EXAM 5~ Study Guide ~ Renal & Urinary Systems

This guide is intended to provide you with direction into areas of importance. It is also intended to
complement your lecture attendance, reading and note taking . . . not replace it..
The questions included are the type you will see on your exam. Some questions may be worded slightly
differently on the exam but the answers will be similar but not exact to assure that you understand the
material. A few questions may include answer choices while most others are intended for you to figure out.
Use your critical thinking skills to understand why certain choices are correct and others are not. You
should begin working on the study guide as soon as we begin the new section. In order for you to confirm
your answers for those questions that you are not sure about, an answer key sheet will be provided to you
during the lecture session just prior to the exam. This will give you at least two days to confirm your work.
If you wait until just prior to the exam it will be too late and you will not have enough time to properly learn
and absorb the material. The highest grades are usually achieved by students who participate with others in
study groups during the course. The exam may include multiple choice, multiple matching or fill in the blank
type questions.
Multiple Choice
1.

The kidney has an endocrine function that involves the secretion of which hormones from the kidney?
You should be able to figure from the choices given

2. The lowest blood concentration of nitrogenous waste occurs in the?

You should be able to figure from the choices given
3. The glomerular capillaries differ from other capillary networks in the body because they?
a. have a larger surface area for anastamosis
b. are derived from and drain into arterioles
c. are not composed endothelial cells
d. are the primary sites of final filtrate formation in the collecting ducts
e. ???
4. Damage to the renal medulla would primarily interfere with the functioning of the?
Know what structures are a part of the renal medulla
5. Which solute(s) is/are reabsorbed by the proximal convoluted tubule?
a. sodium & chloride
b. potassium
c. amino acids
d. glucose
e. ???
6. Glucose is not normally found in the urine because it?
You should be able to figure from the choices given
7. Level of filtration at the glomerulus is directly related to?
a. water reabsorption & capsular hydrostatic pressure
b. arterial blood pressure, blood volume, and state of hydration
c. glomerular hydrostatic pressure
d. volume of venous blood flow to the afferent glomerulus arterioles
e. b & c
8. Renal reabsorption?
a. is a limited active or freely passive transport process
b. of chloride is always linked to the passive transport of water
c. is the movement of substances from the blood into the nephron creating the filtrate
d. of sodium occurs only in the proximal tubule & distal tubule
e. of water involves the secretion of water back into the blood which dilutes the filtrate
9. If a freshly voided urine sample contains excessive amounts of urochrome, it has?
You should be able to figure from the choices given

10.

Conditions such as diabetes mellitus, starvation, and low-carbohydrate diets are closely linked to?
a. ketosis
b. pyuria

c.
d.
e.

albuminuria
hematuria
???

11. The kidney?

You should be able to figure from the choices given
12. The kidneys receive 25% of total cardiac output each minute most directly via the?
a. abdominal aorta
b. renal arteries
c. renal veins.
d. abdominal vena cava
e. efferent renal arteioles
13. The nerve supply to the kidney that regulates renal blood flow through dilation and constriction of renal arterioles
is via ?
Know what extrinsic neural system controls renal function
14. The nephrons of the kidney consist of all of the following except?
You should be able to figure from the choices given
15. All of the following are correct about urine, except?
a. urine is the remaining final filtrate passing into the papillary ducts
b. urine may or may not contain ions or nutrients
c. urine contains nitrogenous wastes such as urea, creatinine, & glucose
d. consists mostly of water
e. does not normally contain proteins
16. The primary role of the nephron in urine formation is to?
a. regulate arterial blood pressure and glomerular filtration rate
b. eliminate nitrogenous wastes and regulate volume, composition and pH of the blood
c. control respiratory acidosis and alkalosis
d. relieve pain in the abdomen due to a distended bladder
e. decrease blood pressure resulting from renin secretion
17. Which of the following is not true about glomerular filtration?
a. the glomeruli function as very efficient filters of blood
b. the glomerular filtration is an active and very selective process in filtering most solutes
c. solutes and fluid are forced through a filtration membrane by hydrostatic pressure
d. glomerular filtration is a passive, non-selective process
e. is dependent on vasomotor activity, blood volume and arterial pressure
18. Which of the following is not a functional process of the nephron in urine formation?
You should be able to figure from the choices given
19. All of the following occurs in the Renin Angiotensin mechanism, except?
Weve been over this mechanism several times this semester
20. Active processes in tubular secretion include all of the following, except?
a. removes water from the glomeruli back into circulation
b. removes drugs from body in urine through secretion
c. removes undesirable wastes such as urea & creatinine
d. removes excess hydrogen and potassium ions
e. maintains acid-base balance of blood, thus preventing metabolic acidosis or alkalosis
21.

