Exam code: H420
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Excretion
The process by which toxic waste products of metabolism and substances in excess of requirement are removed from the body.

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How do the lungs excrete waste?
They excrete the waste product carbon dioxide by gas exchange and the act of breathing out (exhalation).
Which waste product do the kidneys excrete, and how?
The kidneys produce urine that contains the waste product urea in solution.
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Excretion
The process by which toxic waste products of metabolism and substances in excess of requirement are removed from the body.
How do the lungs excrete waste?
They excrete the waste product carbon dioxide by gas exchange and the act of breathing out (exhalation).
Which waste product do the kidneys excrete, and how?
The kidneys produce urine that contains the waste product urea in solution.
Why is excretion important in homeostasis and maintaining metabolism?
Metabolic waste can have serious negative consequences if allowed to accumulate, so its removal helps maintain a stable internal environment for metabolism.
Why do mammals produce relatively large amounts of metabolic waste?
As active, warm-blooded animals, mammals have high metabolic rates, so they produce relatively large amounts of metabolic waste.
What are the main types of metabolic waste produced by mammals?
Carbon dioxide\n\n- Nitrogenous waste (ammonia, urea and uric acid)\n\n- Bile pigments (produced during the breakdown of haemoglobin)
How is carbon dioxide produced as a metabolic waste?
Carbon dioxide is produced from the decarboxylation of respiratory substrates.
How is ammonia produced as a metabolic waste?
Ammonia is produced from the deamination of excess amino acids.
What can happen if carbon dioxide and ammonia are not excreted properly?
They can accumulate and change the cytoplasm and body fluid pH, causing enzymes to work less efficiently.
From the breakdown of which substance are bile pigments produced?
Bile pigments are produced during the breakdown of haemoglobin.
Nitrogenous waste
Metabolic waste containing nitrogen, including ammonia, urea and uric acid.
The liver is a key organ in producing all of the excretory substances except .
The liver is a key organ in producing all of the excretory substances except carbon dioxide.
True or False: Mammals produce large amounts of metabolic waste because of their high metabolic rates.
True
True or False: Bile pigments are produced during the breakdown of amino acids.
False — bile pigments are produced during the breakdown of haemoglobin.
Why does the liver require a good blood supply?
It carries out the breakdown of toxic substances and the production of excretory waste, both of which require a rich blood supply to deliver and remove substances.
Hepatic artery
The vessel that carries oxygenated blood from the heart to the liver, providing oxygen for aerobic respiration to fuel the metabolic activity of liver cells.
Hepatic portal vein
The vessel that carries blood from the digestive system to the liver, allowing the liver to absorb and metabolise nutrients absorbed into the blood in the small intestine.
Which vessel carries blood away from the liver, and what is the nature of this blood?
The hepatic vein carries deoxygenated blood out of the liver and back to the heart.
What are the two roles of the gall bladder?
Store bile, a liquid containing bile salts (for lipid digestion) and bile pigments (from the breakdown of haemoglobin)\n\n- Release bile into the duodenum via the bile duct
What does bile contain, and where does each component come from?
Bile salts for lipid digestion\n\n- Bile pigments from the breakdown of haemoglobin
Hepatocytes
The main cells of the liver, which carry out almost all of the liver's functions.
Lobules
The structures into which liver cells (hepatocytes) are arranged; each is supplied with blood by branches of the hepatic artery and hepatic portal vein.
Sinusoids
Wide capillaries within a liver lobule where blood from the hepatic artery and hepatic portal vein mixes, and where substances are exchanged with nearby hepatocytes.
Within each lobule, blood from the hepatic artery and hepatic portal vein mixes inside wide capillaries known as .
Within each lobule, blood from the hepatic artery and hepatic portal vein mixes inside wide capillaries known as sinusoids.
How is blood drained away from a liver lobule?
Each lobule is connected to a branch of the hepatic vein, which drains blood away from the lobule and into the main hepatic vein.
The liver is mainly made up of cells known as , which carry out almost all of its functions.
The liver is mainly made up of cells known as hepatocytes, which carry out almost all of its functions.
