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Adv. Principles II > Kidney A+P > Flashcards

Kidney A+P Flashcards

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1
Q

What are the homeostatic functions of the kidney?

A
  • Excretion of metabolic waste products and foreign chemicals
  • Regulation of water and electrolyte balances
  • Regulation of blood pressure
  • Regulation of acid-base balance
  • Hormone production
  • Glucose synthesis

These functions are essential for maintaining the body’s internal environment.

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2
Q

What shape do the normal kidneys have?

A

Ovoid ‘bean’ shaped

This shape is typical for human kidneys.

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3
Q

Where do the kidneys lie anatomically?

A

In a retroperitoneal position ‘paravertebral gutters’

This location provides some protection from the rib cage.

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4
Q

What is the approximate weight of each kidney?

A

About 150g

This is an average weight for a normal human kidney.

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5
Q

What is the renal hilum?

A

Concave and indented region on the medial side of each kidney that leads to the renal sinus

The hilum is where blood vessels, lymphatics, nerve supply, and the ureter enter and exit the kidney.

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6
Q

What is the normal glomerular filtration rate (GFR)?

A

125 mL/min or 180L/day

This rate indicates the efficiency of the kidneys in filtering blood.

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7
Q

What are the three layers of the glomerular capillary membrane?

A
  • Endothelium of the capillaries
  • Basement membrane
  • Layer of epithelial cells (podocytes)

These layers work together to filter blood while preventing the passage of blood cells and large proteins.

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8
Q

True or False: The kidney can regenerate new nephrons.

A

False

Nephrons cannot be regenerated, and their number decreases with age or injury.

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9
Q

What are the two major groups of nephrons?

A
  • Cortical nephrons
  • Juxtamedullary nephrons

These groups differ in their structure and function within the kidney.

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10
Q

What is the primary determinant of GFR?

A

Glomerular hydrostatic pressure

This pressure influences the filtration rate significantly.

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11
Q

Fill in the blank: The kidneys receive _______ of cardiac output.

A

20-25%

This percentage indicates the kidneys’ high demand for blood supply relative to their size.

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12
Q

What is the role of the juxtaglomerular apparatus?

A

Regulates renal blood flow (RBF) and GFR by monitoring renal perfusion and sodium chloride concentrations

It plays a crucial role in maintaining homeostasis in the kidneys.

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13
Q

What happens to GFR when glomerular hydrostatic pressure decreases?

A

GFR reduces

Lower pressure leads to less filtration of blood.

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14
Q

Describe the myogenic mechanism of renal autoregulation.

A

Vascular smooth muscle contracts when stretched to regulate blood flow and maintain GFR

This mechanism protects the glomeruli from damage due to excessive pressure.

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15
Q

What is the filtration fraction?

A

Percent of plasma filtered by the glomerular capillaries

It is a measure of how much plasma is being filtered out of the blood.

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16
Q

What is the average colloid osmotic pressure of glomerular capillary plasma proteins?

A

About 30-32 mmHg

This pressure opposes filtration and influences GFR.

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17
Q

What are the primary determinants of glomerular hydrostatic pressure?

A
  • Arterial blood pressure
  • Afferent arteriole resistance
  • Efferent arteriole resistance

Changes in these factors can significantly affect GFR.

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18
Q

What occurs during glomerular filtration?

A

Hydrostatic pressure forces fluids and solutes through a membrane

This passive process is the first step in urine formation.

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19
Q

What is the purpose of autoregulation in the kidneys?

A

To ensure a constant amount of blood is delivered to the kidneys over a wide range of arterial blood pressures

This maintains a stable GFR despite fluctuations in blood pressure.

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20
Q

What is the main effect of increased Bowman’s capsule hydrostatic pressure on GFR?

A

Reduces GFR

Elevated pressure in the capsule opposes filtration.

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21
Q

What are the two components of tubuloglomerular feedback?

A
  • Afferent arteriolar feedback
  • Efferent arteriolar feedback

This feedback mechanism helps regulate GFR based on sodium chloride concentrations.

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22
Q

What normally autoregulates RBF and GFR in parallel?

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A

Tubuloglomerular feedback

Tubuloglomerular feedback involves two components: afferent arteriolar feedback and efferent arteriolar feedback mechanisms.

23
Q

Where is the juxtaglomerular apparatus located?

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A

In the distal tubule

The juxtaglomerular apparatus is the region that passes between the afferent and efferent arterioles.

24
Q

What effect does decreased macula densa sodium chloride have?

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A

Causes dilation of afferent arterioles and increased renin release

The macula densa cells sense changes in volume delivery to the distal tubule.

