2 - A&P

Question 1

Kidneys and ureters location

Answer 1

Retroperitoneal structures located between T11 and L 3

R = 2cm lower than L

Question 2

Layers of the kidney?

Answer 2

Renal fascia
Adipose capsule
Renal capsule

Question 3

Kidney internal structures?

Answer 3

Renal cortex
Renal colums
Renal medulla
Renal pyramids
Renal papillae
Calyces
Renal pelvis

Question 4

What is the functional tissue of the kidneys?

Answer 4

Renal parenchyma

Question 5

Kidney pic

Answer 5

Slide 8

Question 6

Renal blood flow

Answer 6

Abdominal artery - segmental arteries - interlobar a. -> arcuate a. -> interlobular a. -> afferent arterioles (toward nephrons) -> glomerulus

Efferent arterioles (away from nephrons) -> peritubular capillaries -> interlobular v. -> arcuate v. -> interlobar v -> segmental veins -> renal veins -> IVC

Slide 11 pic

Question 7

Afferent vs efferent

Answer 7

Afferent approaches

Efferent exits

Question 8

Where do kidney nerves arise?

Answer 8

Superior mesenteric ganglion -> hilum

Question 9

What do sympathetic fibers do?

Answer 9

Regulate blood flow
-This filtrates blood and forms urine

RAAS system

Question 10

Nephron consists of?

Answer 10

Renal corpuscle (glomerulus + bowman’s capsule)

Renal tubules

Slide 14/15 pic

Question 11

Renal tubules consist of

Answer 11

PCT
Loop of henly
DCT
- becomes the juxtaglomerular apparatus

DCT drains into collecting duct

Question 12

Kidneys role in urinary system

Answer 12

Functional organs of the urinary system

The other parts are just passage ways and storage

Question 13

Main functions of kidney?

Answer 13

1. Regulate blood ionic composition
   - electrolytes (Na, K, Ca, Cl, po4) (or whatever phosphate is, jeeze john)
2. Regulate pH
   - excretion of H ions into urine
   - conserving bicarb
3. Regulation of blood volume
   - ADH or vasopressin
4. BP regulation
   - juxtaglomerular cells - renin activates the RAA pathway
5. Maintenance of blood osmolarity
   - regulating water excretion/loss
6. Production of hormones
   - calcitriol, erythropoietin
7. Regulation of blood glucose levels
   - renal gluconeogeneis
8. Excretion of waste and foreign substances
   - ecogenous substances (drugs)
   - Endogenous substances

Question 14

Where is renin produced?

Answer 14

Juxtaglomerular (JG) cells

Question 15

Where is angiotensinogen produced?

Answer 15

Liver

Question 16

Where is angiotensin I produced

Answer 16

Renin acts on angiotensinogen converting it into angiotensin I

Question 17

Angiotensin II

Answer 17

Converted in blood from angiotensin i by ACE

Question 18

Where does aldosterone come from?

Answer 18

Adrenal cortex

Question 19

RAA pic

Answer 19

Slide 24

Question 20

Renal gluconeogenesis

Answer 20

Renal release of glucose into the blood to help maintain blood glucose level

Question 21

Exogenous vs endogenous substances?

Answer 21

Exogenous - toxins and drugs

Endogenous

• amonia and urea (amino acids)
• bilirubin and hemoglobin catabolism
• creatinine (breakdown of creatine phoshate in muscle)
• uric acid from nucleic acid catabolism

Question 22

Explain glomerular filtration?

Answer 22

Basically blood flows into glomerulus, plasma comes out, solids stay in

Question 23

Components of filtration membrane?

Answer 23

Glomerular endothelial fenestrations (pores) - allow proteins out but not cells/platelets

Basal lamina - small and med proteins out

Slit membrane - only very small proteins

Pic 32

Question 24

Glomular filtration fraction?

Answer 24

Ratio of fluid from blood that becomes glomular filtrate

-20% of total fluid that reaches kidneys enters the capsular space

1-1.2L/min
140-180 L/day

Question 25

Pressures that determine GFR

Answer 25

GBHP - Glomerular blood hydrostatic pressure
- 55mmHg - promotes filtration of wastes

CHP - capsular hydrostatic pressure
-15mmHg - opposes filtration

BCOP - blood colloid osmotic pressure
- 30mmHg - opposes filtration

Pic slide 35q

Question 26

Normal net filtration pressure?

Answer 26

10mmHg

Question 27

Urine production steps?

Answer 27

1. Glomular filtration
2. Tubular reabsorption
3. Tubular secretion

Question 28

Tubular reabsorption?

Answer 28

Tubule cells reabsorb 90% of fltrate

Water and useful solutes (glucose, electrolytes, proteins etc) get kept

Question 29

Tubular secretion?

Answer 29

Tubule and duct cells secrete waste, drugs and excess ions into fluid

1-1.5L of urine/day

Question 30

Urine composition?

Answer 30

95% water

5% electrolytes, solues, exogenous substances

Question 31

Factors affecting urine volume/production

Answer 31

fluid intake – blood pressure – blood osmolality (measure of osmoles of solute per kg of
solvent) – diet – body temperature – diuretics/medications – mental state – general health

Question 32

Location of bladder?

Answer 32

Posterior to pubic symphysis,
anterior to rectum in males,
anterior to vagina in females

Held in place by periotoneal folds

Question 33

Bladder wall?

Answer 33

3 layers
Mucosa 
- rugae, 
- transitional epithelium 
- lamina propria 

Muscularis (detrusor mucle)

• inter longitudinal
• middle cirucular
• outer longitudinal

Serosa 
- covers superior surface
- visceral peritoneum 
Or adventitia
- covers posterior and inferior surfaces
- continuous w ureters

Question 34

I just went on a very strict renal friendly diet.

Answer 34

There are only three things you can’t put in your mouth- a fork, knife and spoon.