Chapter 23 (Saladin): The Urinary System

Normal urine from a healthy person should NOT contain
a. Creatine
b. Urobilin
c. Glucose
d. Ammonia
e. Magnesium

c. Glucose

To meet the definition of polyuria, the minimum daily output of urine is
a. 0.5 L
b. 1.0 L
c. 1.5 L
d. 2.0 L
e. 3.0 L

d. 2.0 L

The pigment responsible for the color of urine is called
a. Monochrome
b. Urochrome
c. Cyanochrome
d. Multichrome
e. Pyuria

b. Urochrome

Prior to chemical tests for glycosuria, clinicians checked for sweetness of the urine as a sign of
a. Diabetes insipidus
b. Acute glomerulonephritis
c. Diabetes mellitus
d. Renal calculus
e. Pyelitis

c. Diabetes mellitus

Loop diuretics reduce body water context by acting on the
a. feedback loop between the kidney and posterior pituitary gland
b. countercurrent multiplier system
c. countercurrent exchanger system
d. aquaporins of the collecting duct
e. thirst mechanism and

b. countercurrent multiplier system

A hospital patient produces 4 mL. min of urine with a urea concentration of 8mg/mL. Venous blood draw reveals urea concentration of .4 mg/mL. What is the percentage of cleared urea from glomerular filrate?
a. 40%
b. 56%
c. 64%
d. 72%
e. 80%

c. 64%

Which two substances are most useful for determining a patient's glomerular filtration rate?
a. insulin and glucose
b. inulin and creatinine
c. sodium and water
d. albumin and inulin
e. insulin and urea

b. inulin and creatinine

Creatinine has a renal clearance of 140 mL/min. Why is this?
a. it is absorbed by the nephronloop
b. it is secreted by the glomerulus
c. it is absorbed by the renal tubules
d. it is secreted by the renal tubules
e. it is produced in the pulmonary tissue

d. it is secreted by the renal tubules

Which of the following is NOTfound in the ureter?
a. Adventitia
b. Two layers of smooth muscle
c. Three layers of smoother muscle
d. Transitional epithelium
e. Skeletal muscle

e. Skeletal muscle

The _____ muscle is located in the urinary bladder?
a. Detrusor
b. Distractor
c. Pubococcygeus
d. corpus spongiosum
e. corpus cavernosum

a. Detrusor

The ____ is NOT a portion of the urethra?
a. external urethral orifice
b. internal urethral sphincter
c. prostatic urethra
d. membraneous urethra
e. spongy urethra

b. internal urethral sphincter

Micturition is another term for _____
a. the production of nitrogenous wastes
b. glomerular filtration
c. the countercurrent multiplier process
d. inflammation of the urinary bladder
e. the elimination of urine

e. the elimination of urine

Which of the following induces rennin secretion, constricts afferent arterioles, and reduces GFR and urine volume?
a. Aldosterone
b. Antidiuretic hormone
c. Parathyroid hormone
d. Norepinephrine
e. Angiotensin II

d. Norepinephrine

The overall purpose of the countercurrent exchange system is to:
a. supply salt and urea to the renal medulla
b. supply nutrients and oxygen to the renal cortex
c. supply nutrients and oxygen to the renal medulla
d. remove metabolic wastes from the renal

a. supply salt and urea to the renal medulla

The countercurrent multiplier recaptures ________ and is based on fluid flowing in the _________ direction in two adjacent tubules
a. Potassium; same
b. Calcium; opposite
c. Calcium; same
d. Sodium; opposite
e. Sodium; same

d. Sodium; opposite

Which of the following does NOT contribute to water conservation?
a. The collecting duct
b. The countercurrent multiplier
c. The countercurrent exchange system
d. Diuretics
e. The length of the nephrons

d. Diuretics

The urine is most likely to be hypotonic when the
a. body's water volume is high
b. body's pH is low
c. output of antidiuretic hormone is high
d. output of natriuretic peptides is high
e. person is lost and deprived of drinking water

a. body's water volume is high

Which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass through?
a. Glomerulus
b. Proximal convoluted tubule
c. Distal convoluted tubule
d. Collecting duct
e. Nephron loop

d. Collecting duct

Hypocalcemia stimulates ______
a. A decrease in aldosterone production
b. Secretion of parathyroid hormone
c. Secretion of rennin
d. An increase in blood urea nitrogen
e. Vasoconstriction of the afferent arterioles

b. Secretion of parathyroid hormone

Because of the great deal of active transport that occurs here, the _______ of all the nephrons collectively account for about 6% of one's daily resting ATP and caloric consumption
a. Proximal convoluted tubules
b. Distal convolutes tubules
c. Loops of He

a. Proximal convoluted tubules

Which of the following is NOT reabsorbed by the proximal convoluted tubule?
a. Potassium
b. Sodium chloride
c. Hydrogen ions
d. Urea
e. Water

c. Hydrogen ions

Total saturation of protein transporters for a given solute in the renal tubules would result in
a. Reabsorption of all the solute
b. A renal clearance of zero
c. A net filtration pressure of 1.0
d. Appearance of that solute in the urine
e. Absence of tha

