Chapter 25: The Urinary System

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1

Upon reaching what point in the nephron is reabsorption (1) dependent upon the body's needs at the time, and (2) regulated by hormones?

A) proximal convoluted tubule

B) ascending limb of the loop of Henle

C) descending limb of the loop of Henle

D) distal convoluted tubule

D) distal convoluted tubule

2

Glomerular Capillaries

Fenestrated vessels that allow passage of all plasma elements but not blood cells

3

Efferent Arterioles

may form meandering vessels or bundles of long straight vessels

4

Vasa Recta

Play a role in urine concentration

5

Afferent Arterioles

high pressure vessel that forces fluid and solutes into the glomerular capsule

6

Peritubular Capillaries

Low pressure, porous vessels that reabsorb solutes and water from the tubule cells.

7

Urinary incontinence may occur if a person has ______.

A) an internal urethral sphincter that is too frequently relaxed

B) an external urethral sphincter that is too frequently contracted

C) an overactive detrusor

D) muscle All of the listed responses are correct.

C) an overactive detrusor

8
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What hormone promotes active tubular secretion of potassium ions in the late distal convoluted tubule (DCT) and collecting ducts?

Aldosterone

9
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Where does ADH exert its effects to promote water reabsorption?

A) distal convoluted tubule (DCT)

B) descending limb of the nephron loop

C) collecting duct

D) ascending limb of the nephron loop

C) collecting duct

10

What is the juxtaglomerular apparatus?

A system that regulates the rate of filtrate formation and systemic blood pressure

11
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...

12

Proximal Convoluted Tubule

site at which most of the tubular reabsorption occurs

13

Golmerulus

Site of filtrate formation

14

Peritubular capillaries

Blood supply that directly receives substances from the tubular cells.

15

Collecting Duct

Site drains the distal convoluted tubules

16

Where does the efferent arteriole of the juxtamedullary nephron carry blood to?

Vasa Recta

17

Which vessel is present in the arterial pathway as blood lfows into the kidney but NOT present in the venous pathway exiting the kidney?

Segmental Artery

18

Which cells of the kidney are chemoreceptors that respond to changed in solute content in the filtrate?

Macula Densa Cells

19

Chemicals that enhance urinary output are called ___.

Diuretics

20

Apprx. 80% of the energy used for active transport is devoted to the reabsorption of ___.

Sodium

21

The fatty tissue surrounding that kidneys is important because it ___.

Stabilizes that position of the kidneys by holding them in their normal position

22
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Structures of the kidney

23

Which statement best describes the effect diuretics have?

Diuretics increase urinary output

24

The ___ artery lies on the boundary between the cortex and medulla of the kidney.

Arcuate

25

Which of the following best describes kidney function in older adults (70 years or older)?

A) Only obese and diabetic older adults have any kidney dysfunction.

B) Kidney function remains the same throughout life, regardless of age.

C) Kidney function decreases due to kidney atrophy.

D) Only about 3% of older adults have any loss of kidney function.

C) Kidney function decreases due to kidney atrophy.

26

Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?

A) by secreting sodium ions

B) by producing new bicarbonate ions

C) by secreting hydrogen ions into the filtrate

D) by reabsorbing filtered bicarbonate ions

A) by secreting sodium ions

27

Excretion of dilute urine requires ___.

impermeability of the collecting tubule to water

28

What type of epithelial tissue forms the mucosa layer of the urinary bladder?

Transitional Epithelium

29

In what part of the renal tubule does Parathyroid Hormone (PTH) promote the reabsorption of calcium ions?

Distal Convoluted Tubule (DCT)

30

In the ascending limb of the loop of Henle the ___.

thick segment moves ions out into interstitial spaces for reabsorption

31

The urinary bladder is composed of ___ epithelium.

Transitional

32

Which vessels supply the cortical tissue of the kidney with blood?

Cortical Radiate Arteries

33

Which of the following statements about aldosterone is NOT correct?

