CH. 26 Assessment

1. Tubular reabsorption and tubular secretion differ in that 2. Which of the following substances utilizes paracellular transport in order to cross the basolateral membrane of the tubule cell during the process of reabsorption?

Check all that occur to the kidneys as a result of aging.

Complete each statement by using the appropriate word or phrase from the list. Negatively charged proteoglycans found in the . prevent most proteins in the blood from exiting the glomerular capillaries. Filtrations slits are formed by Small openings in the capillary endothelium called are too small to allow cells to leave the glomerulus. The volume of blood that enters the afferent arteriole is not equal to the volume of blood that travels through the efferent arteriole due to the process termed . . A kidney infection or injury that results in damage to the may result in proteinuria (protein in the urine).

Complete each sentence regarding urine formation. There are four major stages in the of urine. The first stage involves creating a filtrate in the . Second, the filtrate flows through the tubules and useful substances are . Additionally, waste products are by the tubules. If blood volume or blood pressure is low, the last stage of urine formation includes water in the collecting duct.

Match the region of the kidney tubule with its description. 1. Site where the majority of reabsorption takes place. 2. Contains simple squamous epithelium in the thin segments. 3. Permeability to water and solutes in this region varies based on hormone regulation. 4. Amino acids are reabsorbed in this region.

Correctly complete the sentences below by choosing the appropriate terms. 1. Aging causes the kidneys to gradually decrease in , apparently in association with changes. Blood flowing through the kidneys gradually decreases by about 10% decrease per year as become irregular and twisted and glomeruli are lost. 2. By age 80, 40% of the glomeruli are not functioning. Some lack blood flow, and others become impermeable. Ducts also become thicker, shorter, and more irregular in structure, and there are losses in secretion and . 3. Water retention by declines, increasing risk for dehydration. The ability to eliminate wastes and toxins from the blood also decreases. 4. The kidney decreases renin secretion, and has a reduced ability to participate in vitamin D synthesis, which contributes to , osteoporosis, and bone fractures. 5. Recall that of one kidney is required to maintain homeostasis, and additional kidney tissue constitutes a . Therefore, the age-related changes in the kidney reduce the kidney's

1. The majority of sodium reabsorption occurs at the proximal convoluted tubule. During this process sodium enters the tubule cells at the ___________________ and exits the tubule cells at the ____________________. 2. Glucose that is reabsorbed into tubular cells travels __________ its concentration gradient through sodium-glucose symport channels at the luminal membrane. Glucose in tubular cells exits the basolateral membrane into interstitial fluid through the process of ______________________.

1. Under normal conditions, the majority of uric acid reabsorption occurs at the _______________________. 2. Treatment with Probenecid® results in _________________ levels of uric acid in the urine and __________________ levels of uric acid in the blood.

Complete each statement by using the appropriate word or phrase from the list. 1. The countercurrent multiplier is a phenomenon that occurs in the . 2. Countercurrent exchange occurs as both solutes and water move freely in and out of the . 3. The increase in filtrate osmolarity as it flows down the descending limb is due to moving out of the tubule. 4. The decrease in osmolarity of the filtrate as it flows up the ascending limb is due to moving out of the tubule. 5. The osmolarity of the filtrate is virtually the same at the entrance and exit of the . 6.The osmolarity of the filtrate is approximately 100 mOsm/L at the end of the and around 1200 mOsm/L at the end of the . 7. The recycling of out of the collecting duct and back into the nephron loop contributes significantly to the medullary osmotic gradient.

Indicate whether each statement is true or false regarding the regulation of the glomerular filtration rate. 1. Regulation is achieved through autoregulation 2. The myogenic mechanism involves smooth muscles in the arterioles acting as stretch receptors, thus dilating or constricting the arteriole in response to changes in blood pressure. 3. The myogenic mechanism involves macula densa cells sending signals to the juxtaglomerular cells to either constrict or dilate the arteriole 4. The tubuloglomerular feedback mechanism involves smooth muscles in the arterioles acting as stretch receptors, thus dilating or constricting the arteriole in response to changes in blood pressure. 5. The tubuloglomerular mechanism involves macula densa cells sending signals to the juxtaglomerular cells to either constrict or dilate the arteriole.

Insert the correct word to complete each sentence. 1. Filtration involves the movement of materials across the filtration membrane into the 2. Solutes are reabsorbed across the wall of the nephron by . 3. Water is reabsorbed across the wall of the nephron by . 4. Water and solutes that are reabsorbed across the wall of the nephron enter the . 5. Tubular secretion involves the secretion of water and solutes across the wall of the nephron the filtrate

Place the statements in the correct order to illustrate the role of ADH in regulating extracellular volume.

Place the list of urinary system structures in order from the fewest to most numerous.

1. Filtration is a/an __________ process that depends on a __________ gradient. 2. When systemic blood pressure decreases, the result is that the __________ arterioles change diameter by undergoing __________.

