> Signup and view all the answers

    What is the primary function of facultative water reabsorption?

    <p>To allow precise control of water reabsorption.</p> Signup and view all the answers

    How does increased sodium and chloride ions in the peritubular fluid affect the descending thin limb?

    <p>It enhances countercurrent multiplication.</p> Signup and view all the answers

    What role do aquaporins play in urine concentration?

    <p>They increase water permeability in renal tubules.</p> Signup and view all the answers

    Which segment of the nephron is primarily responsible for obligatory water reabsorption?

    <p>Proximal convoluted tubule and descending limb.</p> Signup and view all the answers

    In which part of the nephron does facultative water reabsorption occur?

    <p>Distal convoluted tubule and collecting tubule.</p> Signup and view all the answers

    How does the presence of ADH affect urine volume?

    <p>Reduces urine volume by increasing water reabsorption.</p> Signup and view all the answers

    What percentage of filtrate is typically recovered during obligatory water reabsorption?

    <p>85 percent.</p> Signup and view all the answers

    What is the primary function of the renal corpuscle?

    <p>Filtration of blood</p> Signup and view all the answers

    Which structure modifies filtrate to create urine?

    <p>Renal tubule</p> Signup and view all the answers

    What is the main role of the proximal convoluted tubule (PCT)?

    <p>Reabsorption of nutrients</p> Signup and view all the answers

    What is the primary process through which blood pressure forces water and solutes into the capsular space during urine formation?

    <p>Filtration</p> Signup and view all the answers

    What does the nephron loop establish?

    <p>Osmotic gradient for water reabsorption</p> Signup and view all the answers

    Which type of cell in the collecting duct is responsible for reabsorbing water?

    <p>Principal cells</p> Signup and view all the answers

    During which urine formation process are water and solutes transported from the tubular fluid into the peritubular fluid?

    <p>Reabsorption</p> Signup and view all the answers

    Which of the following is NOT considered a metabolic waste excreted by the kidneys?

    <p>Glucose</p> Signup and view all the answers

    How long can the renal tubule be?

    <p>Up to 50 mm</p> Signup and view all the answers

    What is the osmolarity range of concentrated urine produced by the kidneys?

    <p>855–1355 mOsm/L</p> Signup and view all the answers

    What is collected in the capsular space after filtration occurs?

    <p>Filtrate</p> Signup and view all the answers

    In the process of secretion, where are solutes transported from during urine formation?

    <p>Peritubular fluid</p> Signup and view all the answers

    What is included in the lining of the collecting duct?

    <p>Intercalated cells and principal cells</p> Signup and view all the answers

    Which component is the most abundant organic waste produced from amino acid breakdown?

    <p>Urea</p> Signup and view all the answers

    What does the term 'tubular fluid' refer to?

    <p>Filtrate after reabsorption</p> Signup and view all the answers

    What mechanism aids the kidneys in regulating blood volume and composition?

    <p>Renin-angiotensin system</p> Signup and view all the answers

    Which nephron component is primarily involved in filtration?

    <p>Glomerulus</p> Signup and view all the answers

    What is primarily excreted as a by-product of creatine phosphate breakdown in muscles?

    <p>Creatinine</p> Signup and view all the answers

    Which urine formation process occurs last in the sequence?

    <p>Secretion</p> Signup and view all the answers

    What is the composition of the urine concentration range aimed to be achieved by the kidneys?

    <p>855–1355 mOsm/L</p> Signup and view all the answers

    What is the main function of the ascending limb of the nephron loop?

    <p>Transports Na+ and Cl– out of the tubule</p> Signup and view all the answers

    What process occurs in the DCT and collecting system?

    <p>Reabsorption and secretion of solutes</p> Signup and view all the answers

    How does the vasa recta contribute to kidney function?

    <p>It maintains the concentration gradient of the medulla.</p> Signup and view all the answers

    What effect does renal failure have on urine production?

    <p>Causes a decrease in urine production</p> Signup and view all the answers

    What condition can result from a decline in erythropoietin production due to kidney impairment?

    <p>Anemia</p> Signup and view all the answers

    What is the primary function of the proximal convoluted tubule (PCT)?

    <p>Absorbs ions and organic substrates</p> Signup and view all the answers

    Which of the following describes a consequence of renal failure?

    <p>Rise in blood pressure</p> Signup and view all the answers

    What is a characteristic of the ascending limb of the nephron loop?

    <p>It actively transports ions out of the tubule.</p> Signup and view all the answers

    Which hormone primarily regulates water reabsorption in the DCT and collecting system?

    <p>Aldosterone</p> Signup and view all the answers

    What initiates central nervous system problems, such as seizures and delirium, during renal failure?

    <p>Accumulation of waste products in blood</p> Signup and view all the answers

    What is the only definitive cure for severe renal failure?

    <p>Kidney transplant</p> Signup and view all the answers

    How does the success rate of kidney transplants change with donor relation?

    <p>Close relative donors increase success rates</p> Signup and view all the answers

    Why are immunosuppressive drugs necessary after a kidney transplant?

    <p>To reduce the risk of transplant rejection</p> Signup and view all the answers

    Which structure is NOT part of the urinary tract?

    <p>Kidneys</p> Signup and view all the answers

    What is the primary function of the urinary bladder?

    <p>To store urine</p> Signup and view all the answers

    What is the normal daily urine volume produced by the kidneys?

    <p>1200 mL/day</p> Signup and view all the answers

    How does the osmotic concentration of normal urine typically compare to its plasma composition?

    <p>Normal urine concentration is the same as plasma concentration.</p> Signup and view all the answers

    What occurs during obligatory water reabsorption in the nephron?

    <p>It recovers 85 percent of filtrate in specific locations.</p> Signup and view all the answers

    What happens to the volume of tubular fluid in the PCT when ions and nutrients are removed?

    <p>The volume of tubular fluid decreases but remains isotonic.</p> Signup and view all the answers

    What is the effect of antidiuretic hormone (ADH) on water reabsorption?

    <p>ADH allows for the formation of aquaporins in tubular cells.</p> Signup and view all the answers

    What is the primary effect of antidiuretic hormone (ADH) on the collecting ducts?

    <p>It increases water reabsorption, making urine more concentrated.</p> Signup and view all the answers

    What is the osmotic concentration of normal urine?

    <p>1000 mOsm/L</p> Signup and view all the answers

    What happens to urine volume in the presence of ADH?

    <p>Urine volume is significantly reduced as water is reabsorbed.</p> Signup and view all the answers

    What happens to the urine osmotic concentration when ADH levels decrease?

    <p>Urine osmotic concentration decreases.</p> Signup and view all the answers

    Which locations in the nephron are the sites for obligatory water reabsorption?

    <p>Proximal convoluted tubule and descending limb.</p> Signup and view all the answers

    What limits the rate of obligatory water reabsorption?

    <p>It cannot be adjusted in the nephron.</p> Signup and view all the answers

    Which process refers to water reabsorption that occurs consistently regardless of hydration status?

    <p>Obligatory water reabsorption</p> Signup and view all the answers

    What characteristic distinguishes the filtrate produced by the renal corpuscle?

    <p>It has the same osmotic composition as plasma.</p> Signup and view all the answers

    How does facultative water reabsorption differ from obligatory water reabsorption?

    <p>Facultative reabsorption occurs in the DCT and collecting tubule.</p> Signup and view all the answers

    What is the role of the kidneys in regulating water balance?

    <p>They alter their function to maintain water balance.</p> Signup and view all the answers

    What is the role of countercurrent multiplication in the renal medulla?

    <p>It maintains a concentration gradient for urine concentration.</p> Signup and view all the answers

    What effect do increased sodium and chloride ions in peritubular fluid have on kidney function?

    <p>They influence water reabsorption in the descending thin limb.</p> Signup and view all the answers

    What primarily facilitates water reabsorption in the proximal convoluted tubule?

    <p>Osmosis following ions and nutrients</p> Signup and view all the answers

    What is a key feature of chronic renal failure?

    <p>Kidney function deteriorates gradually over time.</p> Signup and view all the answers

    Which of the following management strategies is recommended for chronic renal failure?

    <p>Restrict water, salt, and protein intake.</p> Signup and view all the answers

    What may cause acute renal failure?

    <p>Exposure to toxic drugs and renal ischemia.</p> Signup and view all the answers

    What is a possible outcome of acute renal failure if managed properly?

    <p>Partial or complete recovery of kidney function.</p> Signup and view all the answers

    What is the process of dialysis primarily based on?

    <p>Passive diffusion across a selectively permeable membrane.</p> Signup and view all the answers

    In hemodialysis, what is used to connect blood vessels to the dialysis machine?

    <p>Silicone rubber tubes known as shunts.</p> Signup and view all the answers

    Which of the following is commonly countered by ingesting bicarbonate ions in renal failure?

    <p>Acidosis.</p> Signup and view all the answers

    What is the estimated survival rate for patients with acute renal failure receiving supportive treatment?

    <p>Approximately 50 percent.</p> Signup and view all the answers

    What is a common complication associated with chronic renal failure?

    <p>Acidosis.</p> Signup and view all the answers

    What elements are selectively diffused through the membrane during hemodialysis?

    <p>Ions, nutrients, and organic wastes.</p> Signup and view all the answers

    What does net filtration pressure (NFP) represent in glomerular filtration?

    <p>The sum of hydrostatic and colloid osmotic pressures</p> Signup and view all the answers

    Which factor contributes to the higher blood pressure in glomerular capillaries than in other systemic capillaries?

    <p>Increased resistance in the efferent arterioles</p> Signup and view all the answers

    What is the primary role of the juxtaglomerular complex in response to decreased filtration pressure?

    <p>Releasing renin to increase blood pressure</p> Signup and view all the answers

    Which of the following describes the glomerular filtration rate (GFR)?

    <p>Amount of blood filtered by the kidneys each minute</p> Signup and view all the answers

    What is the primary effect of angiotensin II on the central nervous system (CNS)?

    <p>Stimulates thirst and increases blood pressure</p> Signup and view all the answers

    What are the main components involved in maintaining adequate GFR?

    <p>Autoregulation and feedback mechanisms</p> Signup and view all the answers

    What tends to draw water out of the filtrate and into the plasma in relation to blood colloid osmotic pressure?

    <p>Higher concentration of proteins in plasma</p> Signup and view all the answers

    What is the role of autoregulation in the kidneys?

    <p>To maintain constant GFR despite fluctuations in blood pressure</p> Signup and view all the answers

    In what situation does central regulation become necessary?

    <p>If autoregulation is ineffective</p> Signup and view all the answers

    What three elements are essential components of the filtration membrane?

    <p>Basement membrane, endothelial cells, and podocytes</p> Signup and view all the answers

    What is the approximate weight of a human kidney?

    <p>150 g</p> Signup and view all the answers

    How are the kidneys positioned in relation to the peritoneum?

    <p>Retroperitoneally</p> Signup and view all the answers

    What is the function of the hilum in the kidney?

    <p>Point of entry/exit for renal vessels and ureter</p> Signup and view all the answers

    Which of the following structures provides support to the kidneys?

    <p>Supporting connective tissues</p> Signup and view all the answers

    How is the left kidney's position compared to the right kidney?

    <p>It is slightly superior to the right kidney.</p> Signup and view all the answers

    What layer of connective tissue covers the outer surface of the kidney?

    <p>Fibrous capsule</p> Signup and view all the answers

    What anatomical feature is primarily responsible for protecting the kidneys posteriorly and laterally?

    <p>Ribs</p> Signup and view all the answers

    What connects the kidneys to the urinary bladder?

    <p>Ureters</p> Signup and view all the answers

    What primarily composes the visceral layer of the glomerular capsule?

    <p>Podocytes</p> Signup and view all the answers

    Which factor tends to draw water out of the filtrate and into the plasma?

    <p>Blood colloid osmotic pressure</p> Signup and view all the answers

    What provides a barrier that prevents most plasma proteins from entering the capsular space?

    <p>Both B and C</p> Signup and view all the answers

    Which pressure opposes glomerular hydrostatic pressure?

    <p>Capsular hydrostatic pressure</p> Signup and view all the answers

    What is the role of the gaps between adjacent pedicels in the glomerular capsule?

    <p>Serving as filtration slits</p> Signup and view all the answers

    What is the primary function of the perinephric fat capsule surrounding the kidney?

    <p>To provide a thick layer of adipose tissue for cushioning</p> Signup and view all the answers

    Which layer successfully anchors the kidney to its surrounding structures?

    <p>Renal fascia</p> Signup and view all the answers

    What structure lies within the renal sinus of the kidney?

    <p>Fibrous capsule</p> Signup and view all the answers

    Which of the following statements is true regarding the renal columns?

    <p>They separate adjacent renal pyramids</p> Signup and view all the answers

    How many lobes does an average kidney contain?

    <p>6–18 lobes</p> Signup and view all the answers

    What would occur if the collagen fibers of the fibrous capsule became detached?

    <p>The kidney's position may shift</p> Signup and view all the answers

    Which structure of the kidney serves as the outermost protective layer?

    <p>Fibrous capsule</p> Signup and view all the answers

    What is the shape of the renal pyramids in the kidney?

    <p>Conical</p> Signup and view all the answers

    Which anatomical feature of the kidney aids in urine passage and drainage?

    <p>Renal papilla</p> Signup and view all the answers

    Which layer of connective tissue is described as being dense and fibrous, surrounding the kidney?

    <p>Renal fascia</p> Signup and view all the answers

    What process occurs in the renal corpuscle to produce a filtrate?

