Chapter 25: The Urinary System

Where in the nephron does most solute reabsorption occur? A) collecting duct B) glomerulus C) proximal convoluted tubule D) distal convoluted tubule

Approximately 80% of the energy used for active transport is devoted to the reabsorption of __________. A) sodium B) potassium C) glucose D) water

What is the juxtaglomerular apparatus? A) a system that regulates the rate of filtrate formation and systemic blood pressure B) a system for concentrating urine C) a system for diluting urine D) a system that protects the nephron from some chemicals found in blood

Which of the following substances is not normally found in filtrate? A) nitrogenous waste particles, such as urea B) water and small solutes C) blood cells and large particles D) ions, such as sodium and potassium

Which hormone(s) is/are required for facultative water reabsorption in the collecting ducts? A) renin B) aldosterone C) both ADH and aldosterone D) ADH

A nonfasting urine sample from an individual who has previously ingested donuts and a soft drink showed the presence of sugar (glucose). Which of the following statement explains the presence of the glucose in the urine? A) Some glucose is always present in the urine. B) The individual has diabetes mellitus. C) The individual is glucose intolerant. D) The individual exceeded the transport maximum.

Which part of the brain controls the micturition reflex? A) medulla oblongata B) cerebrum C) pons D) hypothalamus

The __________ keeps the urethra closed when urine is not being passed from the bladder and prevents leaking between voiding. A) internal urethral sphincter B) prostatic urethra C) external urethral orifice D) external urethral sphincter

Since most patients with renal failure produce little or no urine, hemodialysis often involves removal of water from the blood. However, side-effects may develop if too much fluid is removed from the blood. Which of the following is NOT one of the potential side-effects? A) dizziness B) vasoconstriction of afferent arterioles C) low blood pressure D) muscle fatigue

The frequency of cystitis in men is lower than in women because ______. A) the external urethral sphincter in men is usually closed B) the internal urethral sphincter in men is usually closed C) the pH of a man's urine is usually more acidic than a woman's urine D) the male urethra is longer than the female urethra

Urinary incontinence may occur if a person has ______. A) an internal urethral sphincter that is too frequently relaxed B) an external urethral sphincter that is too frequently contracted C) an overactive detrusor muscle D) All of the listed responses are correct.

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

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

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

Which of the following is NOT a function of the kidneys? A) producing the hormones melanin and oxytocin B) maintaining the proper balance between water and salts and between acids and bases C) metabolizing vitamin D to its active form D) gluconeogenesis during prolonged fasting

Hydronephrosis may be caused by all EXCEPT which of the following? A) renal ptosis B) kidney stones lodged in a ureter C) renal failure D) tumor in a ureter

Which of the following is the most likely to cause pyelonephritis? A) increased blood flow to the kidneys B) decreased blood flow to the kidneys C) renal failure D) infection of the urinary bladder

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

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

The glomerulus differs from other capillaries in the body in that it ________. A) has a blood pressure much lower than other organ systems B) is impermeable to most substances C) has a basement membrane D) is drained by an efferent arteriole

The renal corpuscle is made up of ________. A) the renal pyramid B) Bowman's capsule and glomerulus C) the descending loop of Henle D) the renal papilla

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

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

Select the correct statement about the nephrons. A) The parietal layer of the glomerular capsule is simple squamous epithelium. B) Podocytes are the branching epithelial cells that line the tubules of the nephron. 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.

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

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

Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate? A) macula densa cells B) mesangial cells C) podocytes D) juxtaglomerular cells

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

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

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

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 water and electrolyte excretion by the kidneys C) help regulate urea absorption by the kidneys D) help regulate blood pressure and the rate of blood filtration by the kidneys

Which of the following is the functional unit of the kidney? A) nephron B) renal pyramid C) renal corpuscle D) renal pelvis

The __________ is an outer layer of dense fibrous connective tissue that anchors the kidney and the adrenal gland to surrounding structures. The __________ prevents infections in surrounding regions from spreading to the kidneys. A) fibrous capsule; renal fascia B) renal fascia; fibrous capsule C) fibrous capsule; perirenal fat capsule D) renal fascia; perirenal fat capsule

The __________ collect(s) urine, which drains continuously from the papillae; the urine is then emptied into the __________. A) renal pyramids; renal pelvis B) calyces; renal pelvis C) renal pyramids; calyces D) renal pelvis; calyces

Each nephron contains a __________, which is a tuft of capillaries, and a __________. A) renal plexus; renal tubule B) glomerulus; renal tubule C) glomerulus; renal plexus D) renal plexus; glomerulus

What arteries branch off the arcuate arteries? A) cortical radiate (interlobular) arteries B) interlobar arteries C) segmental arteries D) renal arteries

Which vessel is present in the arterial pathway as blood flows into the kidney but NOT present in the venous pathway exiting the kidney? A) interlobar B) cortical radiate C) segmental D) arcuate

Which vessels supply the cortical tissue of the kidney with blood? A) cortical radiate arteries B) interlobar arteries C) segmental arteries D) arcuate arteries