True or False: The hepatic artery carries deoxygenated blood to the liver.
False — the hepatic artery carries oxygenated blood to the liver.
True or False: Within a lobule, blood from the hepatic artery and hepatic portal vein mixes in the sinusoids.
True
State three key functions of the mammalian liver.
Storage of glycogen
Formation of urea
Detoxification
Glycogenesis
The conversion of glucose into glycogen, which occurs in the liver.
Describe how the liver stores glycogen.
Insulin (released after the pancreas detects a rise in blood glucose) triggers glycogenesis, the conversion of glucose into glycogen.
The glycogen produced is stored inside hepatocytes.
Why is glycogen a suitable storage molecule in the liver?
Glycogen is a compact storage molecule that allows for easy release of glucose when it is needed.
Excess amino acids reach the liver from the gut via the vein.
Excess amino acids reach the liver from the gut via the hepatic portal vein.
What are the two steps involved in processing excess amino acids in hepatocytes?
Deamination
The ornithine cycle
Deamination
The removal of the amino group (NH2), together with an extra hydrogen atom (H+), from an amino acid; these combine to form ammonia (NH3).
After deamination, what remains of the amino acid?
A keto acid remains.
Why is ammonia converted into urea in the liver?
Ammonia is very soluble and highly toxic, so it can be damaging if it builds up in the blood.
It is converted into urea, which is less toxic than ammonia.
How is urea formed during the ornithine cycle?
Ammonia is combined with carbon dioxide to form urea.
One molecule of urea is produced from one molecule of carbon dioxide and two amino groups.
After it is formed in the hepatocytes, how is urea removed from the body?
Urea diffuses through the phospholipid bilayer of the hepatocytes and is transported to the kidneys dissolved in the blood plasma, where it is excreted.
Detoxification
The breakdown of substances that are not needed, or are toxic (e.g. alcohol, hydrogen peroxide, lactate and medicinal drugs) by the liver.
Describe how the liver detoxifies alcohol (ethanol).
Ethanol is absorbed in the stomach and transported in the blood to the hepatocytes.
Inside the hepatocytes the enzyme alcohol dehydrogenase converts ethanol into ethanal.
Ethanal is then converted into other molecules that enter respiration.
Explain how continuous alcohol detoxification can lead to fatty liver and cirrhosis.
The metabolism of ethanol generates ATP, so hepatocytes do not metabolise as much fat as usual and instead store it, causing fatty liver.
Stored fat reduces the ability of hepatocytes to carry out their other functions, and can eventually lead to cirrhosis (scarring of the liver caused by excessive alcohol consumption).
How does storing glycogen affect blood glucose concentration?
It removes glucose from the bloodstream, decreasing blood glucose concentration back to within the normal range.
What can happen to the keto acid produced by deamination?
It can:
enter the Krebs cycle to be respired
be converted to glucose
be converted to glycogen or fat for storage
True or False: Urea is more toxic than ammonia.
False — urea is less toxic than ammonia.
True or False: Glycogenesis is triggered by insulin.
True
Histology
The branch of biology that studies the microscopic anatomy of biological tissues.
What two other terms are used to describe histology?
Microscopic anatomy
Microanatomy
How can the histology of the liver be studied?
By staining sections of liver tissue and viewing them under a microscope.
What piece of equipment is used to view stained sections of liver tissue?
A microscope.
Once a liver tissue sample has been stained and viewed under the microscope, what is it examined for?
For drawing and labelling of the tissue.
Why is liver tissue stained before it is viewed under a microscope?
Staining makes the otherwise transparent structures of the tissue visible, so the sample can be examined, drawn and labelled.
Histology is the branch of biology that studies the microscopic anatomy of biological .
Histology is the branch of biology that studies the microscopic anatomy of biological tissues.
The histology of the liver can be studied by sections of liver tissue and viewing them under a microscope.
The histology of the liver can be studied by staining sections of liver tissue and viewing them under a microscope.
True or False: Histology is also known as microscopic anatomy or microanatomy.
True
True or False: Liver tissue is stained because its structures are otherwise transparent under the microscope.
True
True or False: Stained sections of liver tissue are examined by the naked eye rather than under a microscope.
