Kidney and Bladder Anatomy Quiz

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Questions and Answers

Which part of the nephron is primarily involved in selective reabsorption?

  • Proximal convoluted tubule (correct)
  • Bowman's capsule
  • Collecting duct
  • Loop of Henle

In which condition does the bladder fail to empty completely?

  • Stress incontinence
  • Urinary retention (correct)
  • Polyuria
  • Oliguria

What is a potential cause of oliguria in a patient with acute kidney injury?

  • Enhanced urine production
  • Decreased renal blood flow (correct)
  • Increased glomerular filtration rate
  • Increased urine output

Why are urinary tract infections more common in women?

<p>Women's urethras are shorter (D)</p> Signup and view all the answers

What complication can arise from an untreated urinary tract infection?

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

What is the primary function of the kidneys?

<p>Filtering blood and removing waste products (C)</p> Signup and view all the answers

Which type of nephron is primarily responsible for urine concentration?

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

What does the glomerulus do?

<p>Filters blood and allows small molecules to pass (D)</p> Signup and view all the answers

What is the primary role of the detrusor muscle?

<p>To contract and allow urine outflow (A)</p> Signup and view all the answers

What defines the condition known as anuria?

<p>Absence of urine production (D)</p> Signup and view all the answers

Where are cortical nephrons primarily located?

<p>In the renal cortex (B)</p> Signup and view all the answers

Which part of the urinary system controls the release of urine from the bladder?

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

How many nephrons does each kidney contain, approximately?

<p>1 to 1.5 million (C)</p> Signup and view all the answers

What is the condition defined by the production of abnormally large volumes of urine, often exceeding 3 litres per day?

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

Which condition is characterized by a significantly reduced urine output, typically less than 400 ml/day?

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

What condition involves the frequent and sudden urge to urinate, which may lead to incontinence?

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

Which term describes the presence of blood in urine, which can indicate kidney stones or infections?

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

What is the primary function of the kidneys related to water and electrolyte balance?

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

Which condition is characterized by the inability to empty the bladder completely?

<p>Urinary Retention (D)</p> Signup and view all the answers

What causes involuntary leakage of urine during activities that increase internal pressure?

<p>Stress Incontinence (D)</p> Signup and view all the answers

What is the condition called where someone cannot urinate in the presence of others due to anxiety?

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

What is a key function of angiotensin II in the body?

<p>Promoting sodium and water retention (A)</p> Signup and view all the answers

In metabolic acidosis, which compensatory mechanism do the lungs utilize?

<p>Increase the rate and depth of breathing (A)</p> Signup and view all the answers

Which condition is characterized by a decrease in blood pH due to excess acid?

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

What role do the kidneys play in regulating pH balance?

<p>Regulating bicarbonate levels and excreting hydrogen ions (C)</p> Signup and view all the answers

Which hormone primarily regulates the reabsorption of water in the kidneys?

<p>Antidiuretic hormone (ADH) (A)</p> Signup and view all the answers

Metabolic alkalosis occurs due to which of the following?

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

What is haematuria?

<p>Presence of blood in urine (A)</p> Signup and view all the answers

Which of the following is a common cause of metabolic acidosis?

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

What is the primary function of selective reabsorption in the nephron?

<p>To return water, electrolytes, and nutrients back into the blood (B)</p> Signup and view all the answers

Which hormone is specifically responsible for stimulating red blood cell production?

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

How does the kidneys participate in acid-base balance?

<p>By excreting hydrogen ions and reabsorbing bicarbonate (D)</p> Signup and view all the answers

What is the Glomerular Filtration Rate (GFR) in healthy adults?

<p>125 ml/min (D)</p> Signup and view all the answers

Which mechanism does renin initiate in response to low blood pressure or sodium levels?

<p>Renin-angiotensin-aldosterone system (RAAS) (B)</p> Signup and view all the answers

What distinguishes facultative reabsorption from obligatory reabsorption?

