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ANA, BCHM, PHY > 1.4 PHYSIOLOGY - Renal > Flashcards

1.4 PHYSIOLOGY - Renal Flashcards

1
Q

Waste product from proteins

A

Urea

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2
Q

Waste product from purines

A

Uric Acid

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3
Q

Waste product from muscles

A

Creatinine

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4
Q

Waste product from RBCs

A

Bilirubin

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5
Q

3 functions of the kidney

A
  1. Excretion
  2. Homeostasis
  3. Secretion
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6
Q

Renal Circulation

A

Renal Artery –> Segmental Artery –> Interlobar Art. –> Arcuate Art –> Interlobular (Cortical radiate/Radial Art) –> Afferent Arteriole –> Glomerular Capillaries –> Efferent Arteriole –> Peritubular capillaries/Vasa recta –> Interlobular Vein –> Arcuate Vein –> Interlobar –> Segmental –> Renal Vein

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7
Q

Organs that produce glucose during starvation state

A

Liver and Kidney

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8
Q

Define Urine

A

an ultrafiltrate of blood

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9
Q

Location of the kidney

A

T12-L3

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10
Q

Weight of the kidney

A

150g

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11
Q

Basic parts of the kidney from lateral to medial

A 
Capsule
Cortex
Medulla
Renal Papilla
Renal Calyces (Major and Minor)
Renal Pelvis
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12
Q

Only capillaries in the human body that leads to arterioles and not venules

A

Glomerular capillaries

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13
Q

2 types of nephrons

A

Cortical and JM nephrons

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14
Q

Capillaries of cortical nephrons

A

Peritubular capillaries

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15
Q

Capillaries of JM nephrons

A

Vasa recta (Peritubular capillary)

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16
Q

Capacity of the bladder

A

600ml

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17
Q

Volume when urge to urinate is felt

A

150ml (25% filled)

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18
Q

Reflex contraction of bladder

A

300ml

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19
Q

Stretch sensitive muscle of the bladder

A

Detrussor

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20
Q

Voluntary sphincter of the urethra

A

External urethral sphincter

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21
Q

Involuntary sphincter of the urethra

A

Internal urethral sphincter

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22
Q

Number of nephrons per kidney

A

1 Million

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23
Q

Nephrons cannot be regenerated. True or false?

A

True

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24
Q

2 Major parts of the nephron

A
  1. Renal Corpuscle

2. Renal Tubular System

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25
Q

How many percent damage until compensatory hypertrophy of the kidneys?

A

75%

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26
Q

Differentiate cortical nephrons and JM nephrons based on:

Percentage
Location
Loops of Henle
Capillary Network

A

Percentage 75% Cortical - 25%JM
Location - Cortical, JM
Loops of Henle - Short LH - Long LH
Capillary Network - Peritubular capillaries - Vasa recta

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27
Q

3 barriers to filtration in the glomerulus

A
  1. Endothelial Cell
  2. Basement Membrane
  3. Podocytes
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28
Q

Cells that secrete renin

A

JG Cells

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29
Q

Podocytes contain

A
  1. Foot processes

2. Filtration Slits

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30
Q

Components of the basement membrane

A

Type IV Collagen

Lainin, Agrin, Perlecan, Fibronectin

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31
Q

Function of the Macula Densa

A

Monitor Na concentration and consequently blood pressure

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32
Q

Where are JG Cells and Macula Densa found?

A

Mnemonic: “JGA, MD”

JG - Afferent Arteriole
MD - Macula Densa Distal tubule

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33
Q

Workhorse of the nephron

A

PCT

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34
Q

Parts of the loop of henle

A

Descending limb
Thin ascending limb
Thick ascending limb

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35
Q

Parts of the distal tubule

A

Early and Late

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36
Q

Substances that are filtered only

A

Inulin and Creatinine

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37
Q

Substances that are filtered and partially reabsorbed

A

Many electrolytes

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38
Q

Substances that are filtered and completely reabsorbed

A

Glucose, Amino acids

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39
Q

Substances that are filtered and secreted

A

PAH, Organic acids and bases

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40
Q

Define filtration fraction

A

Fraction of renal plasma flow that is filtered

GFR/RPF

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41
Q

Normal filtration fraction

A

20%

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42
Q

Filterability of substances accdg to size

A

Water>Na, Glucose, Inulin>Myoglobin>Albumin

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43
Q

Filterability of substances accdg to charge

A

Positive Substances>Neutral>Negative Substances

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44
Q

Formula for GFR

A

GFR = Kf [(Pgc -Pbs) - (Ogc - Obs)]