False — they are viewed under a microscope.
How many kidneys do humans have?
Humans have two kidneys.
What is the role of the kidney as an osmoregulatory organ?
It regulates the water content of the blood, which is vital for maintaining blood pressure.
What is the role of the kidney as an excretory organ?
It excretes the toxic waste products of metabolism (such as urea) and substances in excess of requirements (such as salts).
Fibrous capsule
The tough outer layer that surrounds the kidney.
What are the three main areas of the kidney, beneath the fibrous capsule?
The cortex\n\n- The medulla\n\n- The renal pelvis
Which parts of the nephron are found in the cortex of the kidney?
The glomerulus, the Bowman's capsule, the proximal convoluted tubule and the distal convoluted tubule.
Which parts of the nephron are found in the medulla of the kidney?
The loop of Henle and the collecting duct.
What is the renal pelvis?
The area where the ureter joins the kidney.
Nephron
The functional unit of the kidney, responsible for the formation of urine. Each kidney contains thousands of these tiny tubes.
The functional unit of the kidney, responsible for the formation of urine, is the .
The functional unit of the kidney, responsible for the formation of urine, is the nephron.
Glomerulus
A network of capillaries found within the Bowman's capsule of each nephron, supplied with blood by the afferent arteriole.
Describe the path of blood through the vessels associated with a nephron.
Blood enters via the afferent arteriole (carrying blood from the renal artery)\n\n- It flows into the capillaries of the glomerulus\n\n- These rejoin to form the efferent arteriole\n\n- Blood then flows into a network of capillaries running alongside the rest of the nephron\n\n- Blood eventually leaves via the renal vein
What are the two main functions of the kidney?
Osmoregulation – regulating the water content of the blood
Excretion – removing toxic waste products of metabolism (e.g. urea) and substances in excess of requirements (e.g. salts)
True or False: The medulla is the outermost region of the kidney.
False — the cortex is the outermost region, with the medulla lying beneath it.
True or False: The glomerulus is found within the Bowman's capsule of each nephron.
True
Nephron
The functional unit of the kidney, responsible for the formation of urine.
What are the two stages of urine formation in the kidney?
Ultrafiltration – small molecules are filtered out of the blood into the Bowman's capsule, forming glomerular filtrate
Selective reabsorption – useful molecules are taken back from the filtrate and returned to the blood
Ultrafiltration
The process by which small molecules are forced out of the glomerular capillaries and into the Bowman's capsule under high blood pressure, forming glomerular filtrate.
How does the structure of the glomerular arterioles produce high blood pressure for ultrafiltration?
The afferent arteriole (entering the glomerulus) is wider in diameter than the efferent arteriole (leaving the glomerulus).
This creates high blood pressure within the glomerulus, forcing small molecules out of the capillaries and into the Bowman's capsule.
Which substances pass out of the glomerular capillaries to form the glomerular filtrate?
Amino acids
Water
Glucose
Urea
Inorganic ions (mainly Na⁺, K⁺ and Cl⁻)
Which components of the blood remain in the glomerular capillaries during ultrafiltration?
Blood cells and large proteins remain in the blood.
Which three layers must small molecules pass through during ultrafiltration in the Bowman's capsule?
The capillary endothelium – gaps between endothelial cells allow small molecules through
The basement membrane – a mesh of collagen and glycoproteins with holes small molecules pass through
The epithelium of the Bowman's capsule – made of podocytes with gaps between them
Podocytes
The epithelial cells of the Bowman's capsule that have many finger-like projections; the gaps between these projections allow small molecules to pass through during ultrafiltration.
Selective reabsorption
The process by which only certain useful substances (e.g. water, salts, glucose and amino acids) are reabsorbed from the glomerular filtrate back into the blood as the filtrate passes along the nephron.
Most selective reabsorption occurs in the of the nephron.
Most selective reabsorption occurs in the proximal convoluted tubule of the nephron.
How are the epithelial cells lining the proximal convoluted tubule adapted for reabsorption?