<p>Facultative reabsorption is hormone-regulated while obligatory is not (D)</p> Signup and view all the answers

Which receptors does Anti-Diuretic Hormone (ADH) act on to promote water reabsorption?

<p>V1 and V2 receptors (B)</p> Signup and view all the answers

What role does the kidneys play in Vitamin D activation?

<p>Conversion of Vitamin D into its active form, calcitriol (A)</p> Signup and view all the answers

Flashcards

Where does selective reabsorption primarily occur in the nephron?

The proximal convoluted tubule (PCT) is the main site of selective reabsorption in the nephron. It absorbs vital nutrients, water, and electrolytes back into the bloodstream while regulating waste excretion.

What condition causes the bladder to not empty completely?

Urinary retention refers to the inability to completely empty the bladder. This can be caused by various factors like nerve damage, prostate enlargement, or medications.

What are the causes of acute kidney injury (AKI)?

Acute kidney injury (AKI) can occur due to decreased blood flow to the kidneys (prerenal), damage to the kidney tissue (intrarenal), or obstruction of urine flow (postrenal).

How does oliguria occur in acute kidney injury (AKI)?

Oliguria in AKI is caused by a reduction in glomerular filtration rate (GFR), increased reabsorption of water, or obstruction in the urinary tract.

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Explain the pathophysiology of urinary tract infections (UTIs) and why they are more common in women.

Urinary tract infections (UTIs) occur when bacteria enter the urinary tract, usually through the urethra. Women are more susceptible due to their shorter urethra. Complications include pyelonephritis (kidney infection) and sepsis.

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What are the kidneys?

Paired, bean-shaped organs located below the rib cage, crucial for filtering blood and producing urine.

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What are nephrons?

Functional units of the kidney, responsible for filtering blood and producing urine. Each kidney contains approximately 1 to 1.5 million.

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What are cortical nephrons?

Located primarily in the renal cortex, they have shorter loops of Henle and are responsible for the majority of filtration.

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What are juxtamedullary nephrons?

These nephrons have longer loops of Henle that extend deep into the medulla. They are crucial for concentrating urine and conserving water.

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What is the glomerulus?

A network of capillaries at the beginning of the nephron, responsible for filtering blood. It allows water, electrolytes, and small molecules to pass into the Bowman's capsule while retaining large molecules (proteins and blood cells).

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What is the Bowman's capsule?

A cup-like sac surrounding the glomerulus, collecting the filtrate for processing in the renal tubules.

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What is the bladder?

A hollow, muscular organ that stores urine before it is excreted from the body.

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What is the detrusor muscle?

The smooth muscle that makes up the bladder wall, responsible for contracting to release urine.

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Polyuria

Production of abnormally large volumes of urine, often exceeding 3 liters per day. Occurs in conditions like diabetes mellitus and diabetes insipidus.

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Oliguria

A significantly reduced urine output, typically less than 400 ml/day or less than 20 ml/hour. Sign of acute kidney injury or severe dehydration.

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Urinary Tract Infection (UTI)

Infection of any part of the urinary system, including kidneys, bladder, or urethra. Symptoms include strong urge to urinate, burning sensation, cloudy or smelly urine.

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Benign Prostatic Hyperplasia (BPH)

Enlargement of the prostate gland, common in older men. Can cause urinary retention, nocturia, and weak urine stream.

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Urinary Retention

Inability to empty the bladder completely. Can be acute or chronic, caused by nerve dysfunction, obstruction, or weakened bladder muscles.

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Overactive Bladder

Frequent and sudden urge to urinate that's difficult to control. Can lead to incontinence and affect quality of life.

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Paruresis (Shy Bladder Syndrome)

Social anxiety where a person is unable to urinate in presence of others, even when there's an urgent need.

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Bladder Sphincter Dyssynergia

Lack of coordination between the detrusor muscle and external urethral sphincter, resulting in difficulty urinating and incomplete emptying.

