A&P Flashcards
(86 cards)
1
Q
Body water dynamics
A
wherever sodium goes, water follows
2
Q
Where must any gain/lost of water and/or electrolytes occur initially?
A
ECF
3
Q
What will happen if equilibrium is upset?
A
ICF changes will also occur
4
Q
Nutcracker syndrome
A
- mesenteric mass
- causes pressure in vein which results a buildup to left testicle
5
Q
Renal pelvis
A
- located at the upper end of the ureter
- tunnels urine from the kidneys to the bladder
- calyces converge to from the renal pelvis
6
Q
Renal cortex
A
- outer zone of the kidney
- ultra-filtration
- erythropoietin production
7
Q
Renal medulla
A
- interior of the kidney
- filter waste material, elimination of fluid
8
Q
Upper GI Tract
A
kidneys and ureter
9
Q
Lower GI Tract
A
bladder and urethra
10
Q
Purpose of kidneys
A
- filter
- excrete metabolic waste
- excrete foreign chemicals
- secretion of hormones
- –renin, erythropoietin, vitamin D
11
Q
Nephrons
A
multiple nephrons share the same collecting duct
12
Q
Cortical nephrons
A
short and does not extend to inner medulla
13
Q
Juxtamedullary nephrons
A
produce concentrated urine and extend into inner medulla
14
Q
Bowman’s capsule
A
- where blood is filtered
- afferent in, efferent out
15
Q
Proximal tubule
A
filtered solute and water is reabsorbed
16
Q
Loop of Henle
A
Two parts
-descending
-acsending = thicker
Osmotic gradient - concentrate the urine
17
Q
Distal convoluted tubule
A
some reabsorption of water and ions
18
Q
Collecting tubule
A
- most water is reabsorbed
- aquaporins are present
- H2O and Urea are controlled by vasopressin (ADH-released by pituitary
19
Q
Juxtamedullary apparatus
A
- helps control GFR and renin secretion
- macula dense cells
- extraglomerular mesangial cells
- granular cells
20
Q
Macula densa cells
A
monitor flow of NaC and regular blood flow
21
Q
Extraglomerular Mesangial Cells
A
contract in response to angiotensin II
22
Q
Granular cells
A
secrete renin upon stimulation of SNS
23
Q
Renal Corpuscle
A
filtrate barrier consists of three layers
- capillary endothelium
- basement membrane
- capsular epithelial cells
24
Q
Capillary endothelium
A
inner layer
25
Basement membrane
everything is attached to this layer
26
Capsular Epithelial cells
podocytes: control selective filtration
27
Renal Vasculature
vasa recta
28
Vasa recta
supply blood in the medullary tissue
29
Vasa recta location
within the peritubular capillaries around the juxtamedullary nephron
30
Renal nerve
from sympathetic nervous system
| -release norepinephrine and dopamine
31
Where are A1 receptors?
primarily on afferent but also on efferent
32
What does stimulation of SNS cause?
construction = decrease blood flow and decrease GFR
33
What do prostaglandins cause?
dilate
| increase blood flow and increase GFR
34
When prostaglandins are reduced by NSAIDs
decrease blood flow and decrease GFR
35
Myogenic mechanism
blood vessels contract in response to stretch due to an increase in pressure
36
Tubuloglomerular feedback
increase of GFR causes an increase NaCl delivered to LOH, sensed by macular densa cells, cause contraction in afferent artery
37
Afferent and efferent both dialte
huge increase in RBF
38
constriction of afferent arteriole
decrease RBF, decrease GFR, decrease PGC
39
constriction of efferent arteriole
decrease RBF, increase GFR (to a point), increase PGC
40
constriction of both afferent/efferent
decrease RBF
41
Composition of filtrate
- plasma (minus protein)
- permeability decreases as size increased
- ---pressure can also increase permeability
- basal lamina and slits are coated with negatively charged proteins
42
BUN:Cr - high ratio
acute obstruction - BPH or kidney stone
43
BUN:Cr - low ratio
severe skeletal muscle injury - rhabdomyolysis (increase Cr)
44
Glomerular filtration
H2O solutes more from blood into nephron
45
Tubular reabsorption
-useful substance move from filtration into blood
46
Paracellular
leaky epithelium
47
Tubular secretion
waste and excess substances move from blood into filtrate
48
Water reabsorption
H2O moves from filtrate into blood
49
Osmotic diuresis
HONKS: hyperosmotic nonketotic state
| blood glucose really high = severe dehydration
50
Bicarb buffer
key to maintaining acid base balance
51
Acidotic state
pump out hydrogen
52
Bicarb
weak acid will dissociate twice
53
The countercurrent multiplier