Many microvilli on the luminal membrane – increase surface area for reabsorption
Many co-transporter proteins in the luminal membrane – each transports a specific solute (e.g. glucose or an amino acid)
Many mitochondria – provide energy for the sodium-potassium (Na⁺/K⁺) pumps
Tightly packed cells – so all reabsorbed substances must pass through the cells, not between them
Describe how glucose and amino acids are reabsorbed in the proximal convoluted tubule.
Sodium-potassium pumps actively transport sodium ions out of the epithelial cells and into the blood
This lowers the sodium ion concentration inside the cells, so sodium ions in the filtrate diffuse down their concentration gradient into the epithelial cells
Sodium ions move via co-transporter proteins, which transport glucose or an amino acid at the same time
Once inside the cells, these solutes diffuse down their concentration gradients into the blood
Why does water leave the proximal convoluted tubule during selective reabsorption?
The movement of ions, sugars and amino acids into the surrounding tissues lowers the water potential of the tissues.
Water therefore leaves the proximal convoluted tubule by osmosis, moving down the water potential gradient.
Explain how the ascending limb of the loop of Henle helps to reabsorb water.
Sodium and chloride ions are pumped out of the filtrate in the ascending limb into the surrounding medulla, lowering the water potential of the medulla.
The ascending limb is impermeable to water, so water cannot leave here by osmosis.
The low water potential in the medulla then draws water out of the descending limb and the collecting duct by osmosis.
Why do blood cells and large proteins remain in the glomerular capillaries during ultrafiltration?
They are too large to pass through the holes in the capillary endothelial cells.
True or False: The afferent arteriole is narrower than the efferent arteriole.
False — the afferent arteriole is wider than the efferent arteriole, creating high blood pressure in the glomerulus.
True or False: The ascending limb of the loop of Henle is impermeable to water.
True
Histology
The branch of biology that studies the microscopic anatomy of biological tissues.
Also known as microscopic anatomy or microanatomy.
Nephron
The functional unit of the kidney.
Why are dissections a valuable part of scientific research?
They allow the external and internal structures of organs to be examined, so that theories can be made about how the organs function.
What two types of structure can a kidney dissection reveal?
The external (gross) structure of the kidney
The internal structure, seen in a vertical section
How can the histology of the kidney and nephron be studied?
By staining sections of kidney tissue and viewing them under a microscope.
The stained samples can then be drawn and labelled to identify the different structures within the nephron.
Why is it not possible to see complete nephrons in any section of stained kidney tissue?
Because nephrons are irregular structures that do not lie in any one plane within the kidney.
What do photomicrographs of stained kidney tissue actually show?
The parts of many adjacent nephrons, rather than a single complete nephron.
Which two regions of the kidney can be examined in stained sections under the microscope?
The cortex
The medulla
Histology is the branch of biology that studies the microscopic anatomy of biological .
Histology is the branch of biology that studies the microscopic anatomy of biological tissues.
True or False: Histology is also known as microscopic anatomy or microanatomy.
True
True or False: In these stained kidney sections, the medulla is shown at a higher magnification (×600) than the cortex (×200).
True
Osmoregulation
The control of the water potential of body fluids. It is a key part of homeostasis.
Osmoreceptors
Specialised sensory neurones that monitor the water potential of the blood. They are found in the hypothalamus of the brain.
Where in the brain are osmoreceptors located?
Osmoreceptors are located in the hypothalamus.
Describe the sequence of events when osmoreceptors detect a decrease in the water potential of the blood.
Nerve impulses are sent along the sensory neurones to the posterior pituitary gland
This stimulates the posterior pituitary gland to release antidiuretic hormone (ADH)
ADH enters the blood and travels to the kidneys
The kidneys reabsorb more water, reducing the loss of water in the urine
Antidiuretic hormone (ADH)
A hormone released by the posterior pituitary gland that causes the kidneys to reabsorb more water, reducing the volume of water lost in the urine.
ADH is released from the gland, which lies just below the hypothalamus.
ADH is released from the posterior pituitary gland, which lies just below the hypothalamus.
By what process is water reabsorbed in the nephron under the influence of ADH?
Water is reabsorbed by osmosis from the filtrate.
