Download Renal Anatomy and Physiology Worksheet

Name ______________________________
Revised August 2015
REVISED Renal Anatomy and Physiology Worksheet
1.
On the diagram below label the major organs of the urinary system.
2.
List the major functions performed by the kidneys. List as many as your textbook (or professor)
has given.
3.
On the diagram below label the major parts of the kidney.
outermost connective tissue
conduit for blood vessels & nerves
space
space
region
region
region
rounded tip
entire structure
space
tube
2
4.
On the diagram below label the parts of the cortical and juxtamedullary nephrons and other nonnephron parts of the kidney.
C
O
capillaries
R
B
specialized cells
T
E
capillaries
A
specialized cells
X
O M
U E
T D
E U
R L
L
A
I
N
N
E
R
M
E
D
U
L
L
A
duct - not part of nephron
rounded tip
space - not part of nephron
5.
Which nephron above (A or B) is the cortical nephron and which is the juxtamedullary nephron?
A is the
6.
_____________________________
B is the __________________________
a. Draw at least one arrow in each labelled part of the cortical and juxtamedullary nephrons above
to indicate the direction of fluid flow. The more arrows the better.
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b.
Fill in the blanks below to trace the flow of fluid through a cortical nephron. The first line,
“glomerulus” has been filled in for you.
glomerulus
___________________________
space
___________________________
tubule
___________________________
limb
___________________________
limb
___________________________
tubule
___________________________
tubule
___________________________
duct
both limbs together
c.
Fill in the blanks below to trace the flow of fluid through a juxtamedullary nephron.
glomerulus
___________________________
space
___________________________
tubule
___________________________
limb
___________________________
limb
___________________________
limb
___________________________
tubule
___________________________
tubule
___________________________
duct
all sections of both limbs together
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d.
Fill in blanks to trace urine flow from collecting duct to outside a female’s body.
collecting duct
___________________________
duct through ___________________________
___________________________
___________________________
e.
___________________________
wide area
___________________________
tube
___________________________
hollow muscular organ
___________________________
sphincter (involuntary)
___________________________
tube
___________________________
sphincter (voluntary)
___________________________
opening to exterior
Fill in blanks to trace urine flow from collecting duct to outside a male’s body.
collecting duct
___________________________
duct through ___________________________
___________________________
___________________________
___________________________
wide area
___________________________
tube
___________________________
hollow muscular organ
___________________________
sphincter (involuntary)
___________________________
tube
___________________________
sphincter (voluntary) (omit membranous urethra)
___________________________
tube
___________________________
opening to exterior
5
7.
Three nephron processes are responsible for producing urine. On the simplified diagram below
label each of these 3 processes on the bold label lines.
afferent arteriole
glomerular capillaries
efferent arteriole
Bowman’s capsule
cortical radiate artery
peritubular capillaries
rest of nephron
(proximal convoluted tubule
through collecting duct)
urine
8.
Each of the 6 diagrams below is similar to the one above. Based on the arrows shown in each
diagram determine whether the substance shown is NORMALLY only filtered, only secreted,
filtered and completely reabsorbed, filtered and partially reabsorbed, filtered and secreted, or
filtered and partially reabsorbed and secreted. THEN, name a substance that the nephron handles
in exactly the manner shown.
a.
This substance is __________________________
Optional: An example of a substance handled by
the nephron in this manner is ________________
urine
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b.
This substance is __________________________
Optional: An example of a substance handled by
the nephron in this manner is _________________
urine
c.
This substance is __________________________
An example of a substance handled by the
nephron in this manner is ___________________
urine
d.
This substance is __________________________
Optional: An example of a substance handled by
the nephron in this manner is _________________
urine
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e.
This substance is __________________________
An example of a substance handled by the
nephron in this manner is ___________________
urine
f.
This substance is __________________________
An example of a substance handled by the
nephron in this manner is ___________________
urine
8
9.
Write the names of renal blood vessels on the blanks below to indicate the direction of blood flow
through a kidney. Note that the first line, “aorta” has been filled in for you, as have the names of
some of the arteries and veins. On the three lines labelled “capillaries” you are to write the names
of those particular capillaries.
aorta

