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Chapter 26 Flashcards

1
Q

what are the functions of the kidneys

A

regulation of body fluid osmolality and volumes
regulation of electrolytes balance
regulation of acid base balance
excretion of metabolic products and foreign substances
production and secretion of hormones

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2
Q

what metabolic wastes are excreted

A 
urea (metabolism of amino acids)
creatinine (from muscle creatinine)
uric acid (from nucleic acid)
bilirubin (or other end products of hemoglobin break down)
Metabolites of hormones
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3
Q

what hormones are secreted by the kidneys

A

erythropoietin
vitamin D3
Renin

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4
Q

what is the functional unit of the kidney

A

nephron

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5
Q

describe kidney vasculature

A 
renal artery
arcuate arteries
interlobular arteries
afferent arterioles
glomerular capillaries
efferent arteriole
peritubular capillaries
venous system
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6
Q

from the efferent arteriole, blood can travel where?

A

to peritubular capillaries or descending vasa recta; then to venous system

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7
Q

afferent areteriole does what

A

carries blod to the glomerulus

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8
Q

glomerulus is what

A

tuft of capillaries that filter the plasma entering into Bowman’s capsule (is part of filtration barrier)

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9
Q

efferent arteriole is what

A

carries blood from the lomerulus to peritubular capillaries

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10
Q

peritubular capillaries are what

A

capillary network surrounding the tubular components, supply renal tissue and exchange fluids/substances with tubular components (reabsorption and secretion)

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11
Q

vasa recta

A

specialized peritubular capillaries present in juxtamedullary nephrons

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12
Q

be able to identify on chart

A

x

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13
Q

bowmans capsule does what

A

collects the filtrate from the glomerulus (part of filtration barrier)

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14
Q

proximal tubule

A

mainly uncontrolled reabsorption occurs here; secretion also

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15
Q

loop of henle

A

establishes osmotic gradient in renal medulla; crucial role in ability of kidney to form concentrated or dilute urine

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16
Q

what are the 3 parts of loop of henle

A

descending limb
thin ascending limb
thick ascending limb

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17
Q

distal tubule and collecting duct function in

A

controlled reabsorption of Na and water (ADH dependent); K secretion

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18
Q

cortical nephron

A

renal copuscle located in outer region of cortex
short loop of henle
efferent arteriole forms peritubular capillaries

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19
Q

juxtamedullary nephron

A

renal corpuscle located in region of cortex next to medulle
long loop of henle which extends deeper into medulla
efferent arteriole forms peritubular capillaries and vasa recta