    <p>Filtration</p> Signup and view all the answers

    What is the primary function of the proximal convoluted tubule (PCT)?

    <p>Reabsorbs nutrients from the filtrate</p> Signup and view all the answers

    Which part of the nephron is responsible for establishing an osmotic gradient for water reabsorption?

    <p>Nephron loop</p> Signup and view all the answers

    What types of cells are primarily found in the collecting duct?

    <p>Intercalated cells and principal cells</p> Signup and view all the answers

    What is the nature of the filtrate produced by the renal corpuscle?

    <p>Protein-free solution</p> Signup and view all the answers

    Which function is associated with the distal convoluted tubule (DCT)?

    <p>Modification of tubular fluid composition</p> Signup and view all the answers

    What is the role of intercalated cells in the collecting duct?

    <p>Secreting hydrogen and bicarbonate ions</p> Signup and view all the answers

    How does the nephron loop differ in structure?

    <p>Comprises a thin segment and a thick segment</p> Signup and view all the answers

    Where is the glomerular capsule located?

    <p>In the renal corpuscle</p> Signup and view all the answers

    What type of solution is formed when tubular fluid leaves the proximal convoluted tubule?

    <p>Isosmotic solution</p> Signup and view all the answers

    Which of the following processes in urine formation occurs solely in the renal corpuscle?

    <p>Filtration</p> Signup and view all the answers

    What is the role of the efferent arteriole in the nephron?

    <p>Increase blood pressure in the glomerulus</p> Signup and view all the answers

    Which nephron segment is primarily responsible for the reabsorption of water, sodium, and chloride ions?

    <p>Proximal convoluted tubule</p> Signup and view all the answers

    What structure lies between the layers of the glomerular capsule?

    <p>Capsular space</p> Signup and view all the answers

    How do intraglomerular mesangial cells contribute to kidney function?

    <p>Control capillary diameter and blood flow</p> Signup and view all the answers

    Which of the following statements best describes the final volume and solute concentration of urine?

    <p>Regulated by the interplay between nephron loops and collecting system</p> Signup and view all the answers

    What triggers the secretion of renin from the juxtaglomerular complex?

    <p>Decreased glomerular blood pressure</p> Signup and view all the answers

    What is the primary function of the afferent arteriole in the nephron?

    <p>Deliver blood into the renal corpuscle</p> Signup and view all the answers

    Which structure is responsible for controlling the diameter and blood flow of adjacent glomerular capillaries?

    <p>Mesangial cells</p> Signup and view all the answers

    What is the primary type of epithelium found in the inner mucosa of the ureters?

    <p>Transitional epithelium</p> Signup and view all the answers

    Which component is NOT part of the wall structure of the urinary bladder?

    <p>Serosa</p> Signup and view all the answers

    What functions do the three layers of the muscularis in the bladder collectively support?

    <p>Storage of urine</p> Signup and view all the answers

    How does the external urethral sphincter function in the process of urination?

    <p>It must be voluntarily relaxed to permit urination.</p> Signup and view all the answers

    Which of the following statements about the urethra's structure is correct?

    <p>It has varying epithelial types along its length.</p> Signup and view all the answers

    What is the function of the efferent arteriole in the nephron's blood flow?

    <p>It carries blood from the glomerulus to peritubular capillaries.</p> Signup and view all the answers

    Which sequence correctly represents the pathway of blood through the cortical veins?

    <p>Cortical radiate veins → Interlobar veins → Renal vein.</p> Signup and view all the answers

    How do peritubular capillaries contribute to nephron function?

    <p>They collect waste products secreted by the nephron.</p> Signup and view all the answers

    What is the primary function of the renal fascia?

    <p>To anchor the kidney to surrounding structures</p> Signup and view all the answers

    What is the main role of the vasa recta in renal blood flow?

    <p>To transport water and solutes parallel to the nephron loop.</p> Signup and view all the answers

    What would be the consequence of depleting the perinephric fat layer?

    <p>Potential movement or displacement of the kidneys</p> Signup and view all the answers

    Which statement accurately describes the drainage of blood after it has passed through the peritubular capillaries?

    <p>It moves into the arcuate veins before entering interlobar veins.</p> Signup and view all the answers

    Which component is NOT part of the internal structure of the kidney?

    <p>Perinephric fat</p> Signup and view all the answers

    What is covered by the fibrous capsule of the kidney?

    <p>The entire kidney, including the renal sinus</p> Signup and view all the answers

    What distinguishes juxtamedullary nephrons from cortical nephrons?

    <p>They have vasa recta associated with them.</p> Signup and view all the answers

    How many kidney lobes are typically found in each kidney?

    <p>6-18 lobes</p> Signup and view all the answers

    What contributes to the composition of peritubular fluid surrounding the renal tubule?

    <p>Water and solutes absorbed by the nephron.</p> Signup and view all the answers

    Which structure is the primary site for the reabsorption of water and solutes in the nephron?

    <p>Renal tubule</p> Signup and view all the answers

    Which of the following structures separates adjacent pyramids in the renal medulla?

    <p>Renal columns</p> Signup and view all the answers

    What type of tissue primarily makes up the perinephric fat capsule?

    <p>Adipose tissue</p> Signup and view all the answers

    Which statement about the renal papilla is true?

    <p>It is the tip of the renal pyramid.</p> Signup and view all the answers

    What role does the fibrous capsule play in kidney protection?

    <p>It physical protects the kidney from trauma.</p> Signup and view all the answers

    Which layer of the glomerular capsule is responsible for covering the glomerular capillaries?

    <p>Visceral layer</p> Signup and view all the answers

    What primarily prevents plasma proteins from entering the capsular space during filtration?

    <p>Filtration membrane structure</p> Signup and view all the answers

    What is the role of glomerular hydrostatic pressure (GHP) in the filtration process?

    <p>It tends to push water and solutes out of the plasma.</p> Signup and view all the answers

    Which of the following pressures opposes glomerular hydrostatic pressure?

    <p>Capsular hydrostatic pressure (CsHP)</p> Signup and view all the answers

    Which component of the filtration membrane includes large diameter pores?

    <p>Fenestrated glomerular capillaries</p> Signup and view all the answers

    What primarily results from the resistance of filtrate already present in the nephron?

    <p>Capsular hydrostatic pressure</p> Signup and view all the answers

    Which type of cell makes up the visceral layer of the glomerular capsule?

    <p>Podocytes</p> Signup and view all the answers

    How does blood colloid osmotic pressure (BCOP) affect the filtration process?

    <p>It tends to draw water back into the plasma.</p> Signup and view all the answers

    What role do filtration slits play in the filtration membrane?

    <p>They permit the passage of certain solutes while blocking larger molecules.</p> Signup and view all the answers

    Which factor primarily influences the glomerular filtration rate?

    <p>Hydrostatic and osmotic pressures</p> Signup and view all the answers

    What anatomical feature of the urinary bladder helps prevent backflow of urine into the ureters during contraction?

    <p>Ureteric orifices</p> Signup and view all the answers

    Which ligament is a remnant of the umbilical arteries and supports the urinary bladder?

    <p>Lateral umbilical ligament</p> Signup and view all the answers

    What describes the length and dual function of the male urethra?

    <p>Longer, carries both urine and semen</p> Signup and view all the answers

    Which structure surrounds the urethral opening in the urinary bladder?

    <p>Internal urethral sphincter</p> Signup and view all the answers

    What occurs to the rugae of the urinary bladder when the bladder fills?

    <p>They disappear with expansion</p> Signup and view all the answers

    Which part of the urinary system is responsible for storing urine until it is ready to be expelled?

    <p>Urinary bladder</p> Signup and view all the answers

    What is the triangular area bounded by the ureteral openings and the entrance to the urethra known as?

    <p>Trigone</p> Signup and view all the answers

    In which anatomical region does the urinary bladder reside outside of?

    <p>Peritoneal cavity</p> Signup and view all the answers

    How do the lengths and functions of the urethra compare between males and females?

    <p>Males have a longer urethra with dual functions of urine and semen transport</p> Signup and view all the answers

    Which of the following statements about the ureters is true?

    <p>They transport urine from the kidneys</p> Signup and view all the answers

    What is the only real cure for severe renal failure?

    <p>Kidney transplant</p> Signup and view all the answers

    Why are immunosuppressive drugs necessary after a kidney transplant?

    <p>To prevent donor organ rejection</p> Signup and view all the answers

    What is the primary function of dialysis?

    <p>To eliminate metabolic waste</p> Signup and view all the answers

    What is the role of the ureters in the urinary system?

    <p>To transport urine from the kidneys to the bladder</p> Signup and view all the answers

    What type of imaging can visualize the urinary tract?

    <p>Pyelogram</p> Signup and view all the answers

    How does an increase in sodium and chloride ions in the peritubular fluid affect the descending thin limb?

    <p>It decreases water reabsorption.</p> Signup and view all the answers

    What percentage of the filtrate is typically recovered during obligatory water reabsorption?

    <p>85 percent</p> Signup and view all the answers

    Where does facultative water reabsorption occur in the nephron?

    <p>Distal convoluted tubule and collecting tubule</p> Signup and view all the answers

    What effect does ADH have on the permeability of the DCT and collecting tubule?

    <p>Increases permeability to water</p> Signup and view all the answers

    What is the main role of obligatory water reabsorption in the nephron?

    <p>Recover a fixed portion of filtrate</p> Signup and view all the answers

    What happens to urine volume in the absence of ADH?

    <p>No water is reabsorbed in DCT and collecting tubule</p> Signup and view all the answers

    Which of the following describes the function of countercurrent multiplication?

    <p>Establishes a concentration gradient in the renal medulla</p> Signup and view all the answers

    What occurs to facilitate facultative water reabsorption?

    <p>Formation of aquaporins</p> Signup and view all the answers

    What characterizes chronic renal failure?

    <p>Progression can be slowed with management.</p> Signup and view all the answers

    Which treatment is commonly used to alleviate acidosis in renal failure?

    <p>Ingesting bicarbonate ions</p> Signup and view all the answers

    What can cause acute renal failure?

    <p>Exposure to toxic drugs</p> Signup and view all the answers

    What is the survival rate for patients with acute renal failure receiving supportive treatment?

    <p>Approximately 50 percent</p> Signup and view all the answers

    What is the primary purpose of hemodialysis?

    <p>To regulate blood composition</p> Signup and view all the answers

    What is the primary function of the papillary duct in the nephron?

    <p>Collects fluid from collecting ducts</p> Signup and view all the answers

    What is a key characteristic of the membrane used in hemodialysis?

    <p>Allows diffusion of ions and nutrients</p> Signup and view all the answers

    Which dietary modifications are typically recommended for chronic renal failure?

    <p>Restricted water, salt, and protein intake</p> Signup and view all the answers

    What structure does the renal artery branch into first?

    <p>Segmental arteries</p> Signup and view all the answers

    Which arteries run within the renal columns?

    <p>Interlobar arteries</p> Signup and view all the answers

    What generally happens to kidney function in acute renal failure?

    <p>It deteriorates rapidly.</p> Signup and view all the answers

    How does dialysis remove waste from the blood?

    <p>By passive diffusion</p> Signup and view all the answers

    What is the function of the afferent arterioles?

    <p>Supply blood to each nephron</p> Signup and view all the answers

    What do arcuate arteries primarily follow in the kidney?

    <p>The boundaries of the renal cortex and renal medulla</p> Signup and view all the answers

    What is a common cause of acute renal failure in sensitized individuals?

    <p>Allergic response to antibiotics</p> Signup and view all the answers

    Which of the following arteries directly branches into afferent arterioles?

    <p>Cortical radiate arteries</p> Signup and view all the answers

    How is blood delivered from the renal artery to the nephron?

    <p>Renal artery → Interlobar arteries → Afferent arterioles</p> Signup and view all the answers

    What is NOT a function of the segments of the nephron?

    <p>Production of hormones</p> Signup and view all the answers

    From which artery do the segmental arteries branch?

    <p>Renal artery</p> Signup and view all the answers

    What is the histological appearance of the papillary duct?

    <p>Simple cuboidal epithelium</p> Signup and view all the answers

    What primarily influences blood flow and blood pressure at the glomeruli?

    <p>Sympathetic stimuli from the celiac plexus</p> Signup and view all the answers

    Which type of nephron is primarily associated with the renal medulla?

    <p>Juxtamedullary nephron</p> Signup and view all the answers

    What is the role of sympathetic postganglionic fibers in the kidneys?

    <p>Adjust blood flow and pressure at the glomeruli</p> Signup and view all the answers

    What is indicated by the term 'vasa recta' in relation to the kidneys?

    <p>The straight capillaries that supply the renal medulla</p> Signup and view all the answers

    How does renal nerve innervation occur?

    <p>Through the branches of the renal artery</p> Signup and view all the answers

    What is the primary function of the renal corpuscle?

    <p>Filtration of blood to form urine</p> Signup and view all the answers

    What structural feature of the kidneys contributes to filtering blood effectively?

    <p>The structure of the filtration membrane</p> Signup and view all the answers

    Which process in the nephron involves the movement of substances from the blood into the tubular fluid?

    <p>Secretion</p> Signup and view all the answers

    How does antidiuretic hormone (ADH) influence urine concentration?

    <p>Increases water reabsorption in the collecting ducts</p> Signup and view all the answers

    Which of the following accurately compares cortical and juxtamedullary nephrons?

    <p>Cortical nephrons are more abundant than juxtamedullary nephrons.</p> Signup and view all the answers

    What is the only real cure for severe renal failure?

    <p>Kidney transplant</p> Signup and view all the answers

    What type of nerve fibers predominantly innervate the nephrons in the kidneys?

