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Introduction Page 456 1. What is the major role of the kidneys? A. Filter gallons of fluid from the bloodstream. B. Process the filtrate C. Allows wastes and excess ions to leave the body in urine while returning needed substances to the blood in just the right proportions. D. The kidneys bear the major responsibility for eliminating nitrogenous wastes, toxins, and drugs from the body. •2. Discuss the regulatory responsibilities of the kidneys: • A. The enzyme RENIN is produced by the kidneys to help regulate blood pressure. • B. The hormone ERYTHROPOIETIN is released by the kidney to stimulate red blood cell production in bone marrow. • C. The kidneys convert vitamin D to its active form. • 3. What organs make up the urinary system? • Kidney, the paired ureters, the single urinary bladder, and the urethra. •KIDNEYS (LOCATION AND FUNCTION) PAGE 456 • 4. Where are the kidneys located? • Lies against the dorsal back wall, midways the body, partially covered by the rib cage. • 5. What is the size of the kidney? • 5 inches long, 2.5 inches wide, and 1 inch thick. About the size of a large bar of soap. • 6. What is the HILUS? • A. Medial indentation of the kidney. • B. Here, the ureters, the renal blood vessels, and nerves enter or exit the kidney. • 7. What do we find atop of each kidney? • The adrenal gland. • 8. Describe the RENAL CAPSULE: • A fibrous transparent capsule that covers the kidney and gives it a glossy appearance. • 9. Describe the Adipose Capsule: • A fatty mass that surrounds each kidney and helps hold it in place against the muscles of the trunk wall. • 10. Label the following picture: (location and function of the kidney page 457.) • 11. Discuss HYDRONEPHROSIS: • A. Rapid weight loss causes a reduction in the adipose capsule. • B. The kidneys slip down from their original position. • C. The ureters become kinked and tangled, Urine backs up and starts exerting pressure on the kidney. If untreated, kidney damage can occur. • 12. Discuss the three regions of the kidney: Renal cortex • Structures involved: • Renal medulla • Medullary pyramids • Apex • Renal columns Renal cortex • Function: • Filtration Calyces • Structures involved: • Extension of the renal pelvis Calyces • Function: • Cup shaped structure that collects urine from the renal cortex Renal Pelvis • Structures involved: • Connected to the ureters Renal Pelvis • Function: • Transfers urine out of the kidney to the bladder for storage. Calyces Renal Pelvis Ureter Renal cortex • 13. Discuss the blood supply to and from the kidney: • A. Entering into the hilus of each kidney is the Renal Artery. • B. Once inside the kidney, the renal artery subdivides into many smaller arteries. • C. These smaller arteries carry the blood deep into the renal cortex where cleansing of the blood occurs. • D. The clean blood is collected by smaller veins which merge into the Renal vein. • E. The Renal vein then exits the hilus carrying the clean blood out of the kidney. • NEPHRON AND URINE FORMATION (page 458) • 16. Identify the following nephron structures: Gomerulus • Site of high powered filtration. Renal tubule • Renal tubule is divided into various regions. Name given based on its location: • Glomerular capsule • Proximal convoluted tubule • Loop of Henle • Distal convoluted tubule • 17. Discuss the functional role of the nephron: • The nephron is responsible for filtration, reabsorption, and secretion. • 18. Discuss the process of filtration that occurs in the nephron: • A. Filtration is the job of the high powered glomerulus. • B. Filtrate is mostly blood plasma without the blood cells. It includes all substances that have been filtered out of the blood. • 19. Discuss the process of reabsorption that occurs in the nephron: • In reabsorption, done by tubule cells, amino acids, glucose, water, and some ions are returned to the blood. • 20. Discuss the process of secretion that occurs in the nephron: • A. The tubule cells will secrete substances into the filtrate that will neutralize most toxins that have been removed. • B. This secretion also stabilizes ions that have been removed. • C. This secretion also adjust the pH balance of the filtrate, bringing the pH to neutral. • 22. What is the major factor that affects blood composition: • 22. What is the major factor that affects blood composition: • Our diet • Cellular metabolism • Urinary output • 23. Explain how the kidneys are involved in maintaining blood composition: • A. Allows nitrogen containing waste to go out in the urine. • B. Maintains water and electrolyte balance by absorbing more or less water and reclaiming ions in response to hormonal signals. • C. Maintains the acid base balance by actively secreting bicarbonate ions and by when it needs to lower the pH, and by secreting H+ when it needs to raise the pH. • 24. Describe Urine: • A. Healthy urine is a clear, maybe slightly yellow, and a little acidic. • B. Substances normally found in the urine include nitrogenous wastes, water, and various ions. • URETERS, URINARY BLADDER, AND UTETHRA (page 468) 25. URETERS: • Slender tubes running from the kidneys to the bladder. • The ureters conduct urine by peristalsis from the kidney to the bladder. • 26. URINARY BLADDER • A. A muscular sac posterior to the pubic symphysis. • B. The function of the urinary bladder is to store urine. • C. It has two inlets (ureters) and one outlet (urethra) • D. In males the prostate gland surrounds the urethra (outlet). • 27. The URETHRA: • A. The urethra is a tube that leads urine from the bladder to the body exterior. • B. In females, it is 3-4 cm long and conducts only urine. • C. In males, it is 20 cm long and conducts both urine and sperm. • D. The internal sphincter of smooth muscles is at the bladder – urethra junction. • E. The external sphincter of skeletal muscle is located further down. • 28. Micturition • A. Micturition is the emptying of the bladder by urination. • B. The micturition reflex causes the involuntary internal sphincter to open when stretch receptors in the bladder wall are stimulated. • C. Since the external sphincter is voluntarily controlled, micturition can ordinarily be temporarily delayed. • D. Incontinence is the inability to control micturition. • DEVELOPMENTAL ASPECTS OF THE URINARY SYSTEM (page 471) • 29. When does embryonic kidney function begin? • A. The kidneys begin to develop in the first few weeks of embryonic life and are excreting urine by the third month. • 30. Describe the following congenital kidney abnormalities: • Polycystic kidney • A. A degenerative condition that runs in families. . • B. In this disease, one or both kidneys are enlarged and have many blister – like sacs containing urine. • C. These cysts interfere with renal function by obstructing urine drainage. Treatment? • Use antibiotics to fight infection. • Kidney transplant or eventual death. HYPOSPADIAS. • Occurs in boy babies only. • It occurs when the urethral opening is on the side of the penis instead at the end of the penis. • Corrective surgery is generally done when the child is around 12 months old. 31. Common Urinary problems: • Fecal microorganisms • Sexually transmitted disease organisms • Streptococcus bacteria 32. What is renal failure and how is it treated? • Renal failure is uncommon. • In renal failure, the kidneys are unable to concentrate urine. • Once renal failure has begun, patient must go on dialysis. Here the patient is hooked up to a machine that filters the blood and then pumps it back in. 33. How does Age affect the kidney and kidney function? • With age, filtration rate decreases and tubule cells become less efficient at concentrating urine, leading t urgency, frequency, and incontinence. • In males, urinary retention is another common problem.