______________________________

segmental artery

interlobar artery

arcuate artery

______________________________

______________________________

______________________________ capillaries

______________________________
from both cortical &
juxtamedullary
nephrons
from juxtamedullary
nephrons only
___________________ capillaries
cortical radiate (interlobular) veins

arcuate vein

interlobar vein

______________________________

inferior vena cava
__________________ capillaries
9
10. Write the equation used to define and calculate net filtration pressure (NFP). You may use words
or the standard symbols for the terms of the equation.
11. In 11a and 11c below you are asked to calculate a numerical value for net filtration pressure first
at the afferent end of the glomerular capillaries (11a) and then at the efferent end of the glomerular
capillaries (11b). In 11e you are asked to average these two pressures to determine the average
net filtration pressure across all of the glomerular capillaries. Don’t forget to include units with
your answer.
a. At the afferent end of the glomerular capillaries: glomerular capillary blood (hydrostatic or
hydraulic) pressure is 60 mm Hg; hydrostatic (hydraulic) pressure in Bowman’s capsule is 15
mm Hg; colloid osmotic pressure of blood in the glomerular capillaries at the afferent end is 21
mm Hg; and colloid osmotic pressure in Bowman’s capsule is 0 mm Hg. Please show your
work.
b. Does your answer to the above question indicate that filtration or reabsorption is occurring
across the glomerular capillaries at their afferent end?
c. At the efferent end of the glomerular capillaries: glomerular capillary blood (hydrostatic or
hydraulic) pressure is 58 mm Hg; hydrostatic (hydraulic) pressure in Bowman’s capsule is 15
mm Hg; colloid osmotic pressure of blood in the glomerular capillaries at the efferent end is 33
mm Hg; and colloid osmotic pressure in Bowman’s capsule is 0 mm Hg. Please show your
work.
d. Does your answer to the above question indicate that filtration or reabsorption is occurring
across the glomerular capillaries at their efferent end?
e. What is the average net filtration pressure across the glomerular capillaries in the above 2
problems? Show your work and include units.
f. Write a sentence or two explaining why colloid osmotic pressure in the glomerular capillaries is
greater at the efferent end than at the afferent end.
10
12. a. Calculate a numerical value for net filtration pressure (NFP) in the peritubular capillaries using
the values given below. Peritubular capillary blood (hydrostatic or hydraulic) pressure is 20
mm Hg; hydrostatic (hydraulic) pressure in interstitial fluid outside the capillaries is 3 mm Hg;
colloid osmotic pressure of blood in the peritubular capillaries is 33 mm Hg; and colloid
osmotic pressure of the interstitial fluid is 6 mm Hg. Please show your work and include units
with your answer.
b. Does your answer to the above question indicate that filtration or reabsorption is occurring
across the peritubular capillaries?
13. The following are cause and effect chains of events. In each a sideways arrow () means
“causes.” An up arrow () means “increases.” A down arrow () means “decreases.” Always
assume that any items or variables not listed remain unchanged and so can be ignored. Fill in each
blank with either an up arrow, a down arrow, or No  to indicate “no change” in the listed
variables. As an example to get you started, the blanks in the first chain of events have been filled
in for you.
a.  afferent
arteriole
constriction

