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Life support > Renal structure and function of the renal tubule > Flashcards

Renal structure and function of the renal tubule Flashcards

1
Q

What are the juxtamedullary nephrons key to?

A

The juxtamedullary nephrons are key to the maintenance of counter-current mechanism

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2
Q

What are the 2 types of nephrons?

A

-Cortical nephron
-Juxtamedullary nephron

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3
Q

What is the function of cortical nephrons?

A

Cortical nephrons (85% of all nephrons) mainly perform excretory and regulatory functions

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4
Q

What are the tubules responsible for and what does this maintain?

A

The tubules are responsible to convert the 180 litres of crude glomerular filtrate into high
quality “fit-for-purpose” urine, to maintain body’s salt-water-electrolyte balance

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5
Q

What is the equation for total urine?

A

Glomerular filtration 180L + Tubular reabsorption 178L secretion = Urine 2L

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6
Q

Which tubule does majority of reabsorption take place?

A

Majority of the reabsorption including 65% of water occurs at the proximal convoluted tubule

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7
Q

What type of cells are in the proximal convoluted tubule?

A

Tall cells with numerous
microvilli and mitochondria

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8
Q

What does malfunction of the proximal convoluted tubule cause?

A

Malfunction causes acidosis and
“fanconi syndrome”

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9
Q

What is the descending limb of loop of henle permeable to?

A

The descending limb of loop of Henle is permeable to water

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10
Q

What type of cells does the ascending limb of henle have and what does it transport out of the tubule?

A

The ascending limb has thicker cells with mitochondria, transports electrolytes out of the tubule

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11
Q

What mechanism is the loop of henle responsible for?

A

The loop is responsible for counter current mechanism

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12
Q

What diuretics work at the loop of henle?

A

“Loop diuretics” work here

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13
Q

What are the distal convoluted tubule responsible for?

A

Responsible for more
reabsorption of electrolytes and
water

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14
Q

What type of cells are present in the distal convoluted tubule?

A

Tall cells with numerous
mitochondria

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15
Q

What apparatus does the distal convoluted tubule include?

A

Includes the juxtaglomerular
apparatus

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16
Q

What diuretics work at the distal convoluted tubule?

A

The thiazide diuretics work here

17
Q

What is the collecting duct responsible for?

A

Responsible for water
absorption

18
Q

What are the 2 major types of cells in the collecting duct?

A

-Principal cells
-Intercalated cells

19
Q

What is the structure and responsibility of principal cells?

A

tall, responsible for sodium absorption and
vasopressin action

20
Q

What is the structure and responsibility of intercalated cells?

A

Intercalated cells – more microvilli, numerous
mitochondrion and responsible for
acid secretion

21
Q

Where is majority of sodium absorbed and by what channel ?

A

Majority absorbed in proximal tubule by a Na-H exchanger

22
Q

At what site is sodium absorbed in thick ascending loop of henley?

A

Na-2Cl-K

23
Q

What channel is sodium absorbed in distal tubule?

A

Na-Cl cotransporter

24
Q

What channel is sodium absorbed in distal convoluted tubule?

A

Epithelial Na channel

25
Q

What is the total daily osmotic load to be excreted?

A

The total daily osmotic load to be excreted is 700 mOsm

26
Q

What do vasopressin or antidiuretic hormones regulate from daily osmotic load?

A

The vasopressin or anti-diuretic hormone [ADH] regulates the volume of urine to excrete the daily osmotic load.

27
Q

What happens when there is an increase in salt and water delivery at the distal tubule?

A

Tubulo-glomerular feedback
-Afferent artery vasoconstriction
-Decrease in filtration pressure
-Decrease in GFR

28
Q

What is TGF with SGLT2i associated with and what has it shown improvement with?

A

TGF with SGLT2i is associated with slowing CKD
& improvement in HF hospitalisations and mortality

29
Q

What is the countercurrent mechanism in the loop of henle responsible for?

A

Mechanism by which the osmotic gradient is generated in the medulla

30
Q

What is the countercurrent mechanism generated by in the loop of henle?

A

Generated by differential movement of water in 2 limbs of loop of Henle

31
Q

How is the counter current formed in the loop of henle?

A

The osmotically active molecules [Na,Cl,K] are pumped out from the ascending limb of loop of Henle generating hyperosmolar medulla which drives water out along osmotic gradient in descending limb

32
Q

What is the countercurrent mechanism created by the vasa-recta?

A

Created by movement of water and electrolytes between the descending and ascending vasa-recta

33
Q

What is the process by which the countercurrent mechanism is generated in vasa-recta?

A

water moves out and NaCl moves in the descending and vice versa in ascending

Life support (38 decks)

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