What two structures constitute the renal corpuscle? A) proximal convoluted tubule and nephron loop B) glomerulus and renal tubule C) glomerulus and glomerular (Bowman's) capsule D) renal tubule and collecting duct

Which of the three parts of the renal tubule is formed by cuboidal epithelial cells bordered by dense microvilli? A) distal convoluted tubule B) nephron loop C) collecting duct D) proximal convoluted tubule

In which kidney region are all renal corpuscles located? A) renal columns B) renal medulla C) renal pelvis D) renal cortex

Which of the following is NOT characteristic of the cortical nephrons? A) The efferent arteriole of the cortical nephrons supplies the peritubular capillaries. B) Cortical nephrons have a short nephron loop. C) The glomerulus of the cortical nephron is closer to the cortex-medulla junction. D) Cortical nephrons form the majority of nephrons in the kidney.

Where does the efferent arteriole of the juxtamedullary nephron carry blood to? A) vasa recta B) peritubular capillaries C) glomerulus D) afferent arteriole

Which capillary bed produces filtrate? A) glomerulus B) juxtaglomerular complex (JGC) C) vasa recta D) peritubular capillaries

What is the function of the macula densa cells of the juxtaglomerular complex (JGC)? A) The macula densa cells produce filtrate. B) The macula densa cells pass regulatory signals between other cells of the juxtaglomerular complex. C) The macula densa cells sense blood pressure in the afferent arteriole. D) The macula densa cells monitor the NaCl content of the filtrate entering the distal convoluted tubule.

Where is filtrate produced in the nephron? A) vasa recta B) juxtaglomerular complex C) glomerulus D) peritubular capillaries

What vessel directly feeds into the glomerulus? A) afferent arteriole B) cortical radiate artery C) vasa recta D) efferent arteriole

Which of the following is NOT a cause of anuria? A) renal failure B) obstruction in the urethra C) vasodilation of afferent arterioles D) heart failure

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

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

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

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

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

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

A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________. A) diabetic acidosis B) coma C) diabetes mellitus D) diabetes insipidus

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) 2, 1, 3, 6, 5, 4 B) 3, 1, 2, 6, 5, 4 C) 6, 3, 2, 1, 5, 4 D) 3, 6, 2, 1, 5, 4

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

Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________. A) secondary active transport B) facilitated diffusion C) countertransport D) passive transport

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

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

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 secreting sodium ions C) by secreting hydrogen ions into the filtrate D) by reabsorbing filtered bicarbonate ions

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

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

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

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

How can an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril be effective as an antihypertensive? A) ACE inhibitors reduce blood pressure by causing less aldosterone and antidiuretic hormone to be released, resulting in more water output and a lowering of the blood volume, which lowers the blood pressure. B) ACE inhibitors reduce blood pressure by causing less aldosterone to be released, resulting in more water output and a lowering of the blood volume, which lowers the blood pressure. C) ACE inhibitors reduce blood pressure by causing vasodilation in the blood vessels. D) ACE inhibitors reduce blood pressure by causing less antidiuretic hormone to be released, resulting in more water output and a lowering of the blood volume, which lowers the blood pressure. E) ACE inhibitors reduce blood pressure by causing less atrial natriuretic peptide to be released, resulting in more water output and a lowering of the blood volume, which lowers the blood pressure.

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

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

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

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

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

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 occurs via transcellular or paracellular routes. D) It is a reclamation process.

Which of the following is the least important influence on reabsorption of a substance in the nephron? A) molecular complexity B) lipid solubility. C) molecule size relative to fenestrations. D) number of carriers.

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

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 secondary active transport C) be completely reabsorbed by the tubule cells D) be actively secreted into the filtrate

Which of the choices below is the least important role of tubular secretion? A) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes B) ridding the body of excessive potassium ions C) disposing of substances not already in the filtrate, such as certain drugs D) ridding the body of bicarbonate ions

What type of capillaries make up the glomerulus? A) continuous B) fenestrated C) vasa recta D) sinusoids

Overall, which of the following pressures is ultimately responsible for glomerular filtration? A) blood colloid osmotic pressure B) capsular hydrostatic pressure C) net filtration pressure D) glomerular hydrostatic pressure

Upon reaching what point in the nephron is reabsorption (1) dependent upon the body's needs at the time, and (2) regulated by hormones? A) ascending limb of the loop of Henle B) proximal convoluted tubule C) descending limb of the loop of Henle D) distal convoluted tubule

Chemicals that enhance urinary output are called __________. A) secretagogues B) countercurrent multipliers C) countercurrent exchangers D) diuretics

Which pressure is the chief force pushing water and solutes out of the blood and across the filtration membrane of the glomerulus? A) hydrostatic pressure in glomerular capillaries (HPgc) B) colloid osmotic pressure in glomerular capillaries (OPgc) C) hydrostatic pressure in the capsular space (HPcs) D) colloid osmotic pressure in the capsular space