 
b.  afferent
arteriole
dilation
glomerular capillary   NFP   GFR
blood pressure
renal blood flow
____ glomerular capillary  ____ NFP  ____ GFR
blood pressure
 ____ renal blood flow
c.  efferent
arteriole
constriction
____ glomerular capillary  ____ NFP  ____ GFR
blood pressure
 ____ renal blood flow
d.  efferent
arteriole
dilation
____ glomerular capillary  ____ NFP  ____ GFR
blood pressure
 ____ renal blood flow
e.  both afferent
and efferent
arteriole
constriction
equally
____ glomerular capillary  ____ NFP  ____ GFR
blood pressure
 ____ renal blood flow
11
14. a. Below is part of the wall of a generalized nephron, i.e., the cells could be from any part of the
nephron - the proximal or distal convoluted tubule, thin descending or thin ascending limbs of
Henle’s loop, thick ascending limb of Henle’s loop, connecting tubule, or the collecting duct.
Label the parts shown. Words in small font beneath the lines provide additional information
to guide you. Of course not all parts of the nephron are composed of the non-microvilli simple
cuboidal cells shown in the diagram. So in parts b.-d. at the bottom of the page name the
nephron segment(s) composed of the cell type listed.
Fluid Flow
Blood Flow
space
seal
epithelial cell of nephron
this particular surface or membrane
this particular surface or membrane
route through cell
route through seal and between cells
fluid or space
blood vessel
b. In the __________________________________ the simple cuboidal cells all have microvilli.
1 nephron segment
c. In the ______________________________________________________________________
2 nephron segments
the cells are simple squamous cells.
d. In the ______________________________________________________________________
4 nephron segments
the cells are mainly simple cuboidal cells (without microvilli) as shown above.
12
15. The purpose of the diagrams on this and the next three pages is to show the mechanisms by which
the proximal convoluted tubule reabsorbs common substances. Part 15a shows only Na+
reabsorption, but of course it is essential to keep in mind that it creates the conditions for
reabsorption of most of the other substances in 15b, 15c, and 15d. Also, remember that each
proximal convoluted tubule cell is carrying out all of these processes (and more) simultaneously.
General directions for all 4 diagrams are as follows. To show movement through transporters or
channels, draw arrows across both the luminal (apical) and basolateral (basal) membranes, and/or
through the tight junctions. Use dashed arrows (
) to represent passive transport. Use
dash/dot arrows (
) to represent active transport, either primary or secondary. In addition,
make your arrows slant downward in the direction of flow to show movement of a substance
down its concentration gradient or slant upward to show movement of a substance up its
concentration gradient. Specific instructions for each diagram are given with that diagram.
a. Specific directions: Show how Na+ is reabsorbed across the proximal convoluted tubule cell
below and into the blood. First, show what the Na+ and K+ concentrations are in every
compartment (luminal filtrate, intracellular fluid, interstitial fluid, and blood) by writing either
“High Na+” or “Low Na+” AND either “High K+” or “Low K+” in each compartment. Next
draw and label each of the following: Na+K+ATPase pump, Na+ transporter/channel, and a K+
ion channel. Lastly, draw arrows (as described above in the general directions) to show the
movement of Na+ through each transporter/channel, or pump as it is reabsorbed from filtrate in
the lumen to blood in peritubular capillaries. Also show the pumping and leaking of K+.
interstitial
fluid
lumen
fluid flow ↓
peritubular
capillary
blood flow ↓
PCT cell
PCT cell
PCT cell
13
b. Specific directions: Show how H2O, Cl−, K+, Ca2+, and urea are reabsorbed from luminal
filtrate to blood across the proximal convoluted tubule below. You may wish to start by
redrawing the reabsorption of Na+ from the previous page as a reminder that all of these
substances follow Na+. Draw and label aquaporin channels for water. Transporters and
channels for other substances do not have to be shown. Draw arrows (as described in the
general directions on page 12) to show the pathway(s) for reabsorption of each of the
