Anatomy and Phys II Exam 4 Urinary System
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Free Anatomy and Phys II Exam 4 Urinary System Questions
The presence of protein in the urine indicates which of the following?
- Damage to the filtration membrane
- High levels of transcription and translation by the body's tissues
- Damage to the renal tubules
- Too much protein in the diet
Explanation
Explanation:
Correct Answer: (A) Damage to the filtration membrane
Protein molecules, particularly albumin, are normally too large to pass through the intact glomerular filtration membrane. The presence of significant protein in the urine (proteinuria) indicates that the filtration membrane has been damaged, allowing proteins to leak through into the filtrate. This is a hallmark sign of glomerular diseases such as glomerulonephritis and nephrotic syndrome.
Why Other Options are Incorrect:
- B. High levels of transcription and translation by the body's tissues — Protein synthesis activity in body tissues does not directly cause protein to appear in urine; it is the integrity of the filtration membrane that determines protein loss.
- C. Damage to the renal tubules — Tubular damage would affect reabsorption and secretion of small molecules, not typically result in significant proteinuria, as protein filtration is primarily controlled at the glomerular level.
- D. Too much protein in the diet — Dietary protein intake does not directly cause proteinuria; the kidneys efficiently handle normal variations in dietary protein without allowing protein into the urine.
The chief force pushing water and solutes out of the blood across the filtration membrane is _______.
- The ionic electrochemical gradient
- Glomerular hydrostatic pressure (glomerular blood pressure)
- Protein-regulated diffusion
- The size of the pores in the basement membrane of the capillaries
Explanation
Explanation:
Correct Answer: (B) Glomerular hydrostatic pressure (glomerular blood pressure)
Glomerular hydrostatic pressure is the primary driving force for filtration at the glomerulus. The high blood pressure within the glomerular capillaries — significantly higher than in other capillary beds — pushes water and small solutes out of the blood across the filtration membrane into Bowman's capsule. This pressure-driven process is what initiates urine formation.
Why Other Options are Incorrect:
- A. The ionic electrochemical gradient — Electrochemical gradients drive ion movement across membranes in processes like active transport and diffusion, but they are not the chief force driving bulk filtration across the glomerular membrane.
- C. Protein-regulated diffusion — Filtration across the glomerular membrane is a pressure-driven process, not regulated by transport proteins. Large proteins are actually excluded from filtration.
- D. The size of the pores in the basement membrane — While pore size determines what can be filtered (selectivity), it is not the driving force behind filtration. The hydrostatic pressure is the force that drives fluid through those pores.
What is the effect of antidiuretic hormone on the cells of the collecting duct?
- Triggers synthesis of more sodium channels in the collecting duct apical membranes
- Triggers synthesis of more potassium channels in the collecting duct apical membranes
- Causes aquaporins to be inserted into the collecting duct apical membranes
- Inhibits sodium reabsorption through the collecting duct apical membranes
Explanation
Explanation:
Correct Answer: (C) Causes aquaporins to be inserted into the collecting duct apical membranes
ADH (antidiuretic hormone/vasopressin) binds to V2 receptors on collecting duct cells, triggering a cAMP-mediated signaling cascade that causes aquaporin-2 water channels to be inserted into the apical membranes of the collecting duct cells. This dramatically increases the permeability of the collecting duct to water, allowing water to be reabsorbed by osmosis into the hypertonic medullary interstitium, producing concentrated urine.
Why Other Options are Incorrect:
- A. Triggers synthesis of more sodium channels — Sodium channel regulation in the collecting duct is primarily controlled by aldosterone, not ADH.
- B. Triggers synthesis of more potassium channels — Potassium channel regulation is associated with aldosterone's effects on principal cells, not ADH.
- D. Inhibits sodium reabsorption — ADH does not inhibit sodium reabsorption; its primary action is on water permeability through aquaporin insertion.
An increase in the permeability of the cells of the collecting duct to water is due to a(n) _______.
