AUBF [LEC] - Renal Functions Flashcards
1
Q
functional unit of the kidney
A
nephron
2
Q
4 main components of the urinary system
A
Kidney
Ureters
Bladder
Urethra
3
Q
where blood would be filtered, then the filtrate flows to the ureter
A
kidney
4
Q
if this fills, you will feel the urge to urinate
A
bladder
5
Q
directs it towards the external orifice of the genitalia
A
urethra
6
Q
smallest part of the kidney that can perform all these functions
A
nephron
7
Q
how many nephrons per kidney
A
1-1.5 million
8
Q
2 types of nephron and their percentage
A
cortical (85%)
Juxtamedullary (15%)
9
Q
tuft of capillaries that will allow the unwanted substances to be removed
A
glomerular filtration
10
Q
100% reabsorbed by the renal tubules to maintain blood pH
A
bicarbonates
11
Q
most potent blood buffer
A
bicarbonates
12
Q
pH level of blood
A
7.35 - 7.45
13
Q
human kidney receives __% of the blood
A
25% or 1/4
14
Q
blood enters the nephron via _____ ____
A
afferent arteriole
15
Q
blood flows through the glomerulus and into the ___ ____
A
efferent arteriole
16
Q
the main source of of blood that enters the nephron
A
renal artery from left ventricle of heart
17
Q
blodo from the efferent enters the ___ ___ and the ____ (for immediate reabsorption)
A
peritubular capillaries , vasa recta
18
Q
average size of the kidney
A
1.74 m2
19
Q
total renal blood flow per min
A
1200 ml/min or 1.2 Liters per minute
20
Q
total blood volume
A
5 liters
21
Q
total renal plasma flow per min
A
600-700 mL/min (half because composition of blood is 50% plasma)
22
Q
nephron: long loop, glomerulus closer to cortex medulla, efferent supplies vasa recta
A
juxtamedullary nephron
23
Q
nephron: short loop, glomerulus further from cortex medulla, efferent supplies peritubular capillaries
A
cortical nephron
24
Q
cortical radiate artery will become smaller to ___
A
afferent arteriole
25
where tubular secretion may happen
distal convoluted tubule
26
after blood filtration, what artery will be used
efferent arteriole
27
in order of tubular reabsorption flow
1. proximal convoluted tubules
2. descending loop of henle
3. ascending loop of henle
4. distal convoluted tubule
5. collecting ducts
28
when blood goes back tot he heart, what blood vessel is utilized
renal vein
29
after the collecting duct, it goes to the ___ ___ then ___ ___ then ____ ___ which is the triangular area then ___
1. minor caluces
2. major caluces
3. renal pelvis
4. ureter
30
difference between peritubular capillaries vs vasa recta
peritubular - surrounds proximal and distal
vasa recta - surrounds loop of henle
31
nonselective filter of plasma substances with a molecular weight of less than 70k
glomerulus
32
4 factors influencing filtration process
cellular structure of the glomerulus
hydrostatic pressure
oncotic pressure
feedback mechanism of RAAS
33
simply imagine that this is the blood pressure or the force exerted by the body that affects the filtration process
hydrostatic pressure
34
pressure produced by the solutes like the albumin in the blood
oncotic pressure
35
space in the bowman's capsule
bowman's space
36
3 layers that the plasma filtrate must pass in the glomerulus
1. capillary wall membrane
2. basement membrane (basal lamina)
3. visceral epithelium of the Bowman's capsule
37
___ increase capillary permeability but do not allow passage of large molecules and blood cells in glomerulus
pores
38
what causes further restriction of large molceules in the glomerulus
basement membrane
podocytes - thin membranes covering filtration slits
39
foot like processes that enchanes the filtration
podocytes
40
first part in the glomerulus where urine accumulates
bowman's space
41
what do you call it pag nakapass siya sa tatlogn layers ng glomerulus but babalik parin becuase of ____
shield of negativity (presented by albumin)
42
regulates the blood flow to and within the glomerulus
Renin-Angiotensin-Aldosterone System (RAAS)
43
responds to changes in the blood pressure and plasma sodium content
RAAS
44
helps the urine formation because if there is low blood pressure and low plasma sodium, mababa ung daloy ng dugo sa katawan
RAAS
45
CIte the steps of RAAS
1. low blood pressure, plasma sodium
2. Renin secretion
3. Angiotensin 1; (angiotensinogen)
4. Angiotensin 2 (angiotensin converting enzymes)
5. Vasoconstriction
6. Proximal convoluted tubule for sodium reabsorption
7. angiotensin 2 activates aldosterone in renal cortex; then goes to distal convoluted tubule for sodium reabsorption
8. ADH produced in hypothalamus in posterior pituitary gland goes to collecting duct for water reabsorption
46
concentrating ability of the kidney
tubular reabsorption
47
substances are removed from the glomerular filtrate and returned to the blood
tubular reabsorption
48
2 types of cellular mechanism involvled in tubular reabsorption
Active transport -passive transport
49
plasma concentration where the active transport stops
renal threshold
50
glucose renal threshold
160-180
51
substances reabsorbed in the PCT
glucose
amino acid
salts
52
most important substances are reabsorbed here as early
PCT
53
type of transport of glucose, amino acids, salts in PCT
active transport
54
actively reabsorbed in ascending loop of henle
chloride
55
actively reabsorbed in proximal and distal CT
sodium
56