Which of the following is the volume of filtrate formed each minute by all of the glomeruli of the kidneys? A) hydrostatic pressure in the capsular space (HPcs) B) glomerular filtration rate (GFR) C) hydrostatic pressure in glomerular capillaries (HPgc) D) net filtration pressure (NFP)

Calculate the net filtration pressure if blood pressure in the glomerulus is unusually high, around 68 mm Hg. A) 83 mm Hg B) 23 mm Hg C) 113 mm Hg D) 15 mm Hg

What hormone promotes active tubular secretion of potassium ions in the late distal convoluted tubule (DCT) and collecting ducts? A) antidiuretic hormone (ADH) B) atrial natriuretic peptide (ANP) C) parathyroid hormone (PTH) D) aldosterone

In what part of the renal tubule are aquaporins scarce or absent so that water CANNOT be reabsorbed? A) collecting duct B) ascending limb of the nephron loop C) descending limb of the nephron loop D) proximal convoluted tubule (DCT)

In what part of the renal tubule does parathyroid hormone (PTH) promote the reabsorption of calcium ions? A) proximal convoluted tubule (PCT) B) descending limb of the nephron loop C) collecting duct D) distal convoluted tubule (DCT)

Which of the following promotes the formation of dilute urine? A) increased osmolality of extracellular fluids B) large amounts of antidiuretic hormone (ADH) released from the posterior pituitary C) decreased osmolality of extracellular fluids D) increased number of aquaporins present in the collecting duct

Which statement best describes the effect diuretics have? A) Diuretics promote the formation of the medullary gradient by acting on the ascending limb of the nephron loop. B) Diuretics promote sodium reabsorption and enhance the obligatory water reabsorption that follows. C) Diuretics increase urinary output. D) Diuretics increase water reabsorption as a way to decrease the osmolality of the extracellular fluids.

Where does antidiuretic hormone (ADH) exert its effects to promote water reabsorption? A) descending limb of the nephron loop B) distal convoluted tubule (DCT) C) ascending limb of the nephron loop D) collecting duct

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

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

What is the largest component of urine by weight, other than water? A) creatine B) phosphates C) salt D) urea

When renal calculi obstruct a ureter, pain is perceived to radiate from the lower back to the anterior abdominal wall on the same side. This is an event that ______. A) is called referred pain B) occurs due to movement of the calculi from a kidney to the anterior abdominal region C) is caused by the calculi inflicting damage to the urinary bladder wall D) involves all of the above when a ureter is obstructed by calculi

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

Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs? A) Proteinuria is when there are excessive levels of protein in the blood, resulting in an increased osmotic pressure. The increased osmotic pressure forces fluid into the tissues, resulting in edema. B) Proteinuria is a condition in which large amounts of plasma proteins pass into the glomerular filtrate and are excreted in the urine, decreasing the osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema. C) Proteinuria is when there are excessive levels of protein in the blood, resulting in an increased osmotic pressure. This does not relate to the edema seen in this case. D) Proteinuria is a condition in which proteins are actively secreted into the kidneys at the DCT. This decreases the osmotic pressure, causing more fluid to leave the blood into the tissues in the body, resulting in edema. E) Proteinuria is when the liver does not make enough plasma proteins, resulting in a decreased osmotic pressure. This causes more fluid to leave the blood into the tissues in the body, resulting in edema.

Which of the following is NOT a major urine formation process? A) tubular secretion B) micturition C) glomerular filtration D) tubular reabsorption

Which urinary structure serves as the temporary storage site for urine? A) urinary bladder B) renal pelvis C) ureter D) urethra

Which of the following is NOT one of the things that must happen for micturition to occur? A) The detrusor muscle must contract. B) The internal urethral sphincter must open. C) The external urethral sphincter must open. D) The extrusor muscle must relax.

Which statement best describes the function of the urethra? A) The urethra transports urine from the bladder to the outside of the body. B) The urethra carries out processes that form urine. C) The urethra transports urine from the kidney to the urinary bladder. D) The urethra functions in urine storage.

What region of the male urethra runs through the urogenital diaphragm, extending about 2 cm from the prostate to the beginning of the penis? A) intermediate part of the urethra (membranous urethra) B) prostatic urethra C) spongy urethra D) ureter

What type of epithelial tissue forms the mucosa layer of the urinary bladder? A) pseudostratified columnar epithelium B) simple squamous epithelium C) stratified squamous epithelium D) transitional epithelium

Polycystic kidney disease always affects both kidneys instead of only the right or left kidney because ______. A) it is a disease in which the infection spreads from one kidney to the other kidney B) it is a genetic disease C) it is a disease that occurs in people having a horseshoe kidney (in which the two kidneys have fused) D) it is a disease in which cysts in one kidney trigger the formation of cysts in the other kidney

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

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

Which of the following congenital abnormalities of the urinary system is found in male infants only? A) hypospadias B) renal calculi C) polycystic kidney disease D) horseshoe kidney