Anatomy of the Urinary System Quiz

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Questions and Answers

Which structure encapsulates the blood filtering system of the kidney?

  • Bowman's capsule (correct)
  • Glomerulus
  • Distal convoluted tubule
  • Renal tubule

What role does the juxtaglomerular apparatus play in the kidney?

  • Filters blood in the renal capsule
  • Secretes anti-diuretic hormone
  • Produces urine directly
  • Regulates the function of each nephron (correct)

What happens when systemic blood pressure decreases?

  • Juxtaglomerular cells are stretched more
  • Renin secretion stops completely
  • Filtration in the glomerulus increases
  • Juxtaglomerular cells release more renin (correct)

In which parts of the nephron does reabsorption primarily occur?

<p>Proximal convoluted tubules, Henle’s loop, and distal convoluted tubules (C)</p> Signup and view all the answers

Which hormones are secreted to help maintain fluid and electrolyte balance in the kidneys?

<p>Anti-diuretic hormone (ADH) and aldosterone (C)</p> Signup and view all the answers

What primarily occurs in the distal convoluted tubule?

<p>Secretion of certain ions, nitrogenous waste, and drugs (D)</p> Signup and view all the answers

What is the normal serum creatinine level range for adult females?

<p>0.6 to 1 mg/dl (C)</p> Signup and view all the answers

Which factor has the least effect on serum creatinine levels?

<p>Muscle mass (D)</p> Signup and view all the answers

What indicates a decline in renal function when assessing creatinine levels?

<p>Increased serum level and decreased urine level (C)</p> Signup and view all the answers

Why is urine osmolality testing preferred over specific gravity?

<p>It measures concrete solute levels. (C)</p> Signup and view all the answers

What is considered a normal Prostatic-Specific Antigen (PSA) level?

<p>Less than 4 ng/ml (C)</p> Signup and view all the answers

Which condition can cause an elevation in PSA levels?

<p>Prostate cancer (C)</p> Signup and view all the answers

What should be avoided during the creatinine clearance testing period?

<p>Excessive physical activity (D)</p> Signup and view all the answers

What does urine osmolality help to determine regarding kidney function?

<p>The ability of the kidneys to concentrate urine (C)</p> Signup and view all the answers

Creatinine is a byproduct of which physiological process?

<p>Muscle contraction (C)</p> Signup and view all the answers

Which option correctly describes creatinine clearance?

<p>It assesses renal function through serum and urine levels. (A)</p> Signup and view all the answers

What is crucial to monitor after a procedure involving renal angiography?

<p>Neurovascular checks every 15 minutes for the first hour (C)</p> Signup and view all the answers

Post-procedure care for a patient who has undergone a biopsy involves:

<p>Monitoring the first urine void for signs of bleeding (B)</p> Signup and view all the answers

Which statement regarding nephroscopy is accurate?

<p>It provides direct visualization of upper urinary structures (B)</p> Signup and view all the answers

What is the primary function of the kidneys?

<p>To remove waste, excess water, and electrolytes from the blood (A)</p> Signup and view all the answers

Which part of the kidney serves as the outer covering made of strong connective tissue?

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

Where does urine drain after passing through the papillae?

<p>Calyces (A)</p> Signup and view all the answers

What is the functional unit of the kidney called?

<p>Nephron (B)</p> Signup and view all the answers

What condition is indicated by the presence of ketone bodies in urine?

<p>Diabetes mellitus (D)</p> Signup and view all the answers

What does an increase in urine specific gravity generally indicate?

<p>Dehydration (C)</p> Signup and view all the answers

What is the normal range for blood urea nitrogen (BUN)?

<p>10 to 20 mg/dl (C)</p> Signup and view all the answers

Which substance's presence in urine indicates urinary tract infection?

<p>Leukocytes (C)</p> Signup and view all the answers

What is a condition that may lead to hematuria?

