Function Of The Kidneys Flashcards
Filter Excrete Maintain blood volume (239 cards)
1
Q
Functions of the kidneys
A
Filter:filters blood (liquid part , Plasma)
Excretion: getting rid of things that kidney filters
Maintain blood volume: maintain normal Plasma volume for B/P
2
Q
Renal capsule
A
Surrounds kidneys directly
Some form of connective tissue, adipose tissue
3
Q
adipose capsule
A
Superficial
- Layer of fat that surrounds the kidneys
- protects kidneys
- helps hold kidneys in place
4
Q
Medulla ( pyramid)
A
Intersection ( inner region )
5
Q
How many lobes per kidney
A
7 , 10-12 lobes per kidney
Referred to as renal column
6
Q
Structure that makes urine
A
Kidneys
7
Q
Drains the kidneys
A
Ureters
8
Q
Storage unit for urine
A
Bladder
9
Q
Structure of the how we empty the bladder w/urine leaving body
A
Urethra
10
Q
Cystitis
A
Infection in bladder
11
Q
Pyelitis
A
Infection ureter
12
Q
Peeing is classified as which system
A
Peeing is pns
13
Q
Urine formation is classified as what system
A
Urine formation is sns
14
Q
Nephron
A
Working/ important part of the kidney
Million nephrons per kidney
Make up a lot of functions in kidneys
15
Q
Two types of nephrons
A
- Cortical: 80-85% this type
2. Juxtaglomerular: remaining is 15-20%
16
Q
Renal ptosis
A
Kidneys decrease in space/ decreased in position , drooping “dropped down”
17
Q
Renal ptosis can cause
A
A kinked ureter
18
Q
Hydronephrosis
A
Water on kidneys
** if kidneys can’t drain urine , will begin to compress the structures inside kidneys & you will do damage to the kidneys
19
Q
Glomerular capsule has to regions to it
A
- Partial layer : simple squamous
- podocytes: visceral
** will help form a membrane
20
Q
Renal sinus
A
Contain blood vessels, renal sinus , includes other structure
21
Q
Plasma will do 1 of 2 things
A
- take things from there and put it back in the blood
2. Or it’s going to leave it in there ( if it’s left in the tube , it will be removed as urine )
22
Q
Point of renal system
A
Introduce blood into kidneys
23
Q
Which renal artery is longer
A
Right renal artery will be longer because of the proximity to the aorta
24
Q
Which renal vein is shorter
A
Right renal vein is shorter because it is closer to the aorta
25
Which renal vein is longer
Left renal vein will be longer bwcauee its further away from the aorta
26
How many liters of blood go into the kidneys
1. 5 liters go into the kidneys
27
Calyces (2 types)
1. minor
2. major
* * drains to pelvis almost like a blood flow
28
Glomerular capsule (bowman's)
"baseball mit"
| surrounds glomerulus
29
renal tubular system
- brings blood into kidneys
- introducing blood/ plasma part of blood to renal tubular system
- will change its environment, so that we can make the appropriate concentration volume of urine
30
Glomerulus ( blood flow in & out of)
capillary
| interweaving capillary system
31
Renal pyramid
striated due to the conducting ducts
32
Juxtamedullary glomerular complex ( apparatus )
(JGA / JGC )
| plays a role in in regulating B/P & amount of fluid that leaves
33
mascula densa
referred to as osmo receptors
| - role is to tell how many components ( how many things are dissolved in fluid
34
Extraglomular mesangial cells
"extra"
35
Granular cells ( juxtaglomerular cells)
line the wall
| -specialized smooth muscle cell
36
renin
- comes from granular cells
| -
37
Afferent arterial
brings things in
| - blood or vessels that bring blood into glomerulus
38
efferent arterial
takes things out
39
filtration slits
spaces that allows things to pass through it ( not everything is absorbed )
40
Collecting ducts
-will drain more than one nephron
41
Cortical nephron
surrounded by peritubular
42
juxtamedullary
has a peritubular , but it is not referred as peritubular, but instead vasa recta
-Vasa recta surrounds it
43
Juxtaglomerular is made up of (3)
1. mascula densa
2. extraglomerular (mesangial cells)
3. granular cells
* **play a big role in regulating B/P & fluid that leaves
