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BIOM1052 > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Each nephron contains a filter known as the …

A

glomerulus

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2
Q

The kidneys sit on the … wall of the abdomen, outside the … cavity

A

posterior
peritoneal

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3
Q

The … cappilary network joins the interlobular vein

A

peritibular

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4
Q

List the four vascular components of the nephrons

A

1 - Afferent arteriole
2 - Glomerulus (capillaries)
3 - Efferent arteriole
4 - Peritubular capillaries or vasa recta

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5
Q

Where within the nephron does filtration take place?

A

The glomerulus

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6
Q

T or F
Any substance that ends up in the kidney tubule will get excreted

A

T

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7
Q

T or F
The renal pelvis connects to the renal vein

A

F
It is connected to the ureter

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8
Q

… to …% of cardiac output goes to the kidney

A

20 to 25

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9
Q

The standard, healthy glomerular filtration rate is …ml/min

A

125

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10
Q

…% of plasma flowing through the kidney is filtered

A

20

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11
Q

…% of kidney filtrate is reabsorbed by the body

A

99

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12
Q

Why can creatinine or inulin be used to estimate GFR?

A

Because they get filtered but not reabsorbed or secreted

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13
Q

Define renal clearance

A

The volume of plasma the kidneys can clear of a particular substance in a given time.

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14
Q

What eGFR values indicate stage 1 kidney disease?

A

90+

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15
Q

What eGFR values indicate stage 2 kidney disease?

A

89-60

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16
Q

What eGFR values indicate stage 3 kidney disease?

A

59-45
44-30

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17
Q

What eGFR values indicate stage 4 kidney disease?

A

29-15

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18
Q

What eGFR values indicate stage 5 kidney disease?

A

Less than 15

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19
Q

Why do patients with kidney disease develop anemia?

A

Kidneys produce erythropoietin (EPO) a hormone that stimulates bone marrow to produce red blood cells. Diseased or damaged kidneys do not produce sufficient EPO which causes less blood cells to be produced, causing anemia.

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20
Q

What are the 4 main functions of the kidney?

A

– Regulation of water & electrolyte volume & osmolarity
– Regulation of acid-base balance
– Excretion of metabolic waste products and foreign chemicals
– Secretion of enzymes

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21
Q

Name all the blood vessels associated with the nephron

A
  • Afferent arteriole
  • Glomerulus (capillaries)
  • Efferent arteriole
  • Peritubular capillaries or vasa recta
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22
Q

List the arteries blood flows through to get from the aorta to the afferent arteriole in the kidney

A
  • Renal artery
  • Segmental artery
  • Interlobular artery
  • Arcuate artery
  • Cortical radiate artery
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23
Q

List the veins blood flows through to get from the peritubular capillaries/vasa recta to the renal inferior vena cava

A

Cortical radiate vein
Arcuate vein
Interlobular vein
Renal vein

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24
Q

The kidney is made of individual functional
units called …

A

“nephrons”

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25
Q

The nephron is made up of what two components?

A
  • Vascular components (blood vessels)
  • A complex set of renal tubules
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26
Q

Put simply what is the purpose of the renal tubules in the nephrons?

A

carries the fluid filtered by glomeruli
termed the tubular filtrate

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27
Q

T or F
The interlobular artery and cortical radiate artery are interchangeable names for the same artery

A

T

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28
Q

The … arteriole supplies blood to the glomerulus

A

afferent

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29
Q

The ball of capillaries where filtration takes place is called the …

A

glomerulus

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30
Q

The … arteriole Carries blood away from the glomerulus

A

efferent

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31
Q

… capillaries are wrapped around the renal tubules

A

Peritubular

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32
Q

What are the peritubular capillaries important for?

A

important in
exchanging fluid inside the tubules into
capillaries and vice versa

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33
Q

T or F
The renal artery which carries blood into the kidney divides into
smaller and smaller blood vessels until it gives rise to the afferent arteriole.

A

T

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34
Q

The … is the filtration
unit of the kidney

A

Glomerulus

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35
Q

Before passing through the ureter to the bladder urine collects in the …

A

calyces

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36
Q

Match the tubular elements of the nephron to their function:

A. Bowman’s capsule
B. Proximal Tubule
C. Loop of Henle
D. Distal tubule/collecting duct
E. Renal pelvis

  1. Where the majority of reabsorption takes place
  2. Collects urine and funnels to ureter/bladder
  3. Controlled reabsorption (esp Na+ and H2O)
    and secretion (K+ and H+)
  4. Surrounds the glomerulus; collects filtrate
  5. Important for producing urine of varying
    concentrations
A

A4, B1, C5, D3 and E2

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37
Q

What does glomeruler filtration rate measure?

