Aubf Flashcards by Loui Mojica

What are the urinary system

Kidney
Ureter
Bladder
Urethra

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where urine is formed by FILTRATION of
blood

Kidney

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carry the urine to the bladder

Ureter

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stores the urine produced

Bladder

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delivers the urine for EXCRETION

Urethra

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Major function of kidney is the ___________ of ________; Urinary system is also called _________________

Filtration of blood; excretory system

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Kidney’s function:

Mainting homeostasis
Excretion of waste product
Maintaing blood pressure

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is the production of RBCs.

Erythropoeisis

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is mainly released by the kidneys

Erythropoeitin

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If the kidney is damaged, there is low _________ and ___________

Hemocratic and hemoglobin

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The functional unit of the kidney; Approximately __________________ each kidney

Nephron; 1 to 1.5 million

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is basically connected to the ability of the kidney to clear waste products

Nephron

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Low blood production can lead to __________

blood transfusion

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Parts of nephron

Glomerulus/renal corpucles (capillary tuft)
Bowman’s capsule
Proximal convoluted tubular
Loop of henle (ascending/descending)
Distal convoluted tubular
Afferent arteriole (portal of entry/ unfiltered)
Efferent arteriole (portal of exit / filtered)
Peritubular capillary (proximal and distal convoluted tubular)
Vasa recta (ascending/descending)

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_______________ and ________________ are maintained which is controlled by nephrons

Body’s essential water and electrolyte balance

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as blood flows into each nephron, it will enter a tiny blood vessel (glomerulus)

Glomerulus

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participates in the filtration of
blood from glomerular capillaries

Bowman’s capsule

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reabsorption happens here; give the reabsoption materials that are included:

Proximal convoluted tubular; sugar, sodium chloride, ions and water

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principle function is mainly involved with the recovery of water and sodium chloride from the urine

Loop of henle

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regulates extracellular fluid and maintain
electrolyte homeostasis

Distal convoluted tubular

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provide immediate reabsorption of essential substances from the fluid.
In here, the final adjustments happen when it comes to urinary composition.

Peritubular capillary

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major exchange of water and salt takes place in line with this particular area of____________, maintains the ____________ or __________ concentration of urine

Vasa recta; concentration or gradient

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2 types of nephron

Cortical nephron
Juxtamedullary

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Approximately ____________; Responsible for removal of waste products reabsorption

Cortical nephron; 85%

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Approximately __________ ; Primary function concentration of the urine

Juxtamedullary nephron

4 Renal function

Renal blood flow Glomerular filter Tubular reabsorption Tubular secretion

The ___________ receive a large blood flow (25%); what renal function is responsible to this

Renal blood flow; kidney

Renal blood flow : ______________ supplies blood to the kidney.

RENAL ARTERY

Based on of average body size of ________ in terms of renal blood flow

1.73m^2

TOTAL RENAL BLOOD FLOW:

1200 mL/min

TOTAL RENAL PLASMA FLOW:

600 to 700 mL/min

Served as a sieve or a filter of plasma substances with molecular weight of __________

Glomerulus : less than 70,000

Glomerulus Consists of coil of approx. _____________ referred to as _________

eight capillary lobes ; capillary tuft

Glomerulus Located within the _______________(forms the beginning of the renal tubule)

BOWMAN S CAPSULE

In glomerular pressure has presence of ___________ (cause by size of afferent and efferent arteriole)

Hydrostatic pressure

are necessary to overcome the opposition of pressure from the fluid from the Bowman“s capsule and the ONCOTIC PRESSURE of unfiltered plasma protein

Hydrostatic pressure

This system respond to changes in blood pressure and plasma sodium content

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS)

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS) monitored by

JUXTAGLOMERULAR APPARATUS

is an enzyme which is mainly produced by the________________ cells.

Renin; Juxtamedullary cells

FUNCTION OF ANGIOTENSIN II

Vasolidation Stimulate sodium Release hormone aldosterone Release antidiuretic hormone

Wha are the 2 mechanism of reabsorption

Active transport Passive transport

Substance to be reabsorbed must combine to a carrier protein contained in the membranes of the ________________

Active transport; renal tubular cells.

Can be influenced by the concentration of the substance being transported.

Active transport

plasma concentration at which active transport stops.

Renal threshold

movement of molecules across membrane as a result of differences in their concentration or electrical potential.

Passive transport

Exceeding the renal threshold of substances affects the Maximal reabsorptive capacity of the tubules, leading to the appearance of the substance in the urine

Passive transport

Active transport Substances: Location: proximal convoluted tubule

Glucose Amino acid Salts

Active transport Substances: glucose, amino acid and salt Location:

proximal convoluted tubule

Active transport Substances: sodium Location:

Proximal and distal convoluted tubule

Active transport Substances: Location: Proximal and distal convoluted tubule

Sodium

Passive transport Substance: water Location:

Pct Descending loop of henle Collecting duct

Passive transport Substance: Location: Pct, Descending loop of henle, Collecting duct

Water

Passive transport Substance: Location: Pct, ascending loop of henle

Urea

Passive transport Substance: urea Location:

Pct, ascending loop of henle

Passive transport Substance: Location: ascending loop of henle

Sodium

Passive transport Substance: sodium Location:

ascending loop of henle

Begins in the descending and ascending Loop of Henle

Tubular concentration

COLLECTING DUCT CONCENTRATION

- Depends on the osmotic gradient in the medulla and the hormone VASOPRESSIN (ADH) - Production of vasopressin is determined by the state of body hydration

is an anti-diuretic hormone involve in water reabsorption.

