Exam #4 Study Guide PDF

Exam #4 Study Guide The Urinary and Reproductive System, Urinalysis, and Acid-Base 1. Know the definition of pH (potential of hydrogen). a. A measure of how acidic or basic a substance or solution is. 2. Know the definition of a buffer. a. Exchange of a strong acid or base f...

Exam #4 Study Guide The Urinary and Reproductive System, Urinalysis, and Acid-Base 1. Know the definition of pH (potential of hydrogen). a. A measure of how acidic or basic a substance or solution is. 2. Know the definition of a buffer. a. Exchange of a strong acid or base for a weak one → results in a much smaller pH change. 3. Know how to recognize respiratory acidosis/alkalosis and metabolic acidosis/alkalosis.* a. Respiratory acidosis → high levels of carbon dioxide in the blood (hypercapnia) i. Signs and symptoms: breathlessness, lethargy, disorientation, tremors, respiratory rate rapid and then gradually depressed, skin warm and flushed due to vasodilation causes by excess CO2 (acute conditions: adult respiratory distress syndrome, pulmonary edema, pneumothorax) b. Respiratory alkalosis → carbonic acid deficit (hypocapnia) i. Oxygen deficiency at high altitudes ii. Primary cause is hyperventilation iii. (conditions: pulmonary disease and congestive heart failure, acute anxiety, fever, cirrhosis, early salicylate intoxication, gram-negative sepsis) c. Metabolic Acidosis → bicarbonate deficit i. Symptoms: headache, lethargy, nausea, vomiting, diarrhea, coma, death ii. Causes: loss of bicarbonate through diarrhea or renal dysfunction, accumulation of acids (lactic acid or ketones), failure of kidneys to excrete hydrogen d. Metabolic Alkalosis → bicarbonate excess i. Symptoms: respiration slow and shallow, hyperactive reflexes (tetany), atrial tachycardia, dysrhythmias, often related to depletion of electrolytes 4. Know how to control acidosis or alkalosis.* a. Respiratory Acidosis → restore ventilation, IV lactate solution, treat underlying dysfunction or disease; kidneys eliminate hydrogen ion and retain bicarbonate ion b. Respiratory Alkalosis → IV chloride containing solution (Cl- ions to replace lost bicarbonate ions); kidneys conserve hydrogen ion and excrete bicarbonate ion c. Metabolic Acidosis → increased ventilation, renal excretion of hydrogen ions, IV lactate solution d. Metabolic Alkalosis → hypoventilation limited by hypoxia; electrolytes to replace those lost, IV chloride containing solution and treatment of underlying disorder 5. Know the secretion of the hormones by follicle post-ovulation. a. Luteal Phase (begins after ovulation) → GnRH and elevated estrogen levels stimulate luteinizing hormone release b. Progesterone levels increase while estrogen decreases 6. Know how much urine is reabsorbed percent-wise. a. 99% is reabsorbed and about 60% of water. 7. Know what is in normal urine. a. Ions → sodium, potassium, chloride, bicarbonate b. Metabolites and nutrients → glucose, lipids, amino acids, proteins c. Nitrogenous wastes → urea, creatinine, ammonia, uric acid 1 8. Know how hydrogen ions are eliminated in the urine. a. When the pH of body fluids decreases, hydrogen ions are secreted in exchange for sodium ions. 9. Know the difference between secretion and reabsorption. a. Reabsorption → removal of solutes and fluid from the tubular fluid b. Secretion → transport of solutes and fluid to the tubular fluid 10. Know how the interstitial cells work and how the nurse cells work.* a. Interstitial cells → secrete androgens b. Nurse cells → create blood-testis barrier, protecting seminiferous tubules; attached to developing sperm cells 11. Know the definition of renal columns. a. Separates renal pyramids in the kidneys 12. Know the secondary sex characteristics (male and female).* a. Male - testosterone i. increases in size of larynx (deeper voice) ii. Rapid growth of external genitalia iii. Growth of facial hair, pubes and axilla iv. Development of firmer musculature v. Broad shoulders and narrow hips b. Female - estrogen i. Development of breasts ii. Broadening of hips iii. Growth of hair on the pubis and axilla iv. Onset of menstruation 13. Know where sperm matures before capacitation. a. Epididymis 14. Know the definition of the fornix. a. Shallow recess around the cervix. 15. Know the length of the uterine cycle. a. Averages 28 days in length (range 2-35 days) 16. Know the definition of ligaments → suspensory, ovarian and broad.