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PA 550 > 5/30/25 Renal Phys > Flashcards

5/30/25 Renal Phys Flashcards

(64 cards)

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1
Q

What organ is the master regulator of homeostasis?

A

Kidneys

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2
Q

What are some functions of the kidneys?

A

Fluid balance
Waste excretion
Drug excretion
Blood pressure regulation
Erythropoietin production
Vitamin D activation
Acid-Base balance

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3
Q

What makes up the urinary system?

A

Kidneys, ureters, bladder, urethra

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4
Q

What is the functional unit of the kidney?

A

Nephron

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5
Q

What part of the kidney is made up of parallel nephrons?

A

The pyramid

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6
Q

How does urine flow out of the kidneys from the nephrons?

A

Collecting duct –> minor calyx –> major calyx –> renal pelvis –> ureter

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7
Q

True or false: Multiple nephrons drain into the same collecting duct

A

True

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8
Q

Describe the blood flow into the kidney, specifically into the glomerulus

A

Aorta –> renal artery –> segmental artery –> interlobular artery –> arcuate artery –> cortical radiate artery –> afferent arteriole –> glomerulus

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9
Q

Describe the blood flow out of the kidney, specifically leaving the glomerulus

A

Efferent arteriole –> peritubular capillaries and vasa recta –> cortical radiate vein –> interlobular vein –> renal vein –> inferior vena cava

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10
Q

How many capillary beds supply the nephron? What are their names?

A
  1. The glomerulus and the peritubular capillary bed
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11
Q

What part of the nephron surrounds the glomerulus?

A

Bowman’s capsule

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12
Q

What is the glomerulus main job?

A

Blood filtration, removal of small, excess waste products from the bloodstream

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13
Q

What section of the nephron comes after the Bowman’s capsule?

A

The PCT

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14
Q

What allows the glomerulus to act as a filter?

A

Fenestrated capillary endothelium (size, wont allow proteins to pass into nephron), basement membrane (negative charge, so won’t let negative things pass), and podocytes (cells that form the outer layer of the glomerular filtration barrier)

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15
Q

What does reabsorption mean in the kidneys?

A

Water and solutes from the tubule go back into the bloodstream

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16
Q

Where does most reabsorption occur in the nephron?

A

PCT (65%)

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17
Q

What is reabsorbed at the PCT (from the nephron into the bloodstream)?

A

Amino acids, glucose, vitamins, Sodium and potassium (active transport)

chloride, water (passive transport)

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18
Q

What is secreted at the PCT (secreted from the bloodstream into the nephron)?

A

Hydrogen, ammonia, urea (active transport)

Also organic acids and bases

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19
Q

What part of the nephron comes after the PCT?

A

Loop of Henle

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20
Q

What 2 limbs make up the Loop of Henle?

A

Descending (1st) and Ascending (2nd)

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21
Q

What limb of the loop of henle is permeable to water, but impermeable to sodium?

A

Descending limb

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22
Q

What limb of the loop of henle is impermeable to water, but involves active transport off sodium out of the lumen into the ECF of the mediulla?

A

Ascending limb

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23
Q

How is the concentration gradient created in the kidney?

A

Through countercurrent mechanisms via the vasa recta which runs parallel to the loop of henle.

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24
Q

What part of the nephron comes after the loop of henle?

A

DCT

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25
Where does most secretion happen (from the blood into the nephron)? What is secreted?
DCT. Waste and toxins from bloodstream are secreted into the renal tubule (creatinine, ammonia, drugs...some H+ for pH regulation). Some potassium is also secreted.
26
What is the function of the DCT?
Regulation of plasma potassium and pH (secretion of H+ for pH regulation)
27
What part of the nephron does aldosterone act on?
The DCT
28
What part of the nephron is responsible for excretion?
Collecting ducts
29
Is the collecting duct permeable or impermeable to water?
Impermeable unless ADH is present
30
What gets excreted in the urine?
Metabolic waste (urea, creatinine, uric acid, excess water and salts
31
What is the GFR?
sum filtration rate of all the functioning nephrons. Represents the flow of plasma from the glomerulus into the Bowman's space over a period of time.
32
What is the gold standard for measuring kidney fxn?
GFR
33
How is GFR estimated?
Using serum creatinine
34
Normal GFR
120 mL/min
35
What causes GFR to vary?
age (10% drop/every 10 years of age), sex and body size
36
What does increased creat do to GFR?
Decreases GFR
37
What does decreased creat do to GFR?
Increases GFR
38
Define the glomerular hydrostatic pressure
The blood pressure in the glomerular capillaries. Pushes filtrate out
39
Define plasma oncotic pressure
Protein exerting a force to keep water in the bloodstream
40
Define Bowman's capsule pressure
Pressure of liquid in the Bowman's space pushing back against the glomerulus
41
Where does back up in the urinary system increase pressure at?
The bowman's capsule. Causes filtrate to back up.
42
True or false: In the nephron, capillary pressure > arteriole pressure?
True
43
What would afferent arteriole constriction do to the GFR?
Decrease GFR since there is decreased blood flow to the glomerulus
44
What would efferent arteriole construction do to the GFR?
Increase it, as it would increase pressure in the glomerulus
45
What would decreased proteins in the blood do to GFR?
Increase GFR since the oncotic pressure would be lower
46
What would an obstructing tumor in the bladder do to the GFR?
Decrease GFR. Fluid backs up into the Bowman's capsule which would increase bowman's capsule pressure
47
What effects do E and NE have on the nephron blood supply?
Constricts afferent arterioles causing decreased blood flow (low GFR)
48
What effect does angiotensin II have on the nephron blood supple?
Constriction of efferent arterioles which increases GFR
49
What mechanisms regulate GFR?
Filtration (3 different pressures), width of arterioles, sympathetic response (E and NE), Angiotensin II
50
What is the specialized structure that provides feedback mechanisms to maintain constant blood flow through the kidneys (along with stable GFR) regardless of the mean arterial pressure change?
Juxtaglomerular Apparatus
51
What makes up the Juxtaglomerular Apparatus?
Macula Densa of DCT, Juxtaglomerular (JG) cells of the arterioles
52
What do the Macula densa cells do?
Sense sodium and send signals to JG cells
53
What do the Juxtaglomerular (JG) cells do?
Detect signals from macula densa sensing low blood sodium. Cause the kidneys to release renin in response (RAAS)
54
What 3 things make JG cells secrete renin?
Decreased renal perfusion pressure, decreased NaCL absorption in macula densa, and sympathetic stimulation (afferent constrictionfrom NE and E)
55
Where is aldosterone released?
Adrenal gland (specifically cortex)
56
Where does aldosterone act?
DCT
57
What does aldosterone do to the DCT?
Causes Na reabsorption from kidney into bloodstream. Causes K secretion from bloodstream to nephron
58
How does aldosterone act to increase blood pressure?
If we are reabsorbing sodium, we will retain water which increases BP
59
What is another name for anti-diuretic hormone?
Vasopressin
60
Where is ADH secreted from?
Posterior pituitary in response to hypothalmic osmoreceptors sensing that the blood is getting too salty.
61
What does ADH do?
Causes water reabsorption in the DCT and collecting ducts by inducing aquaporins
62
What drugs inhibit ADH?
Alcohol, caffeine
63
Where are JG cells located?
On the arterioles of the glomerulus
64
What does renin do?
Activates the RAAS to increase blood pressure through constriction of the efferent arterioles and secreting aldosterone

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