44
Filtration membrane
share a basement membrane
45
Glomerular mesangial cells have two functions
1. ability to contract
- can decrease the the size of glomerulus ( if you decrease the size, not much blood is filtered) or not much blood comes in. if it cant filter enough blood, not much fluid will be leaving blood or going into tubular system
2. acts as a macrophage (cells are able to undergo phagocytosis when pathogens are in the area
46
peritubular
surrounds tubular system
47
3 factors that will influence glomerular filtration
1. net filtration pressure ( most)
2. total surface area ( less important)
3. filtration membrane permeability
48
Net filtration pressure
how things move out of capillary
49
4 net filtration pressures
1. hydrostatic pressure is fluid pressure, a pushing pressure
2. hydrostatic pressure
3. onconic pressure
4. no forth pressure
50
Tubular reabsorption
is where fluids , particles & tubular system move back into the blood , to the peritubular capillary
51
Tubular secretion
fluid & particles moving from the peritubular capillaries back into the tubular system
52
osmolality
solutes / 1 liter fluids (solvent)
stuff in fluid
53
Renin
causes B/P to increase
54
renin is released when:
1. decrease in stretch in JG cells
2. detect decrease in sodium chloride in mascula densa
3. beta 1 receptors
55
Renin activates
Angiotensinogen
56
angiotensinogen activates
angiotensin 1 , which causes the formation of angiotensin 2
57
Angiotensin will encounter
ACE
58
Angiotensin 2
1. very potent
2. increases sodium reabsorption
3. increases ADH
4. increases thirst
59
blood pressure equals
C.O. X resistance
60
Cardiac output equals
Heart rate x Stroke Volume
61
Blood Pressure equals
Heart rate x stroke volume x resistance
62
Map equals
systolic + diastolic + diastolic/ 3
63
Nervous system when activated causes ?
vasoconstriction
64
Collecting duct cells
1. principal cells - utilize movement of sodium
| 2. intercalated cells - type A help w/ acid, typle B help w/ base
65
Apical microvilli
increase absorption
66
Distal convoluted Tubule cells
1. Ascending - simple cuboidal (does not have microvilli)
2. descending - simple squamous
( fluid inside is further away than proximal convoluted tubule )
67
Glomerular filtration
ability of leaving , as long as its not cells or proteins " stuff moving from here to there"
68
passive
does not take any energy , just move move down
| nonselective
69
low b/p =
does not profuse kidneys
70
liver damage =
decease in amount of proteins in the blood
| pressure would be lower
71
tissue or membrane damage , w/ disease process =
more things would go out
72
NFP(Net Filtration Pressure)
has hydrostatic pressure pushing out, on-conic pressure pulling in, hydrostatic pressure in glomerular capsule pulling in
73
nephron loop
1. descending limb
| 2. ascending limb
74
together glomerular capsule & glomerulus are referred as
renal corpuscle
75
3 things that regulate renin release
1. Decrease in stretch of jg cells triggers renin release.
2. macula densa cells that detect a decrease in osmolarity ( decrease in sodium chloride concentration or decrease in osmolarity)
3. Direct stimulation of a beta 1 receptor
76
Why is renin released?
Because we want blood pressure to go up
77
Mascula densa cells are
Are osmo receptors, job is to detect concentrations
78
3 stages in urine formation
1. Glomerular formation
2. Tubular reabsorption
3. Tubular secretion
79
2 things in a healthy person that don't undergo glomerular filtration.
1. Cells
| 2. Proteins
80
Glucose
Has the ability of increasing concentration in our body, thereby increasing concentration in filtering
81
Aquaporins
- are special channels, water pores or water channels that allow for water reabsorption, use diuretic hormone
82
Transport maximum
All of our carrying molecules are saturated, and don't have any other left. We've reached transport maximum
83
What does angiotension 2 do?