    <p>Sympathetic postganglionic fibers</p> Signup and view all the answers

    What is a primary benefit of having a close relative as a donor for a kidney transplant?

    <p>It increases the success rate of the transplant</p> Signup and view all the answers

    What role do immunosuppressive drugs play after a kidney transplant?

    <p>Preventing rejection of the transplant</p> Signup and view all the answers

    What role does sympathetic stimuli have in kidney function?

    <p>They adjust blood flow and pressure at the glomeruli.</p> Signup and view all the answers

    Which structures are included in the urinary tract?

    <p>Ureters, urinary bladder, and urethra</p> Signup and view all the answers

    Which component is involved in the formation of a concentration gradient in the renal medulla?

    <p>Countercurrent multiplication</p> Signup and view all the answers

    What is the total capacity of the urinary bladder?

    <p>1 liter</p> Signup and view all the answers

    What is the primary function of the renal corpuscle?

    <p>Filtration of blood</p> Signup and view all the answers

    What factors influence glomerular filtration rate (GFR)?

    <p>Filtration pressure</p> Signup and view all the answers

    Which term describes the blood vessels that supply the nephron tubules in the kidney?

    <p>Vasa recta</p> Signup and view all the answers

    What effect does antidiuretic hormone (ADH) have on urine?

    <p>Increases urine concentration</p> Signup and view all the answers

    What is the approximate number of nephrons found in each kidney?

    <p>1.25 million</p> Signup and view all the answers

    What is the first process involved in urine formation?

    <p>Filtration</p> Signup and view all the answers

    Which of the following substances is the most abundant organic waste found in urine?

    <p>Urea</p> Signup and view all the answers

    What happens during the reabsorption process in the kidneys?

    <p>Water and solutes move into the peritubular fluid.</p> Signup and view all the answers

    What component is primarily responsible for the concentration of urine?

    <p>Water</p> Signup and view all the answers

    During the secretion process in urine formation, where do the solutes move from?

    <p>Peritubular fluid</p> Signup and view all the answers

    Which of the following best describes the role of kidneys in homeostasis?

    <p>Maintain blood volume and composition</p> Signup and view all the answers

    What percentage of glucose is typically reabsorbed in the proximal convoluted tubule?

    <p>More than 99%</p> Signup and view all the answers

    Chronic renal failure is characterized by which of the following?

    <p>Gradual loss of kidney function over time</p> Signup and view all the answers

    What defines hemodialysis in the context of kidney function?

    <p>A method of filtering waste from the blood using a machine</p> Signup and view all the answers

    Which ion is exchanged for sodium ions during reabsorption in the distal convoluted tubule?

    <p>Potassium ions</p> Signup and view all the answers

    Which of the following is NOT a metabolic waste product excreted by the kidneys?

    <p>Glucose</p> Signup and view all the answers

    What is the primary mechanism that allows water to move into the peritubular fluid from the tubular fluid?

    <p>Osmosis</p> Signup and view all the answers

    How much filtrate volume typically reaches the distal convoluted tubule?

    <p>15-20%</p> Signup and view all the answers

    What is the concentration range of urine produced by the kidneys?

    <p>855-1355 mOsm/L</p> Signup and view all the answers

    What effect does increased aldosterone levels have on hydrogen ion secretion in the distal convoluted tubule?

    <p>Increases hydrogen ion secretion</p> Signup and view all the answers

    Which substance's concentration is primarily altered during the reabsorption process in the PCT?

    <p>Glucose</p> Signup and view all the answers

    What is the primary role of carrier proteins in the distal convoluted tubule?

    <p>Secreting toxins or drugs</p> Signup and view all the answers

    What are the three processes that form urine in the kidney?

    <p>Filtration, reabsorption, secretion</p> Signup and view all the answers

    What occurs to the pH of tubular fluid if the Na+ concentration decreases?

    <p>pH decreases</p> Signup and view all the answers

    Where does the process of filtration occur exclusively in the kidney?

    <p>Renal corpuscle</p> Signup and view all the answers

    Which of the following ions is NOT typically reabsorbed in the proximal convoluted tubule?

    <p>Calcium</p> Signup and view all the answers

    Which hormone primarily stimulates sodium reabsorption in the distal convoluted tubule?

    <p>Aldosterone</p> Signup and view all the answers

    Which nephron segment is primarily responsible for reabsorbing water and sodium and chloride ions?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    What role does the efferent arteriole play during the filtration process?

    <p>Increases blood pressure in the glomerulus</p> Signup and view all the answers

    Which structure is primarily found between the layers of the glomerular capsule during filtration?

    <p>Capsular space</p> Signup and view all the answers

    What type of cells control capillary diameter and regulate blood flow within the glomerulus?

    <p>Intraglomerular mesangial cells</p> Signup and view all the answers

    What is a key function of the juxtaglomerular complex?

    <p>Secretes renin when blood pressure decreases</p> Signup and view all the answers

    What is the main factor that aids the filtration process in the glomerulus?

    <p>Blood pressure within the glomerulus</p> Signup and view all the answers

    Which nephron segment has variable reabsorption and secretion depending on the body's needs?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    What occurs in the capsular space of the renal corpuscle?

    <p>Filtration of blood plasma</p> Signup and view all the answers

    What is the primary function of the renal fascia?

    <p>Anchors the kidney to surrounding structures</p> Signup and view all the answers

    Which region of the kidney contains the renal pyramids?

    <p>Renal medulla</p> Signup and view all the answers

    What would likely occur if the perinephric fat layer were depleted?

    <p>The kidney would become hypermobile</p> Signup and view all the answers

    Which of the following structures separates adjacent renal pyramids?

    <p>Renal column</p> Signup and view all the answers

    What structure is lined by the fibrous capsule?

    <p>Renal sinus</p> Signup and view all the answers

    How many lobes does each kidney typically contain?

    <p>6 to 18</p> Signup and view all the answers

    What is the shape of the renal papilla?

    <p>Conical</p> Signup and view all the answers

    Which layer of connective tissue is the thick layer of adipose tissue surrounding the kidney?

    <p>Perinephric fat</p> Signup and view all the answers

    What is the primary process responsible for creating a concentration gradient in the renal medulla?

    <p>Countercurrent multiplication</p> Signup and view all the answers

    Which of the following statements about the thick ascending limb is correct?

    <p>It actively transports Na+ and Cl– out of the tubular fluid.</p> Signup and view all the answers

    What occurs to the tubular fluid in the thin descending limb of the nephron?

    <p>It becomes more concentrated as water is reabsorbed.</p> Signup and view all the answers

    What effect does the activity of the thick ascending limb have on the peritubular fluid concentration?

    <p>It increases the osmotic concentration of the peritubular fluid.</p> Signup and view all the answers

    What typical urea concentration is found in tubular fluid reaching the papillary duct?

    <p>450 mOsm/L</p> Signup and view all the answers

    What is the primary function of the papillary duct in the nephron?

    <p>Delivers fluid to the minor calyx</p> Signup and view all the answers

    What is the primary process occurring in the renal corpuscle that leads to the production of filtrate?

    <p>Filtration</p> Signup and view all the answers

    Which artery directly supplies blood to the nephrons?

    <p>Cortical radiate artery</p> Signup and view all the answers

    In the renal artery branching sequence, which artery follows the segmental artery?

    <p>Interlobar artery</p> Signup and view all the answers

    Which segment of the nephron is responsible for establishing an osmotic gradient for water reabsorption?

    <p>Nephron loop</p> Signup and view all the answers

    Which part of the nephron reabsorbs nutrients from the filtrate that is now referred to as tubular fluid?

    <p>Proximal convoluted tubule</p> Signup and view all the answers

    What is the role of the arcuate arteries in the arterial system of the kidney?

    <p>They arch along the boundary between cortex and medulla</p> Signup and view all the answers

    What is the role of intercalated cells found in the collecting duct?

    <p>Secreting and reabsorbing hydrogen and bicarbonate ions</p> Signup and view all the answers

    What follows the interlobar arteries in the branching of the renal artery?

    <p>Arcuate arteries</p> Signup and view all the answers

    What structure collects the fluid from multiple collecting ducts?

    <p>Papillary duct</p> Signup and view all the answers

    What type of solution is produced during the filtration process in the renal corpuscle?

    <p>Protein-free solution similar to blood plasma</p> Signup and view all the answers

    Which part of the arterial blood flow branches from the renal sinus?

    <p>Segmental arteries</p> Signup and view all the answers

    Which structure collects fluid from multiple nephrons?

    <p>Collecting duct</p> Signup and view all the answers

    Which arteries arch along the boundary between the renal cortex and medulla?

    <p>Arcuate arteries</p> Signup and view all the answers

    What is the total length of the renal tubule?

    <p>50 mm</p> Signup and view all the answers

    Which structures supply each nephron with blood specifically through capillary knots?

    <p>Afferent arterioles</p> Signup and view all the answers

    What type of cells line the collecting duct and are involved in reabsorbing water?

    <p>Principal cells</p> Signup and view all the answers

    Which substance is predominantly reabsorbed in the proximal convoluted tubule?

    <p>Glucose</p> Signup and view all the answers

    What happens to the filtrate as it moves from the renal tubule to the collecting system?

    <p>It becomes concentrated</p> Signup and view all the answers

    Which segment of the nephron is primarily responsible for adjusting tubular fluid composition through reabsorption and secretion?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    What effect does aldosterone have on sodium and potassium ion exchange in the distal convoluted tubule?

    <p>Increases sodium reabsorption and potassium secretion</p> Signup and view all the answers

    Which part of the nephron is mainly responsible for adjusting the solute composition of tubular fluid?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    Approximately what percentage of the initial filtrate volume reaches the distal convoluted tubule?

    <p>15–20 percent</p> Signup and view all the answers

    What role do carrier proteins play in the distal convoluted tubule?

    <p>Secrete toxins or drugs</p> Signup and view all the answers

    How does a decrease in sodium concentration in the filtrate affect the pH of the tubular fluid?

    <p>Decreases pH due to increased hydrogen ion secretion</p> Signup and view all the answers

    What is the primary function of the proximal convoluted tubule in the nephron?

    <p>Reabsorption of nutrients and ions</p> Signup and view all the answers

    Which of the following ions undergoes reabsorption in exchange for potassium ions in the distal convoluted tubule?

    <p>Sodium</p> Signup and view all the answers

    What approximate volume of water is reabsorbed daily in the proximal convoluted tubule?

    <p>108 liters</p> Signup and view all the answers

    Which mechanism primarily describes the process occurring along the proximal convoluted tubule?

    <p>Reabsorption predominating</p> Signup and view all the answers

    What condition is described by excessive urine production, potentially indicating hormonal or metabolic issues?

    <p>Polyuria</p> Signup and view all the answers

    Which condition involves the inability to control urination voluntarily and may result in various types of involuntary leakage?

    <p>Incontinence</p> Signup and view all the answers

    What is indicated by reduced urine production between 50–500 mL/day?

    <p>Oliguria</p> Signup and view all the answers

    What term describes a condition where there is severely reduced urine production, ranging from 0–50 mL/day?

    <p>Anuria</p> Signup and view all the answers

    What condition is characterized by a normal renal function but the patient does not urinate due to a blockage?

    <p>Urinary retention</p> Signup and view all the answers

    Which organ of the urinary system primarily produces urine?

    <p>Kidneys</p> Signup and view all the answers

    What function do the ureters serve in the urinary system?

    <p>Conduct urine to the bladder</p> Signup and view all the answers

    Which of the following is NOT a part of the urinary system?

    <p>Pancreas</p> Signup and view all the answers

    What is the main function of the urinary bladder?

    <p>Receive and store urine</p> Signup and view all the answers

    Which type of nephron is primarily located in the cortex of the kidney?

    <p>Cortical nephron</p> Signup and view all the answers

    How does blood primarily flow through the kidneys?

    <p>Pumping action of the heart</p> Signup and view all the answers

    What drives the process of urination?

    <p>Contraction of bladder wall muscles</p> Signup and view all the answers

    Which segment of the nephron is primarily responsible for reabsorption?

    <p>Proximal convoluted tubule</p> Signup and view all the answers

    Which statement best describes the urethra?

    <p>Conducts urine from the bladder to outside the body</p> Signup and view all the answers

    Which of the following accurately describes the role of the kidneys in the urinary system?

    <p>Excrete waste products and produce urine</p> Signup and view all the answers

    What is the first step in the urine formation process?

    <p>Filtration</p> Signup and view all the answers

    Which metabolic waste is considered the most abundant organic waste product?

    <p>Urea</p> Signup and view all the answers

    What process allows for the transport of solutes from the peritubular fluid back into the blood?

    <p>Reabsorption</p> Signup and view all the answers

    During what process are substances transported from the peritubular fluid into the tubular fluid?

    <p>Secretion</p> Signup and view all the answers

    What is the osmolarity range for concentrated urine?

    <p>855–1355 mOsm/L</p> Signup and view all the answers

    Which by-product is formed during the breakdown of creatine phosphate in muscles?

    <p>Creatinine</p> Signup and view all the answers

    What is the main role of the urinary system in maintaining homeostasis?

    <p>Removing wastes and regulating blood volume</p> Signup and view all the answers

    What are the three processes involved in urine formation?

    <p>Filtration, reabsorption, secretion</p> Signup and view all the answers

    Which statement describes the filtration process in the kidneys?

    <p>Water and solutes pass through glomerular membranes due to blood pressure.</p> Signup and view all the answers

    Filtration takes place exclusively in which part of the nephron?