25
What happens if RBF decreases?
GFR decreases, causing increased reabsorption of NaCl ## Footnote This results in reducing the concentration of NaCl sensed at the macula densa cells.
26
What are the two effects of a decrease in NaCl concentration at the macula densa?
* Decreases resistance to blood flow in afferent arterioles * Increases renin release from juxtaglomerular cells ## Footnote These effects help return GFR to normal.
27
What does angiotensin II do?
* Potent systemic vasoconstriction of arterioles * Increases Na reabsorption * Triggers aldosterone release * Stimulates release of ADH * Constricts efferent arterioles ## Footnote Angiotensin II plays a crucial role in regulating blood pressure and fluid balance.
28
What triggers the release of aldosterone?
* Hyperkalemia * Hyponatremia * Angiotensin II ## Footnote Aldosterone acts on principal cells of the distal convoluted tubule and collecting tubule.
29
What is the net effect of aldosterone?
Sodium reabsorption and potassium loss ## Footnote This process expands blood volume.
30
What happens during strong activation of the renal sympathetic nerves?
Constricts renal arterioles and decreases RBF and GFR ## Footnote Moderate sympathetic stimulation has little influence on RBF and GFR.
31
What are the steps of tubular reabsorption?
* Substance transported across tubular epithelial membranes into renal interstitial fluid * Transported through peritubular capillary membrane back into blood ## Footnote This process is essential for reclaiming substances from the filtrate.
32
What is the primary active transport mechanism for sodium reabsorption?
Na-K ATPase pump ## Footnote This pump moves sodium against its electrochemical gradient.
33
What occurs when the transport maximum (Tm) is exceeded?
Excess substance will be excreted in the urine ## Footnote Example: In hyperglycemia, glucose appears in urine when plasma levels exceed 180 mg/dL.
34
What is the role of the loop of Henle?
Participates in forming concentrated or dilute urine ## Footnote It consists of three segments: thin descending, thin ascending, and thick ascending.
35
What is the primary function of the thick ascending limb of the loop of Henle?
Active reabsorption of sodium, chloride, and potassium ## Footnote This segment is virtually impermeable to water.
36
How does the countercurrent multiplier system function?
Creates the osmotic gradient ## Footnote It is essential for allowing kidneys to dilute or concentrate urine under different conditions.
37
What regulates the reabsorption of water in the late distal tubule and collecting duct?
Concentration of ADH ## Footnote ADH increases water permeability in these segments.
38
What substances are primarily secreted in the renal tubules?
* H+ * K+ * NH4+ * Creatinine * Certain organic acids and bases ## Footnote Secretion occurs mostly in the proximal convoluted tubule and distal convoluted tubule.
39
What is the role of intercalated cells in the collecting tubules?
Regulate acid-base balance ## Footnote They secrete or reabsorb hydrogen, bicarbonate, and potassium ions.
40
How does the medullary collecting duct contribute to urine concentration?
Reabsorbs less than 10% of filtered water and sodium ## Footnote It is the final site for processing urine and is permeable to urea.
41
What substances are typically removed during secretion?
Substances that are too large to be filtered or in excess in the blood, such as H+, K+, NH4+, creatinine, and certain organic acids and bases. ## Footnote Examples of organic acids and bases include bile salts, oxalate, urate, and catecholamines.
42
What is the countercurrent multiplier mechanism?
A process that establishes an osmotic gradient by repetitive reabsorption of NaCl by the thick ascending loop of Henle and continued inflow of new NaCl from the PCT into the descending limb. ## Footnote It involves active NaCl transport, low water permeability of thick ascending limb cells, parallel arrangement of blood vessels, and recycling of urea.
43
What are the components that establish the osmotic gradient in the countercurrent multiplier?
* Active NaCl transport by the thick ascending limb into the medullary interstitial fluid * Very low water permeability of the apical membranes of thick ascending limb cells * Side by side parallel arrangement of blood vessels and tubular segments in the medulla * Recycling of urea between the medullary collecting ducts and the loops of Henle
44
What is the role of the distal convoluted tubule (DCT) and collecting ducts in urine concentration?
The DCT further dilutes tubular fluid by absorbing solutes and being impermeable to water. Water reabsorption in the collecting ducts is dependent on ADH. ## Footnote High ADH levels lead to large amounts of water reabsorbed into the cortex interstitium.
45
What is the function of antidiuretic hormone (ADH)?
ADH stimulates water reabsorption in the distal tubules and collecting ducts by activating V2 receptors and inserting aquaporin-2 channels. ## Footnote It reduces plasma osmolarity and increases urine osmolarity.
46
What is urea recycling and its significance in urine concentration?
Urea contributes to hyperosmotic renal medullary interstitial fluid and formation of concentrated urine by diffusing out of the tubule into the renal interstitial fluid. ## Footnote This process is facilitated by specific urea transporters and involves recirculation between the collecting duct and loop of Henle.
47
What is the role of the vasa recta in the kidney?
The vasa recta act as countercurrent exchangers, maintaining the osmotic gradient and removing reabsorbed water and solutes. ## Footnote They also supply metabolic needs of the medullary tissues.
48
What anatomical layers are present in the ureters?
* Mucosa * Muscularis * Adventitia
49
What is the physiological role of the bladder?
A smooth, collapsible, muscular chamber that temporarily stores urine. ## Footnote Major components include the body, neck, and trigone area.
50
What structures are involved in the innervation of the bladder?
Sympathetic and parasympathetic fibers innervate the bladder, controlling its function.
51
What is the function of the internal urethral sphincter?
Keeps the urethra closed to prevent leakage; it is involuntary and unusual in that contraction opens it while relaxation closes it.
52
What are the three requirements for micturition to occur?
The specific requirements are not detailed in the provided text.
53
True or False: The ureters are well supplied with pain nerve fibers.
True

Adv. Principles II (1 decks)

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