Ch. 25: The Urinary System

1) If the GFR is too low, needed substances may pass so quickly
through the renal tubules that they are not absorbed and instead are
lost in the urine.

FALSE

2) In the kidneys, the countercurrent mechanism involves the
interaction between the flow of filtrate through the nephron loop of
the juxtamedullary nephrons (the countercurrent multiplier) and the
flow of blood through the limbs of adjacent blood vessels (the
countercurrent exchanger). This relationship establishes and maintains
an osmotic gradient extending from the cortex through the depths of
the medulla that allows the kidneys to vary urine concentration dramatically.

TRUE

3) The path urine takes after it is formed until it leaves the body
is the urethra, urinary bladder, and finally the ureter.

FALSE

4) Water reabsorption through the proximal convoluted tubule is
termed obligatory water reabsorption, whereas water reabsorption
through the distal convoluted tubule is termed facultative water reabsorption.

TRUE

5) The position of the kidneys behind the peritoneal lining of the
abdominal cavity is described by the term retroperitoneal.

TRUE

6) The entire responsibility for urine formation lies with the nephron.

TRUE

7) Both the male and female urethras serve both the urinary and the
reproductive systems.

FALSE

8) The act of emptying the bladder is called voiding.

TRUE

9) Glomerular filtration is an ATP-driven process.

FALSE

10) In the absence of hormones, the distal tubule and collecting
ducts are relatively impermeable to water.

TRUE

11) The collecting duct is impermeable to water in the presence of ADH.

FALSE

12) The urethra contains an internal sphincter of smooth muscle.

TRUE

13) Angiotensin II is a substance made by the body to lower blood
pressure during stress.

FALSE

14) Aldosterone is a hormone that causes the renal tubules to reclaim
sodium ions from the filtrate.

TRUE

15) Blood pressure in the renal glomerulus is lower than in most
parts of the body in order to conserve body water.

FALSE

16) The proximal convoluted tubule is the portion of the nephron that
attaches to the collecting duct.

FALSE

17) Urea is reabsorbed in the nephron loop.

FALSE

18) Incontinence is the inability to control voluntary micturition.

TRUE

19) The myogenic mechanism reflects the tendency of vascular smooth
muscle to stretch.

FALSE

20) An excessive urine output is called anuria.

FALSE

21) Tubular secretion is effective in controlling blood pH.

TRUE

22) The trigone is so named because of the shape of the urinary bladder.

FALSE

23) Atrial natriuretic peptide inhibits sodium reabsorption.

TRUE

24) The macula densa cells are chemoreceptors that respond to changes
in the urea content of the filtrate.

FALSE

25) Blood in the urine may be a symptom of bladder cancer.

TRUE

26) Obligatory water reabsorption involves the movement of water
along an osmotic gradient.

TRUE

27) Having a kinked ureter is called renal ptosis.

FALSE

28) Fetal kidneys have the primary responsibility of clearing wastes
from the fetal blood.

FALSE

1) Which of the following is the best explanation for why the cells
of the proximal convoluted tubule (PCT) contain so many mitochondria?
A) Cells of the PCT go through a great deal of mitosis.
B) A great deal of active transport takes place in the PCT.
C) Contraction of the PCT moves filtrate through the tubule.
D) This provides the energy needed to fight kidney infection.

B

2) What is the best explanation for the microvilli on the apical
surface of the proximal convoluted tubule (PCT)?
A) They increase the surface area and allow for a greater volume of
filtrate components to be reabsorbed.
B) Their movements propel the filtrate through the tubules.
C) They increase the amount of surface area that comes in contact
with the blood's plasma to help activly excrete toxins.
D) They hold on to enzymes that cleanse the filtrate before reabsorption.

A

3) The thin segment of the nephron loop's descending limb ________.
A) helps to pack a greater number of nephron loops into a smaller
space B) aids in the passive excretion of nitrogenous waste C) is
easily broken and replaced often D) aids in the passive movement of
water out of the tubule

D

4) The relatively long half-life of lipid soluble hormones (steroid
hormones) compared to water soluble hormones is due in part to the way
that these hormones are passed into the filtrate from the glomerular
capillaries. From the list below select the best explanation for why
lipid soluble (steroid) hormones have a relatively long half-life. A)
The large size of the steroid hormones prevents them from passing
through the filtration membrane. B) Steroid hormones are absorbed by
target cells before they can reach the kidneys. C) The relatively
small size of steroid hormones allows them to easily pass back into
the peritubular capillaries if released into the filtrate. D) Steroid
hormones travel in the plasma on large transport proteins that cannon
pass through the filtration membrane.