In conducting a urinalysis, significant indicators as an aid in diagnosis of diseases of the body include all of the
following, except?
Know what substances are normally found in the urine & which are not

22. Which of the following is/are not a normal chemical composition of the urine?
Know what substances are normally found in the urine & which are not
23. Most proteins are not normally found in the urine because they?
You should be able to figure from the choices given
24. The layer of fibrous connective tissue covering the outer surface of the kidney is the?
You should be able to figure from the choices given
25. The glomerulus is structurally located within the boundaries of?
You should be able to figure from the choices given

26. The capillaries supplying individual nephrons are themselves supplied with blood by the?
a. afferent arterioles
b. efferent arterioles
c. peritubular capillaries
d. vasa recta
e. glomerular capillaries
27. Large cells that wrap around and are part of the glomerular capillaries are?
a. vasa recta
b. podocytes
c. astrocytes
d. macula densa cells
e. juxtaglomerular cells
28. The majority of nephrons are located in which part of the kidney?
a. renal pelvis
b. collecting ducts
c. renal cortex
d. renal medulla
e. ???
29. The distal convoluted tubule & collecting duct are important sites for?
a. active secretion of ions
b. active secretion of acids and other materials
c. selective reabsorption of sodium ions and water due to hormonal influence
d. secretion of creatinine, drugs & toxins
e. ???
30. The endocrine structure that secretes renin & erythropoietin is?
You should be able to figure from the choices given
31. The primary purpose of the collecting system is to?
a. transport urine from the urinary bladder to the urethra
b. selectively reabsorbs sodium ions from the plasma back into the filtrate
c. transport urine from the ureters to the bladder
d. transport urine from the bladder to the urethra
e. make final adjustments to the osmotic concentration and volume of urine
32. Pickup or delivery of substances that are reabsorbed or secreted by the proximal and distal convoluted tubules is
provided by the?
a. afferent arteriole
b. efferent arteriole
c. peritubular capillaries
d. ???
e. ???
33. The most abundant organic or voluminous solute waste material in urine is?
You should be able to figure from the choices given
34. The removal of water & solutes from the filtrate after it enters the renal tubule is?
You should be able to figure from the choices given
35. Changing the diameter of the afferent & efferent arterioles to alter the glomerular filtration
rate is due to?
a. hormonal regulation
b. autonomic regulation
c. sympathetic regulation
d. autoregulation
e. all of the above
36. Blood colloid osmotic pressure or high solute concentration in the plasma, tends to draw water?
a. into bowmans capsule to increase the GFR
b. out of the filtrate and into the plasma
c. across the loop of Henle from descending to ascending limb
d. out of the plasma and into the filtrate at the glomerulus
e. into the collecting duct as a result of ADH & aldosterone secretion
37. Which of the following is not a part of the filtration apparatus of the renal corpuscle?
Weve been over the filtration membrane anatomy several times