1. Very potent ( vasoconstriction)
2. Increases sodium reabsorption ( direct & indirect)
3. Increases ADH
4. Increases thirst
(all increase in blood pressure)
84
Renal threshold
Glucose we've reached transport maximum, is no longer being carried into cell
85
3 ways to increase osmolarity
1. can increase number in solutes, # stuff, particles / amount of fluid
2. can decrease amount of fluid
#solutes/ decrease amount of fluids
3. or both
86
3 ways to decrease osmolarity
1. decrease in solutes/ amount of fluids
2. # of solutes/ decrease of fluids
3. or both
87
intrinsic mechanism utilizes what...
osmolarity
88
solvent is...
always the thing that solutes are dissolved in or held
89
solvent equals
water
90
osmolarity is thought out as
stuff in fluid
91
1 liter of h20
1 kg
92
fluid is called
solvent
93
increase in GFR
Increases velocity , decreases amount of tubular reabsorption, increases in osmolarity, increases vasoconstriction (ATP), vasoconstriction @ afferent arterial , decrease in blood flow, decreases GFR
( when GFR went up, the response is going to be opposite)
94
Decrease in GFR
decreases Velocity , increases tubular reabsorption , decrease in osmolarity , decreases in release of vasoconstriction, decrease in relaxation on AA ( afferent arterial) , increases GFR
(increasing GFR- decrease - to increase GFR: leads to homeostatic response of increasing GFR)
95
when renin is release it encounters a protein
angiotensinogen and angiotension 1
| they are both inactive
96
renin is released from
juxtaglomerular cells / granular cells ( they line the arterial wall)
97
GFR stays constantly between
80-180
98
autoregulation
as long as the Map stays between 80-180 everything tends to be fine
99
surface area
amount of filtrate formed
100
propella
means nipple
101
diuretics
makes people pee
102
Sole purpose of juxatamedullary
Is to increase osmolarity
103
Reason we have the counter current mechanism
Is to set up the increasing of osmolarity ( for hot days)
| So that our blood pressure doesn't drop from the hot days
104
Descending limb is only permeable to?
Water
105
The ascending limb loop is only permeable to
Solutes
106
Things in urine
Ions, sodium chloride , calcium ,magnesium (sometimes proteins)
107
Urine can range in a variety of colors
- drinking appropriate amount of fluid
- things you ingest
- drugs
- diseases( meningococcal disease , antibiotics for it is called Rifampin)
108
PH of urine should be
Around 6
109
If pH of urine goes down below 4.5
a lot of the mechanisms will stop
110
Mucosal is a storage unit for
Urine
| - will be transitional epithlieum ( type of tissue where we store urine)
111
Ureter has what type of tissue
Has transitional epithlieum
| - transitional tissue is the type of epithelial tissue that changes with the presence of urine
112
Bladders sole purpose Is
To store urine. Can hold up to 1 liter
113
The vagina and urethra are examples of
Mucous membrane( have a connection with the outside) structure equals function
114
For females the function of the urethra is
Simply a pathway of urine ( way urine leaves body )
115
For males the function of the urethra is (2)
1. Allows for urine to exit
| 2. Pathway for ejaculation(during Orgasm , during climax)
116
Structure of the urethra is different in a female and male
The size is the difference
Female urethra is an inch to an inch and half
Male urethra is anywhere from 5-6 inches long
117
Acid
Things that donate their ions
118
Base
Something that will donate a hydroxide or bond to a hydrogen ion
119
Strong acid is classified
As an acid that can donate its ion
120
Our bodies primary goal is to keep pH between
7.35-7.45
121
To few and to many proteins
They begin to denature
122
Way body handles pH change
1. Buffers ( chemical buffer system) quickest ( located in extracellular system
2.
123
Where do we have bicarbonate buffer system?