<p>Renal calculus (D)</p> Signup and view all the answers

What does a high blood urea nitrogen (BUN) level indicate?

<p>Low hydration status (C)</p> Signup and view all the answers

What is one of the main roles of serum creatinine tests?

<p>To diagnose impaired kidney function (A)</p> Signup and view all the answers

What can decreased urine specific gravity indicate?

<p>Excess fluid intake (A)</p> Signup and view all the answers

What is the primary function of the ureters in the urinary system?

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

What changes occur in the urinary system of older adults?

<p>Loss of bladder tone and potential for incontinence (A)</p> Signup and view all the answers

What is the primary function of the kidneys related to blood?

<p>To filter waste and excess substances from the blood (D)</p> Signup and view all the answers

What is a common cause of urinary frequency and urgency in older adults?

<p>Diminished bladder capacity and weakened musculature (A)</p> Signup and view all the answers

Which part of the kidney contains the renal tubules?

<p>Renal cortex (C)</p> Signup and view all the answers

What can lead to an increased risk of urinary tract infections in older adults?

<p>Incomplete emptying of the bladder (A)</p> Signup and view all the answers

Which structure serves as the functional unit of the kidney?

<p>Nephron (B)</p> Signup and view all the answers

What is the function of papillae in the renal medulla?

<p>To drain urine into the calyces (C)</p> Signup and view all the answers

How do the kidneys respond to low oxygen levels in body tissues?

<p>By secreting erythropoietin (D)</p> Signup and view all the answers

Flashcards

What is a nephron?

The functional unit of the kidney responsible for filtering blood and producing urine.

What is a glomerulus?

A tightly bound network of capillaries within the renal corpuscle where blood is filtered.

What is the renal cortex?

The outer layer of the kidney, containing millions of renal tubules.

What is the renal medulla?

The inner layer of the kidney, containing the renal pyramids.

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What are the three main functions of the nephron?

They control body fluid levels, regulate blood pH, and remove waste.

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What is a calyx?

The cup-shaped structure that receives urine from the renal pyramids before it drains into the renal pelvis.

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What is the hilus of the kidney?

A notch on the inner border of the kidney where blood vessels, nerves, and the ureter enter and exit.

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Renal Angiography

Procedure where a catheter is inserted into the renal artery to evaluate blood supply to the kidneys. Contrast is injected to visualize the renal artery.

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Brush Biopsy

A procedure where a nylon brush is used to obtain specimens from the renal pelvis or calyces during a cystoscopy.

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Cystoscopy

A procedure where a scope is passed into the bladder to visualize the interior and collect samples or treat conditions.

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Nephroscopy

A procedure where access to the urinary tract is gained through the skin to directly visualize the upper urinary structures.

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Renal Venography

Procedure used to evaluate the kidney's venous drainage.

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Hematuria

The presence of erythrocytes (red blood cells) in the urine.

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Renal Calculus

Kidney stones, also known as renal calculi, are solid masses that form in the kidneys.

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Ketoaciduria (Ketonuria)

The presence of ketone bodies in the urine, often due to excessive breakdown of fatty acids.

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Leukocytes in Urine

White blood cells in the urine, typically indicating an infection in the urinary tract.

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Urine Specific Gravity

The density of urine compared to water, reflecting the patient's hydration status.

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Blood Urea Nitrogen (BUN)

A blood test that measures the amount of urea nitrogen in the blood, reflecting the kidney's ability to filter waste products.

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Serum Creatinine

A blood test that measures the amount of creatinine in the blood, a by-product of muscle breakdown, which is primarily filtered by the kidneys.

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Glomerulonephritis

Inflammation of the glomeruli, the filtering units of the kidneys.

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Pyelonephritis

Infection of the kidney.

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Acute Tubular Necrosis

Damage to the tubules of the nephron, the functional unit of the kidney.

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Glomerular Filtration Rate Control

The difference in diameter between the afferent and efferent arterioles controls the rate of glomerular filtration.

