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ANURBF > [LEC] LESSON 2: RENAL MORPHOLOGY AND FUNCTION > Flashcards

[LEC] LESSON 2: RENAL MORPHOLOGY AND FUNCTION Flashcards

1
Q

-organ responsible for urine formation

A

Kidneys

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2
Q

-bean-shaped paired organs that represent 0.5% of the total body weight

A

Kidneys

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3
Q

-carries urine from the kidneys to the urinary bladder

A

Ureters

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4
Q

-Approximately 25cm in length

A

Ureters

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5
Q

-stores urine

A

Urinary Bladder

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6
Q

-shaped like a 3-sided pyramid

A

Urinary Bladder

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7
Q

-delivers urine for excretion

A

Urethra

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8
Q

—area of attachment through which the blood vessels and nerves pass into and out of the kidneys

A

*Hilus

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9
Q

—blood vessel through which blood enters the kidney

A

*Renal artery

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10
Q

—blood vessel through which blood leaves the kidney

A

*Renal vein

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11
Q

—outer layer of the kidney about 1.4cm thick which serves as the exclusive site for plasma filtration

A

*Renal cortex

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12
Q

—portions of the cortex that extend between renal pyramids

A

*Renal columns

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13
Q

—inner region that has a stringy macroscopic appearance-Contains the collecting ducts

A

Renal medulla

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14
Q

—any of the conical masses that project as renal papillae into the renal pelvis

A

•Renal pyramids/Malphigian pyramid

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15
Q

—overlying the cortex area

A

•Renal lobe

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16
Q

—cup-like divisions of the renal pelvis surrounding one or more renal papillae

A

•Calyces (major and minor)

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17
Q

—funnel-shaped structure that is formed at one end by the expanded upper portion of the ureter

A

•Pelvis

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18
Q

—functional unit of the kidney located mostly in the cortex Each kidney contains 1 to 1.5 million nephrons

A

•Nephron

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19
Q

TWO TYPES OF NEPHRON

A
  1. Cortical Nephrons
  2. Juxtamedullary Nephrons
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20
Q

-Comprise approximately 85% of the total number of nephrons
-Function for urine concentration

A

Cortical Nephrons
Juxtamedullary Nephrons

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21
Q

-Primarily located in the cortex and function for tubular reabsorption and secretion
-Have loops of Henle that extend into the medullary region

A

Juxtamedullary Nephrons

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22
Q

COMPONENTS OF A NEPHRON

A

I. Renal Corpuscle
II. Renal Tubules
III. Collecting Duct

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23
Q

-Tuft of capillaries within the Bowman’s capsule

A

Glomerulus

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24
Q

-Structure that surround the glomerulus

A

•Bowman’s capsule

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25
Q

-Has a bigger lumen and carries blood to the glomerulus

A

•Afferent arteriole

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26
Q

-Has a smaller lumen and carries blood from the glomerulus

A

•Efferent arteriole

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27
Q

-Has a convoluted portion and a straight portion which becomes the Loop of Henle once it reaches the medulla

A

•Proximal Convoluted Tubule (PCT)

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28
Q

-Thin Descending Segment-U-Shaped Segment
-Thin and Thick Ascending Segment

A

•Loop of Henle

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29
Q

-Composed of 2 to 3 loops and begins at the juxtaglomerular paratus with the macula densa

A

•Distal Convoluted Tubule (DCT)

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30
Q

-Serves as the site of final urine concentration

A

III. Collecting Duct

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31
Q

Renal Physiology

A

I. RENAL BLOOD FLOW
II. Glomerular Filtration
III. TUBULAR REABSORPTION

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32
Q

-Directly affects the kidney’s functional ability
-1,200 ml/minute

A

RENAL BLOOD FLOW

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33
Q

Renal Plasma Flow:

A

600-700 ml/min

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34
Q

-process that involves the filtration of blood which leads to the formation of the ultrafiltrate

A

Glomerular Filtration

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35
Q

-Coil of ~8 capillary lobes (capillary tuft)
-Non-selective filter of plasma substances with MW of <70,000 Da

