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x2 - Urinary > Anatomy and physionlogy > Flashcards

Anatomy and physionlogy Flashcards

(65 cards)

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1
Q

Definition and effects of hyperkalaemia

A

> 5.5mmoles/l

Depolarisation –> Ventricular fibrillation –> death

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2
Q

Definition and effects of hypokalaemia

A

<3.5mmoles/l

Hyperpolarisation –> cardiac arrhythmias –> death

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3
Q

Normal potassium concentration

A

4mmoles/l

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4
Q

Where does reabsorption occur

A

Proximal tubule
Loop of Henle
Distal tubule
Collecting duct

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5
Q

Where does secretion occur

A

Proximal tubule
Distal tubule
Collecting duct

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6
Q

Specialised afferent arteriole smooth muscle cells

A

Juxtaglomerular cells

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7
Q

Functions of the juxtaglomerular cells

A 
Renal baroreceptors
Release renin (in response to low pressure)
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8
Q

Specialised cells of the distal tubule

A

Macula densa

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9
Q

GFR is estimated using…

A

Serum creatine

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10
Q

Renal plasma flow (RPF) is…

and is calculated using…

A

A measure of all the plasma flowing through the kidneys at a given time
PAH (para-amino-hippuric acid) clearance

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11
Q

Equation to calculate plasma clearance of X

A

Cx = [Ux]V / [Px]

Ux = urine conc. of X
V = urine flow rate
Px = plasma conc. of x
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12
Q

Vertebral level of the kidneys

A

T12 - L3

Hilum at L1 (transpyloric plane)

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13
Q

Muscles posterior to the kidney

A

Quadratus lumborum

Psoas major

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14
Q

Autonomic nerve supply to the kidneys

A

Sympathetic: From T12 - L1 through the coeliac ganglia
Parasympathetic: Derived from the vagus nerve

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15
Q

Lymphatic drainage of the kidneys

A

To the para-aortic lymph nodes around the origin of the renal arteries

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16
Q

The ureter lies on which muscle as it descends

A

Psoas major

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17
Q

Peritonisation of the kidneys and ureters

A

retroperitoneal

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18
Q

What structures cross the ureter superiorly (male and female)

A

Female: ovarian artery
Male: ductus (vas) deferens

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19
Q

The three constrictions of the ureters

A

pelviureteric junction
Pelvic brim
vesicoureteric junction

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20
Q

The median umbilical ligament attaches to which part of the urinary bladder?
and then attaches to which structure?

A

The apex of the bladder
to
the umbilicus

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21
Q

The median umbilical ligament is a remnant of which umbilical structure?

A

The allantois (drains the urinary bladder through the umbilical cord)

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22
Q

The bladder walls are made of…

A

Detrusor (smooth) muscle

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23
Q

The superior surface of the urinary bladder is lined by…

A

Parietal peritoneum

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24
Q

What kind of epithelium lines the urinary bladder and ureter?