    <p>Renal corpuscle</p> Signup and view all the answers

    Which segment of the nephron is primarily responsible for reabsorbing water and sodium?

    <p>Collecting duct</p> Signup and view all the answers

    What is the significance of uric acid in the body?

    <p>It is formed during the recycling of nitrogenous bases of RNA.</p> Signup and view all the answers

    What does the term 'glomerular capillaries' refer to?

    <p>The network of capillaries where filtration occurs.</p> Signup and view all the answers

    What is the role of the efferent arteriole in the filtration process?

    <p>Increases blood pressure to enhance filtration</p> Signup and view all the answers

    Where is the juxtaglomerular complex primarily located?

    <p>Near the glomerulus</p> Signup and view all the answers

    What function do intraglomerular mesangial cells serve?

    <p>Control capillary diameter and blood flow</p> Signup and view all the answers

    Which part of the nephron is primarily involved in secretion of substances into the tubular fluid?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    Which statement best describes the balance of reabsorption and secretion in the nephron?

    <p>Balance varies by nephron segment</p> Signup and view all the answers

    What occurs in the capsular space of the nephron?

    <p>Filtration of blood plasma</p> Signup and view all the answers

    What is the main factor that influences the final volume and solute concentration of urine?

    <p>Interaction between the collecting system and nephron loops</p> Signup and view all the answers

    What is the primary role of the efferent arteriole in the kidney's blood flow?

    <p>Transports blood away from the glomerulus to the peritubular capillaries</p> Signup and view all the answers

    Which vessel directly drains blood from the peritubular capillaries?

    <p>Cortical radiate veins</p> Signup and view all the answers

    What feature distinguishes vasa recta from peritubular capillaries?

    <p>They run parallel to the nephron loop</p> Signup and view all the answers

    What do the peritubular capillaries primarily collect?

    <p>Water and solutes absorbed by the nephron</p> Signup and view all the answers

    Which sequence of blood drainage from the nephron is correct?

    <p>Cortical radiate veins → Interlobar veins → Renal vein → Inferior vena cava</p> Signup and view all the answers

    In which part of the kidney is the glomerulus located?

    <p>Cortex</p> Signup and view all the answers

    What is the function of the cortical radiate veins in the kidney?

    <p>To collect blood from peritubular capillaries and drain it</p> Signup and view all the answers

    What fluid surrounds the peritubular capillaries?

    <p>Interstitial fluid</p> Signup and view all the answers

    Study Notes

    ### The Urethra

    • In males, the urethra is a muscular tube measuring 18-22 cm long
    • It begins at the internal urethral orifice of the urinary bladder and ends at the external urethral orifice, located on the glans penis
    • The male urethra has four parts: the intramural, prostatic, membranous, and spongy urethra
    •  The female urethra is shorter than the male urethra, measuring 4 cm long
    •  It is exclusively a urinary organ and corresponds to the prostatic and membranous portions of the male urethra
    •  The female urethra extends from the bladder neck to the external urethral orifice, located below the clitoris
    •  In females, the paraurethral glands (homologous to prostate glands in males) are found at the sides of the external urethral meatus

    The Urinary Bladder

    •  The urethra is a tube that carries urine from the bladder to the outside of the body.
    •  The bladder expands upward and becomes more oval in shape as it fills with urine
    •  The bladder wall contains three layers: the mucosa, submucosa, and muscularis
    •  The mucosa of the bladder is lined by transitional epithelium, which allows the bladder to stretch as it fills with urine
    •  The submucosa of the bladder contains blood vessels, nerves, and lymphatics.

    The Renal Corpuscle

    • The renal corpuscle is the filtering unit of the kidney
    • It consists of the glomerulus and Bowman's capsule
    • The glomerulus is a network of capillaries surrounded by Bowman's capsule
    • The Bowman's capsule collects the filtrate produced by the glomerulus

    ### Nephrons

    • Nephrons are the functional units of the kidney
    • They are classified based on their location: cortical and juxtamedullary nephrons
    • Cortical nephrons are located in the cortex and have a short loop of Henle
    • Juxtamedullary nephrons are located at the junction of the cortex and medulla and have a long loop of Henle extending into the medulla
    • All nephrons are found in the cortex

    ### The Mesonephros

    • The mesonephros is a transient kidney that functions during early fetal development
    • It is a longer and more mobile kidney that is surrounded by the urethral sphincter
    • It contributes to the development of the male reproductive system

    The Pronephros

    • The Pronephros is the earliest nephric stage
    • The Pronephros is rudimentary and non-functional
    • The Pronephros develops from the intermediate mesoderm
    • The Pronephros develops into groups of pronephric tubules and ducts, which are vestigial structures that are non-functional
    • The Pronephros disappears by the end of the 4th week of development

    Posterior Abdominal Wall

    • Right kidney:
      • Anteriorly:
        • Liver, ascending colon, duodenum (2nd part)
      • Posteriorly:
        • Upper 1/3: diaphragm, 12th rib
        • Lower 2/3: psoas major, quadratus lumborum, transversus abdominis muscles
    • Left kidney:
      • Anteriorly:
        • Tail of pancreas, spleen (connected via splenorenal ligament), stomach (greater curvature), descending colon, jejunum
      • Posteriorly:
        • Upper 1/3: diaphragm, 12th rib
        • Lower 2/3: psoas major, quadratus lumborum, transversus abdominis muscles

    Renal Fascia and Renal Capsules

    • Renal fascia (Gerota's fascia):
      • Encases kidneys and suprarenal glands
      • Acts as a barrier to infection spread
      • Superiorly: anterior and posterior layers fuse, separating the kidney from the adrenal gland
      • Inferiorly: no fusion of layers, posterior layer continues down to the iliac fascia
    • Renal capsule:
      • Thin fibrous membrane directly covering the kidney
      • Can be stripped off during dissection
      • Serves as protection and cushion

    Renal Parenchyma

    • Outer layer– Cortex:
      • contains nephrons
      • dark brown granular appearance
      • Cortical arches separate renal pyramids from the surface
      • Medullary rays (bundles of tubules) extend into the cortex
    • Inner layer– Medulla:
      • Contains renal pyramids
      • Apex of pyramids (renal papilla) projects into a minor calyx
        • Area cribrosa: perforations in the renal papilla where urine collects
      • Base of pyramid: medullary rays and loops of Henle

    Renal Hilum

    • Vertical cleft on the medial side of the kidney
    • Entrance to the renal sinus
    • Contains:
      • Renal vessels:
        • Renal vein (anterior)
        • Renal arteries (2, anterior)
      • Ureter (posterior)

    Renal Sinus

    • Space within the kidney
    • Contains structures serving the kidney: vessels, nerves, renal pelvis, calices

    Blood Supply and Venous Drainage of Kidneys

    • Renal arteries supply blood to kidneys
    • Renal veins drain blood from kidneys
    • The right renal vein is shorter than the left renal vein

    Ureter

    • Connects kidney to bladder
    • Passage for urine
    • Posterior wall
      • Largely covered by peritoneum
      • Attached to abdominal wall by fascia
    • Venous Drainage:
      • Perivesical plexus: around the base of the bladder, drains into the inferior vesical vein
      • Vesical venous plexus: surrounds the bladder, drains into the inferior vesical veins

    Bladder

    • Vesical venous plexus:
      • Surrounding the bladder, drained by inferior vesical veins
      • May drain via sacral veins into the internal vertebral venous plexus
    • Males:
      • Continuous with the prostatic plexus, surrounding the prostate, seminal glands and ductus deferens
      • Receives blood from the deep dorsal vein of the penis
      • External sphincter located in the middle layer

    Urethra

    • Lumen stellate-shaped
    • Proximal portion lined by urothelium
    • Distal portion lined by stratified squamous epithelium for protection
    • Males (3 parts):
      • Prostatic urethra: lined by urothelium
      • Membranous urethra: lined by transitional epithelium
      • Penile urethra: lined by stratified squamous epithelium

    Embryology

    • Kidneys develop from 3 systems: pronephros, mesonephros, metanephros
    • All three originate from the intermediate mesoderm

    Pronephros

    • Earliest nephric stage
    • Non-functional; rudimentary
    • Forms pronephric tubules and ducts
    • Disappears by the end of the 4th week

    Mesonephros

    • Functional in early fetal period
    • Forms mesonephric tubules and ducts
    • Regresses as metanephros develops

    Metanephros

    • The permanent kidney
    • Develops from metanephric mesoderm (forms nephrons) and ureteric bud (forms collecting ducts and pelvis)
    • Begins to function around the 10th week of gestation
    • At birth, kidney is functional but still developing and growing

    Renal Pain

    • Caused by stretching of renal pelvis and ureters
    • Pain sensation sent to spinal cord segments T11-L2 via visceral afferent fibers
    • Referred pain: felt in cutaneous areas innervated by T11-L2 (lumbar and inguinal regions)
    • Pain may radiate to the proximal thigh via the genito-femoral nerve (L1-L2) and the scrotum (males) or labia majora (females)

    Kidneys

    • Bean-shaped, reddish-brown organs located retroperitoneally.
    • Extend from T12 to L3 vertebral levels.
    • Weight: 120-170g (average: 150g).
    • Length: 10-12 cm.
    • Width: 5-6cm.
    • Anterior-posterior thickness: 3-4cm.

    Right Kidney

    • Anterior Relations: Liver, ascending colon, the second part of the duodenum.
    • Posterior Relations: Diaphragm, 12th rib, and the iliac fascia inferiorly.

    Left Kidney

    • Anterior Relations: Tail of the pancreas, spleen (connected via the splenorenal ligament), greater curvature of the stomach, descending colon, and the jejunum.
    • Posterior Relations: Diaphragm, 12th rib, and the iliac fascia inferiorly.

    Suprarenal Gland

    • Situated on the superior pole of each kidney, it sits on the diaphragm posterolaterally.
    • The right suprarenal gland lies at the level of the omental foramen (Foramen of Winslow).

    Suprarenal Cortex

    • Outer region of the suprarenal gland.
    • Derived from the neural crest (according to some references) or mesoderm (according to others).
    • Function: secretes androgens and corticosteroids to regulate sodium and water retention, blood volume, and blood pressure in response to stress.

    Suprarenal Medulla

    • Inner region of the suprarenal gland.
    • Composed of nervous tissue permeated with capillaries and sinusoids, derived from neural crest cells associated with the sympathetic nervous system.
    • Contains Chromaffin cells that secrete catecholamine, including epinephrine and norepinephrine.

    Renal Capsule

    • Thin, fibrous, glistening membrane that encloses the renal parenchyma.
    • Represents the true capsule of the kidney and is directly in contact with the organ tissue.
    • Can be stripped off from normal renal parenchyma.
    • Provides a barrier against the spread of infection.

    Perirenal/Perinephric Fat

    • Surrounds kidneys and adrenal glands, extending to their hollow centers (renal sinuses).
    • Acts as a cushion.
    • Superiorly, the anterior and posterior aspects fuse, separating the kidney from the adrenal gland and connecting to the diaphragmatic fascia. This causes kidney movement with respiration. Inferiorly, the anterior and posterior covers do not fuse, with the posterior covering descending downward and fusing with the iliac fascia.
    • Clinical Significance: Infection or injury to the kidney can cause pus or blood to travel inferiorly towards the pelvic area or vice versa.

    Ureters

    • Two, muscular tubes each originating from a kidney, responsible for conveying urine from the kidneys to the urinary bladder.
    • Retroperitoneal in location.
    • Length: 20 – 25 cm.
    • Thick walled and narrow.

    Blood Supply and Venous Drainage of the Kidneys

    • Both kidneys drain into the renal veins, which subsequently drain into the inferior vena cava.
    • The renal veins lie anterior to the right and left renal arteries.
    • The left renal vein is longer than the right renal vein due to the location of the inferior vena cava on the right side.
    • Accepts blood from the left suprarenal vein, left gonadal vein, and communicates with the ascending lumbar vein.

    Functions of the Urinary System

    • Excretory: Excretes waste products of metabolism through urine production.
    • Homeostasis: Maintains acid-base balance and normal body fluid levels by eliminating excess water.
    • Endocrine: Releases hormones such as erythropoietin and renin.
    • Reproductive (Male): The urethra serves as a passage for semen.

    Development of the Urinary System

    • The urinary system develops from the metanephros and the ureteric bud (an outgrowth of the mesonephros).
    • Male and female urinary systems develop differently.

    Blood Supply and Venous Drainage of the Ureters

    • The ureters receive their blood supply from:
      • Renal arteries
      • Gonadal arteries
      • Common iliac arteries
      • Internal iliac arteries
    • The venous drainage follows a pattern similar to the arterial supply, with the ureters draining into the:
      • Renal veins
      • Gonadal veins
      • Common iliac veins
      • Internal iliac veins

    Innervation of the Kidneys, Ureters, and Adrenal Glands

    • The kidneys, ureters, and adrenal glands are innervated by the renal plexus.
    • The renal plexus is a network of nerves that originates from the celiac plexus and the sympathetic trunk.
    • The renal plexus also receives contributions from the vagus nerve (parasympathetic) and the hypogastric plexus.
    • The renal nerves carry both sympathetic and parasympathetic fibers:
      • Sympathetic fibers regulate blood flow to the kidneys and adrenal glands, influencing the secretion of hormones like renin and catecholamines.
      • Parasympathetic fibers are responsible for the control of urine production and bladder contraction.

    Lymphatic Drainage of the Urinary System

    • The lymphatic drainage of the kidneys, ureters, and bladder follows a similar pattern to the venous drainage, with lymphatic vessels draining into:
      • The lumbar lymph nodes.
      • The iliac lymph nodes.
      • The para-aortic lymph nodes.