How does ADH make the collecting duct cells more permeable to water?
ADH increases the number of aquaporins (water-permeable channels) in the luminal membranes of the collecting duct cells.
Explain, step by step, how ADH increases the number of aquaporins in the luminal membranes of collecting duct cells.
ADH molecules bind to receptor proteins on the collecting duct cells
This activates a signalling cascade leading to phosphorylation of the aquaporin molecules
This activates the aquaporins, causing vesicles (whose membranes contain aquaporins) to fuse with the luminal membranes
This increases the membrane's permeability to water
Aquaporins
Water-permeable channel proteins in cell membranes. In the collecting duct, ADH increases their number in the luminal membranes to allow more water reabsorption.
Once aquaporins are inserted, explain how water moves out of the collecting duct.
Water moves out of the collecting duct (high water potential), through the aquaporins, into the tissue fluid and blood plasma in the medulla (low water potential).
This movement occurs by osmosis, down a water potential gradient.
What is the effect of high ADH levels on the volume and concentration of urine produced?
As the filtrate loses water it becomes more concentrated.
A small volume of concentrated urine is produced.
Describe what happens when the water potential of the blood is too high.
Osmoreceptors in the hypothalamus are not stimulated
No nerve impulses are sent to the posterior pituitary gland, so no ADH is released
Aquaporins are moved out of the luminal membranes, so collecting duct cells are no longer permeable to water
The filtrate loses no water, so a large volume of dilute urine is produced
What do osmoreceptors detect?
They detect changes in the water potential of the blood.
From which structures of the nephron is water reabsorbed under the influence of ADH?
Water is reabsorbed as the filtrate passes through the collecting ducts.
True or False: When the water potential of the blood decreases, the posterior pituitary gland releases ADH.
True
True or False: High levels of ADH cause a large volume of dilute urine to be produced.
False — high ADH causes a small volume of concentrated urine to be produced.
State four possible causes of kidney failure.
Any four of:
Blood loss in an accident
High blood pressure
Diabetes
Overuse of certain drugs (e.g. aspirin)
Certain infections
Explain what happens to urea, water, salts and toxins if the kidneys fail.
They are retained and not excreted, leading to a build-up of toxins in the blood.
How does kidney failure affect the glomerular filtration rate (GFR)?
Less blood is filtered by the glomerulus, so the GFR decreases.
As well as retaining toxins, kidney failure disrupts the balance of the blood, so the concentrations of ions and charged compounds are not maintained.
As well as retaining toxins, kidney failure disrupts the electrolyte balance of the blood, so the concentrations of ions and charged compounds are not maintained.
Describe the effects of excess potassium ions in the blood during kidney failure.
Can cause abdominal cramps, tiredness, muscle weakness and even paralysis.
If concentrations keep rising, the frequency of impulses from the sinoatrial node may decrease, potentially leading to arrhythmia and cardiac arrest.
Why is maintaining sodium balance important during kidney failure?
Sodium plays an important role in neuromuscular function, fluid balance and acid/base balance.
What are the two main forms of treatment for kidney failure?
Renal dialysis - toxins, metabolic waste and excess substances are removed from the blood by diffusion across a dialysis membrane
Kidney transplant - the non-functioning kidney(s) is replaced with a functioning kidney
Renal dialysis
A treatment for kidney failure in which small and large molecules are separated across a partially permeable membrane, using a machine (haemodialyser) that acts as an artificial kidney to remove wastes from the blood.
Dialysate
The dialysis fluid in a haemodialyser. It contains substances needed in the blood (e.g. glucose and sodium ions) at normal blood concentrations, but contains no urea.
Why does the dialysate contain glucose and salts at concentrations similar to normal blood levels?
Because glucose is at a concentration equal to normal blood sugar, there is no concentration gradient, so there is no net movement of glucose out of the blood.
Salts are at the ideal blood concentration, so salts only move where there is an imbalance (diffusing into the blood if it is too low, out of the blood if it is too high).
Explain how urea is removed from the blood during haemodialysis.
The dialysate contains no urea, so urea diffuses down its concentration gradient from the blood into the dialysate.