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Metabolic Acidosis

Metabolic acidosis occurs when there's too much acid in the body or not enough bicarbonate, causing blood pH to drop.

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Metabolic Alkalosis

Metabolic alkalosis is when there's too much bicarbonate or not enough acid in the body, leading to a rise in blood pH.

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Kidney Compensation for Acidosis

The kidneys counter metabolic acidosis by reabsorbing bicarbonate and excreting hydrogen ions in urine, helping to restore pH balance.

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Kidney Compensation for Alkalosis

To compensate for metabolic alkalosis, the kidneys excrete excess bicarbonate and reduce hydrogen ion secretion, bringing the pH back to normal.

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Lungs in pH Regulation

The lungs play a role in acid-base balance by regulating CO2 levels, which indirectly affects blood pH.

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Hyperventilation for Acidosis

Hyperventilation, or increased breathing, can increase CO2 expulsion, raising blood pH in metabolic acidosis.

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Hypoventilation for Alkalosis

Hypoventilation, or slower breathing, conserves CO2, lowering pH in metabolic alkalosis.

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Kidney's Role in pH

The kidneys regulate bicarbonate and hydrogen ion levels to maintain blood pH within a narrow, healthy range.

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Selective Reabsorption

The process by which the nephron selectively reabsorbs water, electrolytes, and nutrients back into the blood, based on what the body needs.

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Selective Secretion

The process by which additional waste products and excess ions are secreted into the tubular fluid, becoming urine.

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Acid-Base Balance

The kidneys regulate the body's pH by excreting hydrogen ions (H+) and reabsorbing bicarbonate (HCO3-), keeping the blood pH balanced.

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Erythropoietin

A hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow in response to low oxygen levels.

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Renin

An enzyme released by the kidneys in response to low blood pressure or low sodium levels. Renin starts a chain reaction to regulate blood pressure and fluid balance.

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Vitamin D Activation

The kidneys convert vitamin D into its active form, calcitriol (vitamin D3), which is essential for calcium absorption and bone health.

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Glomerular Filtration Rate (GFR)

The rate at which filtrate is formed in the kidneys, typically around 125 ml/min in healthy adults. This means 180 liters of filtrate is produced each day.

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Obligatory Reabsorption

Reabsorption of water and solutes that occurs regardless of the body's needs, mainly in the proximal convoluted tubule.

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Facultative Reabsorption

The adjustable reabsorption of water and solutes in response to the body's needs, regulated by hormones like antidiuretic hormone (ADH).

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Anti-Diuretic Hormone (ADH)

ADH acts on V1 receptors to contract blood vessels and on V2 receptors in the kidneys to promote water reabsorption, concentrating the urine.

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Renin-Angiotensin-Aldosterone System (RAAS)

Renin is released due to low blood pressure or low sodium. It converts angiotensinogen to angiotensin I, leading to a cascade of events that help regulate blood pressure and fluid balance.

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Study Notes

Kidney Anatomy and Physiology

  • The kidneys filter blood, remove waste, regulate electrolytes, and maintain acid-base balance
  • Kidneys are bean-shaped organs on either side of the spine, below the rib cage
  • Nephrons are the functional units of the kidney, with approximately 1-1.5 million per kidney
  • Cortical nephrons are primarily in the renal cortex, with shorter loops of Henle; responsible for bulk of filtration
  • Juxtamedullary nephrons have longer loops of Henle, extending deep into the medulla; crucial for concentrating urine and water conservation
  • Glomerulus is a network of capillaries at the beginning of the nephron; filters blood, allowing water, electrolytes, and small molecules into Bowman's capsule, retaining larger molecules
  • Bowman's capsule is a cup-like sac that surrounds the glomerulus, collecting the filtrate to be processed in the renal tubules