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Bowman's Capsule

A cup-like structure that surrounds the glomerulus, where blood is filtered.

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Renal Tubule

The long, winding tube in the kidney where filtered fluid travels and is processed into urine.

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Reabsorption

The process of taking back valuable substances (water, glucose, ions) from the filtered fluid and returning them to the blood.

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Secretion

The process of adding unwanted substances (waste products, drugs) from the blood to the filtered fluid.

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Juxtaglomerular Apparatus (JGA)

A microscopic structure located near the glomerulus, responsible for regulating blood pressure and filtration rate.

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Renin

An enzyme released by the JGA when blood pressure drops, triggering a chain reaction to increase blood pressure.

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Collecting Duct

The final stage of urine formation, where water and electrolytes are adjusted to create the final urine concentration.

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Stages of Urine Formation

The three steps involved in urine production: Filtration, Reabsorption, and Secretion.

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What is creatinine?

Creatinine is a byproduct of muscle metabolism, produced at a steady rate based on muscle mass.

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Why is creatinine a better indicator of kidney function than BUN?

Creatinine levels are primarily influenced by kidney function, unlike BUN which can be affected by factors like dehydration and liver function.

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What's the normal range for creatinine?

The normal creatinine range for females is 0.6 to 1 mg/dL, while for males it's 0.7 to 1.3 mg/dL. This difference is due to the generally larger muscle mass in males.

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What is creatinine clearance?

Creatinine clearance is a test that measures how effectively your kidneys are filtering waste products from your blood.

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What is the patient's role in creatinine clearance testing?

During creatinine clearance testing, patients are asked to avoid strenuous physical activity as it can influence creatinine production.

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What do abnormal creatinine levels indicate?

An elevated serum creatinine level combined with a decline in urine creatinine level indicates potential kidney problems.

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What is PSA?

PSA (Prostatic-Specific Antigen) is a protein produced by the prostate gland.

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Why is PSA important?

PSA is used in the diagnosis and monitoring of prostate health, particularly in men being treated for prostate cancer.

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What can lead to elevated PSA levels?

Elevated PSA levels can occur due to various factors including prostate cancer, benign prostatic hypertrophy (BPH), and prostatitis.

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What does urine osmolality tell us?

Urine osmolality measures the concentration of particles (solutes) in urine, providing information on the kidneys' ability to concentrate urine.

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What are the main tasks of a nephron?

The main functions of the nephron are to control fluid levels, regulate blood pH, and remove waste products.

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What are ureters and what is their function?

Ureters are tubes that carry urine from the kidneys to the bladder. They act as valves to prevent urine from flowing back into the kidneys.

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What is the bladder and what's its role in the urinary system?

The bladder is a muscular sac that stores urine before it is eliminated from the body. It expands as it fills with urine and signals the need to urinate when it's about 1/3 full.

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What is the urethra and what does it do?

The urethra is the final tube that carries urine from the bladder to the outside of the body.

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What are some normal changes to the urinary system as we age?

Normal age-related changes to the urinary system include: Decreased kidney filtering efficiency, loss of bladder tone, and prostate enlargement in men.

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What are common urinary problems in older adults?

Common urinary problems in the elderly include frequent urination, urgent need to urinate, nighttime urination, and incontinence.

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Study Notes

Anatomy of the Urinary System

  • The urinary system is crucial for homeostasis, maintaining balance in the body.
  • It comprises two kidneys, two ureters, a bladder, and a urethra.
  • Kidneys remove waste, excess water, and electrolytes from the blood, concentrating them into urine, and secrete erythropoietin to stimulate red blood cell production.
  • Kidneys are located behind the parietal peritoneum, roughly 4-5 inches (10-12 cm) long, 2-3 inches (5-7.5 cm) wide, and 1 inch (2.5 cm) thick.
  • The right kidney is lower than the left due to the liver's position.
  • Each kidney is surrounded by adipose tissue.
  • The hilus, a notch near the kidney's center, is where the ureter, blood vessels, and nerves enter and exit.

