Flashcards in Exam 3 Deck (281)
At what spinal level would we find innervation to the kidneys and ureters?
At what spinal level would we find innervation to the pelvic organs?
Primarily lumbosacral with some lower thoracic input
At what spinal level would we find innervation to the bladder?
T11-L2 (Dome), S2-S4 (Neck)
At what spinal level would we find innervation to the prostate?
T11-L2 and S2-S4
How many thoracic nerves do we have?
How many lumbar nerves do we have?
What plexus does T11 and S2 come from?
How much of the CO does the Kidneys receive?
What makes the kidneys an endocrine organ?
Secretion of renin, erythropoietin and 1,25-dihydroxycholecalciferol
Where is the medulla of the kidneys located?
Central region, located under the kidney capsule
Where is the papilla of the kidney located?
Inner most tip of the inner medulla
What is the functional unit of the kidney?
Describe the renal tubules
Lined with epithelial cells which serve the functions of reabsorption and secretion
What does a nephron consist of?
Glomerulus and a renal tubule
Describe superficial cortical nephrons
Glomeruli in the outer cortex, short loops of henle which descend only into the outer medulla
Describe juxtamedullary nephrons
Glomeruli near the corticomedullary border, larger nephrons with higher GFR, long loops of henle that descend deep into the inner medulla and papilla
Where does the glomerulus emerge from?
What surrounds the glomerulus?
What is the goal in the OR in regards to BP and renal function?
Maintain a good BP because urine output is not a good indicator of renal fx
What consideration do we make with insufflation in regard to the kidneys?
Insufflation can compress blood flow to kidneys
3 Renal Vasoconstrictors
1. Sympathetic nerves (catecholamines)
2. Angiotensin 2
3. Endothelin (21 amino acid peptide)
6 Renal Vasodilators
3. Nitric Oxide
6. Atrial Natruiretic Peptide
What are the afferent and efferent arterioles innervated by?
SNS fibers that produce vasoconstriction by activating alpha 1 receptors
What does increased sympathetic nerve activity cause when acting on the afferent arteriole?
Decrease in RBF and GFR
What does the baroreceptor response in situations like blood loss cause?
Increased SNS activity and reduced GFR
Describe Angiotensin 2 in regards to the kidneys (2)
1. A potent vasonstrictor of both afferent and efferent arterioles
2. Constricts both arterioles, increases resistance, and decreases blood flow
Describe ANP in regard to the kidneys (2)
1. Cause dilation of afferent arterioles and constriction of efferent arterioles
2. Because dilatory effects on afferent is greater than constrictor effect on efferent arterioles, there is an overall decrease in renal vascular resistant and resulting increase in RBF
Describe Prostaglandins in regards to the kidneys (2)
1. Several are produced locally in the kidneys (PGE2, PGI2)
2. Cause vasodilation of both afferent and efferent arterioles
Describe dopamine in regards to the kidneys (2)
1. Dopamine, a precursor of norepinephrine, has selective actions on arterioles
2. At low levels, dopamine dilates cerebral, cardiac, splanchic, and renal arterioles, and it constricts skeletal muscle and cutaneous arterioles