A

the volume of plasma filtered per minute

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38
Q

T or F
eGFR increases in kidney disease

A

F
decreases

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39
Q

What is filtration fraction?

A

The fraction of
the renal plasma flow that is filtered in the
glomerulus during a single pass through
the kidney = GFR/Renal Plasma flow

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40
Q

…% of the filtrate is taken back into
the body

A

99

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41
Q

T or F
Glomerular filtration rate (ml/min) can be estimated using a molecule which gets reabsorbed but
does not get filtered or secreted.

A

F
Glomerular filtration rate (ml/min) can be estimated using a molecule which gets filtered but
does not get reabsorbed or secreted.

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42
Q

How do you calculate creatinine clearance?

A

Urine concentration of Cr/ Plasma concentration of Cr x urine flow rate

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43
Q

What is renal clearance?

A

volume of plasma kidneys
can clear of a particular substance in a given
time

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44
Q

How do you calculate renal clearance?

A

renal clearance rate (ml/min) = (concentration (mg/ml) of substance in urine x flow rate of urine formation (ml/min)) / concentration of same substance in plasma

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45
Q

What does it mean if renal clearance is 0?

A

substance was completely
reabsorbed, or not filtered

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46
Q

What does it mean if renal clearance is less than 125ml/min?

A

means substance
reabsorbed

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47
Q

What does it mean if renal clearance is greater than 125ml/min?

A

substance was secreted
(most drug metabolites)

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48
Q

What does it mean if renal clearance is equal to 125ml/min?

A

no net reabsorption or
secretion

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49
Q

T or F
GFR cannot be measured directly

A

T

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50
Q

Erythropoietin also known as … or …, is a glycoprotein cytokine secreted by
the kidney in response to ….; it
stimulates red blood cell production
(erythropoiesis) in the ….

A

haematopoietin or
haemopoietin
ellular hypoxia
bone marrow

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51
Q

What is glomerular filtration?

A

the movement of fluid and
solutes from the glomerular
capillaries into Bowman’s space.

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52
Q

What is tubular reabsorption?

A

the movement of materials from the filtrate in the tubules into the peritubular capillaries. (moving fluid back into the body)

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53
Q

What is tubular secretion?

A

the movement of solutes from the peritubular capillaries into the tubules
– Removing fluid from the body

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54
Q

T or F
some substances almost completely reabsorbed by the kidneys

A

T

55
Q

T or F
Waste products highly reabsorbed from the kidneys

A

F
Waste products poorly reabsorbed

56
Q

T or F
Ions are highly reabsorbed by the kidney

A

T

57
Q

without tubular reabsorption → whole plasma volume &
essential solutes excreted within …min

A

30

58
Q

For most substances that are actively reabsorbed (or secreted) there is a limit to the rate the solute can be transported, why is this?

A

Due to saturation of available carrier proteins (what is not transported will be excreted)

59
Q

In a healthy individual what is the reabsorbance rate for glucose?

A

100%

60
Q

In a healthy individual what is the reabsorbance rate for water?

A

99%

61
Q

In a healthy individual what is the reabsorbance rate for sodium?

A

99.5%

62
Q

In a healthy individual what is the reabsorbance rate for urea?

A

44%

63
Q

T or F
The descending Loop of Henle undergoes osmosis whereas the ascending loop of henle is impermeable

A

T

64
Q

Where in the nephron does the majority of water reabsorption take place?

A

In the proximal tubules (67%) via osmosis

65
Q

Why can the presence or the absence of vasopressin influence the osmolarity of urine?

A

Vasopressin (another name antidiuretic hormone (ADH)) increases the tubular permeability in the collecting duct.

66
Q

In which 3 parts of the nephron is water reabsorbed?

A

Proximal tubules
Loop of Henle
Distal tubule and collecting duct

67
Q

Describe the pathway by which ADH secretion is lowered upon drinking
a litre of soft drink and water excretion raised?

A

Drinking a litre of soft drink lowers ECF osmolarity, lowers ADH secretion, lowers collecting duct permeability to H2O, lowers H2O reabsorption which increases H2O secretion

68
Q

T or F
Dehydration will have no effect on plasma volume

A

F
It will reduce plasma volume

69
Q

What is the kidneys response to dehydration?