- Increase in the production of aldosterone
- Decrease in the production of ADH
- Decrease in the concentration of the blood plasma
- Increase in the production of ADH
Explanation
Explanation:
Correct Answer: (D) Increase in the production of ADH
Antidiuretic hormone (ADH), also known as vasopressin, is responsible for increasing the permeability of the collecting duct cells to water. When ADH is released from the posterior pituitary gland, it binds to receptors on collecting duct cells, triggering the insertion of aquaporin channels into the cell membranes. This allows water to be reabsorbed from the filtrate back into the bloodstream, concentrating the urine.
Why Other Options are Incorrect:
- A. Increase in the production of aldosterone — Aldosterone acts on the collecting duct to increase sodium reabsorption and potassium excretion, not to increase water permeability directly.
- B. Decrease in the production of ADH — A decrease in ADH would reduce water permeability of the collecting duct, resulting in more dilute urine and increased urine output.
- C. Decrease in the concentration of the blood plasma — A decrease in blood plasma concentration would actually suppress ADH release, reducing water reabsorption rather than increasing it.
Which of the following hormones acting on the distal convoluted tubule is most responsible for retaining sodium ions in the blood?
- Parathyroid hormone
- Aldosterone
- Atrial natriuretic peptide
- Antidiuretic hormone
Explanation
Explanation:
Correct Answer: (B) Aldosterone
Aldosterone is the primary hormone responsible for sodium retention in the blood. It acts on the principal cells of the distal convoluted tubule and collecting duct to increase the number of sodium channels and Na⁺/K⁺-ATPase pumps in the cell membranes, promoting sodium reabsorption from the filtrate back into the bloodstream. Water follows the reabsorbed sodium by osmosis, increasing blood volume and pressure.
Why Other Options are Incorrect:
- A. Parathyroid hormone — PTH acts on the DCT to increase calcium reabsorption and decrease phosphate reabsorption; it is not primarily responsible for sodium retention.
- C. Atrial natriuretic peptide — ANP actually promotes sodium excretion (natriuresis) by inhibiting sodium reabsorption in the collecting duct, having the opposite effect of aldosterone.
- D. Antidiuretic hormone — ADH primarily increases water reabsorption by inserting aquaporins in the collecting duct; while it indirectly affects sodium concentration, it is not the primary hormone responsible for sodium retention.
Which of the following acts as the trigger for the initiation of micturition (voiding)?
- Motor neurons
- The sympathetic efferents
- The pressure of the fluid in the bladder
- The stretching of the bladder wall
Explanation
Explanation:
Correct Answer: (D) The stretching of the bladder wall
Micturition (voiding) is initiated when the bladder wall stretches as it fills with urine. Stretch receptors (mechanoreceptors) in the detrusor muscle of the bladder wall detect this stretching and send afferent signals to the micturition center in the sacral spinal cord, triggering the micturition reflex. This leads to parasympathetic stimulation causing detrusor muscle contraction and internal urethral sphincter relaxation.
Why Other Options are Incorrect:
- A. Motor neurons — Motor neurons are involved in the efferent (output) response of micturition, carrying signals to the bladder to contract, but they are not the initial trigger for voiding.
- B. The sympathetic efferents — Sympathetic stimulation actually promotes urine storage by relaxing the detrusor muscle and contracting the internal urethral sphincter; it does not trigger micturition.
- C. The pressure of the fluid in the bladder — While increased fluid volume contributes to bladder pressure, it is specifically the mechanical stretching of the bladder wall detected by stretch receptors that triggers the micturition reflex, not fluid pressure alone.
What is the most direct function of the juxtaglomerular apparatus?
- Help regulate urea absorption by the kidneys
- Help regulate blood pressure and the rate of excretion by the kidneys
- Help regulate blood pressure and the rate of blood filtration by the kidneys
- Help regulate water and electrolyte excretion by the kidneys
Explanation
Explanation:
Correct Answer: (C) Help regulate blood pressure and the rate of blood filtration by the kidneys
The juxtaglomerular apparatus most directly regulates blood pressure and the glomerular filtration rate (GFR). It does this through the release of renin in response to decreased blood pressure or decreased NaCl delivery, initiating the RAAS cascade. It also monitors filtrate composition via the macula densa to adjust afferent arteriole resistance and thereby control the rate of blood filtration.