substances above. Show which substances are reabsorbed via the transcellular route, which
via the paracellular route, and which via both routes.
interstitial
fluid
lumen
fluid flow ↓
peritubular
capillary
blood flow ↓
PCT cell
PCT cell
PCT cell
14
c. Specific directions: Show how the proximal convoluted tubule removes bicarbonate ion,
HCO3−, from the filtrate and adds it to the blood. Show that this process is not technically
reabsorption because the HCO3− removed from the filtrate is not the same one that is released
into the blood. In the lumen write the complete chemical reaction of HCO3− with H+ to H2CO3
and then to CO2 and H2O. Show which step is catalyzed by a famous enzyme. Draw in the
location of the enzyme and label it. Show which substance(s) can cross the apical (luminal)
membrane and enter the cell. Use the appropriate arrows described in the general directions
on page 12. Next write the complete chemical reaction that these substances undergo within
the proximal convoluted tubule cell being sure to show again which step is catalyzed by the
famous enzyme and labelling that enzyme. Lastly, use the appropriate arrows to show the
correct movement of the products of this chemical reaction out of the cell, into the interstitial
fluid and peritubular capillary blood.
interstitial
fluid
lumen
fluid flow ↓
peritubular
capillary
blood flow ↓
PCT cell
PCT cell
PCT cell
15
d. Specific directions: Show how glucose and amino acids are reabsorbed from luminal filtrate
to blood across the proximal convoluted tubule below. Draw and label a Na+-glucose
cotransporter, a Na+-amino acid cotransporter, Na+K+ ATPase pump, a facilitated diffusion
glucose transporter and a facilitated diffusion amino acid transporter. Next show what the Na+
concentration is in every compartment (luminal filtrate, intracellular fluid, interstitial fluid,
and blood) by writing either “High Na+” or “Low Na+” in each compartment. Write “High
glucose” and “High amino acids” in the compartment that has the highest concentration of
these substances. Write “Low glucose” and “Low amino acids” in each of the other
compartments. Lastly and most importantly, draw arrows (as described in the general
directions on page 12) to show the pathway for reabsorption of Na+, glucose, and amino acids.
interstitial
fluid
lumen
fluid flow ↓
peritubular
capillary
blood flow ↓
PCT cell
PCT cell
PCT cell
16
16. On page 17 is a diagram of a juxtamedullary nephron, well, at least most of one. It includes
Bowman’s capsule, proximal convoluted tubule, descending limb of the loop of Henle, thin and
thick ascending limbs of the loop of Henle, and the distal convoluted tubule. Collecting ducts for
this nephron are shown on pages 19 & 20. The general instructions for page 17 are to show which
substances are reabsorbed and/or secreted in each segment from the proximal convoluted tubule
through the collecting duct. For each substance use the symbol
drawn across the nephron’s
wall to represent active transport, either primary or secondary, and the symbol  also drawn
across the nephron’s wall to represent passive transport. Of course each arrow could be coming
out of the tubular fluid to represent reabsorption or going into tubular fluid to represent secretion.
The line representing the nephron’s wall is a composite of BOTH the luminal (apical) and
basolateral (basal) membranes. If a substance is actively reabsorbed or secreted across either
membrane, use the active transport symbol (
) to show its movement. If a substance is
passively reabsorbed or secreted across both membranes, use the passive transport symbol () to
show its movement. Specific instructions for each nephron segment follow. A curved arrow
glancing off the nephron’s wall shows that the nephron segment is impermeable to that substance.
These curved arrows have been added for you on page 17.
PROXIMAL CONVOLUTED TUBULE: In the proximal convoluted tubule segment of the
nephron on page 17 use the symbols
or  to show the reabsorption or secretion (if
applicable) for each of the following substances: Na+, H2O, Cl, K+, Ca2+, HCO3, H+, urea,
glucose, and amino acids. Label each symbol with the substance being reabsorbed or secreted.
As an example Na+, H+, and H2O have been done for you. Note: Here we simplify HCO3−