    Urinary Bladder

    • A temporary storage organ for urine.
    • Parts: Fundus, apex, body, base, and neck.
    • Orientation: Lies posterior to the pubic symphysis and anterior to the rectum in males and uterus in females.
    • Ligament Support: Supported by the pelvic ligaments, including the ligaments of the bladder and the urogenital diaphragm.
    • Blood Supply: Receive blood from the superior and inferior vesical arteries.
    • Venous Drainage: Drain into the internal iliac veins.
    • Innervation: Innervated by the hypogastric plexuses.

    Urethra

    • The passageway through which urine is voided from the urinary bladder.

    Male Urethra

    • Longer than the female urethra.
    • Consists of three parts:
      • Prostatic urethra: Passes through the prostate gland.
      • Membranous urethra: Short segment passing through the urogenital diaphragm.
      • Spongy urethra: Runs through the corpus spongiosum of the penis, ending at the external urethral orifice.

    Female Urethra

    • Shorter than the male urethra.
    • Lies anterior to the vagina.
    • Opens at the external urethral orifice.

    Areas of Normal Constrictions along the Ureter

    • The ureters usually have three areas of normal constrictions:
      • The ureteropelvic junction, where the ureter exits the kidney.
      • The pelvic brim, where the ureter crosses the common iliac artery.
      • The ureterovesical junction, where the ureter enters the urinary bladder.

    Histological Features of the Nephron

    • Glomerulus:
      • A tuft of capillaries surrounded by Bowman's capsule.
      • Functions in ultrafiltration of blood.
    • Proximal Convoluted Tubule (PCT):
      • Highly convoluted segment, responsible for reabsorption of water, electrolytes, and nutrients.
      • Characterized by cuboidal epithelial cells with a brush border.
    • Loop of Henle:
      • Hairpin-shaped loop that descends into the medulla and then ascends back to the cortex.
      • Plays a crucial role in establishing the concentration gradient in the medulla.
      • Descending limb - permeable to water, reabsorbs water.
      • Ascending limb - permeable to salts, reabsorbs salts.
    • Distal Convoluted Tubule (DCT):
      • Convoluted segment, primarily involved in the regulation of water balance and electrolyte homeostasis.
    • Collecting Duct:
      • Lined by cuboidal epithelial cells, collect filtrate from multiple nephrons.
      • Further regulates water and solute transport.

    Differences Between Cortical and Juxtamedullary Nephrons

    • Cortical Nephrons:
      • Have short loops of Henle.
      • Located primarily in the cortex.
      • Play a primary role in filtration and reabsorption.
    • Juxtamedullary Nephrons:
      • Have long loops of Henle that extend deep into the medulla.
      • Located near the medulla.
      • Play a crucial role in regulating urine concentration.

    Juxtaglomerular Apparatus (JGA)

    • Specialized region of the nephron where the distal convoluted tubule contacts the afferent arteriole.
    • Components:
      • Macula densa: Modified cells in the DCT that sense changes in the composition of the tubular fluid.
      • Juxtaglomerular cells: Modified smooth muscle cells in the afferent arteriole that secrete renin.
      • Extraglomerular mesangial cells: Located between the afferent and efferent arterioles; support the JG apparatus and function in modulation of filtration.
    • Clinical importance: Plays a crucial role in the regulation of blood pressure and renal blood flow.

    Lobes and Lobules of the Kidney

    • The kidney is comprised of lobules: conical renal pyramids, each composed of collecting ducts arising from cortical nephrons.
    • It is divided into lobes: each lobe consists of a medullary pyramid and its associated cortical tissue.

    Hormonal Function of the Kidney

    • The kidney produces and secretes several hormones that play essential roles in maintaining homeostasis:
      • Erythropoietin: Stimulates red blood cell production.
      • Renin: Initiates the renin-angiotensin-aldosterone system, regulating blood pressure and electrolyte balance.
      • Vitamin D (calcitriol): Helps regulate calcium and phosphate levels in the blood.

    Flow of Glomerular Filtrate

    • After filtration through the glomerulus, the filtrate moves through:
      • Proximal convoluted tubule.
      • Loop of Henle.
      • Distal convoluted tubule.
      • Collecting duct.
      • Minor calyx.
      • Major calyx.
      • Renal pelvis.
      • Ureter.
      • Urinary bladder.
      • Urethra.
      • External urethral orifice.

    Histological Features of Collecting Tubules

    • The collecting tubules, lined by cuboidal epithelial cells, further regulate water and solute transport.
    • Their structure is characterized by principal cells, which are involved in water reabsorption, and intercalated cells, which regulate acid-base balance by secreting protons and reabsorbing bicarbonate.
    • The collecting duct system is an important area for the fine-tuning of urine concentration and composition.

    Male Urethra

    • 18-22 cm long
    • Muscular tube
    • Starts at internal urethral orifice in the urinary bladder and ends at the external urethral orifice in the glans penis
    • Has 4 parts:
      • Intramural (Preprostatic) Part:
        • Varies in length and diameter depending on bladder filling
        • When the bladder is filling the internal urethral orifice is is small and high
        • When the bladder is emptying the internal urethral orifice is wide and low
      • Prostatic Urethra:
        • 3 cm long
        • Traverses through the prostate gland
        • Widest and most dilatable part of the urethra
        • Features:
          • Urethral Crest: Most prominent feature of prostatic urethra found in the medulla, composed of pale-staining principal cells
      • Membranous Urethra:
        • 15 cm long
        • Longest and most mobile part
        • Found within the urogenital diaphragm surrounded by the urethral sphincter
        • Traverses the bulb, body and glans of the penis
      • Spongy Urethra:
        • Enclosed within the corpus spongiosum of the penis
        • Enlarges into the Fossa Navicularis
        • Terminate at the external urethral meatus

    Female Urethra

    • Proximal portion: lined by transitional epithelium
    • Distal portion: lined by stratified squamous non-keratinized epithelium

    Urinary Bladder

    • Lined by transitional epithelium with umbrella cells
      • When the bladder is empty the mucosa is highly folded.
      • When the bladder is full the mucosa is smooth, the urothelium is thinner, and the umbrella cells are flatter
    • Lamina propria is a connective tissue bed filled with blood vessels
    • Muscularis mucosae consists of 3 poorly delineated layers of the detrusor muscles
      • Inner and outer longitudinal smooth muscle layers
      • Middle circular smooth muscle layer
    • Upper part of the bladder is covered by serous peritoneum; the rest of the urinary passages are covered by an adventitial layer

    Distal Convoluted Tubule (DCT)

    • Has 3 parts: pars recta, pars convoluta, pars maculata (macula densa)
    • Thick straight part ascends from the loop of Henle into the cortex
    • Convoluted part is completely in the cortex
    • Transports ions to maintain acid-base balance in the blood
    • Smaller than the PCT, more distinct nuclei, lumen appears wider and empty.
    • Lined by simple cuboidal epithelium with very few to no brush border.
    • Rate of Na+ absorption is regulated by aldosterone from the adrenal glands.

    Collecting Tubule

    • Located in the medulla
    • Composed of pale-staining principal cells, few organelles, sparse microvilli and distinct cell boundaries
    • Receives urine from the DCT
    • Tubules join to form the collecting duct or papillary ducts of Bellini which empty into the minor calyces
    • Carries out the final mechanism of urine concentration system where there is reabsorption of water
    • Large compared to the DCT, pale-staining
    • Lined by simple cuboidal epithelium
    • Principal cells contain aquaporins.
    • Aquaporins are pore proteins that help the tubule to absorb water
    • ADH (antidiuretic hormone) is released by the pituitary gland when the body is dehydrated.

    Kidney Development

    • Mesonephros:
      • 2nd stage of nephric development
      • Becomes segmented and gives rise to mesonephric tubules and ducts
      • Tubules lengthen into a S-shaped loop and acquire a tuft of capillaries that form a glomerulus at the medial extremity.
      • Tubules form a Bowman’s capsules alongside the glomerulus, and together these structures constitute a renal corpuscle.
      • Principal excretory organ during embryonic life from the 4th to 8th week of life
      • In females, there is COMPLETE degeneration of the mesonephric duct.
      • In males, the mesonephric duct becomes the Wolffian duct.
    • Metanephros:
      • Forms the permanent kidney
      • Appears in the 5th week
      • Develops from the metanephrogenic tissue
        • This tissue originates from the intermediate mesoderm.
        • Gives rise to tubules and parts of the nephron
      • Collecting ducts of the permanent kidney develop from the ureteric bud.
        • A derivative of the mesonephric duct.
        • Gives rise to ureters, renal pelvis, major and minor calyces, and collecting ducts.
      • The ureteric bud penetrates the metanephrogenic tissue to give rise to the tubules invaginated by tufts of capillaries.

    Male Urethra

    • 18-22 cm long
    • Starts from the internal urethral orifice and ends at the external urethral orifice, located at the glans penis
    • Has 4 parts (Moore): intramural, prostatic, membranous, and spongy
    • Has 3 parts (2018 trans): prostatic, membranous, and spongy
    • Intramural (preprostatic) part of urethra
      • Varies in diameter and length depending on bladder filling
      • Bladder neck is tonically contracted when bladder is filling, making the internal urethral orifice small and high
      • Bladder neck relaxes when the bladder empties, making the orifice wide and low
    • Prostatic Urethra
      • 3 cm long
      • Traverses the prostate gland
      • Widest and most dilatable portion
      • Has urethral crest on the posterior wall, prostatic sinuses, and a seminal colliculus
    • Membranous Urethra
      • 15 cm long
      • Longest and most mobile
      • Found within the urogenital diaphragm surrounding the urethral sphincter
    • Spongy Urethra
      • Traverses the bulb, body, and glans of the penis
      • Enclosed within the corpus spongiosum of the penis
      • Enlarges into the Fossa Navicularis at the glans
      • Terminates at the external urethral meatus

    Urinary Bladder

    • In adults, lies within the lesser pelvis
    • In infants, found in the abdominal cavity
    • Enveloped by a visceral fascia
    • Parts
      • Fundus: central and superior-posterior part that expands freely, rises above the pubic crest
      • Apex: anterior-superior part, connected to the anterior abdominal wall by the median umbilical ligament
      • Body: between the fundus and apex
      • Neck: inferior, narrowest portion, continuous with the urethra

    Orientation of the Urinary Bladder

    • Males: prostate gland is attached directly to the base of the bladder and lies anterior to the rectum
      • Fundus is separated from the rectum by the rectovesical septum laterally by the seminal glands and ampullae of the ductus deferentes
    • Females: bladder rests directly on the pelvic floor, inferior to the uterus, and closely related to the anterior vaginal wall

    Blood Supply to Urinary Bladder

    • Main supply: Internal iliac artery
      • Superior vesical artery: supplies the superolateral/anterosuperior parts of the bladder
      • Inferior vesical artery: supplies the ureter, fundus, and neck of the bladder, prostate, and urethra in males
        • Females: have the vaginal artery instead of the inferior vesical artery, sending small branches to the postero-inferior parts of the bladder
    • Obturator and inferior gluteal arteries: supply small branches to the bladder

    Innervations of the Urinary Bladder

    • Sympathetic: conveyed from the inferior thoracic and upper lumbar spinal cord levels to the visceral (pelvic) plexuses
      • Hypogastric plexus (L1-L2): inhibits detrusor muscle contraction, increases urethral sphincter tone
    • Parasympathetic: conveyed from the sacral segments of the spinal cord (S2-S4) via the pelvic splanchnic nerves
      • Pelvic plexuses: stimulates detrusor muscle contraction, relax the urethral sphincter

    Ureters

    • Stellate-shaped lumen
    • Lined by transitional epithelium (urothelium)
      • Single layer of small, basal cells
      • Intermediate region containing one to several layers of columnar cells
      • Umbrella cells:
        • Bi- or multi-nucleated cells
        • Large, polyhedral or bulbous cells
        • Highly differentiated to protect underlying cells against the cytotoxic effects of hypertonic urine

    Suprarenal Glands

    • Also called Adrenal Glands
    • Yellowish in living persons
    • Endocrine glands located between the superomedial aspects of the kidneys and the diaphragm
    • Enclosed by renal fascia, attached to the crura of the diaphragm
    • Major attachment is to the crura of the diaphragm, not the kidneys
    • Right Suprarenal gland: pyramid-shaped
      • Lies behind the right lobe of the liver
      • Extends medially behind the IVC
      • Situated over the superior pole relative to the kidney
      • Lies anterolateral to the right crus of the diaphragm
    • Left Suprarenal Gland: crescent-shaped
      • Lies medial to the superior half of the kidney

    Renal Artery

    • Longer right renal artery passes posterior to the IVC
    • Each artery divides close to the hilum into 5 segmental arteries that are end arteries
      • End arteries: do not anastomose significantly with other segmental arteries
    • Segments:
      • Apical: apical segmental artery
      • Anterosuperior: anterosuperior segmental artery
      • Anteroinferior: anteroinferior segmental artery
      • Inferior: inferior segmental artery
        • Apical, anterosuperior, anteroinferior, and inferior arteries originate from the anterior branch of the renal artery
      • Posterior: posterior segmental artery
        • Originates from a continuation of the posterior branch of the renal artery