A

Transitional epithelium

allows the bladder to expand as it fills

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25
what divides part of the allantois and cloaca from the gut tube? and what does this divided section become?
Divided by the urorectal septum, | they become the urogenital sinus which forms the urinary bladder and urethra
26
Early in the 4th week of development, the intermediate plate mesoderm in the neck region becomes the...
Pronephros (rudimentary kidney)
27
Late in the 4th week, the intermediate plate mesoderm in the thorax forms the...
mesonephros
28
What is the final fate of the mesonephros?
Becomes the gonad
29
The mesonephros is drained into the cloaca by the...
Mesonephric duct
30
The mesonephric duct develops form what? | and what does it eventually form?
Pronephric duct - -> mesonephric duct - -> Rete testes
31
The tubules, collecting ducts, calyces, renal pelvis and ureters are formed from the...
Ureteric bud (grows off the mesonephric duct) Branches to form all these structures
32
The metanephros (definitive kidney is formed from the...
Ureteric bud | Metanephric mesoderm
33
The nephrons are formed from the...
Metanephric mesoderm (develops from the intermediate plate mesoderm in the lumbar region)
34
Normal arterial pH =
7.4
35
Normal Pco2
40mmHg
36
Normal [HCO3-]
34mmoles
37
To maintain pH, [HCO3-] : [H2CO3] ration must be...
20:1
38
actions of interneurons activated by the micturition reflex
1. *Excitation pf parasympathetic outflow 2. inhibition of sympathetic outflow 3. *inhibition of somatic motoneurons to external urethral sphincter 4. sensation of fullness ascends to bladder *=influenced by higher centres
39
parasympathetic control of bladder | nerves + actions
S2 - 4 (pelvic nerves) contraction of detrusor muscle
40
Sympathetic control of bladder | nerve + actions
Hypogastric nerves inhibits bladder contraction
41
Substances reabsorbed by carrier mediated transport
Phosphate + sulphate (conc. regulated by Tm) | Amino acids + glucose (Tm way above health levels)
42
Tm
Maximum transport capacity of a carrier protein | sets the maximum amount of a substance that can be reabsorbed into the blood
43
Reabsorption of sodium is by...
Na/KATPase pumps Na into ECF, creating a gradient into the tubule cell that Na follows (bringing glucose with it through SGLTs)
44
reabsorption of Cl- is by...
passive diffusion following the electrical gradient created by the active transport of Na
45
reabsorption of H2O is by...
passive diffusion following Na (active transport) and Cl
46
Reabsorption of K, Ca and urea is by...
passive diffusion, following water | the reabsorption of water leaves the contents of the tubule very concentrated
47
Substances that are secreted
``` Protein bound substances (too large for filtration) Harmful substances) K+ (stimulated by aldosterone) Na+ H+ ```
48
renal threshold
plasma concentration at which carrier saturation occurs
49
juxtaglomerular cells produce renin in response to...
sympathetic discharge (fired due to low pressure at carotid baroreceptor) low afferent arteriole pressure low NaCl at macula densa
50
Juxtaglomerular production of renin is inhibited by...
ADH | ANP
51
ANP production is stimulated by
increased atrial stretch
52
Angiotensinogen is produced by...
the liver
53
Action of renin
catalyses conversion of angiotensinogen to angiotensin I
54
Action of ACE
catalyses conversion of angiotensin I to angiotensin II
55
Actions of angiotensin II
increases CV response increases vasoconstriction* stimulates aldosterone release stimulates thirst and ADH release (in severe hypovolaemia) from hypothalamus *efferent arteriole constriction --> decreased peritubular hydrostatic pressure --> increased H20 and NaCl reabsorption in proximal tubule
56
Actions of aldosterone in nephron
increases H2O and NaCl reabsorption in distal tubule
57
actions of macula densa
detects low NaCl --> stimulates juxtaglomerular cells detects increased flow --> constricts afferent arteriole --> decreased GFR
58
Autoregulation
Maintains GFR over changes in BP (independent of nerves/hormones) alters afferent arteriole constriction
59
the descending limb of the loop of henle is...
permeable to H20 impermeable to NaCl H20 leaves, concentrating the tubule contents, and is then removed by the vasa recta (this maintains the gradient)
60
the ascending limb of the loop of henle is...
impermeable to H2O actively transports NaCl out this "dilutes" the tubule contents
61
Permeability of the collecting duct is...
under ADH control recruits AQP2 pores and increases permeability to urea
62
the mechanism creating a concentration gradient in the interstitium in the medulla (driven by the Na/KATPase)
the counter-current multiplier
63
hypothalamic osmoreceptors are stimulated by...
high osmolarity (high NaCl concentration) --> ADH release
64
ADH is released in response to...
high osmolarity (hypothalamic osmoreceptors) decreased atrial stretch low BP detected by carotid + aortic baroreceptors
65
Actions of ANP
inhibits renin production inhibits ADH secretion inhibits aldosterone secretion decreases CV response

x2 - Urinary (2 decks)

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