In extracellular fluid
124
Where do we have phosphate buffer?
Inside cell and urine
125
How do the bicarbonate and phosphate system work
They work the same
| Take strong acid and combine it with a weak base
126
Base ( how it works )
Take a strong base and combine it with a weak acid
127
Acid ( how it works )
Take a strong acid and combine it with a weak base
128
Protein buffer system
Is the largest because of how many proteins we have
| Its our amphotheater system
129
How do you change a pH
Intubating
130
Renal regulation
Is the longest to take place
| Anywhere from hours to days to start trying to fix the problem
131
Renal regulation
Is the longest to take place
| Anywhere from hours to days to start trying to fix the problem
132
As bicarb goes up
pH goes up
133
higher risk of pathogen in a female urethra
1. due to sexual intercourse ( due a lot of pathogens being introduced )
2. has to with length (longer the urethra easier it is to wipe away bacteria, doesnt cause colonization and gives the immune system a chance to respond. ) shorter urethra = easier chance for bacteria to colonize and immune system doesnt respond fast enough
134
the process of voiding is called
urinating , voiding , diuresis , micturition
135
voiding will have two processes
1. involuntary
| 2. voluntary (normally if over the age of 2-3 , intact spinal cord )
136
when you cant control urinating it is called
incontinence
137
somatic motor represents
skeletal muscle (which is voluntary)
138
if you decrease activity (which is under voluntary control to the skeletal muscle )
leads to external sphincter opening up
139
internal urethral sphincter is
under involuntary control
140
male urethra is divided into 3 parts
1. intermediate part( goes thru pelvis floor)
2.prostate
3.
141
water content (high to low)
1. babies have the highest amount of water
2. adults
3. elderly has the least amount of water
142
where the fluid is in the body
1. inside the cell 1/3
| 2. outside the cell (interstitial 2/3 or vascular space 1/3 )
143
solutes are broken down into
electrolytes-have ability of conducting electrical impulse or non-electrolytes:
-play a active role in osmotic activity
144
an area of low water content has
higher osmotic activity ( more solutes)
145
osmotic activity
has to do with the ability of drawing water towards a certain substance
146
impermeable membrane is
nothing will change regardless. water cant leave, nothing can come in
147
permeable membrane is
mishmash together (like soup)
148
semi permeable membrane is
can regulate things ( if you can keep solutes in a certain area, means water has ability of moving)
it will move not to where water concentration is equal but until water osmotic activity is equal in both areas
149
proteins have a
sucking pressure
150
water
hydrostatic
151
solutes
sucking pressures
152
colloid osmotic pressure
on-conic pressure
153
tenecity
a solution and how it will effect the volume of a cell
154
hypertonic
cell gets bigger
155
isotonic
stays the same ( equal amount of fluid)
156
water comes in
intake
| can be from fluids, ingesting fluids, what we eat , water of oxidation
157
bicarbonate is located in
extracellular fluid
158
two mechanism for bicarbonate
1. hydrogen will bring pH up when we get rid of of it
| 2. pressure of bicarbonate will bring pH up
159
acids & bases are classified based on
strength
| (their strength is based on how well they are able to do
160
strong acid
a strong acid has the ability of donating its hydrogen
161
acidosis
pH is <7.35 ( renal regulation takes over , buffer system is overwhelmed / continuing to work but not handling problem, respiratory system isnt handling problem either
162
CO2
- bicarbonate uses it to depend on environment
| - can diffuse into the cell
163
renal regulation
- can take hrs or days
- utilizes kidneys
- tries to fix the problem
164
HC3/C02
Keep ratio constant & pH should be fine
165
two types of output
1. obligatory:whenever aquaporins are present , water undergo tubular reabsorption
2. facultative: was the hormone driven process with antidiuretic hormone ( vasopresence )
166
concentrated urine has
a small amount of urine
167
dilute urine has
high amounts of urine
168
dehydration can exist in two forms
1. can lose just water , diarrhea, vomiting , sweating
| 2. can lose solutes to sametime ( see it in fluid loss, bleeding )
169
hypotonic hydration
opposite of dehyrdation
| people that drink lots of water but dont have the ability to regulate it, so causes swelling in the brain
170
penetrating solutes
solutes that have the ability to enter and exit a cell
| **could effect the size of cell
171
tenecity
no value, no test ,
| ** only takes account in taking in the non-penetrating solutes
172
isotonic solutes
same (equal amounts of water moving around the cell )