    Urinary Disorders

    • Change in urine volume and appearance can be a sign of urinary disorders
      • Polyuria is excessive urine production
        • Can be caused by diabetes or glomerulonephritis
      • Oliguria is reduced urine production (50–500 mL/day)
      • Anuria is severely reduced urine production (0–50 mL/day)
      • Oliguria and anuria indicate serious kidney problems and potential renal failure
    • Change in urination frequency is another sign of urinary disorders
      • Increased urgency or frequency can result from irritation of the ureters or urinary bladder
      • Incontinence is the inability to control urination voluntarily
        • Stress incontinence is periodic involuntary leakage
        • Urge incontinence is the inability to delay urination
        • Overflow incontinence is a continual trickle of urine from a full bladder
      • Urinary retention is the inability to urinate
        • Can occur due to an enlarged prostate gland in males
    • Pain is a symptom of urinary issues
      • Pain in the superior pubic region is associated with bladder disorders
      • Pain in the superior lumbar region or flank that radiates to the right or left upper quadrants is associated with kidney infections (pyelonephritis) and kidney stones (renal calculi)
      • Dysuria is painful or difficult urination
        • Occurs with cystitis or urethritis or urinary obstructions
    • Edema (swelling) can be caused by proteinuria
      • Facial swelling, especially around the eyes, is common
    • Fever often indicates urinary tract infection
      • Cystitis usually causes low-grade fever
      • Pyelonephritis can produce high fevers
    • Dysuria is painful or difficult urination

    Renal Failure

    • Renal failure occurs when the kidneys cannot filter wastes from the blood and maintain homeostasis
    • Signs of renal failure include:
      • Decreased urine production
      • Rise in blood pressure
      • Anemia from decline in erythropoietin production
      • Central nervous system problems (sleeplessness, seizures, delirium, and coma)
    • Chronic renal failure deteriorates gradually
      • Associated problems build up over time
      • The condition is not reversible but progression can be slowed
      • Management involves restricted water, salt, and protein intake
        • Minimizes urine volume and nitrogenous waste
      • Acidosis can be countered by ingesting bicarbonate ions
    • Acute renal failure deteriorates rapidly in just a few days
      • May be impaired for weeks
      • Caused by toxic drugs, renal ischemia, urinary obstruction, or trauma
      • Allergic response to antibiotics or anesthetics can cause acute renal failure
      • Recovery is possible if patients survive the initial incident
      • Survival rate ~50 percent with supportive treatment

    Dialysis and Treatment of Renal Failure

    • Dialysis is the process of passive diffusion across a selectively permeable membrane
      • Hemodialysis uses an artificial membrane to regulate blood composition
        • Shunts connect blood vessels to the dialysis machine
      • Dialysis fluid containing specific concentrations of solutes is run on the other side of the membrane
    • Dialysis relieves renal failure symptoms but is not a cure
    • Kidney transplant is the only cure for severe renal failure
      • Patient survival is more than 90 percent at 2 years after the transplant
      • A close relative donor increases success rate
      • Immunosuppressive drugs are necessary to reduce rejection of the transplant

    Urinary Tract

    • The urinary tract transports, stores, and eliminates urine
    • Includes the ureters, urinary bladder, and urethra
    • Can be visualized using a pyelogram
      • X-ray image after a radiopaque dye is administered intravenously
    • Ureters are paired muscular tubes extending from the kidneys to the urinary bladder
      • About 30 cm long
      • Retroperitoneal and attached to the posterior abdominal wall
    • Urinary bladder is a hollow, muscular organ that holds up to a liter of urine
    • Urethra is a tube that carries urine from the bladder to the outside of the body

    Kidney Location and Structure

    • The kidneys are located retroperitoneally on either side of the vertebral column
    • The kidneys are held in position by:
      • Perinephric Fat Capsule: A thick layer of adipose tissue that surrounds the kidney.
      • Renal Fascia: A dense, fibrous outer layer that attaches the kidney to surrounding structures.
    • The hilum is a medial indentation of the kidney where structures enter and exit. Structures entering and exiting include:
      • Renal artery: Supplies blood to the kidney.
      • Renal vein: Removes blood from the kidney.
      • Ureter: Carries urine from the kidney to the bladder.

    Kidney Internal Structure

    • The Renal Sinus: An internal cavity within the kidney.
    • Fibrous Capsule: Lines the renal sinus and is a tough outer layer that protects the kidney.
    • Renal Cortex: The superficial region of the kidney, containing nephrons.
    • Renal Medulla: The inner region of the kidney, containing renal pyramids, renal papillae, and renal columns.
      • Renal Pyramids: Conical structures in the medulla that contain collecting ducts.
      • Renal Papilla: Tip of the renal pyramid that drains urine into the minor calyx.
      • Renal Columns: Bands of cortical tissue that extend between renal pyramids.
    • Kidney Lobe: A functional unit of the kidney, made up of a pyramid, overlying cortex, and adjacent renal columns. Every kidney contains 6-18 lobes.

    Nephron and Collecting System

    • Nephron: Functional unit of the kidney, responsible for filtering blood and producing urine.
    • Renal Corpuscle: Contains the glomerulus and Bowman's capsule.
      • Glomerulus: A ball of capillaries that filters the blood.
      • Bowman's Capsule: Encloses the glomerulus and collects the filtered fluid (filtrate).
    • Renal Tubule: Extends from the Bowman's capsule and is where filtrate is modified to produce urine.
      • Proximal Convoluted Tubule: Segment of the tubule where most reabsorption occurs.
      • Loop Of Henle: Loop-shaped segment in the medulla that helps to concentrate urine.
      • Distal Convoluted Tubule: Segment connecting the Loop of Henle to the collecting duct.
    • Collecting System: Collects fluids from multiple nephrons and delivers it to the renal pelvis.
      • Collecting Ducts: Carry filtrate from the distal convoluted tubule to the papillary duct.
      • Papillary Duct: Collects fluid from multiple collecting ducts and delivers it to the minor calyx.
      • Minor Calyx: Funnel-shaped structure that receives fluid from multiple papillary ducts.
      • Major Calyx: Larger, funnel-shaped structure that receives fluid from multiple minor calyces.
      • Renal Pelvis: Connects the major calyces to the ureter.

    Kidney Blood Supply

    • Renal Artery: Delivers blood to the kidney.
    • Segmental Arteries: Branches of the renal artery within the renal sinus.
    • Interlobar Arteries: Branches of segmental arteries that run within the renal columns.
    • Arcuate Arteries: Branches of the interlobar arteries that arch along the boundary between the renal cortex and medulla.
    • Cortical Radiate Arteries: Branches of the arcuate arteries that extend into the cortex.
    • Afferent Arterioles: Branches of cortical radiate arteries that supply blood to the glomerulus.
    • Glomerulus: Ball of capillaries where filtration of blood occurs.
    • Efferent Arteriole: Carries blood away from the glomerulus.
    • Peritubular Capillaries: Network of capillaries surrounding the renal tubules, involved in reabsorption.

    Filtration

    • Filtration Membrane: Specialized structure that filters blood in the glomerulus.
      • Fenestrated Capillaries: Capillaries with large pores that allow fluid to exit.
      • Basement Membrane: Specialized layer that prevents large molecules from passing.
      • Filtration Slits: Gaps between podocyte foot processes that further restrict filtration.
    • Glomerular Hydrostatic Pressure (GHP): Blood pressure in the glomerulus, forcing fluid out of the capillaries.
    • Capsular Colloid Osmotic Pressure: Low pressure due to the absence of large molecules in Bowman's capsule.
    • Blood Colloid Osmotic Pressure (BCOP): Pressure due to proteins in the blood, pulling fluid back into the capillaries.
    • Capsular Hydrostatic Pressure (CsHP): Pressure created by fluid in Bowman's capsule, opposing filtration.

    Renal Failure

    • Renal Failure: Inability of the kidneys to filter blood effectively.
      • Acute Renal Failure: Sudden and reversible kidney failure due to injury or disease.
      • Chronic Renal Failure: Progressive and irreversible kidney failure due to long-term disease.
    • Dialysis: Procedure to remove waste products from the blood and maintain fluid balance in people with kidney failure.
    • Kidney Transplant: The only cure for severe renal failure, involves replacing the failed kidney with a healthy one.

    Urinary Tract

    • Urinary Tract: Consists of the ureters, bladder, and urethra, responsible for transporting, storing, and eliminating urine.
      • Ureters: Paired tubes extending from the kidneys to the bladder.
      • Urinary Bladder: Hollow muscular organ that stores urine.
      • Urethra: Tube that carries urine from the bladder to the outside of the body.
    • Micturition Reflex: Reflexive process of urination.
      • Urine Storage Reflex: Sympathetic activity relaxes the detrusor muscle of the bladder and contracts the internal urethral sphincter, holding in urine.
      • Urine Voiding Reflex: Parasympathetic activity contracts the detrusor muscle and relaxes the internal urethral sphincter, allowing urination.
    • External Urethral Sphincter: Skeletal muscle that surrounds the urethra, allowing voluntary control of urination.

    Renal Physiology in Maintaining Homeostasis

    • The urinary system regulates the volume and composition of blood, thus maintaining homeostasis.
    • Urine concentration ranges from 855-1355 mOsm/L.
    • The kidneys excrete metabolic wastes such as urea, creatinine, and uric acid.

    Urine Formation: Three Processes

    • Filtration: Blood pressure forces water and solutes across the glomerular capillaries into the capsular space.
    • Reabsorption: Water and solutes are transported from the tubular fluid across the tubular epithelium into the peritubular fluid.
    • Secretion: Solutes are transported from the peritubular fluid across the tubular epithelium into the tubular fluid.

    Key Components of Nephron and Collecting System

    • Renal Corpuscle: Includes the glomerular capsule (Bowman's capsule) and glomerulus (a capillary network).
    • Proximal Convoluted Tubule (PCT): Reabsorbs nutrients from the filtrate.
    • Nephron Loop: Establishes an osmotic gradient for water reabsorption, composed of thick and thin segments.
    • Distal Convoluted Tubule (DCT): Adjusts tubular fluid composition through reabsorption and secretion.
    • Collecting System: Series of tubules carrying tubular fluid away from the nephron.
    • Collecting Duct: Collects fluid from multiple nephrons and carries it through the renal medulla, lined with intercalated cells and principal cells.

    Mechanisms to Regulate Urine Volume and Concentration

    • Countercurrent Multiplication: Creates a concentration gradient in the renal medulla.
    • Obligatory Water Reabsorption: Occurs in the PCT and descending limb of the nephron loop.
    • Facultative Water Reabsorption: Occurs in the DCT and collecting tubule, controlled by ADH.
    • ADH: Promotes water channels (aquaporins) formation in the DCT and collecting tubule, enhancing water reabsorption.

    Renal Failure

    • Characterized by the kidneys' inability to filter waste and maintain homeostasis.
    • Results in reduced urine production, elevated blood pressure, anemia, and central nervous system problems.

    Urine Volume and ADH

    • Without ADH, no water is reabsorbed in the DCT and collecting tubule, leading to dilute urine.
    • ADH allows water channels to form, resulting in concentrated urine.

    Role of Vasa Recta

    • Absorbs solutes and water from the tubules into the systemic circuit.
    • Contributes to the maintenance of the concentration gradient of the medulla.

    Urinary Disorders

    • Common signs include edema, fever, and pain.
    • Painful or difficult urination is called dysuria.
    • Urinary obstruction at the urethra is more dangerous than at the ureter.

    Key Take Away:

    • The kidneys are vital for maintaining homeostasis through urine formation.
    • Urine formation involves filtration, reabsorption, and secretion processes.
    • Countercurrent multiplication and hormonal regulation play crucial roles in regulating urine volume and concentration.
    • Renal failure can have severe consequences due to its impact on various bodily systems.

    Urine Volume and Concentration

    • Obligatory water reabsorption occurs in the proximal convoluted tubule (PCT) and descending limb of the nephron loop, where water movement cannot be prevented. This process recovers 85% of the filtrate.
    • Facultative water reabsorption occurs in the distal convoluted tubule (DCT) and collecting tubule, allowing precise control of water reabsorption. This process adjusts urine volume by reabsorbing a portion (or all) of the remaining 15% of filtrate volume.
    • Antidiuretic hormone (ADH) allows water channels to form (aquaporins) in the DCT and collecting tubule, increasing water permeability and reabsorption.
    • Normal urine production is about 1200 mL/day with an osmotic concentration of 1000 mOsm/L.

    Renal Function as an Integrative Process

    • The renal corpuscle produces filtrate with the same osmotic composition as plasma (~300 mOsm/L), excluding plasma proteins.
    • The proximal convoluted tubule (PCT) removes ions and organic nutrients from tubular fluid, followed by water due to osmosis, keeping tubular fluid and peritubular fluid isotonic.
    • The PCT and descending limb of the nephron loop are responsible for obligatory water reabsorption, concentrating the tubular fluid.

    Glomerular Filtration and Factors Controlling It

    • The filtration membrane is composed of the fenestrated endothelium of the glomerular capillaries, the basement membrane, and the filtration slits of the podocytes.
    • Blood pressure is higher in glomerular capillaries than in other systemic capillaries due to the larger diameter of the afferent arteriole compared to the efferent arteriole.
    • Blood colloid osmotic pressure draws water out of the filtrate and into the plasma due to the higher concentration of proteins in the plasma.

    Autoregulation and Central Regulation of Glomerular Filtration Rate (GFR)

    • Autoregulation at the local level stabilizes GFR. This involves myogenic mechanisms (constriction or dilation of afferent arterioles due to changes in blood pressure) and tubuloglomerular feedback (responding to changes in NaCl delivery to the distal convoluted tubule).
    • Central regulation involves both endocrine and neural components.
      • The endocrine component is initiated by the kidneys.
      • The neural component involves the sympathetic division of the autonomic nervous system (ANS).
    • The juxtaglomerular complex is involved in central regulation.