38. The correct pathway of movement of filtrate from the time it is produced in the renal corpuscle is?
Know the structure of the nephron & collecting system from renal arterys to ureters
39. The urinary system regulates blood volume and pressure by?
a. adjusting the volume of water lost in the urine
b. releasing erythropoietin
c. releasing renin
d. adjusing to sympathetic stimulation
e. ???
40. The balance of solute & water reabsorption in the renal medulla is maintained by the?
Know what part of the nephron is located in the renal medulla ~ Hint: in the LOH
Know the blood supply
41. A decrease in capsular hydrostatic pressure caused by damage to the glomerulus, would?
a. decrease the amount of blood delivered to the kidney by the renal vein
b. enhance the movement of water & solutes into bowmans capsule & glomerular filtrate
c. cause an decrease in blood pressure due to the increase of volume in the systemic circulation
d. decrease movement of water & solutes into the glomerular filtrate since the glomerulus is damaged
e. shut off the renin-angiotensin-aldosterone mechanism and stimulate diuresis resulting in a diluted urine
42. Sodium reabosrption in the distal convoluted tubule is accelerated by the secretion of which mineraloccorticoid?
Know your renal hormones & their effects
43. When ADH levels rise?
Figure this out based on knowing the effects of ADH
44. The control of blood pH by the kidneys during the correction of acidosis involves?
Know what needs to happen with hydrogen & bicarbonate ion to reverse acidosis
45. All of the following are true about the kidneys, except ?
Know where the kidneys are located in the body & know the external anatomy
46. The ureters & urinary bladder are lined by what type of epithelium?
a. stratified squamous
b. pseudostratified columnar
c. simple cuboidal
d. transitional
e. simple columnar
47. The detrusor muscle?
Know where the detrusor muscle is and how it functions in micturation
48. What statement(s) about the micturation process is/are not correct?
a. detrusor muscle relaxation results from sympathetic stimulation due to bladder wall stretch receptors
sending afferent impulses to the lumbar spinal cord
b. there is increased activity of the parasympathetic motor neurons that control the smooth muscle relaxation
of the internal urethral sphincter
c. the internal & external sphincters must be voluntarily relaxed in order to void urine
d. the external sphincter relaxes as a result of the parasympathetic reflex
e. ???
49. Changes that occur in the urinary system with aging include all of the following, except?
a. the number of functional nephrons decline
b. a reduction in the GFR occurs
c. there is increased sensitivity to ADH resulting in a better ability to concentrate the urine
d. there are more problems with the micturation process resulting in urinary incontinence
e. there is a loss of sphincter muscle tone resulting in urinary incontinence
50. Calculate the correct Net Filtration Pressure in mmHg if arterial pressure is 55, the efferent arteriole pressure is
10, the afferent arteriole pressure is 50, the glomerular hydrostatic pressure is 40, the capsular hydrostatic
pressure is 5, and the blood colloid osmotic pressure is 10?
You should be able to calculate NFP

51. Which is the most correct and most complete order of processes for the bulk formation of urine in a
juxtamedullary nephron?

glomerular filtration, PCT reabsorption, LOH reabsorption of H2O, LOH reabsorption of Na +, DCT
tubular secretion, Collecting Duct reabsorption & secretion
52. Aldosterone & ADH are two hormones that effect the reabsorption of H2O to maintain adequate blood pressure &
fluid volume of the blood. Which statement(s) below is/are ncorrect?
You should be able to figure this out
53. Which statement below regarding the filtration bed & absorption/secretion beds is correct?
a. both type beds have both fenestrations & filtration slits
b. filtration beds are found surrounding the PCT & DCT
c. absorption & secretion beds are found in the renal corpuscle
d. filtration beds make up the peritubular capillaries
e. reabsorption & secretion beds make up the glomerular capillaries
54. Which statement below regarding glomerular filtration rate (GFR) is not correct?
a. systemic vasocilation causes decreased GFR
b. renal afferent arteriole dilation causes increased GFR
c. systemic vasoconstrictors cause increased GFR
d. renal afferent arteriole constriction causes decreased GFR
e. renal efferent arteriole dilation causes increased GFR
55. The voiding reflex of micturation occurs as a result of contraction of which muscle(s)?
a. detrusor muscle
b. internal urethral sphincter
c. external urethral sphincter
d. ureter muscularis
e. ???
56. The compact ball of capillaries in a nephron is called the?
glomerular capillaries
57. Which of the nitrogenous waste solutes is the most abundant solute found in urine?
urea
58. Which structure below lies in closest proximity to the renal cortex?
renal capsule
59. Most sodium and water is reabsorbed from the glomerular filtrate by the?
Proximal Convoluted Tubule ~ PCT
60. A glomerulus & bowmans capsule make up one?
You should be able to figure this out
61. Which structure below does the kidney have the greatest numbers of?
You should be able to figure this out
62. The renal filtration of what solute listed below is nearly zero?
proteins
63. Increased ADH secretion should normally cause the urine to have a?
a. higher specific gravity
b. lighter color
c. higher pH
d. lower urea concentration
e. lower potassium concentration
True or False

Mark:

1 for TRUE

2 for FALSE

64. ___________

The distal convoluted tubules & collecting ducts are not subject to
hormonal influence?

65. ___________

Sodium is the most abundant solute found in the urine?

66. ___________

The kidney has more distal convoluted tubules than major calyces?

67. ___________

Tight junctions prevent material from leaking between cells of the renal tubules and
peritubular capillaries?

68. ___________

All forms of diabetes are characterized by high levels of glucose in the urine?