- the blood of filtrate in the lumen vs blood in the vasa recta move in opposite direction
- allows the nephron to maintain osmotic gradient in order to vary the urine concentration
54
Importance of Urea
- metabolized by the liver
- high protein diets create more urea and have a higher ability to concentrate urine (urea increase concentration gradient)
- permeability to urea of the inner medullary portion of the collecting duct is controlled by ADH
- ----ADH controls urea permeability in the CD only
- -----Urea can't pass the distal convoluted tubule
55
Late distal convoluted tubule and collecting duct
principle cells (main cell)
56
Principle cells
- reabsorbed Na and secrete K
| - site of aldosterone action (salt reabsorption)
57
RAAS
- enzyme renin is secreted by the kidneys in response to a decrease in renal pressure/flow
- renin binds and cleaves to angiotensinogen made by the liver
- angiotensinogen form angiotensin I (inactive)
- angiotensin I travels to lungs where ACE converts angiotensin I to angiotensin II (vasoconstriction)
- angiotensin II binds to angiotensin II receptor cells in Zona Glomerulus of the adrenal which decrease aldosterone
- aldosterone bind to the principle cells and increased the number of apical Na channels and Na/K/ATPas in the intersitum in the late convoluted tubule and collecting duct
58
ANP (Atrial Natriutetic Peptide)
dilates the afferent arterial and increase GFR and filters NaCl
59
Calcium
reabsorption occurs throughout the nephron except in the descending limb of LOH
60
Calcium reabsorption - proximal tubule
passive reabsorption, couple to Na
| -when Na is high so is Ca uptake
61
Calcium reabsorption - thick ascending LOH
Na/K/2CL symporter pumps ions in but K+ leaks back into the lumen this forms a positive charge
62
Active Vitamin D
```
-produced by kidney
utilized in other areas of the body
-intestine absorption
-increase bone mineralization
-immune cells
-tumor microenvironmental
```
63
The glomeruli -secreted/absorbed
blood
64
Proximal tubule - secreted
creatine, antibiotics, diuretics, uric acid
65
Proximal tubule - reabsorbed
- NaCl
- K
- H2O
- HCO3-
- Glucose
- Amino Acid
66
Loop of Henle - descending - secreted
nothing
67
Loop of Henle - descending - reabsorbed
```
NaCl
K
H2O
Mg
Ca
```
68
Loop of Henle - ascending - secreted
nothing
69
Loop of Henle - descending -reabsorbed
Ca
Mg
NaCl
70
Distal Convoluted Tubule - proximal - secreted
nothing
71
Distal Convoluted Tubule - proximal - reabsorbed
NaCl
| H2O
72
Distal Convoluted Tubule - distal - secreted
K
H
Urea
73
Distal Convoluted Tubule - distal - reabsorbed
NaCl
| H2O
74
Collection Duct - secreted
nothing
75
Collection Duct - reabsorbed
H2O
76
ANP - atrial natriuretic peptide
- releases from the atria when they come distended do to volume overload
- increase NaCL excretion by increase GFR
- decreases NaCl reabsorption by the CD
77
ADH - antidiuretic hormone
- most important hormone in regulating water balance
- released by posterior pituitary
- binds to receptor on the collecting duct and causes aquaporins to be interested into the apical membrane and water to be reabsorbed
78
Aldosterone
- causes water and sodium to be reabsorbed
| - increased blood volume and blood pressure
79
Renin
secreted when there is a sense change in renal perfusion pressure via stretch receptors in the vascular walls to help maintain blood pressure
80
Calcitriol
-helps kidneys maintain blood calcium levels
81
Erythropoietin
stimulates the production and maintenance of red blood cells
82
Excretion of toxins
the kidneys filter out a variety of water-soluble waste products and environmental toxins into urine for excretion
83
Chemical regulation
the kidneys are responsible for maintaining relatively constant levels of key ions including sodium, potassium, and calcium
84
Fluid balance
the kidneys helps keep extracellular fluid from becoming too dilute or concentrated with respect to the solute carried in the fluid
85
Blood volume and pressure regulation
- the kidneys work to ensure an adequate quantity of plasma to keep blood flowing to vital organs
- they remove excess water from the body to help regular pressure
86
Secretion of erythropoietin
- kidneys produce erythropoietin which stimulates red blood cell synthesis and renin, which help control salt and water balance and blood pressure
- also helps regulate plasma, calcium, and glucose