Vasopressin

is removed by osmosis in the descending loop of Henle, and sodium and chloride are reabsorbed in the ascending loop

Water

Dilation of the afferent arterioles and constriction of the efferent arterioles

BP drops

Body hydration: high Adh: low Urine volume:

High

Body hydration: high Adh: Urine volume: high

Low

Body hydration: Adh: low Urine volume: high

High

Body hydration: low Adh: Urine volume: low

High

Body hydration: Adh: high Urine volume: low

Low

Body hydration: low Adh: high Urine volume:

Low

2 MAJOR FUNCTIONS: tubular secretion

1. Elimination of waste products not filtered by the glomerulus (Ex.Urea&Medications) 2. Regulation of acid- base balance (secretion of hydrogen ions)

ACTS AS BUFFER TO THE BLOOD MAINTAINING NORMAL pH.

BICARBONATE

Measure the filtering capacity of the glomeruli. And the rate at which the kidneys are able to remove (to clear) a filterable substance from the blood.

Clearance test

The substance analyzed must be one that is neither reabsorbed nor secreted by the tubules.

Clearance test

Clearance test Stability of substance in urine during _________________

24- hour urine collection

Clearance test Reported in what unit

mL/min

STANDARD METHOD for GFR and it Demonstrate progression of renal disease or response to therapy

Urea clearance test

Not give reliable estimates of GFR (Approximately 40% of filtered urea is reabsorbed) and It is about 50% of creatinine clearance.

Urea clearance test

REFERENCE METHOD for GFR and Not routinely done because of the necessity for continuous IV infusion

Insulin clearance test

insulin clearance test PRIMING DOSE:

25mL of 10% insulin solution

Insulin clearance test CONTINUOUS INFUSION:

500mL of 1.5% insulin solution

REFERENCE VALUES: insulin clearance test Male: Female:

Male: 127mL/min Female: 118mL/min

Most commonly used; screening method of GFR and waste product of muscle metabolism

Creatinine clearance

Excellent measurement of renal function

Creatinine clearance

is freely filtered by the glomerulus but not reabsorbed.

Creatinine

A measure of the completeness of a 24 hour urine collection.

Creatinine clearance

REFERENCE VALUES: creatinine clearance Male: Female:

Male: 85-125mL/min Female: 75-112 mL/min

Determines the functional capacity of nephrons

Glomerular filtration rate

Determines the extent of nephron damage in known cases of renal disease. ◦ Monitor the effectiveness of treatment ◦ Determines the feasibility of administering medications

Creatinine clearance

Disadvantage of CCT:

◦ Some Creatinine is secreted by tubule ◦ Chromogens present in human plasma ◦ Some medications causes false decreased value ◦ Creatinine breakdown by some bacteria ◦ influenced by heavy diet ◦ Interference by muscle wasting disease.

Disadvantage of CCT:

◦ Indirect estimate of GFR ◦ A low molecular weight protease inhibitor ◦ Completely reabsorbed by the PCT, hence its presence in urine denotes damage to the tubules ◦ good procedure for screening and monitoring GFR.

Cystatin C

Cystatin C Specimen: Increased levels: Method:

SPECIMEN: Serum or plasma (fasting is not required INCREASED LEVELS: Acute & Chronic Renal failure, Diabetic nephropathy METHOD: Immunoassay

Dissociates from human leukocyte antigens at constant rate and is rapidly removed from the plasma by glomerular filtration. ◦ A rise has been shown to be more sensitive indicator of decrease in GFR than creatinine clearance. ◦ Not reliable in patients who have history of immunologic disorders.

Beta 2 microglobulin

- used for routinely screening patients as part of a metabolic profile - to monitor patients already diagnosed with renal disease or at risk for renal disease. - the formulas are valuable when medications that require adequate renal clearance need to be prescribed.

Estimated Glomerular Filtration Rates (eGFR)

Ability of the tubules to reabsorb the essential salts and water that have been nonselectively filtered by glomerulus

Concentration test

Concentration test The specific gravity of urine before entering the renal tubules is________

1.010

2 specific gravity test

Fishberg test Mosenthal test

Patients were deprived of fluids for 24 hours prior to measuring specific gravity

Fishberg test

Compare the volume and specific gravity of urine of day and night urine samples

Mosenthal test

measures only the number of particles in a solution, specific gravity is influenced by the number and density (molecular weight) of the particles.

Osmolality

is performed for a more accurate evaluation of renal concentrating ability.

Osmolality

FREEZING POINT OSMOMETERS Principle: Standard reference:

Principle: Measurement of freezing point depression Standard reference: NaCl

Temperature at which water and ice are in equilibrium and is related to solute concentration

Freezing point

VAPOR PRESSURE OSMOMETERS Principle: Standard reference:

Principle: Measurement of dew point (Temperature at which water vapor condenses to a liquid) Standard reference: NaCl

- test most commonly associated with tubular secretion and renal blood flow

p-aminohippuric acid (PAH) test.

-The inability to produce an acid urine in the presence of metabolic acidosis - This condition may result from impaired tubular secretion of hydrogen ions associated with the proximal convoluted tubule - defects in ammonia secretion associated with the distal convoluted tubule.

RENAL TUBULAR ACIDOSIS

Aubf Flashcards

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