    Renal Failure

    • Chronic renal failure involves a gradual deterioration of kidney function, with associated problems accumulating over time. It is not reversible, but progression can be slowed.
    • Acute renal failure involves rapid deterioration of kidney function within a few days, often caused by factors such as toxic drugs, renal ischemia, urinary obstruction, or trauma.

    Dialysis and Renal Failure Treatment

    • Dialysis is a process of passive diffusion across a selectively permeable membrane.
    • Hemodialysis utilizes an artificial membrane to regulate the composition of blood using a dialysis machine.
    • Dialysis fluid is run alongside the membrane containing specific concentrations of solutes, allowing diffusion of ions, nutrients, and organic wastes.
    • Shunts connect blood vessels with the dialysis machine.
    • Dialysis relieves symptoms but is not a cure.
    • Kidney transplant is the only real cure for severe renal failure.

    Urinary Tract, Storage, and Elimination of Urine

    • The urinary tract transports, stores, and eliminates urine. It consists of the ureters, urinary bladder, and urethra.
    • The ureters are paired muscular tubes extending from the kidneys to the urinary bladder.
    • The urinary bladder is a hollow, muscular organ storing urine up to a liter.
    • The urethra is a tube carrying urine from the bladder to the external urethral orifice.
    • A pyelogram x-ray image of the urinary tract can be visualized after administering a radiopaque dye intravenously.

    Kidney Location and Structure

    • The kidneys are retroperitoneal, meaning they are located between the muscles of the posterior body wall and the parietal peritoneum.
    • They are positioned on either side of the vertebral column, protected by visceral organs anteriorly, body wall musculature, and ribs posteriorly and laterally.
    • The left kidney is slightly superior to the right kidney.
    • The kidneys are connected to the urinary bladder by the ureters.
    • The ureters empty into the posterior inferior surface of the urinary bladder.

    Kidney Structure

    • The kidneys are reddish brown in color.
    • They are approximately 10 cm long, 5.5 cm wide, and 3 cm thick.
    • The hilum is a medial indentation where the renal artery, renal nerves, renal vein, and ureter enter and exit the kidney.

    Kidney Support

    • The kidneys are supported by connective tissues:
      • The fibrous capsule is a layer of collagen fibers that covers the outer surface of the kidney and projects fibers through the perinephric fat to the renal fascia.
      • The perinephric fat is a thick layer of adipose tissue surrounding the kidney.
      • The renal fascia is a dense, fibrous outer layer that anchors the kidney to surrounding structures.

    Kidney Internal Structure

    • The kidney is divided into three major regions: the fibrous capsule, the renal cortex, and the renal medulla.
      • The fibrous capsule lines the renal sinus, an internal cavity within the kidney.
      • The renal cortex is the superficial region of the kidney.
      • The renal medulla is the inner region of the kidney, which contains the:
        • Renal pyramids, conical structures with a renal papilla at the tip.
        • Renal columns, which separate adjacent pyramids.
    • A kidney lobe consists of a pyramid, the overlying cortex, and adjacent renal columns. Each kidney contains 6-18 lobes.

    Nephrons

    • Nephrons are the functional units of the kidney.
    • Each nephron has two main parts:
      • The renal corpuscle is responsible for filtration.
        • It consists of a cup-shaped glomerular capsule (Bowman’s capsule) surrounding a capillary network called the glomerulus.
        • The blood pressure within the glomerulus forces water and solutes out of the capillaries and into the capsular space, producing filtrate, a protein-free solution similar to blood plasma.
      • The renal tubule is a tubular passageway that receives filtrate and modifies it to create urine.
        • The renal tubule has four segments:
          • Proximal convoluted tubule (PCT) reabsorbs nutrients from the filtrate (now called tubular fluid).
          • Nephron loop establishes an osmotic gradient for water reabsorption.
          • Distal convoluted tubule (DCT) adjusts tubular fluid composition through reabsorption and secretion.
          • Collecting duct collects fluid from multiple nephrons and carries it through the renal medulla.

    Collecting System

    • The collecting system consists of a series of tubes that carry tubular fluid away from the nephron.
    • The collecting duct has two main types of cells:
      • Intercalated cells play a role in secreting and reabsorbing hydrogen and bicarbonate ions.
      • Principal cells reabsorb water and secrete potassium.

    Urine Formation

    • Three distinct processes occur in urine formation:
      • Filtration occurs only in the renal corpuscle.
      • Reabsorption and secretion vary in the remaining nephron segments.
      • The interaction between the collecting system and the nephron loops regulates the final volume and solute concentration of urine.

    Filtration

    • Filtration is driven by the difference in pressure between the glomerulus and the capsular space:
      • Glomerular hydrostatic pressure (GHP) is the blood pressure within the glomerulus, which forces water and solutes out of the plasma.
      • Capsular hydrostatic pressure (CsHP) is the pressure of filtrate already in the nephron, which opposes GHP.
      • Blood colloid osmotic pressure (BCOP) is the pressure due to materials in solution, which opposes filtration by drawing water out of the filtrate and into the plasma.
      • Capsular colloid osmotic pressure is negligible since few plasma proteins enter the capsular space.

    Glomerular Filtration

    • Blood flows to the glomerulus through an afferent arteriole, a small artery.
    • Blood leaving the glomerulus enters an efferent arteriole, a small artery with a smaller diameter than the afferent arteriole.
    • This smaller diameter increases the blood pressure in the glomerulus, aiding filtration.
    • The juxtaglomerular complex is a specialized structure that secretes renin when glomerular blood pressure decreases.
    • Intraglomerular mesangial cells are supporting cells that lie between glomerular capillaries, controlling capillary diameter and blood flow.

    Glomerular Capsule

    • The glomerular capsule forms the outer wall of the renal corpuscle and covers the glomerular capillaries.
    • It has two layers:
      • Parietal layer forms the outer capsule.
      • Visceral layer covers the capillaries and is composed of podocytes, large cells with foot processes (pedicels) that wrap around the glomerular capillaries.
        • Gaps between pedicels are called filtration slits.

    Filtration Membrane

    • The filtration membrane is composed of three layers:
      • Fenestrated glomerular capillaries: Have large diameter pores.
      • Dense layer: A specialized basement membrane.
      • Filtration slits: From podocytes.
    • The filtration membrane prevents most plasma proteins from entering the capsular space.

    Venous Blood Flow in the Kidney

    • Cortical radiate veins collect blood from the nephron capillaries and drain into the arcuate veins.
    • Arcuate veins drain into the interlobar veins.
    • Interlobar veins drain into the renal vein.
    • The renal vein drains into the inferior vena cava.

    Blood Flow Around a Cortical Nephron

    • Afferent arterioles supply blood to individual nephrons.
    • The glomerulus filters blood.
    • Efferent arterioles carry blood from the glomerulus to the peritubular capillaries.

    Peritubular Capillaries

    • Peritubular capillaries surround the renal tubule and are surrounded by peritubular fluid.
    • They collect water and solutes absorbed by the nephron.
    • They deliver other solutes to the nephron for secretion.
    • They drain into cortical radiate veins.

    Blood Flow Around a Juxtamedullary Nephron

    • Blood flow is the same as a cortical nephron until after the peritubular capillaries.
    • Vasa recta (straight vessels) are connected to the distal end of the peritubular capillaries.
    • Vasa recta are long, straight capillaries that parallel the nephron loop.
    • They transport water and solutes within the renal medulla.
    • They drain into cortical radiate veins.

    Connective Tissues Supporting the Kidney

    • Perinephric fat is a thick layer of adipose tissue.
    • Renal fascia anchors the kidney to surrounding structures with a dense, fibrous outer layer.

    Kidney’s Position

    • If the perinephric fat layer were depleted and collagen fibers of the fibrous capsule detached, the kidney could move.

    Major Structural Landmarks of the Kidney

    • Fibrous capsule lines the renal sinus.
    • Renal cortex is the superficial region of the kidney.
    • Renal medulla is the inner region of the kidney.
    • Renal pyramids are cone-shaped structures in the medulla.
    • Renal papilla is the tip of the pyramid.
    • Renal columns separate adjacent pyramids.
    • A kidney lobe is a pyramid, the overlying cortex, and adjacent renal columns.
    • Each kidney contains 6–18 lobes.

    Glomerular Capsule

    • Glomerular capsules form the outer wall of the renal corpuscle and cover the glomerular capillaries.
    • Parietal layer forms the outer capsule.
    • Visceral layer covers the capillaries.
    • Podocytes (foot cells) make up the visceral layer and have large cells with foot processes (pedicels) that wrap around the glomerular capillaries
    • Gaps between pedicels are filtration slits.

    Filtration Membrane

    • Fenestrated glomerular capillaries have pores.
    • A specialized basement membrane is the dense layer.
    • Filtration slits from podocytes contribute to the membrane.

    Factors Controlling Glomerular Filtration

    • Glomerular hydrostatic pressure (GHP) is blood pressure in the glomerular capillaries which pushes water and solutes out of the plasma and into the filtrate.
    • Capsular colloid osmotic pressure has few plasma proteins in the capsular space.
    • Blood colloid osmotic pressure (BCOP) is pressure due to materials in solution that draws water out of the filtrate and into the plasma.
    • Capsular hydrostatic pressure (CsHP) opposes GHP and pushes water and solutes out of the filtrate and into the plasma.
    • CsHP results from resistance of filtrate in the nephron.

    Urethra

    • The urethra extends from the neck of the urinary bladder to the exterior of the body.
    • It is different lengths and functions in males versus females.
    • The male urethra is longer and transports semen as well as urine.

    Urinary Bladder

    • The urinary bladder is filled by the ureters and drained by the urethra.
    • The dimensions vary with distension.
    • The posterior, inferior, and anterior surfaces are outside the peritoneal cavity
    • It is anchored to the pelvic and pubic bones by supporting ligaments.
    • Lateral umbilical ligaments are vestiges of the umbilical arteries.
    • The middle umbilical ligament is also present.

    Urinary Bladder: Rugae and Orifice

    • Rugae are folds in the bladder lining that disappear with expansion as the bladder fills.
    • Ureteric orifices are slitlike to prevent urine backflow.

    Urinary Bladder: Ureters and Trigone

    • Ureters penetrate the posterior bladder wall at an oblique angle.
    • Trigone is a triangular area bounded by the ureteral openings and the entrance to the urethra.

    Urinary Bladder: Internal Urethral Sphincter and Neck

    • The neck of the urinary bladder surrounds the urethral opening.
    • The internal urethral sphincter is involuntary smooth muscle.

    Urinary Bladder: External Urethral Sphincter

    • The external urethral sphincter is under voluntary control where the urethra passes through the urogenital diaphragm.
    • Voluntary relaxation of the external urethral sphincter is necessary for urination.

    Ureters

    • The inner mucosa has transitional epithelium and a surrounding lamina propria.
    • The middle muscular layer has bands of smooth muscle that create peristaltic waves to move urine to the bladder.
    • The outer connective tissue layer is continuous with the fibrous capsule and peritoneum.

    Wall of the Urinary Bladder

    • The wall contains mucosa, submucosa, and muscularis layers.
    • The muscularis layer has three layers: inner longitudinal, circular, and outer longitudinal.
    • These layers, altogether, make up the detrusor muscle.

    Wall of the Urethra

    • It is lined with stratified epithelium that varies in location: transitional at the neck, stratified columnar at midpoint, and stratified squamous near the external urethral orifice.
    • It has a thick, elastic lamina propria.
    • Longitudinal folds in the mucous membrane contain mucin-secreting cells.

    Countercurrent Multiplication

    • An increase in sodium and chloride ions in the peritubular fluid affects the descending thin limb of the nephron loop by increasing the water permeability of the descending limb, further concentrating the tubular fluid.
    • This process, known as countercurrent multiplication, is critical to the formation of a concentration gradient in the renal medulla.

    Renal Medulla

    • The renal medulla has a high osmotic pressure, which is crucial for the concentration of urine.
    • This gradient is established by the countercurrent multiplier system, which involves interactions between the descending thin limb of the nephron loop, the ascending thin limb, and the vasa recta.

    Obligatory vs. Facultative Water Reabsorption

    • Obligatory water reabsorption occurs in the proximal convoluted tubule (PCT) and descending limb of the nephron loop, and is essential for the recovery of 85% of the filtrate. Water reabsorption is not regulated in this process.
    • Facultative water reabsorption occurs in the distal convoluted tubule (DCT) and collecting tubule, where the reabsorption of water is regulated by the hormone ADH. This mechanism allows precise control over urine volume.

    ADH & Water Reabsorption

    • Antidiuretic hormone (ADH) plays a crucial role in regulating water reabsorption in the DCT and collecting tubule.
    • ADH stimulates the formation of water channels called aquaporins in the apical plasma membranes of the DCT and collecting tubule cells, increasing their permeability to water.

    Collecting System

    • The collecting system consists of collecting ducts and papillary ducts.
    • Collecting ducts receive urine from multiple nephron segments, and papillary ducts collect fluid from multiple collecting ducts, delivering it to the minor calyx.

    Nephron Innervation

    • The kidneys are innervated by renal nerves, mainly sympathetic postganglionic fibers. These nerves follow the renal artery branches.
    • These nerves regulate blood flow and blood pressure at the glomeruli, and stimulate the release of renin.