t/f: all renal tubules are capable of water reabsorption except descending loop of henle
false, ascending loop of henle
57
passively transported by PCT and ascending
Urea
58
t/f: Urea is passively reabsorbed even though we dont want it because there is high concentration of it in the urine
true
59
passively reabsorbed in the ascending
sodium
60
begins in the Descending and Ascending Loop of Henle
Renal concentration
61
Water is removed by osmosis in the _____
Descending Loop of Henle
62
Na and Cl are reabsorbed in the _____
Ascending Loop of Henle
63
unidirectional flow of the urine, to ensure that the urine would flow towards the collecting ducts and the other way around na pabalik sa glomerulus
countercurrent mechanism
64
selective reabsorption process
countercurrent mechanism
65
serves to maintain the osmotic gradient of the medulla
countercurrent mechanism
66
involves the addition of substances form the blood
tubular secretion
67
Involves the passage of substances from the blood in the peritubular capillaries to the tubular filtrate
tubular secretion
68
2 major functions of tubular secretion
1. eliminate waste products not filtered by the glomerulus
2. regulation of acid base balance through secretion of H ions
69
determined to be a glomerular filtration test except _____ because it is part of tubular reabsorption test
Free water clearance test
70
measures the rate in milliliters per minute at which the kidneys are able to remove a dilterbale substance from the blood
GFR
71
unit used in GFR
ml/min
72
charactersitics of substance to be tested
1. not reabsorbed/secreted by tubules
2. stable for 24 hrs
3. constant plasma level
4. available in body
5. availability of test
73
urea clearance test requires __ sample
2 hour sample
74
___ is naturally found as the most organic abundant in urine and it can be a factor to differentiate urine from other bodily fluids
urea
75
earliest clearance test
urea clearance test
76
t/f: in urea clearance test, the patient must be properly hydration to prevent more than 40% reabsorption of urea
true
77
problem in urea clearance test
reabsorbed by the tubule
78
t/f: urea clearance test is now an obsolete test
true
79
most accurance clearance test in the past
inulin clearance test
80
synthetic substance from fructose that is not originally part of hte systemic circulation
inulin
81
disadvantage of inulin clearance test
infused at constant rate
82
creatinine clearnac etest requires __ sample
24 hour urine sample
83
endogenous procedure for evaluating glom filtration
creatinine clearance test
84
body surface area factor
1.73
85
ref range for male creatining clearance
107 - 139 ml/min
86
ref range for female crea clearance
87 - 107 ml/min
87
used for routinely screening patients as part of a metabolic profile and to monitor patients already diagnosed with renal disease or at risk for renal disease
Est. GFR
88
MDRD
modification of diet in renal disease
89
formula for GFR
175 x serum crea^-1.154 x Age^-0.203 x 0.742 for females or x 1.212 for black race
90
produced by all nucleated cell at constant reate
cystatin C
91
substance that is endofenous kasi naturally found by all nucleated cells
Cystatin C
92
Filtered readily by the glomerulus and reabsorbed and broken down by the renal tubular cells
Cystatin C
93
advantage of Cystatin C
Independent of muscle mass
94
clearnace test recommended for pedia, elders, diabetic, crit ill
cystatin C
95
Missociates from human leukocyte antigen at constant rate
B2M
96
Removed rapidly from the plasma by glomerular filtration
B2M
97
Most sensitive indicator of a decrease in GFR
Beta 2-Microglobulin
98
salts and water are reabsorbed in the tubules
tubular reabsorption test
99
Used to determine the ability of the tubules to reabsorb essential salt and water that have been non-selectively filtered by the glomerulus
concentration test
100
Urine concentration is largely determined by the body’s state of hydration
tubular reabsorption test
101
2 obsolete test in tubular reabs
mosenthal
fishberg
102
high spec gravity of urine
1.018
103
Measures only the number of particles in a solution
osmolality
104
factor for GFR female
0.742
105
factor of black in GFR
1.212
106
comparison of day time and night time urine test
mosenthal test
107
in mosenthal test, spec gravity at night can be as high as _
1.018
108
test that deprives the person of water for 24 hours
fishberg test
109
in fishberg test, at 16th hour, the spec gravity should be ___
1.025
110
2 colligative properties tested in tubular reabsorption test
freezing point osmometers
vapor pressure osmometers
111
uses reagent strips
spec grav determination
112
same reagent formula for crea clearnace but basis is osmolality and the use of osmometers
free water clearance
113
tranditional but not used anymore test for tuular secretion and renal blood flow
PSP - phenolsulfonpthalein excretion test
114
most commonly associated with tubular secreitona dnrenal blodo flow that replaced PSP
PAH - P-aminohippuric acid
115
exogenous substances used and it is a test for kidney function
indigo carmine test
116
uses oral acid load of ammonium chlroide
titratable acidity and urinary ammonia
117
reference range of titratable acidity and urinary ammonia
70 mEq/day of acid in the form of titratable hydrogen ions or ammonium ions
