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Urea
Nitrogenous waste product excreted in the urine; end product of protein metabolism
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Renal Cortex
- The outer layer of kidney tissue
- Contains the renal corpuscles and convoluted tubules of nephrons
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Renal Medulla
- The inner layer of kidney tissue
- Contains the wedge shaped pieces called renal pyramids
- Contains the loops of Henle and the collecting tubes of nephrons
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Renal Pelvis
- A cavity formed by the expansion of the ureter within the kidney at the hilus
- The calyces are funnel-shaped pieces called renal pyramids
- Urine enters from the papillae of the renal pyramids
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Glomerulus
- Cluster of capillaries surrounded by the nephron's glomelular capsule.
- At the beginning of the nephron, the glomerulus is a network (tuft) of capillaries that performs the first step of filtering blood.
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Location of kidneys in relation to peritoneum and backbone
- They are not in the peritoneal cavity, but in the retroperitoneal space, behind the peritoneum
- At level of last thoracic and first 3 lumbar vertebrae
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How do the kidneys regulate BP?
- When bp falls, it may limit filtration.
- The cells release renin which activates angiotensin. Angiotensin constricts blood vessels, causing BP to raise
- ANP is released when blood pressure is too high to lower
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Erythropoietin
- Produced when kidneys don't have enough O2Stimulates red cell production in the bone marrow
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Retroperineal
Behind the peritoneum
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Structure of kidney
- Right kidney lower than left to accommodate liver
- Enclosed in renal capsule on outside, then adipose capsule
- fascia anchors kidney to peritoneum and abd wall
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Blood path of the kidney
- Renal artery
- Afferent arteriole
- Glomerulus
- Efferent arteriole
- Peritubular capillaries
- Renal vein
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Tubular resportion takes place where
From the renal tubule to the peritubular capillaries
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Where does filtration take place in the kidney?
the glomerulus and glomerular capsule
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What part of nephron drains to the loop of Henle?
- Renal tubule
- (distal convoluted tubule)
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Afferent arteriole
Supplies the gomerulus with blood
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Efferent arteriole
carries blood from the glomerulus
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Functional unit of the kidney
Nephron
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What drives materials out of glomerulus into glomelurlar capsule?
- Blood pressure
- (3-4 times higher than in other capillaries)
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Normal urinary output in 24 hours
1000 - 2000 mL
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Where does reabsorption take place?
Proximal convoluted tubules
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Where does secretion take place?
Peritubrular capillaries in the renal tubules
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Pinocytosis
Reabsorption of small proteins
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Process which water is reabsorbed by renal filtrate
Osmosis
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Substances are reabsorbed from the distal convoluted tube into what?
The interstitial fluid, then peritubular capillaries, then return to circulation
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Where is urine formed?
Begins with the glomerulus and into the renal tubule
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How the kidneys regulate acid-base balance (PH) of body fluids
Active secretion of hydrogen ions and bicarbonate. when body fluids become too acidic kidneys secrete more hydrogen into renal filtrate and return bicarbonate ions back into blood. when too alkaline bicarbonate is excreted to renal filtrate and hydrogen into blood
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Average PH of urine
4.6 - 8.0, with an average of 6.0
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Kidneys respond to increased acidity in body fluids by doing what?
They secrete more hydrogen ions into renal filtrate and return more bicarbonate ions back into the blood
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Normal glomerular filtration rate (GFR)
105 - 125 mL/min
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Location of urinary bladder
- Inside the peritoneum behind the pubic bones.
- In women: bladder is inferior to uterus
- In men: bladder is superior to the prostate gland
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Ureters go from what to what?
from the hilus of the kidney to the lower, posterior side of the urinary bladder
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In men, what does the urethra pass through?
It is 7-8 inches long and extends through the prostate gland and penis.
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What sphincter provides voluntary control of urination reflex?
External urethral sphincter
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How much urine does the bladder contain after urination?
<50 mL
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Substances normally found in urine
- Urea
- Uric acid
- Creatinine
- Electrolytes
- Pigment (Urochrome)(bilirubin)
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Specific gravity measures what
- The amount of dissolved solids and gases.
- Range is 1.002 (very dilute) - 1.040 (very concentrated)
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ADH does what
Increases water reabsorption in the kidney to dilute the excess sodium
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Normal characteristics of urine
- 1000 - 2000 mL/day
- Straw or amber colored
- Specific gravity: 1.002 - 1.035
- PH 4.6 - 8.0
- 95% water
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Where does creatinine in urine derive from?
The metaboilism of creatine phosphate, an energy source in muscles
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Uremia
Waste products building up in the blood
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Single best indicator of fluid balance
Weight
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11 Things that are tested in Urinalysis
- Color
- Odor
- PH
- Specific gravity
- Protein content
- Glucose
- Ketones
- Bilirubin
- Nitrate
- RBC
- WBC
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Good indicator of renal disease
- Protein in urine
- High creatinine level
- Potassium level
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If older patient has ↑ BUN, what could be the reason?
- Dehydration
- high-protein diet
- GI bleeding
- heart failure
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What would be considered abnormal if found in urine?
- Protein
- Glucose
- Ketones
- Bilirubin
- Nitrate
- RBC and WBC's
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Normal urinary output per hour
- 30-60 mL
- or 1 mL/kg per hour
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Calyces
- Funnel shaped extensions of the renal pelvis
- They enclose the papillae of the renal pyramids
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Structures at the hilus of kidney
- Renal artery
- Renal vein
- Ureter
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What provides energy for filtration?
- Blood pressure
- (active transport is energized by ATP or stored energy)
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What enzyme does Juxtaglomelular apparatus secrete?
- Renin
- (stimulated by low blood pressure)
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