25. The Urinary System

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Practice this topic

The ________________ is the finest layer of the filtration membrane.

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In the process of filtrate formation, which of the following factors creates an osmotic gradient?

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Every day the kidneys filter nearly __________ of fluid from the bloodstream.

Which of the following is a possible consequence of a prolonged or chronic decrease in glomerular filtration rate?

In what part of the nephron is plasma filtered?

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The hydrostatic pressure in glomerular capillaries is the chief force pushing water and solutes out of the blood and across the filtration membrane.

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An important factor directly affecting the glomerular filtration rate is __________.

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Which substance would NOT normally be expected in urine?

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All of the following are layers of the filtration membrane in the glomerular membrane EXCEPT the __________.

The ________________ is the finest layer of the filtration membrane.

Net filtration pressure in most capillary beds favors:

a. absorption.

b. osmosis.

c. filtration.

d. secretion.

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The glomerular capillaries differ from other capillary networks in the body because they a. have a larger area of anastomosis, b. are derived from and drain into arterioles, c. are not made of endothelium, d. are sites of filtrate formation.

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Multiple Choice More than one choice may apply. What is the glomerulus? a. The same as the renal tubule b. The same as Bowman's capsule c. The same as the nephron d. Capillaries

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Explain the process and purpose of tubular secretion.

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Explain the important differences between blood plasma and glomerular filtrate, and relate the differences to the structure of the filtration membrane.

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Filtration at the glomerulus is inversely related to a. water reabsorption, b. capsular hydrostatic pressure, c. arterial blood pressure, d. acidity of the urine.

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Multiple Choice More than one choice may apply. Which of the following is dependent on tubular secretion? a. Clearing penicillin from the blood b. Removal of nitrogenous wastes that have been reabsorbed c. Removal of excess potassium ions from the blood d. Control of blood pH

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Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

d. Filtrate flows from the renal corpuscle to the distal tubule, the nephron loop, the proximal tubule, and into the collecting system.

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Describe the structure of the filtration membrane.

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Which of the following substances would pass through the filtration membrane to become part of the filtrate under normal circumstances? (Circle all that apply.)

a. Sodium ions

b. Albumin

c. Glucose

d. Erythrocytes

e. Leukocytes

f. Amino acids

g. Urea

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Which of the following is false about the GFR?

a. The GFR averages about 120 ml/min.

b. The GFR increases when the afferent arteriole dilates.

c. The GFR decreases when the efferent arteriole constricts.

d. The GFR decreases when the afferent arteriole constricts

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Fill in the blanks: Glomerular hydrostatic pressure _____ filtration; colloid osmotic pressure and capsular hydrostatic pressure_____ filtration.

a. favors; favor

b. opposes; oppose

c. favors; oppose

d. opposes; favor

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The route by which substances are reabsorbed by crossing through the cells of the renal tubule and collecting system is known as the:

a. paracellular route.

b. transcellular route.

c. primary active transport route.

d. facultative route.

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Predict the effects the following scenarios would have on glomerular filtration:

a. Having excess proteins in the blood, increasing colloid osmotic pressure

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Predict the effects the following scenarios would have on glomerular filtration:

b. Having low arterial blood pressure (hypotension)

187

Why is urinalysis a routine part of any good physical examination?

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Mr. Jessup, a 55-year-old man, is operated on for a cerebral tumor. About one month later, he complains that he is excessively thirsty and that he has been voiding almost continuously. A urine sample is collected, and its specific gravity is 1.001. What is your diagnosis of Mr. Jessup's problem, and how might it be related to his previous surgery?

184

Raymond is hypertensive and was recently diagnosed with impaired kidney function based on urinalysis and a blood test for creatinine. What sorts of test results would you expect, and how is hypertension related to kidney function?

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A 55-year-old woman is awakened by an excruciating pain that radiates from her right abdomen to her flank on the same side. The pain is not continuous, but it recurs every 3 to 4 minutes. Diagnose this patient's problem, and cite factors that might favor its occurrence. Explain why this woman's pain comes in 'waves.'

195

What happens to the rate of RBC production in a patient on dialysis with total renal failure? What could be given to the patient to counteract such a problem? (Hint: You might want to check Table 9.2 for help with this one.)

195

Normal urine should have which of the following properties? Circle all that apply.

a. Translucency

b. Yellowish pigment

c. Cloudy appearance

d. pH less than 4.5

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The GFR may be estimated by measuring the rate at which certain substances are removed from the blood, which is known as:

a. renal clearance.

b. plasma creatinine.

c. glomerular hydrostatic pressure.

d. inulin estimation.

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What might it mean if you found a high concentration of urobilinogen in your patient's urine? (Hint: Consider the source of urobilinogen.) (Connects to Chapter 19)

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Patty, aged 55, is awakened by excruciating pain that radiates from her right abdomen to the loin and groin regions on the same side. The pain is not continuous but recurs at intervals of 3 to 4 minutes. Diagnose her problem, and cite factors that might favor its occurrence.

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While repairing a frayed utility wire, Kevin, an experienced lineman, slips and falls to the ground. Medical examination reveals a fracture of his lower spine and transection of the lumbar region of the spinal cord. How will Kevin's micturition be controlled from this point on? Will he ever again feel the need to void? Will there be dribbling of urine between voidings? Explain the reasoning behind all your responses.

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