A

Glomerulus

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36
Q

Factors affecting filtration

A

a.Filtration Barrier
b.Net Filtration Pressure
c.Feedback mechanism of RAAS

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37
Q

: increases permeability

A

Fenestrated endothelium

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38
Q

: provides further restriction of main size discriminant barrier to protein passage

A

Basement membrane

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39
Q

: afforded by negatively charged components provides additional restriction by repelling positively-charged molecules

A

Shield of Negativity

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40
Q

: with intertwining foot processes (podocytes) forms filtration slitss

A

Visceral epithelium

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41
Q

-Pressure that forces substances from the glomerular capillaries into the Bowman’s capsule

A

Net Filtration Pressure

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42
Q

-pressure in the glomerular capillaries forcing water and solutes through filtration slits

A

Glomerular Blood Hydrostatic Pressure (GBHP)

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43
Q

-Pressure exerted against the filtration membrane by fluid already in the capsular space

A

Capsular Hydrostatic Pressure (CHP)

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44
Q

Blood Colloid Osmotic Pressure (BCHP)-Pressure exerted by the proteins in blood plasma

A
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45
Q

-Regulates the blood flow to and within the glomerulus
-Responds to changes in blood pressure and plasma sodium concentration

-Juxtaglomerular apparatus: (?)

A

Renin-Angiotensin-Aldosterone System (RAAS)
juxtataglomerular cells + macula densa

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46
Q

Effects of Angiotensin II
-Release of (?) to increase Na reabsorption (DCT)
-Release of (?) to increase water reabsorption (CD)
-constriction of (?) to increase blood pressure

A

ALDOSTERONE
Antidiuretic Hormone (ADH)
efferent arterioles

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47
Q

-Essential substances are returned to the circulation
-Substances are transported from the filtrate back to the blood

A

TUBULAR REABSORPTION

48
Q

Reabsorption Mechanisms:

A

a. Active transport
b. Passive transport

49
Q

-Substance must combine with a carrier protein
-Transfer of substance is brought about by the electrochemical energy

A

Active transport

50
Q

-Movement of molecules across a membrane by diffusion because of a physical gradient

A

Passive transport

51
Q

ACTIVE TRANSPORT
PCT:
ALH:
PCT and DCT:

A

glucose, amino acids, salts
Cl ions
Na and Cl ions

52
Q

PASSIVE TRANSPORT

All areas except ALH:
PCT and ALH:
ALH:

A

water
urea
Na and Cl ions

53
Q

: major site (65%) of reabsorption

A

Proximal Convoluted Tubule

54
Q

Urine Concentration

-Begins in the (?)
-Final urine concentration begins in the (?) and continues up to the
-Affected by the two hormones

A

Loop of Henle
late DCT
CD

55
Q

-responds to the body’s need for Na
-promotes Na reabsorption in the DCT
-responds to the body’s need for water
-promotes water reabsorption in the DCT and CD

Countercurrent Mechanism
-DLH: (?) is reabsorbed
-ALH: (?) are reabsorbed

A
  1. Aldosterone
  2. Antidiuretic Hormone

water
Na and Cl ions

56
Q

-Movement of substances from the blood in renal capillary beds to the filtrate in the tubular lumen

A

TUBULAR SECRETION

57
Q

2 major functions:
1.Elimination of waste products not filtered by the glomerulus
2.Regulation of acid-base balance through H+ ion secretion

A
58
Q

GLOMERULAR FILTRATION TESTS

A

ENDOGENOUS: 1.CREATININE CLEARANCE 2.UREA CLEARANCE 3.BETA2MICROGLOBULIN 4.CYSTATIN-C B.EXOGENOUS: 1.INULIN CLEARANCE 2.RADIOISOTOPES

59
Q

TUBULAR REABSORPTION TESTS

A

FISHBERG B.MOSENTHAL C.OSMOLARIITY D.FREE WATER CLEARANCE 1.FREEZING POINT 2.VAPOR PRESSURE

60
Q

TUBULAR SECRETION TESTS:

A

A.PHENOLSULFONA PHTHALEIN (PSP)
B.PAMINOHIPPURIC ACID (PAH)
C.TITRATABLE ACIDITY
D.URINARY AMMONIA

61
Q

Procedures performed to determine the ability of the kidneys to carry out its metabolic functions