Why Other Options are Incorrect:
- A. Help regulate urea absorption — Urea handling is primarily a passive process in the tubules and is not a direct function of the juxtaglomerular apparatus.
- B. Help regulate blood pressure and the rate of excretion — While blood pressure regulation is correct, the juxtaglomerular apparatus more specifically regulates the rate of filtration, not excretion directly.
- D. Help regulate water and electrolyte excretion — Water and electrolyte balance is more directly regulated by ADH and aldosterone acting on the collecting duct and distal tubule, not by the juxtaglomerular apparatus directly.
If the diameter of the afferent arterioles leading to the glomerulus increases (vasodilation), which of the following is NOT likely to occur?
- Net filtration pressure will increase
- Glomerular filtration rate will increase
- Systemic blood pressure will go up
- Urine output will increase
Explanation
Explanation:
Correct Answer: (C) Systemic blood pressure will go up
When afferent arterioles vasodilate, more blood flows into the glomerulus, increasing glomerular hydrostatic pressure, net filtration pressure, GFR, and ultimately urine output. However, afferent arteriole vasodilation actually decreases systemic blood pressure because blood is being redirected into the kidney's capillary beds, reducing peripheral vascular resistance. Therefore, systemic blood pressure going up is NOT an expected outcome.
Why Other Options are Incorrect (i.e., these WOULD likely occur):
- A. Net filtration pressure will increase — TRUE; increased blood flow into the glomerulus raises hydrostatic pressure, increasing net filtration pressure.
- B. Glomerular filtration rate will increase — TRUE; greater blood flow and increased hydrostatic pressure directly increase GFR.
- D. Urine output will increase — TRUE; a higher GFR means more filtrate is produced, leading to increased urine output.
The thin segment of the loop of Henle descending limb _______.
- Aids in the passive movement of water out of the tubule
- Is easily broken and replaced often
- Aids in the passive excretion of nitrogenous waste
- Helps to pack a greater number of nephron loops into a smaller space
Explanation
Explanation:
Correct Answer: (A) Aids in the passive movement of water out of the tubule
The thin descending limb of the loop of Henle is highly permeable to water. As the tubular fluid descends into the increasingly hypertonic medullary interstitium, water moves passively out of the tubule by osmosis. This passive water movement concentrates the tubular fluid and is a critical step in the countercurrent multiplication system that establishes the medullary osmotic gradient.
Why Other Options are Incorrect:
- B. Is easily broken and replaced often — This is not a recognized physiological characteristic of the thin descending limb; renal tubule cells are not described in terms of being easily broken and replaced.
- C. Aids in the passive excretion of nitrogenous waste — Urea recycling occurs primarily in the inner medullary collecting duct, not in the thin descending limb.
- D. Helps to pack a greater number of nephron loops into a smaller space — While the thin segment does allow for a longer loop in a compact space, this is a structural feature, not a functional description, and is not the best answer.
The urinary bladder is composed of _______ epithelium.
- Pseudostratified columnar
- Transitional
- Simple squamous
- Stratified squamous
Explanation
Explanation:
Correct Answer: (B) Transitional
The urinary bladder is lined with transitional epithelium, also called urothelium. This specialized epithelium is uniquely designed to stretch and recoil as the bladder fills and empties. When the bladder is empty, the cells appear rounded and the epithelium is several layers thick; when the bladder is full and stretched, the cells flatten and the layers appear thinner. This ability to change shape without tearing makes transitional epithelium perfectly suited for the bladder.
Why Other Options are Incorrect:
- A. Pseudostratified columnar — This epithelium lines the respiratory tract and parts of the male reproductive system; it is not found in the urinary bladder.
- C. Simple squamous — Simple squamous epithelium lines structures requiring rapid diffusion such as air sacs and blood vessels; it lacks the stretch properties needed for the bladder.
- D. Stratified squamous — This epithelium lines areas subject to abrasion such as the skin, mouth, and esophagus; it does not have the distensibility required for bladder function.
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