The fluid is continually refreshed to maintain the gradient, and blood and dialysate flow in opposite directions (countercurrent) so a gradient is maintained along the whole dialyser, removing almost all the urea.
Why is heparin added to the blood during dialysis?
Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.
Give two ways that renal dialysis restricts a patient's lifestyle.
Regular trips to hospital for treatment lasting at least three hours each time
Having to carefully control their diet to minimise urea production and salt intake
Why must a kidney transplant patient take immunosuppressant drugs?
The donor kidney is often a different tissue type, so the patient's immune system may reject it (the donor will not have the same cell-surface antigens).
State two benefits of a kidney transplant over dialysis.
Any two of:
Much more freedom, as the patient is not tied to regular dialysis sessions
Diet can be much less restrictive
Removes the high cost of using dialysis machines
A long-term solution, whereas dialysis only works for a limited time
What can a build-up of sodium in the blood cause during kidney failure?
Disorientation, muscle spasms, higher blood pressure and general weakness.
What is a drawback of taking immunosuppressant drugs after a kidney transplant?
They must be taken for life, can have long-term side effects and leave the patient vulnerable to infections.
True or False: During haemodialysis, blood and dialysate flow in the same direction.
False — they flow in opposite directions (countercurrent), maintaining the concentration gradient along the whole dialyser.
True or False: The dialysate contains no urea.
True — this means urea diffuses down its concentration gradient out of the blood and into the dialysate.
Why should there normally be no glucose present in the urine of a healthy person?
All of the glucose in the glomerular filtrate should be reabsorbed by the proximal convoluted tubule (PCT), so none remains to be excreted in the urine.
What does the presence of glucose in a urine test suggest?
It suggests something is wrong with the person's homeostatic control of glucose, in particular a problem with the functioning of insulin.
What does a positive urine or blood test for ketones suggest?
It suggests the person has diabetes mellitus.
What can the presence of protein in a urine test indicate?
It can indicate that:
The person's blood pressure may be too high
There is a kidney infection
There is something wrong with their blood filtration mechanism
What does a positive test for nitrate ions in the urine indicate?
It indicates the person has a bacterial infection in the urinary tract.
Human chorionic gonadotropin (hCG)
A hormone produced during pregnancy, secreted by the early embryo after it has implanted in the uterus. Its presence in the mother's urine is detected by pregnancy tests.
How do pregnancy testing sticks detect pregnancy?
They contain monoclonal antibodies that are specific to hCG, a hormone that becomes present in the mother's urine during pregnancy. The antibodies bind hCG to give a positive result.
Why does using monoclonal antibodies from a single clone of B lymphocytes minimise false pregnancy test results?
Because they all originate from a single clone of B lymphocytes, they produce the same antibody specific to hCG. This specificity minimises the chance of false results.
The antibodies in a pregnancy testing stick are specific to the hormone , which is secreted by the early embryo after implantation.
The antibodies in a pregnancy testing stick are specific to the hormone human chorionic gonadotropin (hCG), which is secreted by the early embryo after implantation.
Why are athletes' urine samples tested for anabolic steroids?
Anabolic steroids can be used to rapidly build muscle mass by stimulating protein synthesis, so athletes are regularly tested to detect their illegal use.
Which techniques are used to detect anabolic steroids in urine?
Anabolic steroids are detected in urine via:
Gas chromatography
Mass spectrometry
All the glucose in the glomerular filtrate should be reabsorbed by the , so there should be no glucose present in the urine.
All the glucose in the glomerular filtrate should be reabsorbed by the proximal convoluted tubule (PCT), so there should be no glucose present in the urine.
Why are ketones produced in a person with diabetes?
Ketones, such as acetone (propanone) and acetoacetate, are produced by the metabolism of people who have diabetes.
True or False: A healthy person should normally have no glucose present in their urine.
True — all glucose in the glomerular filtrate is reabsorbed by the proximal convoluted tubule (PCT).
True or False: A positive urine test for nitrate ions indicates that the person's blood pressure is too high.
False — nitrate ions in the urine indicate a bacterial infection in the urinary tract; protein is the marker linked to high blood pressure.
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