* a. Suspensory ligament → lateral ovary to pelvic wall b. Ovarian ligament → ovary to uterine wall c. Broad ligament → mesentery connecting ovaries, uterine tubes, and uterus to pelvic cavity wall 17. Know the erectile tissues (male and female). a. Erectile tissues → corpora cavernosa & corpus spongiosum (males) b. Erectile tissue → clitoris & vestibular bulbs 18. Know what separates the testes. a. Scrotal septum 19. Know where the glomerulus is located. a. Glomerulus (capillary network) located within the renal corpuscle. 20. Know the secretory cells of the male. 2  a. Seminal glands (seminal vesicles) → contribute 60% of semen; secretion ejected by smooth muscle lining in gland; stimulates flagellum movement in spermatozoa (capacitation) b. Prostate gland → contributes 20% - 30% of semen; contains seminalplasmin (antibiotic for male tract) c. Bulbo-urethral glands → secrete alkaline mucus for lubrication and pH buffer 21. Know the anatomy and position of the male sex glands. a. Seminal glands (seminal vesicles) → paired, lobulated 5-7 cm long; posterior to bladder and lateral to ductus deferens b. Prostate gland → single, walnut-sized, 20 grams; inferior to bladder and surrounds prostatic urethra c. Bulbo-urethral glands → small, pea-sized; either side of membranous urethra and at the base of the penis 22. Know the function of FSH and LH in male and females.* a. (MALE) FSH → stimulates nurse cells, promotes spermatogenesis, secrete androgen-binding protein (ABP), stimulates maturation of spermatids, secrete inhibin to feed back to anterior pituitary b. (MALE) LH → stimulates testosterone secretion from interstitial cells, maintain libido and associated behaviors, stimulation of bone and muscle growth, maintenance of secondary sexual characteristics, maintenances of accessory glands c. (FEMALE) FSH → helps control the menstrual cycle by stimulating the ovaries to produce eggs during the follicular phase of the ovarian cycle d. (FEMALE) LH → triggers ovulation (release of an egg from the ovary), regulates the length and order of the menstrual cycle and supports pregnancy 23. Know the order of follicular maturation → from primordial.* a. Primordial follicle in egg nest - primordial follicles stored in ovarian cortex b. Formation of primary follicles - follicular cells enlarge and form several layers c. Formation of secondary follicles - follicle wall thickens and follicular cells secrete fluid d. Formation of tertiary follicle - secondary becomes a tertiary or mature follicle e. Ovulation - tertiary follicle releases secondary oocyte into pelvic cavity, marks follicular phase end and start of luteal phase f. Formation of corpus luteum - remaining granulosa cells proliferate secreting progesterone and estrogen, stimulate maturation of uterine lining g. Formation of corpus albicans - degeneration of corpus luteum if no fertilization 24. Know the forces in the bowman's capsule (glomerular capsule). a. Glomerular hydrostatic pressure (GHP) b. Capsular hydrostatic pressure c. Blood colloid osmotic pressure (BCOP) d. Capsular hydrostatic pressure 25. Know the reproductive structures (gender dependent). a. Gonads → reproductive organs that produce gametes and hormones b. Accessory glands and organs → secrete fluids into reproductive system or other excretory ducts c. Perineal structures (external genitalia) 3 d. Male i. Testes: gonad producing spermatozoa or sperm 1. Tunica albuginea: outer capsule continuous with septa subdividing testes into lobules 2. Seminiferous tubules: coiled tubules within lobules; site of sperm production 3. Rete testis: collecting area outside of lobules 4. Efferent ductules: lead from rete testis to epididymis ii. Male reproductive tract: transport semen (sperm with secretions of accessory glands) iii. Accessory organs: 1. Ductus deferens - conducts sperm from epididymis to prostate gland 2. Seminal glands - secrete fluid forming bulk semen volume 3. Ejaculatorducts (seminal vesicle) 4. Prostate gland - secretes fluid and enzymes 5. Urethra (bulbo-urethral glands) - conducts semen to exterior 6. Epididymis - site of sperm maturation iv. External genitalia: 1. Penis - deposits sperm into vagina 2. Scrotum - surrounds testes a. Scrotal cavities: houses tested - separated by scrotal septum (marked by raised raphe) b. Dartos muscle: elevates testes and wrinkles scrotal surface c. Cremaster muscle: pulls