handling and say it is reabsorbed. As you showed on page 14, the HCO3− ion that enters the blood
is not the same one that was filtered. However, the net effect is that HCO3− is removed from the
filtrate and added to the blood as if it had been reabsorbed.
DESCENDING LIMB OF THE LOOP OF HENLE: In the descending limb of the loop of Henle
on page 17 use the appropriate symbols to show the reabsorption or secretion (if applicable) of
H2O and urea. The curved arrow with Na+Cl− at its end shows that this segment is impermeable to
Na+ and Cl−.
THIN ASCENDING LIMB OF THE LOOP OF HENLE: In the thin ascending limb of the loop
of Henle on page 17 use the appropriate symbols to show the reabsorption or secretion (if
applicable) of Na+, Cl, and urea. The curved arrows with H2O show that this segment is
impermeable to water.
THICK ASCENDING LIMB OF THE LOOP OF HENLE: In the thick ascending limb of the
loop of Henle on page 17 use the appropriate symbols to show the reabsorption or secretion (if
applicable) of Na+, Cl, and K+. The curved arrows with H2O and urea at their ends show that this
segment is impermeable to both water and urea.
DISTAL CONVOLUTED TUBULE: In the distal convoluted tubule on page 17 use the
appropriate symbols to show the reabsorption or secretion (if applicable) of Na+ and Cl, and then
Ca2+ when parathyroid hormone (PTH) is present. The curved arrows with H2O and urea at their
ends show that this segment is relatively impermeable to both water and urea. (Note: Connecting
tubule will be included with the collecting duct in the next section.)
Na+ H2O
H+
to
collecting
duct
H2O
urea
urea
Na+Cl−
H2O
17
Na+Cl−
H2O
18
GENERAL DIRECTIONS FOR COLLECTING DUCTS: For this exercise the connecting
tubules may be considered to be part of the collecting duct system. Because so many substances
are reabsorbed and/or secreted across the collecting duct system and because the final reabsorption
or secretion depends upon various conditions and hormones in the body and because the
mechanisms of reabsorption and secretion are sometimes not straightforward, the functions of the
collecting duct system are complicated. The approach here is to try to simplify the functions and
mechanisms to the level of an introductory, two-semester anatomy and physiology course. For
example we will treat HCO3− as being reabsorbed, when as was seen on page 14, the process is
not that simple, although the net effect is “reabsorption”. In another attempt at simplification, the
collecting duct is treated separately for each of four contrasting conditions:  ADH,
 aldosterone,  dietary K+, and  acidosis/alkalosis. Separate directions for each set of
contrasting conditions are given below.
COLLECTING DUCT IN PRESENCE AND ABSENCE OF ANTIDIURETIC HORMONE
(ADH): The purpose of this section is to show the collecting duct’s reabsorption, secretion, and/or
impenetrability to H2O and urea when ADH is present (left side) and when ADH is absent (right
side). A simplifying assumption is that the collecting duct’s permeability to Na+ and Cl− is very
low and unchanging. Use the following symbols to show the movement (or lack of movement)
across the collecting duct:
H2O ← or → H2O for passive transport of H2O down its concentration gradient
H2O for H2O unable to pass through collecting duct cells (see example on p. 17)
urea ← or → urea for passive transport of urea down its concentration gradient
urea
for urea unable to pass through collecting duct cells (see example on p. 17)
Recall that ADH does not directly affect the movement of urea. However water’s movement, or
lack of movement, may affect urea’s concentration in the collecting duct fluid and hence affect
urea’s movement. The dashed line represents the boundary between the cortical collecting duct
above the line and the medullary collecting duct below the line. Be sure to show any differences in
the reabsorption, secretion, or impenetrability of H2O and urea in these two regions of the collecting
duct. Lastly, at the bottom of each side of the collecting duct, circle the most appropriate water
content of the urine, volume of the urine, and osmolarity (compared to plasma) of the urine that is
produced in the presence and absence of ADH.
COLLECTING DUCT IN PRESENCE AND ABSENCE OF ALDOSTERONE: The purpose of