d. Appearance of that solute in the urine

Which of the following is a direct result of antidiuretic hormones?
a. Decreased urine volume
b. Decreased urine molarity
c. Increased urine volume
d. Increased urine salinity
e. Increased urine acidity

a. Decreased urine volume

Aldosterone acts on the
a. proximal convoluted tubule
b. medullary portion of the collecting duct
c. descending limb of the nephron loop
d. distal convoluted tubule
e. glomerulus

d. distal convoluted tubule

Renin hydrolyzes angiotensinogen, which is released from the _______ to form angiotensin I
a. Lungs
b. Kidneys
c. Liver
d. Heart
e. Spleen

c. Liver

Assuming all other values are normal, calculate the net filtration pressure in a patient with a drop in capsular hydrostatic pressure to 8 mm Hg
a. 10 mm Hg out
b. 20 mm Hg out
c. 30 mm Hg out
d. 40 mm Hg out
e. 50 mm Hg out

b. 20 mm Hg out

In response to a drop in overall blood pressure, _________ stimulates constriction of the glomerular inlet and even greater constriction of the outlet.
a. Azotemia
b. Sodium chloride
c. Parathyroid hormone
d. Aldosterone
e. Angiotensin II

e. Angiotensin II

The mechanism of stabilizing the GFR based on the tendency of smooth muscle to contract when stretched is known as
a. Renal autoregulation
b. The myogenic mechanism
c. Tubuloglomerular feedback
d. Sympathetic control
e. The rennin angiotensin aldosterone

b. The myogenic mechanism

Which of the following would reduce the glomerular filtration rate?
a. Vasoconstriction of the efferent arteriole
b. A drop in oncotic pressure
c. Vasodilation of the afferent arteriole
d. Vasoconstriction of the afferent arteriole
e. An increase in osmot

d. Vasoconstriction of the afferent arteriole

In a healthy kidney, very little _________ is filtered by the glomerulus
a. Amino acids
b. Electrolytes
c. Glucose
d. Vitamins
e. Protein

e. Protein

Glucose and amino acids are reabsorbed from the glomerular filtrate by the
a. renal corpuscle
b. proximal convoluted tubule
c. distal convolutes tubule
d. glomerular capillaries
e. collecting duct

b. proximal convoluted tubule

In the nephron, the fluid that immediately precedes urine is known as
a. Plasma
b. Glomerular filtrate
c. Tubular fluid
d. Renal filtrate
e. Medullary filtrate

c. Tubular fluid

Which are primarily responsible for maintain the salinity gradient of the renal medulla?
a. Cortical nephrons
b. Juxtamedullary nephrons
c. Collecting ducts
d. Proximal convoluted tubules
e. Distal convoluted tubules

b. Juxtamedullary nephrons

Which of the following is NOT composed of cuboidal epithelium
a. The thin segment of the nephron loop
b. The thick segment of the nephron loop
c. The collecting duct
d. The proximal convoluted tubule
e. The distal convoluted tubule

a. The thin segment of the nephron loop

Which of the following form the inner layer of the glomerular capsule and wrap around the capillaries of the glomerulus?
a. Macula densa cells
b. Mesangial cells
c. Nephrocytes
d. Podocytes
e. Monocytes

d. Podocytes

Blood plasma is filtered in the
a. renal tubule
b. renal corpuscle
c. renal capsule
d. renal column
e. renal calyx

b. renal corpuscle

Which of these correctly traces blood flow from the renal cortex to the renal vein?
a. interlobular v.-> interlobar v. ->segmental v. -> renal v.
b. arcuate v. -> interlobar v. -> segmental v. -> renal v.
c. interlobar v. -> interlobular v. -> arcuate v.

e. interlobular v. -> arcuate v. -> interlobar v. -> renal v.

The average person has approximately __________ nephrons per kidney
a. 1.2 million
b. 2.4 million
c. 3.6 million
d. 4.8 million
e. 5.6 million

a. 1.2 million

The transition from an afferent arteriole to an efferent arteriole occurs in the
a. Glomerulus
b. Medulla
c. Cortical radiate veins
d. Peritubular capillaries
e. Vasa recta

a. Glomerulus

Which of these correctly traces blood flow from the renal artery into the renal cortex?
a. Arcuate a. -> interlobar a. -> arfferent arteriole -> interlobular a.
b. Interlobar a. -> interlobular a. -> segmental a. -> arcuate a.
c. Segmental a. -> interloba

c. Segmental a. -> interlobar a. -> arcuate a. -> interlobular a.