A
  • Retain sodium and water to minimise ECF osmolarity and volume loss (increasing ECF osmolarity)
  • Osmoreceptors trigger thirst
  • Increased ADH from the posterior pituitary
  • Increased water reabsorption
  • Decreased water excretion
70
Q

Which parts of the nephron are under fine control from ADH?

A

Distal tubule
& Collecting Duct

71
Q

Once released from the … pituitary vasopressin reaches the kidney via ….

A

posterior
systemic circulation

72
Q

What effect does ADH have on the proximal tubule and collecting duct of the nephron?

A

increasing water reabsorption and thereby minimising loss of
water.

73
Q

Via what mode of transport does the ascending loop of henle reabsorb sodium?

A

active transport

74
Q

T or F
The descending loop of henle cannot reabsorb sodium

A

T

75
Q

Where in the nephron in 64% of sodium reabsorbed?

A

The proximal tubules

76
Q

The distal tubule and collecting ducts of the nephron reabsorb sodium under the fine control of…

A

aldosterone

77
Q

T or F
Atrial natriuretic peptide is a protein

A

F
hormone

78
Q

T or F
Atrial natriuretic peptide is a potent vasoconstrictor

A

F
vasodilator

79
Q

Atrial natriuretic peptide regulates … and …

A

Regulates sodium balance and blood volume

80
Q

Atrial natriuretic peptide acts on tubules to inhibit … reabsorption

A

sodium

81
Q

T or F
Atrial natriuretic peptide can increase GFR

A

T
and thus further contributes to
increased sodium excretion

82
Q

T or F
Secretion is a transport processes similar to
tubular reabsorption but in reverse direction

A

T

83
Q

What is secretion important for?

A

– Disposing of substances not in
filtrate such as drugs (penicillin)
– Eliminating undesirable substances
that have been reabsorbed by
passive processes such as urea
– Ridding body of excessive K+
– Controlling blood pH

84
Q

T or F
For each substance in plasma, a particular combination of
filtration, reabsorption & secretion occurs.

A

T

85
Q

For each of the following name a substance or type of substance that undergoes the described pattern through the nephron

A - Not filtered
B - Filtered but not
reabsorbed or secreted
C - Filtered,
completely reabsorbed & not secreted.
D - Filtered, some
reabsorbed, not secreted

A

A - Large proteins
B - inulin, creatinine
C - glucose
D - many electrolytes

86
Q

What 3 layers make up the Glomerular Filtration Barrier?

A
  1. Endothelium of glomerular capillaries
  2. Basement membrane (negatively charged)
  3. Podocytes of glomerular capsule Glomerular capsule = Bowman’s capsule
87
Q

Why are Glomerular capillaries more
efficient filters than other
capillaries?

A

– very large fenestrations
– high hydrostatic pressures driving
filtration (55 vs 18 mmHg)

88
Q

Why are most proteins unfiltered by the glomerulus?

A

Most proteins prevented due to negative charge they carry

89
Q

What is the most abundant protein in the plasma?

A

albumin

90
Q

… in urine indicates an
underlying renal disease.

A

Protein

91
Q

What force drives glomerular filtration?

A

glomerular capillary pressure

92
Q

What 2 forces oppose glomerular filtration?

A
  1. Pressure in glomerular/Bowman’s capsule
  2. Osmotic force due to proteins in plasma
    plasma osmotic pressure
93
Q

T or F
Hydrostatic pressure from the heart favors filtration

A

T

94
Q

T or F
An increase in GFR leads an increase in
flow rate and vice versa

A

T

95
Q

reabsorption of H2O & other substances
from filtrate partly dependent on rate of
… through tubules

A

flow

96
Q

Why does GFR need to be relatively constant?

A

Increased GFR→inadequate reabsorption → substances lost in urine
Decreased GFR→ reabsorption increased→wastes not excreted

97
Q

10% increase in GFR equals …L more filtrate to be processed

A

18

98
Q

Increased arterial pressure will have what effects on glomerular capillary pressure and GFR?

A

increases glomerular capillary pressure and GFR

99
Q

Increased Afferent Arteriolar Resistance will have what effects on glomerular capillary pressure and GFR?

A

decreased glomerular capillary pressure and GFR

100
Q

Decreased Afferent Arteriolar Resistance will have what effects on glomerular capillary pressure and GFR?

A

increases glomerular capillary pressure and GFR

101
Q

Increased Efferent Arteriolar Resistance will have what effects on glomerular capillary pressure and GFR?

A

increases glomerular capillary pressure and GFR

102
Q

Decreased Efferent Arteriolar Resistance will have what effects on glomerular capillary pressure and GFR?