Bladder Anatomy and Physiology

  • The bladder is a hollow, muscular organ that stores urine before excretion
  • Bladder structure includes a muscular wall (detrusor muscle) and an internal urethral sphincter, made of smooth muscle; controls urine release
  • Bladder function is storing urine until it reaches a volume triggering urination; bladder contracts, sphincter relaxes for urine flow

Common Clinical Conditions

  • Anuria: Absence or very minimal urine production (less than 50 ml/day), indicating severe kidney dysfunction or urinary tract obstruction
  • Polyuria: Production of abnormally large urine volumes (often exceeding 3 litres/day); occurs in diabetes mellitus or insipidus
  • Oliguria: Significantly reduced urine output (typically less than 400 ml/day or 20 ml/hour); can be a sign of acute kidney injury or severe dehydration
  • Urinary Tract Infection (UTI): Infection of any part of the urinary system; symptoms include strong urge to urinate, burning sensation, cloudy or smelly urine
  • Benign Prostatic Hyperplasia (BPH): Prostate gland enlargement in older men; can cause urinary retention, nocturia, and a weak urine stream
  • Urinary Retention: Inability to empty the bladder completely; can be acute or chronic, resulting from nerve dysfunction, obstruction, or weakened bladder muscles
  • Overactive Bladder: Frequent and sudden urge to urinate that is difficult to control; significantly affects quality of life
  • Paruresis (Shy Bladder Syndrome): Social anxiety preventing urination in the presence of others, even with urgent need

Physiology of the Kidney

  • Excretion and Water-Electrolyte Balance: Blood is filtered at the glomerulus, forming a filtrate (180 litres/day); nephrons selectively reabsorb water, electrolytes, and nutrients; and selectively secrete waste products
  • Acid-Base Balance: Kidneys regulate body pH by excreting hydrogen ions and reabsorbing bicarbonate
  • Endocrine Secretions: Kidneys produce erythropoietin, stimulating red blood cell production in response to low oxygen levels

Ultrafiltration, Selective Reabsorption, and Secretion

  • Glomerular Filtration Rate (GFR): Rate at which filtrate is formed in kidneys (typically 125 ml/min in healthy adults); around 180 litres of filtrate per day, only 1-2 litres excreted as urine
  • Obligatory Reabsorption: Water and solutes absorbed regardless of body needs; primarily in the proximal convoluted tubule
  • Facultative Reabsorption: Adjustable water and solute reabsorption; regulated by hormones like ADH
  • Anti-Diuretic Hormone (ADH): Acts on V1 receptors (vasoconstriction), V2 receptors (water reabsorption) to concentrate urine
  • Renin-Angiotensin-Aldosterone System (RAAS): Mechanism for regulating blood pressure; renin converts angiotensinogen to angiotensin II, a potent vasoconstrictor; stimulates aldosterone release, promoting sodium and water retention

Role of Kidneys in pH Regulation

  • Kidneys regulate acid-base balance by regulating bicarbonate (HCO3-) levels in the blood; excrete hydrogen ions (H+) to maintain narrow pH range

Metabolic Acidosis/Alkalosis

  • Metabolic acidosis occurs when excess acid or bicarbonate loss, leading to decreased blood pH, often caused by renal failure, diabetic ketoacidosis, or diarrhea. Compensation involves increased breathing rate (hyperventilation) and increased bicarbonate reabsorption by the kidneys
  • Metabolic alkalosis arises from excess bicarbonate or acid loss, leading to increased blood pH. Prolonged vomiting or use of antacids can cause this. Compensation involves decreased breathing rate (hypoventilation) and increased bicarbonate excretion, and reduction of hydrogen ion secretion, by the kidneys.

Multiple Choice Questions

  • 1: What is the primary function of the juxtamedullary nephrons?: Concentration of urine
  • 2: Which hormone is primarily responsible for the regulation of water reabsorption in the kidneys? Antidiuretic hormone (ADH)
  • 3: What condition is characterized by the presence of blood in the urine? Haematuria

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