this section is to show the reabsorption, secretion, and/or no transport of Na+, Cl−, K+ and H2O
when aldosterone is present (left side) and absent (right side). Because this section is meant to
focus on aldosterone’s effect on Na+Cl− reabsorption, you should assume constant and normal
blood K+ levels. However, because aldosterone also affects K+ reabsorption/secretion, you must
show the results of those affects. Also, even though the collecting duct is able to separate Na+Cl−
reabsorption from H2O reabsorption, some H2O usually follows Na+Cl−. Please show this H2O
movement. Use the following symbols to show movement (or lack of movement) across the
collecting duct:
Na+Cl−
or
Na+Cl− for active transport of Na+Cl− against its concentration gradient
Na+Cl− for Na+ Cl− essentially unable to pass through collecting duct (see example on p. 17)
K+
or
K+ for active transport of K+
+
+
K  or  K for passive transport of K+
H2O  or  H2O for passive transport of H2O
19
H2O
for H2O essentially unable to pass through collecting duct (see example on p. 17)
Lastly, at the bottom of each side of the collecting duct, circle the most appropriate Na+, Cl−, K+,
and H2O contents of the urine produced.
COLLECTING DUCT UNDER HIGH AND LOW K+ CONDITIONS: The purpose of this
section is to show the net reabsorption and/or net secretion of K+ under conditions of high K+ (left
side) and low K+ (right side). In this section ignore the effects of acidosis/alkalosis. They will be
covered in the next section. Also, because the collecting duct is constantly reabsorbing some K+
and can only change K+ secretion, show only the net K+ reabsorption or net K+ secretion. Use the
symbol K+
or
K+ to show net active transport of K+, and K+  or  K+ to show net
+
passive transport of K . Lastly, at the bottom of each side of the collecting duct, circle the most
appropriate K+ content of the urine produced.
COLLECTING DUCT DURING ANIMAL PROTEIN DIET/ACIDOSIS OR VEGETARIAN
DIET/ALKALOSIS: The purpose of this section is to show how the collecting duct is involved in
acid-base regulation by reabsorbing or secreting H+ and HCO3− and how this process affects K+
reabsorption/secretion. At the top of each collecting duct, write the type of intercalated cell
carrying out the transport processes you will show below. Use the following symbols to show the
movement across the collecting duct:
H+
or
H+ for active transport of H+
H+
H+
or
for the active transport exchange of H+ for K+
K+
K+
−
HCO3  or  HCO3− for passive transport of HCO3−
Lastly, at the bottom of each side of the collecting duct, circle the most appropriate H+, HCO3−,
and K+ contents of the urine produced.
+ ADH
 ADH
interstitial
fluid
and
blood
+ aldosterone
 aldosterone
more Na+ in urine
less Na+ in urine
more Cl in urine
less Cl in urine
more K+ in urine
less K+ in urine
more H2O in urine
less H2O in urine
more Na+ in urine
less Na+ in urine
more Cl in urine
less Cl in urine
more K+ in urine
less K+ in urine
more H2O in urine
less H2O in urine
interstitial
fluid
and
blood
20
more H2O in urine
less H2O in urine
large urine volume
small urine volume
iso-osmotic urine
hyperosmotic urine
hypo-osmotic urine
more H2O in urine
less H2O in urine
large urine volume
small urine volume
iso-osmotic urine
hyperosmotic urine
hypo-osmotic urine
normal or high K+ diet,
hyperkalemia, or
+ aldosterone
low K+ diet,
hypokalemia, or
 aldosterone
interstitial
fluid
and
blood
animal protein in diet,
or body in acidosis
interstitial
fluid
and
blood
_________________
type of CD cell
vegetarian diet, or
body in alkalosis
_________________
type of CD cell
21
more K+ in urine
less K+ in urine
more K+ in urine
less K+ in urine
more H+ in urine
less H+ in urine
more HCO3 in urine
less HCO3 in urine
more K+ in urine
less K+ in urine
more H+ in urine
less H+ in urine
more HCO3 in urine
less HCO3 in urine
more K+ in urine
less K+ in urine
22
17. Control of renin secretion. The three ways in which renin secretion is controlled are listed below
in a, b, & c. The steps in each cause and effect chain of events leading to renin secretion have
been scrambled. Your job is two-fold. First, put the steps in the correct order leading to renin
secretion. Second, in front of each step place either an up arrow () to indicate “increased”, or a
