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Anatomy > Renal 3 Urine and renal function > Flashcards

Renal 3 Urine and renal function Flashcards

1
Q

normal blood osmolarity

A

300 mOsm/L

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2
Q

what type of nephron is responsible for making dilute urine?

A

short loop nephron

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3
Q

what type of nephron is responsible for making concentrated urine?

A

long loop nephron

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4
Q

how is dilute urine made?

A
  1. solutes + water reabsorbed in PCT
  2. filtrate enters LOH and equilibirates; loss of water only makes filtrate more concentrated and osmolarity rises
  3. filtrate enters thick ascending limb of LOH; solutes are transported out by symporters (Na+-K+-2Cl-) and water cannot follow (filtrate loses solute and osmolarity decreases)
  4. filtrate flows to DCT and loses more solute
  5. filtrate enters collecting ducts and more solute is pumped out to be most dilute (NO ADH, impermeable to H2O)
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5
Q

how is the osmotic gradient in the interstitial space set up?

A

by the thick ascending limb of the LOH pumping out ions but not water; the descending limb loses water but not ions, so much water is removed by the descending limb of the LOH

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6
Q

why do we make concentrated urine?

A

if there is too little water/too many ions in the body, urine must be made which reestablishes ionic balance
- needs to be more concentrated in ions than the blood to get rid of excess ions therefore has to be greater than blood osmolarity

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7
Q

how is concentrated urine made?

A
  1. solutes and waters reabsorbed in PCT
  2. filtrate enters LOH and equilibriates; filtrate highly concentrated and osmolarity rises
  3. filtrate enters thick ascending limb of LOH and solutes are transported out by symporters (water does not follow) - osmolarity decreases
  4. filtrate flows to DCT and loses more solute; osmolarity further decreased
  5. filtrate enters collecting duct which is permeable to H2O in presence of ADH; water flows out to match high osm. of interstitial fluid
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8
Q

the longer the loop of Henle:

A

the greater the time for the ascending limb to pump out solutes

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9
Q

how do diuretics work?

A

they inhibit the Na+-K+2Cl- symporter in the ascending limb so there is decreased water reuptake and more urine

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10
Q

ADH in urine production

A
  • ADH tastes the blood and if its too salty it wont make urine
  • released into the blood stream, goes to kidneys and puts holes in the collecting ducts (allows for concentration)
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11
Q

ADH and aquaporins

A

ADH leaves the blood and leads to synthesis of water pores (aquaporin 2) in nephron collecting ducts, allowing water to easily leave tubular fluid

  • the water then dilutes the blood and brings the osmolarity down to normal
  • ADH also increases Na+-K+-2Cl- symporter activity
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12
Q

angiotensin II and blood pressure

A

constriction of afferent arteriole meaning little blood going to glomerulus and little filtrate made (can lead to waste accum. in blood)

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13
Q

angiotensin, aldosterone and filtration

A

AII also increases Na+ reabsorption by Na+/H+ antiporters to maintain pH balance in blood
- also causes aldosterone release from adrenal cortex, which increases Na+ and Cl- reabsorption by collecting ducts (H2O follows if ADH present)

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14
Q

urinalysis

A

anaylzing the volume, physical, chemical and microscopic properties of urine

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15
Q

blood analysis

A

involves looking a the level of waste products in the blood

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16
Q

blood urea nitrogen (BUN)

A

a measure of urea nitrogen which is produces due to protein breakdown and usually filtered by kidneys; increases in blood when GFR decreases sharply an durine production is low such as w/ dehydration

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17
Q

plasma creatinine

A

waste product from creatine phosphate breakdown in muscle; normally, the levels remain steady in blood since urine excretion = its discharge from muscle
- creatinine at levels above 110 μmols/L can indicate poor kidney function

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18
Q

what are the renal function tests?

A

renal plasma clearance and GFR

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19
Q

renal plasma clearance

A

volume of plasma that is cleared of a substance per unit of time (mL/min)

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20
Q

why may a substance have a high clearance rate?

A

it is not reabsorbed back into the capillaries and it may also be actively secreted into the tubules

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21
Q

why do many substances have a clearance rate of 0mL/min?

A

they are completely reabsorbed e.g. glucose, amino acids

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22
Q

what does renal plasma clearance depend on?