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20
Q

what are the components of a renal corpuscle

A

bowmans capsule

glomerular capillaries

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21
Q

what is the function of the renal corpuscle

A

ultrafiltarion

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22
Q

what are the components of a juxtaglomerular apparatus

A

macula densa cells and juxtaglomerular cells

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23
Q

what is the function of juxtaglomerular apparatus

A

feedback mechanism

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24
Q

what are the major processes in the nephron

A
  1. filtration
  2. reabsorption
  3. secretion
  4. excretion
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25
which process of the nephron is discriminating
secretion
26
which part is nondiscriminating
filtration
27
what substance undergoes filtration only (and therefore is 100% excreted)?
creatinine
28
what substance is filtered and partially reabsorbed
Na and Chloride
29
What substance is completely filtered and completely reabsorbed
amino acids and glucose
30
what substances are secreted
organic acids and bases (PAH)
31
GFR is equal to what?
the sum of the filtration rates of all functioning nephrons
32
monitoring GFR provides what information
the severity or progression of renal dysfunction
33
what is the filtration barrier (the renal corpuscle) composed of?
1. fenestrations in glomerular capillary 2. basement membrane 3. filtration slits created by the foot processes on the podocytes
34
fenestrations in glomerular capillary
freely permeable to water and small solutes but not cells or large proteins express negatively charged glycoproteins to repel filtration of proteins *size and charge barrier*
35
basement membrane
acellular, porous matrix of negatively charged extracellular proteins that repel the filtration of proteins *charge barrier*
36
filtration slits created by the foot processes on the podocytes make up the ____
inner layer of bowman's capsule
37
filtration slits created by the foot processes on the podocytes
podocytes are specialized epithelial cells | also have negatively charged glycoprotein to repel proteins
38
filtrate is essentially free of what
proteins and cellular elements (RBC)
39
Why are large amounts of solutes filtered, then reabsorbed?
GFR allows kidneys to rapidly remove wastes; | allows all body fluids to be filtered multiple times a day
40
blood flow to the kidneys is ____ of cardiac output
about 25%
41
what is the filtration fraction?
the proportion of the plasma that enters the glomerulus and is subsequently filtered is ~20%; the remainder continues on through the glomerular capillaries to the efferent arteriole and peritubular capillaries
42
filtration fraction is equal to
GFR/RBF
43
What forces favor filtration
glomerular hydrostatic pressure | colloid oncotic pressure of bowmans capsule would if it existed
44
what forces oppose filtration
glomerular colloid osmotic pressure | bowmans capsule hydrostatic pressure
45
What is the Kf
the product of hydraulic conductivity and surface area of glomerular capillaries
46
increase in Kf causes
increase in GFR
47
increase in bowmans capsule hydrostatic P causes
decrease in GFR (urinary tract obstruction)
48
increase in glomerular capillary coloid osmotic pressure causes
decrease in GFR (decrease in RBF, increase in plasma proteins)
49
increase in glomerular capillary hydrostatic P causes
increase in GFR (decrease in arterial P, decrease in sympathetic activity, decrease angiotensin II)
50
decrease Kf causes
decrease GFR (renal dz, diabetes mellitis, hypertension)
51
what happens to colloid osmotic pressure in glomerular capillaries when there is an increase in the filtration fraction (GFR or RBF)
there is an increase in the rate at which plasma colloid osmotic pressure rises along the glomerular capillary (decrease in filtration fraction has opposite effect)
52
glomerular hydrostatic pressure is determined by
arterial pressure afferent arteriolar resistance efferent arteriolar resistance
53
an increase in resistance of afferent arteriole does what
reduces glomerular hydrostatic pressure and decreases GFR
54
dilation of afferent arteriole does what
increases GFR
55
Constriction of efferent arterioles does what
increases glomerular hydrostatic pressure and as long as the increase in efferent resistance does not reduce renal blood flow too much, GFR increases
56
what would happen if efferent arteriole resistance increased too much
a rise in colloid osmotic pressure exceeds increase in glomerular capillary hydrostatic pressure and GFR decreased
57
renal blood flow indirectly determines ____
GFR
58
Kidneys regulate blood flow by adjusting what
vascular resistance
59
what are the major resistance vessels in the kidney
afferent and efferent arteriole and interlobular artery
60
what are the hormones that control renal blood flow
``` norepinephrine epinephrine endothelin angiotensin II endothelial-derived nitric oxide prostaglandins ```
61
norepinephrine and epinephrine have what effect on gfr
decreases gfr
62
endothelin does what to gfr
decreases gfr
63
angiotensin II does what to GFR
prevents decrease of gfr
64
endothelial derived nitric oxide does what to GFR
increases gfr
65
what does prostaglandin do to GFR
increases GFR
66
How does angiotensin II prevent decrease in GFR
it increases glomerular hydrostatic pressure while reducing renal blood flow; by constricting efferent arterioles, angiotensin II helps prevent decreases in GFR
67
what arterioles are more susceptible to vasoconstriction
efferent arterioles are more susceptibel than afferent arterioles
68
what is the function of prostaglandins
to dampen vasoconstrictor effects of sympathetic nerves and angiotensin II;
69
what is the net effect of prostaglandins
to increase RBF without a change in GFR; prevents severe and potenitally harmful vasoconstriction and renal ischemia
70
prostaglandin synthesis can be stimulated by
dehydration stress sympathetic nerve outflow angiotensin II
71
why do you need to be careful when administering NSAIDs
NSAIDs block prostaglandin formation and thus block the protective effects they have
72
what are the 2 mechanisms of autoregulation
myogenic mechanism | tubuloglomerular feed back mechanism
73
what is the myogenic mechanism
ability of blood vessels to resist stretching during increased arterial pressure (by raising vascular resistance because vessels arent stretching, prevents excessive increases in renal blood flow and GFR)
74
tubuloclomerular feed back mechanism
macula densa cells sense changes in volume delivery
75
what are the steps in tubuloglomerular feedback
``` decreae in arterial pressure causes decrease in glomerular hydrostatic pressure, causes decrease in GFR, causes decrese in macula densa Na Cl, causes increase in renin, causes increase in angiotensin II, causes increase in efferent arteriolar resistance, decrease afferent areteriolar resistence ```
76
despite autoregulation, RBF and GFR can be changed by
hormones and sympathetic nerve activity
77
RBF is a determinant of ___ so both are regulated by same mechanisms
GFR
78
What is filtered load
total amount filtered into bowmans capsule (mass/time)
79
filtered load is equal to
GFR x Plasma concentration

Physiology (4 decks)

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