A renal pyramid voids urine into the
a. minor calyx
b. major calyx
c. renal medulla
d. renal papilla
e. ureter

a. minor calyx

A single lobe of a kidney is comprised of
a. Two calyces and a renal pelvis
b. One pyramid and the overlying cortex
c. One major calyx and all of its minor calyces
d. A renal medulla and two renal columns
e. One collecting duct and all nephrons that drain

b. One pyramid and the overlying cortex

The innermost connective tissue layer protecting the kidney and assisting in staving off infection is known as the
a. perirenal fat capsule
b. renal fascia
c. hilum
d. fibrous capsule
e. renal medulla

d. fibrous capsule

A patient enters a hospital after a motorcycle accident. He complains of mid-back pain. X rays reveal both rib and pelvic fractures. His emergency room examination includes urinalysis. Which of the following findings from the urinalysis would most likely

c. Albuminuria

The ____ is NOT an organ of the urinary system
a. Urethra
b. Liver
c. Ureter
d. Urinary bladder
e. Kidney

b. Liver

Which of the following is NOT a function of the kidneys?
a. They regulate osmolarity of the body fluids
b. They fight osteoporosis by synthesizing vitamin D
c. They help control blood pressure
d. They release waste into the bloodstream
e. They indirectly

d. They release waste into the bloodstream

Which organ system does not excrete waste?
a. The urinary system
b. The cardiovascular system
c. The integumentary system
d. The digestive system
e. The respiratory system

b. The cardiovascular system

A byproduct of protein catabolism, ________ constitutes approximately one-half of all nitrogenous wastes
a. Urea
b. Creatinine
c. Uric acid
d. Azotemia
e. Ammonia

a. Urea

In life-threatening starvation, the kidneys synthesize glucose by
a. Secreting erythropoietin
b. Secreting rennin
c. Deaminating amino acids
d. Contributing to calcium homeostasis
e. Producing uric acid

c. Deaminating amino acids

Which of the following is NOT true about the anatomy of the urinary system?
a. the kidneys are retroperitoneal
b. the ureters connect the kidneys to the urinary bladder
c. the urethra of males is longer than the urethra of females
d. the kidneys are at eq

d. the kidneys are at equal heights within the pelvic cavity

The medial concavity of the kidney is called the _____, which admits the renal nerves, blood vessels, lymphatic vessels, and ureter
a. medulla
b. corpuscle
c. cortex
d. hilum
e. capsule

d. hilum

The _____ innervation of the kidneys reduces urine production, while the function of its _____ innervation is unknown
a. sympathetic; parasympathetic
b. parasympathetic; sympathetic
c. central; peripheral
d. peripheral; central
e. enteric; somatic

a. sympathetic; parasympathetic

Natiuretic peptide inhibits ____ reabsorption by the cooecting ducts, which _____ urine output.
a. K+; increases
b. NaCl; decreases
c. NaCl: increases
d. K+; decreases
e. Ca2+; increases

c. NaCl: increases

In the thick segment of the ascending limb of the nephron loop, K+ reenters the cell from the interstitial fluid via the _____. K+ is then secreted into the tubular fluid.
a. Na+-K+ pump
b. countercurrent multiplier
c. countercurrent exchange
d. vasa rect

a. Na+-K+ pump

Which of the following is NOT a method by which atrial natriuretic peptide reduces blood volume and pressure?
a. increasing glomerular filtration rate
b. inhibiting renin and aldosterone secretion
c. inhibiting the action of ADH on the kidney
d. inhibitin

e. preventing sodium loss in the urine

The ureters pass anterior to the bladder and enter it from below.
T/F?

FALSE

Albuminuria is a common sign of diabetes mellitus.
T/F?

FALSE

Diseases that affect the descending corticospinal tracts may limit inhibition of the sacral somatic motor neurons and thus could result in urinary incontinence.
T/F?

TRUE

Ethyl (drinking) alcohol stimulates the secretion of ADH, thereby reducing reabsorption by the collecting duct.
T/F?

FALSE

Parathyroid hormone increases phosphate excretion by the proximal convoluted tubule as well as promotes synthesis of calcitriol.
T/F?

TRUE

The countercurrent multiplier mechanism for water conservation was discovered by limiting studies to humans and thus hypothesizing how form determines function.
T/F?

FALSE

The thick segment of the nephron loop is impermeable to water.
T/F?

TRUE

Glomerular filtration occurs because glomerular oncotic pressure overrides glomerular blood pressure
T/F?

FALSE

Angiotensin-converting enzyme is found only in the kidneys and converts angiotensinogen to angiotensin I.
T/F?

FALSE

Cells in the cleft between the afferent and efferent arterioles and among capillaries of the glomerulus are known as mesangial cells.
T/F?

TRUE

Glomerular capillaries suffer little damage from hypertension because of the protective influence of the afferent arterioles.
T/F?

FALSE

The fenestrated endothelium of the capillary has pores small enough to exclude blood cells from the filtrate.
T/F?

TRUE

The most toxic of our metabolic wastes are nitrogenous wastes.
T/F?

TRUE

Image:
Identify the 6 principle "organs" of the urinary system

2 Kidneys
2 Ureters
1 Urinary bladder
1 Urethra

What are the two poles of a renal corpuscle?
NOTE: Where blood enters and leaves & where filtrate leaves to become urine

The vascular pole
The Urinary Pole