down arrow () to indicate “decreased”, or No  to indicate “no change” in that variable. For the
purpose of this example, each of the three methods of altering renin secretion will begin with a
decrease in mean arterial blood pressure indicated by “MAP”. As an example to get you started,
the first one has been done for you.
a. Scrambled steps: MAP, CNS vasomotor center activity, stimulation of granular cells of
afferent arteriole, renin, sympathetic nerve impulses to kidney, carotid sinus and aortic arch
baroreceptor activity
correct answer:
MAP
carotid sinus and aortic arch baroreceptor activity
CNS vasomotor center activity
sympathetic nerve impulses to kidney
stimulation of granular cells of afferent arterioles
renin secretion
b. Now it’s your turn. The scrambled steps are: MAP, renin secretion, stimulation of granular
cells of afferent arterioles, blood pressure in afferent arterioles
MAP
c. Scrambled steps: MAP, glomerular filtration rate, net filtration pressure, stimulation of
granular cells of afferent arteriole, blood pressure in glomerular capillaries, blood pressure in
afferent arterioles, Na+ delivery to macula densa cells, renin secretion, amount of filtered Na +
MAP
23
18. Write several sentences to describe in the correct order the sequence of events leading from
increased secretion of renin to increased formation of angiotensin II. Include all of the following
in your description: renin, angiotensin II, angiotensin I, angiotensinogen, the source of
angiotensinogen, angiotensin converting enzyme, and the primary location of angiotensin
converting enzyme in the body.
19. To summarize the effects of factors in #17 & #18 above, put either an up or down arrow on each
of the blank lines below.
MAP  ____ renin  ____ angiotensin II
MAP  ____ renin  ____ angiotensin II
20. The questions below ask you to summarize the effects of the renin-angiotensin system on blood
pressure homeostasis, particularly how the renin-angiotensin system causes an increase in MAP
back toward the set point after an unexpected drop in MAP. The steps in several cause and effect
chains of events involved in blood pressure regulation are scrambled below. As you did in #17 on
the previous page, put the steps in the correct order and then put an up or down arrow in front of
each step to indicate whether it is increased or decreased in the attempt to return blood pressure to
normal. A review of basic cardiovascular physiology may be helpful if you have difficulty. Note
that every chain of events will begin with a decrease in MAP and end with either an increase or
decrease in MAP.
a. Scrambled steps: MAP, angiotensin II, total peripheral resistance (TPR), renin,
vasoconstriction of arterioles throughout body, MAP.
MAP
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b. Scrambled steps: MAP, end diastolic volume (EDV), stroke volume (SV), blood volume,
renin, aldosterone, angiotensin II, stretch of ventricles, venous return to heart, cardiac output
(CO), Na+ (& H2O) reabsorption in collecting duct, ventricular filling, force of contraction via
preload (Frank-Starling law of heart), MAP
MAP
c. Scrambled steps: MAP, end diastolic volume (EDV), stroke volume (SV), blood volume,
renin, antidiuretic hormone (ADH), angiotensin II, stretch of ventricles, venous return to heart,
cardiac output (CO), H2O reabsorption in collecting duct, ventricular filling, force of
contraction via preload (Frank-Starling law of heart), MAP
MAP
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d. Scrambled steps: MAP, end diastolic volume (EDV), stroke volume (SV), blood volume,
renin, activation of hypothalamic thirst center, angiotensin II, stretch of ventricles, venous
return to heart, cardiac output (CO), fluid intake, ventricular filling, force of contraction via
preload (Frank-Starling law of heart), MAP
MAP
e. Do your answers to 20a-d make sense? Each of the above cause and effect chains of events is
a homeostatic mechanism designed to correct for deviations in blood pressure and to bring
blood pressure back toward the set point.
1) Does each of your chains of events end with MAP moving in a direction opposite to the
initial change? yes or no _______
2) Questions 20b-d each involved 14 steps. Does each of your answers have 14 steps?
yes or no _______
End of 2015 revised anatomy and physiology worksheet.