69. ___________

If all other conditions remain the same, constriction of the afferent arteriole reduces GFR?

70. ___________

Angiotensin II reduces urine output?

71. ___________

The minimum osmolarity of urine cannot go below 300 mOsm/L which is the osmolarity of
blood?

72. ___________

Micturation is dependent on contraction of the of the detrusor muscle and relaxation of

both the external & internal urethral sphincter muscles?

Fill in the blanks

73. _________________________

Concave medial surface of kidney where blood vessels and

ureter enter and exit?

74. _________________________

Fibrous supporting tissue capsule which adheres to surface of

kidney that provides a barrier to infection?

75. _________________________

The outer layer of fatty tissue that holds the kidney in place and
provides a cushion against contusions?

76. _________________________

The outermost layer of dense fibrous connective tissue that

completely surrounds the kidney and adrenal gland & anchors
kidney in place?

77. _________________________

Most superficial internal region of kidney that contains parts of

most nephrons?

78. _________________________

Deep to cortex, darker and reddish brown, this portion of the

kidneys contains the medullary pyramids?

79. _________________________

Tubes that carry urine between the kidney and bladder?

80. _________________________

Arteries that deliver 25% of total cardiac output every minute to

the kidneys.

81. _________________________

Functional and structural unit of the kidney that carries out

processes that form urine located in the mostly in the renal
cortex?

82. _________________________

Tuft of specialized capillaries in the renal corpuscle associated

with a renal tubule?

83. _________________________

Cup shaped portion of the nephron surrounding the glomerulus

that serves as part of the filtration membrane?

84. _________________________

The area of the nephron consisting of the glomerulus and

Bowmans Capsule?

85. _________________________

Plasma derived fluid that is the raw material processed by the

renal tubules that includes substances smaller than most
proteins?

86. _________________________

Coiled tubular portion of the nephron connected to Bowmans

Capsule, confined to the renal cortex, in which most of the filtrate
is reabsorbed?

87. _________________________

Part of a nephron mostly in the renal medulla, consisting of a

descending limb and ascending limb, involved in secretion and
reabsorption of filtrate and water permeability?

88. _________________________

Part of the nephron confined to the renal cortex that plays a

significant role in secreting substances into the filtrate, that is
very permeable to water when influenced by hormones?

89. _________________________

Part of the nephron located both in the renal cortex and renal
medulla that receives filtrate from many nephrons, helps finalize
concentration of urine, and merges into papillary ducts?

90. ________________________

A fusion of collecting ducts which deliver urine into the renal

pyramids, then to minor calyx?

91. ________________________

A type of nephron that makes up 85% of the nephrons located

almost entirely in the cortex that are less permeable to water, and
are major areas for reabsorption of glomerular filtrate?

92. ________________________

A type of nephron that makes up 15% of nephrons located close to

the cortico-medullary junction, that plays an extensive role in
concentration of urine and medullary osmotic gradient?

93. ________________________

The only capillaries in the body having both afferent and efferent
arterioles?

94. ________________________

Does higher or lower systemic blood pressure increase hydrostatic

pressure which in turn increases filtration through glomerular
capillaries?

95. ________________________

What percent of glomerular filtrate is reabsorbed by the renal

tubules and returned to the blood via the peritubular capillaries?

96. ________________________

Name the unique bundles of straight capillary vessels deep within

the medulla that surround the juxtaglomerular nephrons and help
establish medullary osmotic gradient?

97. ________________________

Cells of the distal tubule located near the glomerulus that play a
role in blood pressure regulation by releasing the hormone Renin?

98. ________________________

Cells of the distal tubule located near the glomerulus that play a
role in blood pressure regulation by detecting the chemical levels
& osmolarity of filtrate. They stimulate the release of renin.

99. ________________________

Kidney filtrate contains everything that blood plasma contains

except what large molecules?

100. _______________________

The passive, non-selective renal process in urine formation in

which solutes and fluids are forced through the filtration
membrane by hydrostatic pressure?

101. _______________________

The glomerular membrane that filters out most plasma proteins

except only the smallest ones?

102. _______________________

The difference between glomerular hydrostatic pressure, blood

colloid osmotic pressure and capsular hydrostatic pressure is?

103. _______________________

The pressure that is the most significant factor in affecting

glomerular filtration is?