Gross Anatomy of the Kidney

  • The renal capsule, a strong connective tissue covering, surrounds the kidney.
  • The renal cortex lies just beneath the capsule and contains 1.25 million renal tubules.
  • The renal medulla is deeper and darker in color, containing triangular pyramids.
  • Urine drains from the pyramid papillae into the calyces.
  • Calyces drain into the renal pelvis, which is the upper extension of the ureters.
  • Ureters carry urine to the bladder, which expels urine via the urethra.

Microscopic Structure of the Kidney

  • The nephron is the functional unit of the kidney, with over one million per kidney.
  • Nephrons filter blood and process urine.
  • Nephrons have three major functions.

Urine Formation

  • Filtration of water and blood products occurs in the glomerulus of Bowman's capsule.
  • Reabsorption of water, glucose, and necessary ions back into the bloodstream occurs mainly in the proximal convoluted tubules, Henle's loop, and the distal convoluted tubules.
  • Secretion of certain ions, waste products, and drugs primarily takes place in the distal convoluted tubule.

Urine Composition and Characteristics

  • Urine is mostly water (95%) with the remainder being nitrogenous waste and salts.
  • Normal urine color is yellow due to urochrome.
  • Urine maintains a consistent pH and electrolyte balance.
  • Urine excretion helps regulate blood pressure and maintain homeostasis.

Other Urinary System Components

  • Ureters transport urine from the kidneys to the bladder.
  • The bladder stores urine and expels it via the urethra.
  • With aging, kidneys lose function, blood supply decreases, and nephron numbers diminish.
  • Potential incontinence issues may arise with aging for both men and women, particularly in the form of stress incontinence for women and constriction of the urethra due to an enlarged prostate in men.

Urine Tests

  • Routine urinalysis: examination of urine's physical and chemical characterstics to detect medical issues, including color, clarity, odor, pH, specific gravity, and presence of substances like glucose, protein, ketones, red blood cells, and white blood cells.
  • 24-hour urine: measuring excreted substances over 24 hours for a comprehensive evaluation of kidney function, including protein, creatinine, urea, uric acid, and catecholamines (Epinephrine and Norepinephrine).
  • Blood urea nitrogen (BUN) and serum creatinine measurements assess kidney function, and normal ranges are provided.

Other Diagnostic Procedures

  • Renal angiography—evaluates blood supply to the kidneys, assesses masses, and detects potential transplant complications.
  • Intravenous pyelography (IVP)—evaluates the urinary tract using contrast dye to visualize the renal pelvis, ureters, and bladder.
  • Computed tomography scan (CT)—creates detailed images of the kidneys, bladder, and other organs, often including the structures in a cross-sectional view.
  • Magnetic resonance imaging (MRI)—produces detailed anatomical images of the urinary system, often used for more in-depth evaluations.
  • Ultrasonography—employs sound waves to create images of internal structures, often used for initial evaluation of the urinary tract.
  • Cystoscopy—uses a scope to view the urinary bladder and urethra for diagnosis or treatment, often allowing biopsies or other procedures to be performed.
  • Retrograde pyelography—injects contrast dye to visualize the upper urinary tract (including ureters and renal pelvis).
  • Voiding cystourethrography—evaluates the bladder and urethra using contrast dye to assess for infections or structure problems during urination.
  • Urodynamic studies—assesses bladder muscle activity and the flow of urine, often used to evaluate incontinence.
  • Renal scan—a series of images to examine the kidneys and their blood supply.
  • Transrectal ultrasound—used to visualize and evaluate the prostate gland.
  • Renal Biopsy—a procedure in the assessment for diseases and complications impacting the kidneys
  • Procedures using contrast material should have patient preparation (NPO) and consideration of allergies to iodine or contrast agents.

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