D

5) The presence of protein in the urine indicates which of the
following? A) too much protein in the diet B) damage to the filtration
membrane C) high levels of transcription and translation by the bodies
tissues D) damage to the renal tubules

B

6) Hydrostatic pressure is the primary driving force of plasma
through the filtration membrane into the capsular space. All but one
of the following statements reflects why hydrostatic pressure is so
high in the glomerular capillaries. Select the one statement that does
not explain the high pressure within the glomerular capillaries. A)
The diameter of the efferent arteriole is smaller than the afferent
arteriole. B) The volume of plasma in the efferent arteriole is higher
when compared to the afferent arteriole. C) The efferent arteriole has
higher resistance to blood flow than the afferent arteriole. D) The
flow of blood is reduces as blood reaches the efferent arteriole.

B

7) Cells and transport proteins are physically prevented from passing
through the filtration membrane. This has the following effect on
filtration. A) decreased osmotic pressure in the filtrate that
increases the amount of filtration B) increasing osmotic pressure in
the glomerular capillaries that reduces the amount of filtration C)
neutral change in osmotic pressure with no effect on filtration D)
increased osmotic pressure in the filtrate the draws plasma through
the membrane

B

8) If the diameter of the afferent arterioles leading to the
glomerulus increases (vasodilation) which of the following is not
likely to occur? A) Net filtration pressure will increase. B) Urine
output will increase. C) Systemic blood pressure will go up. D)
Glomerular filtration rate will increase.

C

9) If the diameter of the efferent arterioles leading away from the
glomerulus increases (vasodilation) which of the following is not
likely to occur? A) Urine output will decrease. B) Net filtration
pressure will decrease. C) Systemic blood pressure will decrease. D)
Glomerular filtration rate will decrease.

C

10) If the diameter of the afferent arterioles leading to the
glomerulus decreases (vasoconstriction) which of the following is not
likely to occur? A) Glomerular filtration rate will decrease. B) Urine
output will decrease. C) Systemic blood pressure will decrease. D) Net
filtration pressure will decrease.

C

11) If the diameter of the efferent arterioles leading away from the
glomerulus decrease (vasoconstriction) which of the following is not
likely to occur? A) Urine output will increase. B) Systemic blood
pressure will go up. C) Glomerular filtration rate will increase. D)
Net filtration pressure will increase.

B

12) If the glomerular mesangial cells contract, reducing the overall
surface area of the glomerulus which of the following is not likely to
occur? A) Systemic blood pressure will be lowered. B) Glomerular
filtration rate will decrease. C) Net filtration rate will decrease.
D) Urine output will decrease.

A

13) If blood pressure drops very low (MAP is below 80mmHg) renin
enzyme will be secreted by granular cells. Which of the following is
not likely to occur? A) Blood plasma and extracellular fluids volume
will increase B) Glomerular filtration rate (GFR) will decrease C) Net
filtration pressure (NFP) will decrease D) Kidney perfusion will increase

D

14) Which of the following statements best describes the difference
between the intrinsic and extrinsic controls of the kidney? A)
Extrinsic controls have the greatest effect on systemic blood pressure
while intrinsic control have a greater effect on GFR. B) Extrinsic
controls will reduce blood plasma volume while intrinsic controls will
increase blood plasma volumes. C) Intrinsic controls raise blood
pressure while extrinsic controls lower blood pressure. D) Extrinsic
and intrinsic controls work in nearly opposite ways.

A

15) Reabsorption of nutrients like glucose and amino acids takes
place in the proximal convoluted tubule (PCT) via cotransporters that
utilize secondary active transport. Which of the following would stop
the reabsorption of glucose at the apical surface of the cells in the
PCT? A) loss of Na+-K+ ATPase in the basolateral surface of PCT cells
B) loss of K+ leak channels at the apical surface C) increasing Na+
concentration in the filtrate D) increasing Na+ in the interstitial fluid

A

16) Bulk flow of nutrients, ions and water into the peritubular
capillaries is the result of all of the following except one. Select
the answer below that does not describe a cause of bulk flow of fluids
into the peritubular capillaries. A) higher osmotic pressure in the
peritubular capillary B) increased resistance to blood flow at the
efferent arteriole C) leaky tight junctions of peritubular capillary's
endothelium D) lower hydrostatic pressure in the peritubular capillary

C

17) The mechanism that establishes the medullary osmotic gradient
depends most on the permeability properties of the ________. A)
collecting duct B) glomerular filtration membrane C) nephron loop D)
distal convoluted tubule

C

18) Which of the following is not associated with the renal
corpuscle? A) a fenestrated capillary B) a podocyte C) an efferent
arteriole D) a vasa recta