1. The interstitial fluid within the medulla has a __________________ osmolarity than the interstitial fluid within the cortex. 2. The vasa recta is a specialized capillary that branches from the ___________ arteriole. The blood flow in the vasa recta runs _______________ to the flow of tubular filtrate within the nephron loop.

1. Individuals with Bartter syndrome have a defective gene coding for Na+/K+/2Cl- symport (NKCC2) that disables it from functioning. These individuals are expected to have ___________ than normal blood potassium levels. This response is the ___________ what is expected from individuals taking prescribed loop diuretics. 2. The nephron loop is responsible for approximately 25% of the reabsorption of sodium. Loop diuretics cause an overall __________________ in the reabsorption of sodium in this region resulting in a/n ________________________ in the osmolarity of the tubular filtrate. 3. Decreased Na+ and water reabsorption due to the use of loop diuretics and thiazides __________ the concentration gradient of the interstitial fluid, thereby _____________ the osmotic force at the collecting tubule and duct.

1. Inactivating the sodium-glucose symport SGLT2 inhibits the reabsorption of glucose by 2.Inhibiting the sodium-glucose symport SGLT2 is expected to cause a/an __________________________ in the osmolarity of the tubular filtrate, and would thus _____________________ the risk of dehydration.

Click and drag each word or phrase on the left to complete the sentences on the right. 1. Production of urine by the begins to fill the urinary bladder. 2. The fullness of the is detected by . 3. Sensory nerve impulses travel along the to the spinal cord. 4. Efferent impulses excite the and relax the . 5. Voiding of the bladder is delayed by the control of the .

The total amount of a substance that passes through the filtration membrane into the nephrons each minute is called the __________.

Select all that are characteristics of inulin, a substance used for renal function tests.

List the tissue layers of the urinary bladder from the most interior cell type or tissue layer to the final exterior layer.

1. An increase in the NFP would result in a(n) _______________ in the GFR. 2. Renin is released in response to ________________________ stimulation.

1. Angiotensin II triggers the __________________________ of the intraglomerular mesangial cells which results in a/an _______________________________ of the filtration surface area. 2. ACE inhibitors are prescribed to control blood pressure. These drugs work by reducing

1. Aldosterone enhances the reabsorption of sodium through the upregulation of the sodium-potassium pump found at the ________________. 2. In addition to enhancing the reabsorption of sodium, aldosterone also enhances the __________________ of potassium. 3. Antidiuretic hormone enhances water ______________ by _______________ the number of aquaporins at the tubular cell membrane.

1. Pendrin is found in __________ intercalated cells where it allows for the ________________ of bicarbonate. 2. The expected response to metabolic alkalosis is the ___________________ of Pendrin. Type _____________ also assist in buffering the alkaline blood through its transport of H+.

Complete each statement by using the appropriate word or phrase from the list 1. The process of . is the ability of the kidneys to maintain a relatively constant GFR. 2. The process whereby the flow of filtrate through the distal tubule results in changes in GFR is termed . 3. The three components of the are the JG cells, the macula densa, and the mesangial cells. 4. Epithelial cells found where the distal tubule passes between the afferent and efferent arterioles comprise the . 5. The afferent arteriole contains cells called that secrete the enzyme renin. 6. The afferent arteriole reflexively contracts in response to a rise in blood pressure, thus preventing a rise in GFR. This form of regulation is called the 7. An increase in the rate of filtrate flow through the distal tubule results in contraction of the and a decrease in GFR. 8. When blood pressure drops, renin is released into the blood, resulting in an increase in the hormone , which acts to decrease GFR while simultaneously raising blood pressure.

1. If both the glomerular and capsular hydrostatic pressures remain unchanged, an increase in the blood colloid osmotic pressure results in a/an _____________ in the net filtration pressure. 2. 2. Which of the following forces oppose glomerular filtration?

1. Glomerulosclerosis results in a ____________________ of the basement membrane. 2.Proteinuria occurs when the filtration membrane becomes leaky, allowing proteins to cross. This impacts the blood colloid osmotic pressure by ____________________ the osmolarity gradient between the blood and filtrate, thereby ________________ the strength of this pressure.

Select the correct word to complete each sentence. 1. Most water and NaCl reabsorption takes place in the 2. In the thin segment of the descending loop of Henle, filtrate concentration is . to interstitial fluid concentration. 3. The ascending loop of Henle is impermeable to water. 4. Solutes pass out of the ascending loop of Henle via diffusion or transport mechanisms. 5. Water and NaCl are reabsorbed at the distal convoluted tubules and collecting ducts. 6. As the filtrate travels through the ascending loop of Henle, its concentration is .

Check all that are a function of the kidneys.

Select all that are true regarding the use of PAH to determine renal plasma flow.