| **the cell does not get bigger or smaller, does not change size of cell
173
hypertonic solutes
a lot of particles in solution, more particles than you would find inside a cell, the water would leave the cell or cremate. (causes cell to shrink)
**could lose function that way in
174
hypotonic solutes
very little particles , but mostly water, & put a cell in it , and non-penetrating solutes( particles in the cell and solutions aren't going to go anywhere) looking at just water
which would cause the cell to swell, it can swell to the point that it burst , if cell just got bigger which stretches the channels, its damaging or potentially damaging receptors
175
hypertonic solution
pulls fluids away from the brain, goes the kidneys, pts pee it away
176
electrolytes are referred as
salts
177
salts are
a positive ion and negative ion coming together
178
3 main salts we are concerned about
sodium , calcium , potassium
179
sodium
natrium
180
the bodies response is to keep the blood at 300mosm using
counter current mechanism
181
the counter current mechanism
which the nephron loop of juxatmedullary nephron and vasa recta of the juxatmedullary nephron which is the counter current exchanger
182
what is the primary ion that contributes to the amount of body water we have
sodium
| where sodium goes water goes, if its allowed. if no aquaporins present
183
sodium is reabsorbed
terminal portion of the distal convoluted , as well as collecting ducts but if theres no aquaporins present, which we get from diuretic hormones, then water cannot follow
184
sodium levels over 145 are referred as
hypernatremia ( high levels of sodium in blood)
185
sodium levels below 135 are referred as
hyponatremia ( low levels of sodium in blood )
186
high levels of calcium in the blood
hypercalciumia
187
low levels of calcium in the blood
hypocalciumia
188
high levels of magnesium
hypermagnesiumia
189
low levels of magnesium
hypomagnesiumia
190
sodium is regulated by
will be freely reabsorbed in the proximal convoluted tubule , as we move thru the ascending and distal convoluted tubule , and collecting, is where we start regulatin or reabsorbing sodium
191
one of the primary hormones concerned about
aldosterone ( comes from different places, activate it based on renin angiotension aldosterone system)
192
sametime we reabsorb sodium we are
secreting potassium
193
if we high blood pressure
baroreceptors will be stimulated , then go to the cardiac center.
194
what happens in the cardiac center when baroreceptors are activated
decrease in hr, decrease in contractility , vasodilation
195
hormone referred as
atrial natriuretic peptide
- released from atrial of the heart
- undoes everything that renin does ( causes a stretch in the cells of the atrium, causes bp to decrease)
- causes blood pressure to lower ( causes renin to stop)
196
trigger for renin
is most things that have to do with a low blood pressure
197
decrease in anti diuretic hormones
wont be making aquaporins, if you dont make aquaporins , cant reabsorbed the water, which mean water leaves the body in urine
198
increase fluid lost
stroke volume goes down, and blood pressure goes down
199
blood pressure is a factor of three things
1. heart rate
2. stroke volume
3. resistance
200
progesterone
has the opposite effect ( released later in the female reproductive system)
201
two types of glucocorticoid
1. endogenous :administer to pts
| 2. indigenous :released from adrenal cortex
202
tubular reabsorption can also be increase by
glucocorticoid
203
calcium exist in two phases
bound to a protein , and albumin ( when it occurs 50% calcium is unbound , 50% is bound to albumin
204
unbound calcium is referred as
iconic calcium: calcium that does the work
205
calcium bound to a protein
does not do anything
206
total calcium
its bound to albumin or ionized calcium
207
calcium is an important ion in the body
it causes the plateau in the body , so we have appropriate contractions in our cardiac cells, causes the skeletal muscle contraction, its involved in the bleeding process(one of the things that stops the bleeding) responsible for hormonal secretion, responsible for neuron secretions
208
essentially calcium does 4 things
1. bone resorption : breaking bone down(99% calcium is in our bones)
2. parathyroid will cause calcium to be reabsorbed in the kidneys
3. parathyroid causes vitamin D inside the kidneys to be activated
4. the activated vitamin D allows for absorption in GI tract
209
three types of cells in the bones
1. osteoclast: breakdowns bones
| 2. osteoblast :build bones
210
osteoclast
will move to the surface of the bone in areas that dont have a lot of stress, they will break bone down( bone resorption ), and release calcium into the the bloodstream
211
when calcium levels are down ..