D

19) An increase in the permeability of the cells of the collecting
tubule to water is due to a(n) ________. A) increase in the production
of ADH B) decrease in the concentration of the blood plasma C)
increase in the production of aldosterone D) decrease in the
production of ADH

A

20) The urinary bladder is composed of ________ epithelium. A)
transitional B) stratified squamous C) pseudostratified columnar D)
simple squamous

A

21) The kidneys are stimulated to produce renin ________. A) when the
pH of the urine decreases B) when the specific gravity of urine rises
above 1.10 C) when the peritubular capillaries are dilated D) by a
decrease in the blood pressure

D

22) Which of the choices below is not a function of the urinary
system? A) helps maintain homeostasis by controlling the composition,
volume, and pressure of blood B) maintains blood osmolarity C)
regulates blood glucose levels and produces hormones D) eliminates
solid, undigested wastes and excretes carbon dioxide, water, salts,
and heat

D

23) The ________ artery lies on the boundary between the cortex and
medulla of the kidney. A) interlobar B) cortical radiate C) arcuate D) lobar

C

24) The descending limb of the nephron loop ________. A) is not
permeable to water B) is freely permeable to sodium and urea C)
contains fluid that becomes more concentrated as it moves down into
the medulla D) pulls water by osmosis into the lumen of the tubule

C

25) Select the correct statement about the ureters. A) The ureters
are capable of peristalsis like that of the gastrointestinal tract. B)
Ureters contain sphincters at the entrance to the bladder to prevent
the backflow of urine. C) The ureter is innervated by parasympathetic
nerve endings only. D) The epithelium is stratified squamous like the
skin, which allows a great deal of stretch.

A

26) The fatty tissue surrounding the kidneys is important because it
________. A) produces vitamin D and other chemicals needed by the
kidney B) stabilizes the position of the kidneys by holding them in
their normal position C) is necessary as a barrier between the adrenal
glands and kidneys D) ensures adequate energy for the adrenal glands
to operate efficiently

B

27) The functional and structural unit of the kidneys is the
________. A) nephron B) glomerular capsule C) nephron loop D) capsular space

A

28) Which of the following does not describe the justaglomerular
complex? A) Its granular cells produce rennin. B) Its macula densa
cells produce aldosterone. C) It helps control systemic blood
pressure. D) It regulates the rate of filtrate formation.

B

29) The chief force pushing water and solutes out of the blood across
the filtration membrane is ________. A) the ionic electrochemical
gradient B) glomerular hydrostatic pressure (glomerular blood
pressure) C) protein-regulated diffusion D) the size of the pores in
the basement membrane of the capillaries

B

30) Which of the following acts as the trigger for the initiation of
micturition (voiding)? A) the pressure of the fluid in the bladder B)
motor neurons C) the stretching of the bladder wall D) the sympathetic efferents

C

31) The filtration membrane includes all except ________. A) basement
membrane B) renal fascia C) glomerular endothelium D) podocytes

B

32) The mechanism of water reabsorption by the renal tubules is
________. A) filtration B) active transport C) osmosis D) cotransport
with sodium ions

C

33) Most electrolyte reabsorption by the renal tubules is ________.
A) hormonally controlled in distal tubule segments B) not limited by a
transport maximum C) in the distal convoluted tubule D) accomplished
after the nephron loop is reached

A

34) The macula densa cells respond to ________. A) changes in
pressure in the tubule B) aldosterone C) antidiuretic hormone D)
changes in Na+ content of the filtrate

D

35) Which of the following is not reabsorbed by the proximal
convoluted tubule? A) K+ B) Na+ C) creatinine D) glucose

C

36) The fluid in glomerular capsule is similar to plasma except that
it does not contain a significant amount of ________. A) electrolytes
B) hormones C) glucose D) plasma protein

D

37) Alcohol acts as a diuretic because it ________. A) is not
reabsorbed by the tubule cells B) inhibits the release of ADH C)
increases the rate of glomerular filtration D) increases secretion of ADH

B

38) The function of angiotensin II is to ________. A) decrease the
production of aldosterone B) decrease water absorption C) constrict
arterioles and increase blood pressure D) decrease arterial blood pressure

C

39) An important characteristic of urine is its specific gravity or
density, which is ________. A) less than water B) much higher than
water C) the same as water D) slightly higher than water

D

40) Place the following in correct sequence from the formation of a
drop of urine to its elimination from the body. 1. major calyx 2.
minor calyx 3. nephron 4. urethra 5. ureter 6. collecting duct A) 6,
3, 2, 1, 5, 4 B) 3, 6, 2, 1, 5, 4 C) 3, 1, 2, 6, 5, 4 D) 2, 1, 3, 6,
5, 4

B

41) Select the correct statement about the nephrons. A) Podocytes are
the branching epithelial cells that line the tubules of the nephron.
B) The parietal layer of the glomerular capsule is simple squamous
epithelium. C) The glomerulus is correctly described as the proximal
end of the proximal convoluted tubule. D) Filtration slits are the
pores that give fenestrated capillaries their name.