104. _______________________

The renal regulation of glomerular filtration that involves

vasodilation or vasoconstriction that enables the kidney to
maintain constant renal blood flow and glomerular filtration rate is?

105. _______________________

Regulation of glomerular filtration is mediated by extrinsic neural

control and baroreceptor sensed changes in blood pressure. What
nervous system is stimulated?

106. _______________________

What mechanism is stimulated by a sensed drop in blood pressure

by baroreceptors that result in increased aldosterone release by
the adrenal cortex?

107. _______________________

The active and passive, selective and non-selective renal

reclaimation processes in urine formation in which solutes are
returned to peritubular capillaries is called?

108. _______________________

The area of tubular reabsorption in which all amino acids and

glucose are reabsorbed, in which 65% of sodium and water are

reabsorbed, in which 90% of bicarbonate is reabsorbed, and in

which 50% of potassium and chloride ion are reabsorbed is the?
109. _______________________

The area of the loop of henle that is most freely permeable to

water but impermeable to NaCl is?

110. _______________________

The area of the loop of henle that is impermeable to water but

freely permeable to NaCl is?

111. _______________________

The area of nephron which is the last resort area for tubular
reabsorption that is dependent on body needs is the?

112. _______________________

The area of rnephron is most affected by the hormone Aldosterone

that facilitates reabsorption of water?

113. _______________________

The area of nephron most affected by the hormones ADH that

facilitates reabsorption of water?

114. _______________________

The active and selective renal process in urine formation in which

substances such as drug metabolites, urea, creatinine, etc., are
added to the filtrate from blood or tubular cells is called?

115. _______________________

Kidney solute concentration is dependent on the number of

osmotically active particles in a liter of filtrate. The total molarity of
a solution that drives osmosis or movement of particles across a
gradient is known as?

116. _______________________

Does increased ADH released from the posterior pituitary

concentrate (less urine) or dilute (more urine) the urine?

117. _______________________

Does increased ADH released from the posterior pituitary increase

or lower blood pressure?

118. _______________________

An important renal diagnostic blood test used to evaluate the

kidneys ability to dispose nitrogenous waste products, and
diagnose reversible glomerular problems?

119. _______________________

An important renal diagnostic blood test used to evaluate the

kidneys ability to dispose nitrogenous waste products and
diagnose irreversible glomerular problems?

120. _______________________

An important health diagnostic test involving analysis of urine for

indicators such as protein, glucose, acetone, blood, pus, bacteria,
pH, and specific gravity?

121. _______________________

Name the yellow pigment derived from hemoglobin and bile

destruction that gives urine its color?

122. _______________________

Does a bacterial infection in the bladder result in a highly alkaline

or highly acidic urine?

123. _______________________

A specific gravity of urine at or below what level indicates renal

disease whereby the kidney cannot concentrate urine?

124. _______________________

Extreme back pain occurs when these slender tubes contain sand
like calculii passing from the kidneys to the bladder?

125. _______________________

This very thin muscular tube conveys urine from the bladder to the
exterior of the body?

126. _______________________

This skeletal muscle surrounding the urethra provides voluntary

control of urine release?

127. _______________________

The gland that surrounds the urethra below the bladder trigone is
called the?

128. _______________________

Pathological or normal presence of glucose in the urine is called?

129. _______________________

Pathological or normal presence of protein in the urine is called?

130. ______________________

Pathological presence of ketones in the urine is called?

131. ______________________

Pathological presence of hemoglobin in the urine is called?

132. ______________________

Pathological presence of bilirubin in the urine is called?

133. ______________________

Pathological presence of erythrocytes in the urine is called?

134. ______________________

Pathological presence of leukocytes in the urine is called?

135. ______________________

Pathological presence of bacteria in the urine is called?

136. ______________________

The process of emptying the bladder is called?

137. ______________________

Inability to control micturation voluntarily is called?

138. ______________________

Inability of the bladder to expel its contents is called

139. ______________________

Inflammation of the bladder is called?

140. ______________________

Inflammation of the glomeruli resulting in damaged filtration and

increased abnormal permeability?

141._______________________

A condition in which the kidneys are unable to concentrate urine

caused by too little or no release of ADH?

142. ______________________

Chemicals or drugs that enhance urinary output frequently used

as hypotensive drugs to lower blood pressure?

143. ______________________

Urine specific gravity of 1.010?

144. ______________________

Another name for bladder stones?

145. ______________________

Another name for kidney stones?