testes closer to the body during sexual arousal or cold d. Spermatic cords: contains the ductus deferens, blood vessels, nerves and lymphatic vessels e. Superficial inguinal ring: entrance to inguinal canal f. Inguinal canal: extends from body cavity into scrotum i. Inguinal hernias: protrusions through canal e. Female i. Female reproductive tract 1. Uterine tubes - deliver oocyte or embryo to uterus 2. Uterus - site of embryonic and fetal development 3. Vagina - site of sperm deposition ii. Gonads - produce oocytes and hormones iii. External genitalia 1. Clitoris: erectile tissue producing pleasurable sensations 2. Labia: contain glands to lubricate vagina a. Suspensory ligament: lateral ovary to pelvic wall b. Ovarian ligament: ovary to uterine wall c. Broad ligament: mesentery connecting ovaries, uterine tubes, and uterus to pelvic cavity wall d. Mesovarium: mesentery support ovary 4  iv. Mammary glands - produce nourishing milk for infant v. Ovaries - production of immature female gametes (oocytes); secretion of estrogen and progesterone vi. Uterine tube - conducts oocytes from ovary to uterus 1. Infundibulum: expanded funnel near ovary vii. Uterus - site of embryo implantation viii. Vesicouterine pouch - pocket between uterus and posterior bladder wall ix. Rectouterine pouch - pocket between posterior uterus and anterior colon x. Vagina - extends from uterus base to exterior 26. Know what’s in and the definition of spermatic cord.* a. Spermatic cord → cord-like structure that contains the nerve, artery, venous plexus and ductus deferens in the male reproductive system 27. Know the definition of menstruation, menopause and menarche.* a. Menstruation → process of endometrial sloughing b. Menopause → end of menstrual cycle c. Menarche → first menstrual cycle 28. Know the layers of the uterus (from outer to inner).* a. Perimetrium → incomplete serosa continuous with peritoneal lining b. Myometrium → smooth muscle layer providing force for childbirth c. Endometrium → inner epithelial lining whose character changes monthly 29. Know the functions of the gonad (male and female). a. Gonads → reproductive organs that produce gametes and hormones 30. Know the functions of the loop of henle. a. Nephron loop → establishes osmotic gradient for water reabsorption. i. Reabsorption of water, sodium and chloride ions present in the original filtrate; creation of concentration gradient in the renal medulla. ii. Actively pumps Na and Cl out of urine and into the medulla 31. Know the formula for net filtration pressure.* a. Net filtration pressure (NFP) = glomerular blood hydrostatic pressure (GBHP) - capsular hydrostatic pressure (CHP) + blood colloid osmotic pressure (BCOP) 32. Know the parts of the uterine (fallopian) tube.* a. Fimbriae → fingerlike extensions that drape near the ovary b. Infundibulum → expanded segment near the ovary c. Ampulla → muscular middle segment d. Isthmus → short segment attached to uterine wall ➔ Hyperventilation: abnormally prolonged rapid and deep respirations; heart palpitations and chest pains; patient breathes fast and/or deeper than the metabolic needs of the body - eliminating more carbon dioxide than is being produced ➔ Hypoventilation: breathing is too shallow or too slow to meet the needs of the body ➔ Normal urine characteristics: pale-yellow, clear not cloudy, 1.003-1.03 specific gravity, odorless, no glucose, very little amino acids, no bacteria, pH 4.5-8, no protein and no blood cells ➔ (1) Buffer systems exchange a strong acid or base for a weak one → (2) Respiratory mechanisms: exhalation of carbon dioxide, body pH can be adjusted by changing rate and depth of breathing → 5  (3) Kidney excretion eliminates large amounts of acid and excretes base, most effective regulatory of pH (if kidney fails, pH balance fails); can conserve and produce bicarb ions ➔ Females secrete follicular cells | Males secrete interstitial cells, sertoli cells, and nurse cells ➔ Broad ligament - mesentery connecting ovaries, uterine tubes, and uterus to pelvic cavity wall ➔ Bowman’s Capsule + Glomerulus = Renal Corpuscle + Distal/Proximal Convoluted Tubules = are in the Renal Cortex ➔ Loops of henle (cortical nephron + juxtamedullary nephron) are in the renal medulla ➔ Can be filtered into urine → water, glucose, ions, amino acids, metabolic waste products and toxins; Can not be filtered into urine → blood cells and proteins 6