45
Q

Net filtration pressure

A

10 mmHg

46
Q

Glomerular hydrostatic pressure

A

60mmhg

47
Q

Bowman’s capsule pressure

A

18 mmHg

48
Q

glomerular oncotic pressure

A

32 mmHg

49
Q

Describe the effect on GFR:

Afferent arteriole dilate

A

Increase

50
Q

Describe the effect on GFR:

Aferrent arteriole constrict

A

Decrease

51
Q

Describe the effect on GFR:

Eferrent arteriole dilate

A

Decrease

52
Q

Describe the effect on GFR:

Eferrent arteriole constrict moderately

A

Increase

53
Q

Describe the effect on GFR:

Eferrent arteriole constrict severely

A

Decrease

(Albumin collects in the glomerulus)

Gibbs-Donnan Effect

54
Q

Describe the effect on GFR:

GC hydrostatic pressure increased

A

Increase

55
Q

Describe the effect on GFR:

GC oncotic pressure increased

A

Decrease

56
Q

Describe the effect on GFR:

BS hydrostatic pressure increased

A

Decrease

57
Q

Describe the effect on GFR:

Kf increased

A

Increase

58
Q

What are the causes of decreased Kf?

A

Renal diseases
DM
HTN

59
Q

What is the cause of increased BS hydrostatic pressure?

A

Urinary tract obstruction

60
Q

What are the causes of decreased GC hydrostatic pressure?

A 
Hypotension (dec arterial pressure)
ACE-I (decreased eferrent arteriole constriction)
Sympathetic activity (inc aferrent arteriole constriction)
61
Q

What are the hormones that will increase GFR?

A

EDRF, PGE2, PGI2, Bradykinin, Glucocorticoids, ANP, BNP

62
Q

Which hormone will preserve GFR?

A

Angiotensin II
Preferentially constricts eferrent arteriole

Net effect is a decrease in GFR but only slightly hence preserves GFR

63
Q

Blood flow is greater where?

Cortex or medulla?

A

Cortex

64
Q

Local autoregulation of renal blood flow is exhibited at a BP range of?

A

75-160 mmHg

65
Q

What do you call massive sympathetic stimulation that results in massive vasoconstriction of the kidneys?

A

CNS Ischemic Response

66
Q

Other name for tubuloglomerular feedback

A

Macula densa feedback

67
Q

Feedback mechanism that is responsible for autoregulation of GFR at a BP of 75-160 mmHg

A

Tubuloglomerular feedback

68
Q

Action of adenosine in tubuloglomerular feedback

A

Vasoconstricts afferent arteriole

69
Q

Action of nitric oxide in tubuloglomerular feedback

A

Vasodilates aferrent arteriole

70
Q

Illustrate regulation of GFR in scenarios of High and low BP.

A

Pathways at Page 19 of handouts

71
Q

Define glomerulotubular balance

A

Percentage of solute reabsorbed is held constant; Buffers effect of drastic GFR changes in urine output.

72
Q

Define Renal threshold

A

Substances start to appear in the urine.

SOME nephrons exhibit saturation.

73
Q

Define renal transport maximum.

A

ALL excess substances appear in the urine.

ALL nephrons exhibit saturation.

74
Q

Some solutes do not have a transport maximum or threshold. What is this principle and how does this happen?

A

Gradient-Time transport

Rate of transport is dependent upon electrochemical gradient, membrane permeability and time.

Occurs for active and passive transport. The greater the concentration, the greater the flow rate and vice versa.