B

42) What would happen if the capsular hydrostatic pressure were
increased above normal? A) Capsular osmotic pressure would compensate
so that filtration would not change. B) Net filtration would decrease.
C) Net filtration would increase above normal. D) Filtration would
increase in proportion to the increase in capsular pressure.

B

43) Which of the following is not a part of the juxtaglomerular
complex? A) macula densa B) granular cells C) podocyte cells D)
mesangial cells

C

44) Which of the following is not true regarding tubular
reabsorption? A) It involves hormonal signals in the collecting ducts.
B) It is a purely passive transport process. C) It is a reclamation
process. D) It occurs via transcellular or paracellular routes.

B

45) Which of the choices below is a function of the nephron loop? A)
form a large volume of very dilute urine or a small volume of very
concentrated urine B) absorb electrolytes actively and water by
osmosis in the same segments C) absorb water and electrolytes into the
tubular network D) form a large volume of very concentrated urine or a
small volume of very dilute urine

A

46) Which of the following is the correct sequence of kidney
development from embryo to fetus? A) mesonephros, metanephros,
pronephros B) pronephros, metanephros, mesonephros C) pronephros,
mesonephros, metanephros D) mesonephros, pronephros, metanephros

C

47) Which of the following best describes kidney function in older
adults (70 years or older)? A) Kidney function decreases due to kidney
atrophy. B) Only about 3% of older adults have any loss of kidney
function. C) Only obese and diabetic older adults have any kidney
dysfunction. D) Kidney function remains the same throughout life,
regardless of age.

A

48) The factor favoring filtrate formation at the glomerulus is the
________. A) glomerular hydrostatic pressure B) myogenic mechanism C)
capsular hydrostatic pressure D) colloid osmotic pressure of the blood

A

49) If the Tm for a particular amino acid is 120 mg/100 ml and the
concentration of that amino acid in the blood is 230 mg/100 ml, the
amino acid will ________. A) appear in the urine B) be completely
reabsorbed by the tubule cells C) be actively secreted into the
filtrate D) be completely reabsorbed by secondary active transport

A

50) If one says that the clearance value of glucose is zero, what
does this mean? A) Normally all the glucose is reabsorbed. B) The
clearance value of glucose is relatively high in a healthy adult. C)
The glucose molecule is too large to be filtered out of the blood. D)
Most of the glucose is filtered out of the blood and is not reabsorbed
in the convoluted tubules.

A

51) Excretion of dilute urine requires ________. A) impermeability of
the collecting tubule to water B) the presence of ADH C) relative
permeability of the distal tubule to water D) transport of sodium and
chloride ions out of the descending nephron loop

A

52) Which of the choices below is not a method by which the cells of
the renal tubules can raise blood pH? A) by producing new bicarbonate
ions B) by reabsorbing filtered bicarbonate ions C) by secreting
hydrogen ions into the filtrate D) by secreting sodium ions

D

53) In the ascending limb of the nephron loop the ________. A) thick
segment moves ions out into interstitial spaces for reabsorption B)
thin segment is freely permeable to water C) thin segment is not
permeable to sodium and chloride D) thick segment is permeable to water

A

54) Select the correct statement about urinary system development. A)
The metanephric ducts will become the urethras. B) The pronephros
(first tubule system) develops during the tenth week of gestation. C)
The mesonephros will develop into the kidneys. D) Kidneys develop from
urogenital ridges.

D

55) What is the most direct function of the juxtaglomerular
apparatus? A) help regulate blood pressure and the rate of excretion
by the kidneys B) help regulate blood pressure and the rate of blood
filtration by the kidneys C) help regulate water and electrolyte
excretion by the kidneys D) help regulate urea absorption by the kidneys

B

56) Which of the choices below is the salt level-monitoring part of
the nephron? A) nephron loop B) vasa recta C) principal cell D) macula densa

D

57) Which of the hormones below is responsible for facultative water
reabsorption? A) thyroxine B) atrial natriuretic peptide C) ADH D) aldosterone

C

58) Which of the choices below is not a glomerular filtration rate
control method? A) electrolyte levels B) hormonal regulation C) renal
autoregulation D) neural regulation

A

59) Which of the choices below are the most important hormone
regulators of electrolyte reabsorption and secretion? A) angiotensin I
and epinephrine B) angiotensin I and atrial natriuretic peptide C)
angiotensin II and ADH D) angiotensin II and aldosterone

D