A

GFR, reabsorption and secretion

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23
Q

renal plasma clearance formula

A

urine concentration x urine flow/plasma concentration

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24
Q

what is the significance of the renal plasma clearance formula?

A

high urine levels along w/ low plasma levels indicate a substance is being cleared from a lot of plasma in a short time period; it also suggests that if rate of urine flow (production) is high, then the substance will be cleared at a particularly high rate

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25
Q

why is renal clearance of drugs important?

A

if urine production goes down and therefore renal plasma clearance, the drugs are kept in circulation a very long time and can build up to toxic levels

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26
Q

measuring GFR

A

rate at which glomeruli prod. filtrate and for substances, is equal to renal plasma clearance rate
- only true if substance is filtered by glomerulus but not reabsorbed/secreted by tubules (e.g. creatinine, inulin)

27
Q

what is the normal range for GFR?

A

120-140 mL/min

28
Q

what must happen to substances w/ renal plasma clearance in excess of the normal range?

A

must be secreted from blood into the tubules

29
Q

what is the renal plasma clearance of urea?

A

less than the GFR; it is filtered and partly reabsorbed (freely moving)

30
Q

what is the renal plasma clearance of penicillin?

A

greater than the GFR; filtered and secreted (gets into filtrate but tubule cells can actively pump it into filtrate

31
Q

Dilute Urine is made

A

too much water or too few ions in blood

- made to concentrate blood

32
Q

Fatal Water intoxication

A

result of blood which is too dilute

33
Q

Fatal water intoxication numbers

A

6L in less than 3 hours

34
Q

Hyponatremia

A

dilute all the sodium chloride in your blood and neurons do not function

35
Q

Tubulues are … to water

A

impermeable to water

36
Q

Collecting ducts are … to water

A

largely permeable to water in the presence of ADH

37
Q

The fluid outside the tubules outside the kidney itself is

A

not salty at cortex but salty at tip of medulla

38
Q

Descending limb will

A

lose water but not ions and remove a lot of water

39
Q

Kindey failure

A

stop making urine

40
Q

Are long loop nephrons juxtamedullary?

A

yes they are next to medulla

41
Q

Blood that does not have enough water=

A

concentrated urine

42
Q

How do we fine tune the system for each ion?

A

hormones are normally involved

43
Q

T/F collecting ducts are selectively permeable to water?

A

True

44
Q

Collecting duct with holes?

A

concentrated

45
Q

Collecting duct with no holes?

A

dilute

46
Q

What does ADH make?

A

aquaporin to make holes in collecting ducts for water

47
Q

Obligatory reabsorption

A

water has to follow ions

48
Q

hormones involved in regulation

A

ADH and RAAA system

49
Q

Where does ADH act?

A

only where ADH receptors are

50
Q

What stimulates the release of ADH?

A

high osmolality

51
Q

Where is ADH made?

A

posterior pituitary

52
Q

Where is the Na+K+2Cl symporter located?

A

in the thick ascending limb of the loop of henley

53
Q

Dilute urine and ADH

A

no ADH

54
Q

Concentrated urine and ADH

A

yes ADH

55
Q

Urine Volume values

A

consistently less than 1L of urine= dehydration

consistently more than 1L of urine= diabetic or kidney malfunction

56
Q

Urine colour

A
  • vitamin c can make urine yellow
  • dark red means hemolysis of RBC
  • dark in babies means problems with liver
  • milky means theres bacteria
57
Q

Urine turbidity

A

cloudy means infection

transparent is normal

58
Q

Urine odour

A

fruity means the person is diabetic

foul means there is bacteria

59
Q

pH

A
  • normal is 6
  • abnormal is below 4.5 and above 8
    constantly low means metabolic acidosis
60
Q

High Plasma clearance indicates

A

efficient excretion of a substance in urine

61
Q

Low plasma clearance indicates

A

inefficient excretion

62
Q

Glucose clearance rate

A

0= filtered than all absorbed

63
Q

Inulin clearance rate

A

Clearance=GFR (filtered and never reabsorbed)

64
Q

Penicillin clearance rate

A

Clearance is greater than GFR (filtered and also secreted)

Anatomy (14 decks)

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