75
Q

Tubule with the highest number of mitochondria

A

PCT

76
Q

Lining of the PCT

A

Low columnar with extensive brush border (microvilli)

77
Q

Percent of glucose and amino acids reabsorbed in the PCT.

Percent of NaCl and H20 rebasorbed in the PCT.

A

100%

66%

78
Q

Which substances are rapidly filtered and almost none are reabsorbed in the PCT?

A

H+, Organic acids, bases, (bile salts, oxalate, urate and catecholamines) and drugs

79
Q

Which is more hyperonic relative than the other? The fluid entering the PCT or the fluid leaving the PCT?

A

None. Isoosmotic.

80
Q

Permeability of the loop of henle

A

“ASIN DING LIMB”

Descending limb
IMPERMEABLE to solutes
Permeable to water

Ascending limb
PERMEABLE to solutes
IMPERMEABLE to water

81
Q

Histology of the thin and thick segments of the loop of henle

A

Thin segment - simple squamous with no brush border and few mitochondria

Thick segment - simple cuboidal

82
Q

Percent of water reabsorbed in the loop of henle.

A

20%

83
Q

Percent of Na, K, Cl reabsorbed in the loop of Henle

A

25%

84
Q

Where is Mg2+ mainly reabsorbed?

A

Loop of henle

85
Q

Hydrogen is secreted in the LH via the

A

Na-H countertransport

86
Q

The distal tubule is divided into the

A

First part and second part

87
Q

Histology of the distal tubule

A

Simple cuboidal without brush border

88
Q

What is contained in the first part of the distal tubule?

A

JGA - macula densa, JG cells, lacis cells

89
Q

Permeability of water in the first part of the distal tubule?

A

Relatively impermeable to water (similar to thick segment of the LH)

90
Q

Structures contained in the second part of the distal tubule.

A

Principal cells

Intercalated cells

91
Q

The second part of the distal tubule is responsive to which hormone?

A

Aldosterone

92
Q

Absorption and secretion of principal and intercalated cells?

A

“PRINCIPE K”

Principal cells- secrete K, Absorb Na+ and H2O
Intercalate cells - secrete H+ , absorb K

93
Q

Channels for absorption of Sodium in principal cells

A

ENaC channels

94
Q

Secretion of H+ in intercalated cells is possible through the

A

H-ATPase pump

Na-H countertransport

95
Q

Histology of collecting ducts

A

Cuboidal with well defined boundaries between cells

96
Q

Site for regulation of final urine volume and concentration

A

COllecting ducts

97
Q

Main hormone acting on the collecting ducts

A

Vasopressin

98
Q

Collecting duct is permeable to ____ and secrets ____

A

Urea, H+ ions

99
Q

What happens to tubular reabsorption and tubular secretion when peritubular capillary hydrostatic pressure increases?

A

Reabsorption decrease

Secretion increase

100
Q

What happens to tubular reabsorption and tubular secretion when peritubular capillary oncotic pressure increases?

A

Reabsorption increase

Secretion decrease

101
Q

Determine the site of action and effect of the hormone.

Aldosterone

A

DT and CD

Inc Na reabsorption
Inc H20 reabsorptiom
Inc K secretion
Inc H secretion

102
Q

Determine the site of action and effect of the hormone.

ANP and BNP

A

DT and CD

Dec Na reabsorption

103
Q

Determine the site of action and effect of the hormone.

Dopamine

A

PCT

Dec Na and water reabsorption

104
Q

Determine the site of action and effect of the hormone.

Uroguanylin, Guanylin

A

PCT CD

Dec water and Na reabsorption

105
Q

Determine the site of action and effect of the hormone.

PTH

A

PCT TAL LH

Dec phosphate reabsorption (phosphate trashing hormone)
Inc Ca reabsorption
Stimulates 1 alpha hydroxylase

106
Q

What are the triggers of ADH secretion?

A

Inc plasma osmolarity
Dec blood pressure
Dec blood volume

107
Q

What is the effect of alcohol on ADH secretion?

A

Dec ADH

108
Q

Which hormone secreted by DT and CD acts similar to ANP?

A

urodilatin

ANA, BCHM, PHY (23 decks)

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