parathyroid hormones are released
212
why do you need activated Vitamiin D?
need vitamin D activated in order to absorb calcium out of the GI tract
213
what does calcitonin do ?
helps with bone buildup
214
where is calcitonin released from
```
thyroid gland (causes bone to be formed)
inhibits the activity of osteoclast
```
215
what should pH level be at?
7.35-7.45
216
alkalosis is referred as
a pH higher that 7.45 (in a condition of alkalosis)
217
acidosis is referred as
a pH lower than 7.35
218
acid is
is something that when placed in a solution, will donate a hydrogens (gives up hydrogens)
219
base is
something that will generally accept a hydrogen or sometimes something that will give up a hydroxide
220
strong acid
has a low pH (lower the pH, stronger the acid)
221
carbonic is
a weak acid (small amounts of hydrogens )
| -does not donate free hydrogen ions
222
hydrochloric acid
is a strong acid (because the large amounts of hydrogens , which cause pH to go down)
its a disassociate and tends to donate a lot of free hydrogen ions (which causes pH to decrease)
223
acid base is important because
because pH has the ability to effect protein structures ( causes proteins to denature)
224
ways to keep the pH between 7.35-7.45
1. is the buffer system (chemical buffer system)
225
a buffer is
something that resist change
226
if the body generates to many hydrogen ions or base
body starts to take care of it, so that your pH doesnt have such big swings
227
chemical buffer system
1. bicarbonate system: located in extracellular fluid
2. phosphate
3. protein (largest)
228
a weak acid/ base
does not donate hydroxides or doesnt accept as many hydrogens , pH go back to a normal range instead of going up
229
where is the extracellular fluid ?3 primary compartments
1. inside the cell
2. outside the cell (anything outside the cell is extracellular )
3.
230
extracellular is broken down into
1. vascular : where we have bicarbonate ions
| 2. interstitial fluid
231
inside urine and interstitial fluid we have a
phosphate mechanism
232
where the bicarbonate buffer system is
take a strong acid, combine it with a weak base= weak acid (which wont change pH to a degree)
take a strong base, combine with a weak acid=weak base
233
where does the phosphate happen & how does it work?
inside the cell and in the blood
strong acid plus weak base= weak acid
strong base plus weak acid= weak base
234
protein buffer system
proteins have an ability to either accept or donate hydrogen ions
(proteins can go in both directions)
***amphoteric:how proteins work, depends on environment (when he talked about bisexuals)
235
how can you remove a lot of hydrogen ions
by decreasing CO2
236
When does the respiratory system kick in?
when the chemical buffer system cant fix something going on in the body
237
the most complex issue is when the acid or base problem is continuing to go on
the chemical buffer system didnt work, respiratory system didnt work either, then the kidneys would have to fix it
238
how quickly things respond to an acid or base problem
1. chemical buffer system responds
2. respiratory system responds if chemical buffer system doesnt work
3. kidneys fix it, if chemical or respiratory system dont work
239
what do the kidneys do in an acid problem
get rid of hydrogens ( secrete hydrogen ions)
and reabsorb bicarbonate
** if a pt is alkalosis , then it would be the opposite