A

decreased glomerular capillary pressure and GFR

103
Q

T or F
many daily activities change mean arterial pressure

A

T

104
Q

Autoregulation of GFR avoids imbalances in …, … and … excretion
due to changes in mean arterial pressure

A

fluid, electrolyte and waste

105
Q

Autoregulation of GFR prevents damage to the filtration barriers by
….

A

high blood pressures

106
Q

What are the 2 types of renal autoregulation?

A
  1. Myogenic mechanism
  2. Tubuloglomerular feedback mechanism
107
Q

Renal autoregulation maintains nearly a constant GFR when MAP is in range of … to … mm Hg - Autoregulation ceases if out of that range

A

80–180

108
Q

Controlled regulation of GFR usually involves changes in ….

A

glomerular capillary pressure

109
Q

T or F
An increase in glomerular capillary pressure would increase GFR (assuming no other alterations) if there was no autoregulation.

A

T

110
Q

Myogenic tone is a property of …. muscle; it involves contraction of the muscle in response to …

A

arteriolar smooth
stretch

111
Q

An increase in MAP will … the diameter of the afferent arteriole

A

reduce

112
Q

Increase in blood pressure = … =
… = No change in GFR

A

Myogenic response: Reduction in afferent arteriolar diameter

keeps glomerular capillary pressure constant

113
Q

What 3 cell populations are seen in the Juxtaglomerular Complex?

A

1- Macula densa
2- Granular cells (juxtaglomerular, or JG cells)
3- Extraglomerular mesangial cells

114
Q

The … cells of the juxtaglomerular complex contain chemoreceptors that sense NaCl content of filtrate

A

Macula densa

115
Q

The … cells of the juxtaglomerular complex are tall, closely packed cells of ascending limb

A

Macula densa

116
Q

Enlarged, smooth muscle cells of arteriole are called …

A

Granular cells (juxtaglomerular, or JG cells)

117
Q

The … cells of the juxtaglomerular complex act as mechanoreceptors to sense blood pressure in afferent
arteriole

A

Granular cells (juxtaglomerular, or JG cells)

118
Q

The … cells of the juxtaglomerular complex contain secretory granules that contain enzyme renin

A

Granular (juxtaglomerular, or JG cells)

119
Q

The … cells of the juxtaglomerular complex are located between arteriole and tubule cells

A

Extraglomerular mesangial cells

120
Q

The … cells of the juxtaglomerular complex are interconnected with gap junctions

A

Extraglomerular mesangial cells

121
Q

The … cells of the juxtaglomerular complex may pass signals between macula densa and
granular cells

A

Extraglomerular mesangial cells

122
Q

The macula densa is a collection of specialized … cells in the …. that detect … concentration of
the fluid in the tubule

A

epithelial
distal convoluted
tubule
sodium chloride

123
Q

increase in GFR = increase … reaching
macula densa cells = macula densa sends a
signal to … arteriole to … = reduce GFR = reduce … reaching macula densa

A

NaCl
afferent
constrict
NaCl

124
Q

Aldosterone promotes … reabsorption

A

sodium

125
Q

Name the three pathways to renin release by granular cells

A
  1. Direct stimulation of granular cells by sympathetic
    nervous system
  2. Stimulation by activated macula densa cells when
    filtrate NaCl concentration is low
  3. Reduced stretch of granular cells
126
Q

What is the kidneys main mechanism for increasing blood pressure?

A

Renin-angiotensin-aldosterone mechanism

127
Q

The chronic overactivation
of the renin angiotensin system
leads to … and …

A

kidney fibrosis and kidney
disease.

128
Q

What are the actions of ANG II within the RAAS

A
  • potent vasoconstrictor
  • activates sodium reabsorption
  • stimulates aldosterone production
  • Stimulates ADH release
129
Q

Direct stimulation of … by the … nervous system increases
renin release

A

granular cells
sympathetic

130
Q

What effects does Angiotensinogen II have on the body?

A

Vasoconstriction
Aldosterone secretion
Increased tubular Na+ reabsorption
Stimulates ADH secretion
thirst

131
Q

… renin release in turn … the formation of angiotensin II

A

Increase
increases

132
Q

T or F
Indirect stimulation of granular cells by the sympathetic nervous system increases
renin release

A

F
Direct

133
Q

What are forces that oppose glomerular filtration?

A
  1. Pressure in glomerular capsule
  2. Osmotic force due to proteins in plasma (plasma osmotic pressure)

BIOM1052 (9 decks)

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