    Blood Flow in the Kidney

    • Blood enters the kidney via the renal artery and exits via the renal vein.
    • The renal artery branches into segmental arteries, interlobar arteries, arcuate arteries, cortical radiate arteries, and finally, afferent arterioles that supply each nephron.
    • Each nephron receives blood from an afferent arteriole that branches into a capillary network called a glomerulus.
    • Blood leaves the glomerulus via efferent arterioles, which then lead to peritubular capillaries that surround the nephron tubules.
    • In juxtamedullary nephrons, the efferent arterioles lead to vasa recta, which are capillaries in the renal medulla.

    Glomerular Filtration Rate

    • The glomerular filtration rate (GFR) is the volume of filtrate formed per minute.
    • It is regulated by factors including blood pressure, blood flow, and the permeability of the filtration membrane.

    Transport Mechanisms in the Nephron

    • The proximal and distal convoluted tubules utilize various active and passive transport mechanisms for reabsorption and secretion.
    • The PCT is responsible for the reabsorption of most nutrients, electrolytes, and water.
    • The DCT is involved in the fine-tuning of electrolyte levels and contributes to the reabsorption of water and bicarbonate ions.

    Renal Failure

    • Chronic renal failure is a progressive deterioration of kidney function, often caused by chronic diseases.
    • Acute renal failure is a sudden decline in kidney function that often occurs due to acute conditions such as infections, trauma, or toxic exposure.
    • Dialysis is a process used to filter blood and remove waste products, providing temporary treatment for renal failure.
    • Kidney transplant is the only permanent solution for end-stage renal failure.

    Urinary Tract

    • The urinary tract is responsible for transporting, storing, and eliminating urine. It includes the ureters, urinary bladder, and urethra.
    • The ureters are paired muscular tubes that connect the kidneys to the urinary bladder.
    • The urinary bladder is a hollow muscular organ that stores urine.
    • The urethra is a tube that carries urine from the bladder to the outside.

    Urine Storage and Voiding Reflexes

    • Urine storage is controlled by the autonomic nervous system.
    • The bladder fills with urine, and the internal sphincter relax, allowing urine to pass into the urethra.
    • The external sphincter, under voluntary control, regulates urine release.
    • The urine voiding reflex is a combination of involuntary and voluntary responses.

    Nephron Innervation

    • Each kidney contains approximately 1.25 million nephrons.
    • Both cortical and juxtamedullary nephrons receive innervation from renal nerves.
    • Renal nerves enter the kidney at the hilum and follow the branches of the renal artery.
    • Most renal nerve fibers are sympathetic postganglionic fibers from the celiac plexus and inferior splanchnic nerves.
    • Sympathetic stimulation adjusts blood flow and pressure at the glomeruli.
    • Sympathetic stimulation also stimulates the release of renin.

    Blood Flow in the Kidney

    • Blood enters the kidney through the renal artery.
    • The renal artery branches into segmental arteries, interlobar arteries, arcuate arteries, interlobular arteries, and afferent arterioles.
    • Afferent arterioles deliver blood to the glomerulus.
    • The glomerulus is a network of capillaries within the renal corpuscle.
    • Blood exits the glomerulus through the efferent arteriole.
    • The efferent arteriole branches into peritubular capillaries, which surround the renal tubules.
    • Peritubular capillaries and vasa recta return blood to the renal vein.
    • The renal vein carries blood back to the inferior vena cava.

    Overview of Renal Physiology

    • Kidneys maintain homeostasis by regulating the volume and composition of blood.
    • Kidneys concentrate urine to 855–1355 mOsm/L.
    • Kidneys excrete solutes, particularly metabolic wastes.

    Metabolic Wastes

    • Urea is the most abundant organic waste.
    • Urea results from the breakdown of amino acids.
    • Creatinine results from the breakdown of creatine phosphate in muscles.
    • Uric acid forms during the recycling of nitrogenous bases of RNA.

    Urine Formation

    • Filtration, reabsorption, and secretion are the three key processes involved in urine formation.
    • Filtration forces water and small solutes from the blood in the glomerular capillaries into the capsular space.
    • Reabsorption involves the movement of water and solutes from the tubular fluid across the tubular epithelium into the peritubular fluid.
    • Secretion is the movement of solutes from the peritubular fluid across the tubular epithelium into the tubular fluid.

    Nephron Segments and Urine Formation

    • Filtration only occurs in the renal corpuscle.
    • The proximal convoluted tubule (PCT) primarily reabsorbs water and solutes.
    • The loop of Henle is responsible for concentrating the filtrate.
    • The distal convoluted tubule (DCT) fine-tunes the composition of tubular fluid.
    • The collecting duct concentrates urine and regulates water reabsorption.

    Filtration

    • Filtration occurs at the renal corpuscle.
    • The afferent arteriole carries blood to the glomerulus.
    • The glomerulus is a knot of capillaries where filtration takes place.
    • The efferent arteriole carries blood away from the glomerulus.
    • The capsular space is the region between the glomerulus and the glomerular capsule.
    • The juxtaglomerular complex secretes renin in response to a decrease in glomerular blood pressure.

    Reabsorption

    • The proximal convoluted tubule reabsorbs most of the water, solutes, and nutrients from the glomerular filtrate.
    • The descending limb of the loop of Henle is permeable to water and reabsorbs water.
    • The ascending limb of the loop of Henle is impermeable to water and reabsorbs sodium chloride.

    Secretion

    • The distal convoluted tubule and collecting duct are involved in secretion and fine-tuning urine composition.
    • The DCT secretes potassium, hydrogen ions, and organic wastes into the tubular fluid.

    Renal Failure

    • Dialysis removes wastes and excess fluids from the blood in patients with renal failure.
    • A kidney transplant is the only permanent cure for end-stage renal disease.
    • Immunosuppressant drugs are necessary after a transplant to prevent rejection.

    Urinary Tract

    • The urinary tract transports, stores, and eliminates urine.
    • The urinary tract includes the ureters, urinary bladder, and urethra.
    • Ureters are muscular tubes that carry urine from the kidneys to the bladder.
    • The urinary bladder stores urine until it is released through urination.
    • The urethra is a tube that carries urine from the bladder to the outside of the body.

    Urine Storage and Voiding

    • The bladder is a muscular organ that stretches to accommodate urine.
    • Urine storage depends on the bladder's ability to relax and expand.
    • Urine voiding occurs when the bladder contracts and the internal urethral sphincter relaxes.

    Urinary Disorders

    • Urinary disorders involve problems with urine production, storage, or elimination.
    • Urinary tract infections (UTIs) are common and involve bacterial infections in the urinary tract.
    • Urinary incontinence is the inability to control urine flow and can be due to various causes.
    • Kidney stones are mineral deposits that form in the urinary tract and can cause pain and blockages.

    Kidney Location and Structure

    • The kidneys are retroperitoneal organs, meaning they are located behind the peritoneum
    • The kidneys are located in the superior lumbar region, on either side of the vertebral column
    • Each kidney is surrounded by three layers of connective tissue
      • Fibrous capsule is the innermost layer that forms a smooth, transparent covering that helps maintain the kidney shape
      • Perinephric fat capsule is the middle layer that helps cushion the kidney and hold it in place.
      • Renal fascia is the outermost layer that anchors the kidney to surrounding structures such as the abdominal wall

    Kidney Gross Anatomy

    • The renal sinus refers to the internal cavity within the kidney
    • The renal cortex is the superficial region of the kidney, just beneath the fibrous capsule
    • The renal medulla is the inner region of the kidney, composed primarily of renal pyramids
    • The renal pyramids are conical structures in the medulla that have broader bases that face the cortex and a tip called the renal papilla that points towards the renal sinus
    • The renal columns are extensions of the cortex that separate adjacent pyramids
    • A kidney lobe is a structural unit of the kidney, formed by a renal pyramid, the overlying cortex, and the adjacent renal columns
    • Each kidney typically contains 6-18 lobes

    Nephron

    • The nephron is the functional unit of the kidney, responsible for the production of urine
    • Each kidney contains roughly 1 million nephrons
    • The main parts of a nephron are:
      • Renal corpuscle:
        • Glomerular capsule (Bowman's capsule): A cup-shaped chamber that surrounds the glomerulus
        • Glomerulus: A network of capillaries where filtration occurs
      • Renal tubule: A tubular passageway that receives filtrate and modifies it to create urine. The renal tubule is subdivided into four segments:
        • Proximal convoluted tubule (PCT): The first segment; reabsorbs nutrients, water, ions, and other substances from the filtrate
        • Nephron loop (loop of Henle): Forms a hairpin loop, has two limbs — a descending limb and an ascending limb; establishes an osmotic gradient for water reabsorption
        • Distal convoluted tubule (DCT): The fourth segment; makes final adjustments to tubular fluid composition through reabsorption and secretion

    Collecting System

    • The collecting system is a series of tubes within the kidney that carries tubular fluid away from nephrons and into the ureter
    • The collecting system consists of:
      • Collecting duct: Collects filtrate from multiple nephrons and carries it through the renal medulla
      • Papillary duct: Collects fluid from several collecting ducts and delivers it to a minor calyx

    Kidney Circulation

    • The renal artery delivers blood to the kidney
    • The renal artery branches into:
      • Segmental arteries: Located in the renal sinus
      • Interlobar arteries: These arteries run within the renal columns
      • Arcuate arteries: These arteries arch along the boundary between the cortex and the medulla
      • Cortical radiate arteries: These arteries branch from arcuate arteries and extend into the cortex
      • Afferent arterioles: These very small arteries deliver blood to the glomerulus
      • Efferent arterioles: These arterioles drain blood from the glomerulus

    Nephron Transport

    • The Proximal convoluted tubule primarily reabsorbs solutes and water from the filtrate
      • This process is driven by active and passive transport mechanisms and includes reabsorption of >99 percent of glucose, amino acids, and other organic nutrients, as well as sodium, potassium, bicarbonate, magnesium, phosphate, and sulfate ions
      • Water follows the solute movement by osmosis, resulting in a decrease in the solute concentration of the tubular fluid
    • The Distal convoluted tubule fine-tunes the composition of the filtrate
      • It reabsorbs sodium ions in exchange for potassium ions and hydrogen ions are secreted in exchange for sodium ions
      • These processes are regulated by hormones, such as aldosterone, and help to maintain pH balance in the body
    • The nephron loop plays a crucial role in creating an osmotic gradient in the renal medulla, which is essential for the production of concentrated urine.
      • The process of countercurrent multiplication occurs in the nephron loop where the descending limb is permeable to water but impermeable to solutes, and the ascending limb is impermeable to water but actively pumps sodium and chloride ions into the peritubular fluid.
      • The result is an increase in the osmotic concentration of the peritubular fluid, which drives water reabsorption from the descending limb

    Kidney Circulation

    • Blood is collected from the nephron capillaries by the cortical radiate veins
    • Cortical radiate veins drain into the arcuate veins
    • Arcuate veins drain into interlobar veins, which drain into the renal vein.
    • The renal vein drains into the inferior vena cava
    • The afferent arteriole supplies blood to individual nephrons
    • The glomerulus is a cluster of capillaries where filtration occurs
    • The efferent arteriole carries blood away from the glomerulus to the peritubular capillaries
    • Peritubular capillaries surround the renal tubule and are surrounded by peritubular fluid
    • Peritubular capillaries collect water and solutes absorbed by the nephron and drain into cortical radiate veins
    • Vasa recta are long, straight capillaries that parallel the nephron loop in juxtamedullary nephrons
    • Vasa recta transport water and solutes within the renal medulla and drain into cortical radiate veins

    The Urinary System

    • Major excretory organs of the urinary system are the kidneys, ureters, urinary bladder, and urethra
    • Kidneys receive 25% of cardiac output and produce urine
    • Ureters transport urine from the kidneys to the bladder
    • Urinary bladder stores urine and contracts to drive urination
    • Urethra conducts urine from the bladder to the exterior of the body

    Kidney Function

    • The kidneys maintain homeostasis by regulating blood volume and composition
    • Urine concentration is between 855 and 1355 mOsm/L
    • The kidneys excrete solutes, including urea, creatinine and uric acid

    Urine Formation

    • Filtration forces water and solutes from the glomerular capillaries into the capsular space
    • Reabsorption transports water and solutes from the tubular fluid into the peritubular fluid
    • Secretion transports solutes from the peritubular fluid across the tubular epithelium into the tubular fluid.

    Nephron Function

    • Filtration occurs only at the renal corpuscle
    • The renal corpuscle consists of the glomerulus and glomerular capsule
    • The balance between reabsorption and secretion varies in each nephron segment
    • The collecting system interacts with the nephron to regulate final volume and solute concentration

    Filtration

    • The afferent arteriole delivers blood to the glomerulus
    • The glomerulus is a network of capillaries where filtration occurs
    • The efferent arteriole carries blood from the glomerulus to the peritubular capillaries
    • The capsular space is located between the inner and outer layers of the glomerular capsule
    • The juxtaglomerular complex secretes renin when glomerular blood pressure decreases
    • Intraglomerular mesangial cells support the glomerular capillaries and control capillary diameter

    Urinary Disorders

    • Polyuria is excessive urine production and can be caused by diabetes or glomerulonephritis
    • Oliguria is reduced urine production (50-500 mL/day)
    • Anuria is severely reduced urine production (0-50 mL/day)
    • Increased urgency or frequency of urination can be caused by irritation of the ureters or bladder
    • Incontinence is the inability to control urination voluntarily
    • Urinary retention is the inability to urinate despite having a full bladder

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    Description

    Explore the key differences between the male and female urethra, including their structures and lengths. Additionally, learn about the anatomy of the urinary bladder, its function, and essential features. This quiz will test your knowledge of these important components of the urinary system.

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