A) Aldosterone increases the number of passive sodium channels in the luminal membrane of the distal tubule and collecting duct, thus aiding sodium reabsorption.

B) Aldosterone is stimulated by decreased plasma sodium levels and increased plasma potassium levels.

C) Aldosterone is produced in the adrenal cortex.

D) Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule.

D) Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule.

34

Which of the following statements about AHD is correct?

A) ADH is released by the posterior pituitary gland.

B) ADH is synthesized by the adrenal gland and works in the kidney.

C) ADH inserts water channels into the luminal membrane of the proximal tubules.

D) ADH would increase urine volume.

A) ADH is released by the posterior pituitary gland.

35

Wha tis the osmolarity of the filtrate at the end of the proximal tubule?

Isotonic - 300 mOsm

36

In overhydration, what would be the levels of ADH (high, normal, or low) and what would be the osmolarity of the urine?

ADH - low; 100 mOsm (urine)

37

In severe dehydration or blood loss, what would be the levels of ADH and what would be the urine flow rate?

ADH- HIGH; low urine flow rate (0.25 ml/min)

38

Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs

Proteinuria is a condition in which large amounts of plasma proteins pass into the glomerular filtrate and are excreted in the urine, decreasing the colloid osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema.

39
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What region subdivides to form two or three major calyces and several minor calyces? Select from letters A-D.

C

40

An important characteristic of urine is its specific gravity or density, which is ________.

Slightly higher that water

41

When renal calculi obstruct a ureter, pain is perceived to radiate from the lower back to the anterior abdominal wall on the same side. This is an event that ______.

is called referred pain

42

Which of the following is not reabsorbed by the proximal convoluted tubule?

A) Na+

B) creatinine

C) glucose

D) K+

B) Creatinine

43

Which of the following is the least important influence on reabsorption of a substance in the nephron?

A) molecule size relative to fenestrations.

B) number of carriers.

C) molecular complexity

D) lipid solubility.

C) molecular Complexity

44

Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.

secondary active transport

45
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Where is filtrate produced in the nephron?

A) peritubular Capillaries

B) Vasa Recta

C) Juxtaglomerular Complex

D) Glomerulus

D) Glomerulus

46
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Structures of the Bladder

47

Which of the choices below is the salt level-monitoring part of the nephron?

A) macula densa

B) vasa recta

C) loop of Henle

D) principal cell

A) Macula Densa

48

An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.

A) increase in the production of ADH

B) decrease in the concentration of the blood plasma

C) increase in the production of aldosterone

D) decrease in the production of ADH

A) increase in the production of ADH

49

The __________ keeps the urethra closed when urine is not being passed from the bladder and prevents leaking between voiding.

Internal Urethral Sphincter

50

Which of the following is not a part of the juxtaglomerular apparatus?

A) granular cells

B) podocyte cells

C) mesangial cells

D) macula densa

B) Podocyte Cells

51
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...

52

Which of the following does not describe the juxtaglomerular complex?

A) It helps control systemic blood pressure.

B) It regulates the rate of filtrate formation.

C) Its macula densa cells produce aldosterone.

D) Its granular cells produce renin.

C) Its macula densa cells produce aldosterone.

53

The __________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the __________.

calyces

renal pelvis

54

Which arteries branch off the arcuate arteries?

Cortical radiate (interlobar) arteries

55
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...

56

Each nephron contains a ___, which is a tuft of capillaries, and a ___.

Glomerulus

Renal Tubule

57

Which of the choices below is the least important role of tubular secretion?

A) disposing of substances not already in the filtrate, such as certain drugs

B) ridding the body of bicarbonate ions

C) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes

D) ridding the body of excessive potassium ions

B) ridding the body of bicarbonate ions

58
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...

59

The mechanism of water reabsorption by the renal tubules is ________.

osmosis

60

Which of the following congenital abnormalities of the urinary system is found in male infants only?

A) polycystic kidney disease

B) renal calculi

C) hypospadias

D) horseshoe kidney

C) Hypospadias

61

If one says that the clearance value of glucose is zero, what does this mean?

A) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules.

B) The glucose molecule is too large to be filtered out of the blood.

C) Normally all the glucose is reabsorbed.

D) The clearance value of glucose is relatively high in a healthy adult.

C) Normally all the glucose is reabsorbed

62

T/F: The leading cause of chronic renal disease is hypertension.

FALSE

63

The fluid in the glomerular (Bowmans) capsule is similar to plasma except that it does not contain a significant amount of ___.

plasma protein

64

Polycystic Kidney Disease always affects both kidneys instead of on the right or left kidney because ___.

it is a genetic disease

65
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Kidney

Renal Artery

Renal Hilum

Renal Vein

Ureter

Urinary Bladder

Urethra

66

___ and ___ are the most important hormone regulators of electrolyte reabsorption and secretion.

Angiotensin II and Aldosterone

67

Which statement best describes the function of the urethra?

The urethra transports urine from the bladder to the outside of the body

68

The renal corpuscle is made up of ___.

Bowman's Capsule and glomerulus

69

What would happen is the capsular hydrostatic pressure were increased above normal?

Net filtration would decrease

70
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Calculate the net filtration pressure if blood pressure in the glomerulus is unusually high, around 68 mm Hg.

23 mm Hg

71

Which capillary bed produces filtrate?

Glomerulus

72

The filtration membrane includes all except ___.

A) Renal Fascia

B) Podocytes

C) Glomerular Endothelium

D) Basement Membrane

Renal Fascia

73
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...

74

Which of the following is NOT characteristic of the cortical nephrons?

A) Cortical nephrons form the majority of nephrons in the kidney.

B) The glomerulus of the cortical nephron is closer to the cortex-medulla junction.

C) Cortical nephrons have a short nephron loop.

D) The efferent arteriole of the cortical nephrons supplies the peritubular capillaries.

B) The glomerulus of the cortical nephron is closer to the cortex-medulla junction.

75

What is the most direct function of the juxtaglomerular apparatus?

help regulate blood pressure and the rate of blood filtration by the kidneys

76

What two structures constitute the renal corpuscle?

Glomerulus and Glomerular (Bowmans) Capusle

77

The chief force pushing water and solutes out of the blood across the filtration membrane is ________.

Glomerular hydrostatic pressure (glomerular blood pressure)

78

Which of the following is NOT a function of the kidneys?

A) producing the hormones melanin and oxytocin

B) metabolizing vitamin D to its active form

C) maintaining the proper balance between water and salts and between acids and bases

D) gluconeogenesis during prolonged fasting

A) producing the hormones melanin and oxytocin

79

Which pressure is the chief force pushing water and solutes out of the blood and across the filtration membrane of the glomerulus?

hydrostatic pressure in glomerular capillaries (HPgc)

80
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...

81

The kidneys are stimulated to produce renin ________.

by a decrease in the blood pressure

82

The factor favoring filtrate formation at the glomerulus is the ________.

glomerular hydrostatic pressure

83

Which of the choices below is not a function of the urinary system?

A) maintains blood osmolarity

B) helps maintain homeostasis by controlling the composition, volume, and pressure of blood

C) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat

D) regulates blood glucose levels and produces hormones

C) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat

84

Which of the following promotes the formation of dilute urine?

A) increased osmolality of extracellular fluids

B) large amounts of antidiuretic hormone (ADH) released from the posterior pituitary

C) increased number of aquaporins present in the collecting duct

D) decreased osmolality of extracellular fluids

D) decreased osmolality of extracellular fluids

85

Alcohol acts as a diuretic because it ________.

inhibits the release of ADH

86

Select the correct statement about the ureters

A) The ureter is innervated by parasympathetic nerve endings only.

B) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.

C) The epithelium is stratified squamous like the skin, which allows a great deal of stretch.

D) The ureters are capable of peristalsis like that of the gastrointestinal tract.

D) The ureters are capable of peristalsis like that of the gastrointestinal tract.