A

RENAL FUNCTION TESTS

62
Q

–Standard test used to determine the filtering capacity of the glomeruli

A

Clearance Test

63
Q
  1. Some creatinine is secreted by the tubules, and secretion increases as (?)
A

blood level rise

64
Q
  1. (?) is secreted by the tubules, and secretion increases as blood present in human plasma react in the chemical analysis.
A

Chromogens

65
Q
  1. Medications, including (?) inhibit tubular secretion of creatinine
A

gentamicin, cephalosporins, and cimetidine (Tagamet)

66
Q
  1. (?) will break down urinary creatinine if specimens are kept at room temperature for extended periods.
A

Bacteria

67
Q
  1. An increased intake of (?) can raise the urine and plasma levels of creatinine during the Measurement of hour collection period.
A

meat

68
Q
  1. Accurate results depend on the accurate completeness of a (?)
A

24 hour collection.

69
Q
  1. It must be corrected for (?), unless normal is assumed, and must always be corrected for children.
A

body surface area

70
Q

Measurement of creatinine clearance not a reliable indicator in patients suffering from (?) or persons involved in heavy exercise or (?) supplementing with creatine

A

muscle wasting diseases
athletes

71
Q

creatinine suffering from muscle clearance is not a reliable indicator in patients wasting diseases or persons involved in heavy exercise or athletes supplementing with creatine

A
72
Q

Formulas developed to provide estimates of the GFR based on the (?) without the urine creatinine

A

serum creatinine

73
Q

-most frequently used formula-used to evaluate patient placement on kidney transplant lists

A
  1. Cockcroft and Gault
74
Q
  • Multiply results by (?) for female patients
A

0.85

75
Q
  1. Modification of Diet in Renal Disease (MDRD) System Formula
A

GFR = 170 x serum creatinine - 0.999 x age -0.176 x [0.822 (if patient is female)] x [1.1880(if patient is black)] x BUN-0.170 x serum albumin + 0.318

76
Q

By far the greatest source of error in any clearance procedure utilizing urine is the use of

A

improperly timed urine specimens

77
Q

 Routinely performed for screening glomerular filtration

A

UREA CLEARANCE

78
Q

 First substance to be used for clearance test

A

UREA CLEARANCE

79
Q

 Readily-filtered but partially reabsorbed by the renal tubules

A

UREA CLEARANCE

80
Q

 Measures renal functions and is not specific for glomerular filtration

A

UREA CLEARANCE

81
Q

 No longer performed

A

UREA CLEARANCE

82
Q

 dissociates from HLA at a constant rate and is rapidly removed from the plasma by glomerular filtration

A

BETA2MICROGLOBULIN

83
Q

 not reliable on patients with a history of immunologic disorders or malignancy

A

BETA-2-MICROGLOBULIN

84
Q

 produced at a constant rate by all nucleated cells

A

CYSTATIN-C

85
Q

 readily filtered by the glomerulus and reabsorbed and broken down by the renal tubular cells

A

CYSTATIN-C

86
Q

 recommended for pediatric, diabetic, geriatric and critically-ill patients

A

CYSTATIN-C

87
Q

 test requires an infused substance

A

Exogenous Clearance Test

88
Q

 stable exogenous substance, neither reabsorbed nor secreted by the tubules

A

INULIN

89
Q

 provides filtration a method through for the determining plasma disappearance enables glomerular of the radioactive filtration

A

Injecting 125 radionucleotides Iiothalamate

90
Q

 This in material one or and both procedure kidneys can measure kidney .

A

Injecting 125 radionucleotides Iiothalamate

91
Q

 used to evaluate tubular reabsorption

A

Concentration Test

92
Q

 stable exogenous substance, neither reabsorbed nor secreted by the tubules

A

FISHBERG

93
Q

 volume and specific gravity comparison of day and night urine samples

A

MOSENTHAL

94
Q

 Influenced by the numberand densityof particles in a solution

A

SPECIFIC GRAVITY

95
Q

 Influenced by the numberof particles in a solution

A

OSMOLARITY

96
Q

 Based on the measurement of colligative properties

A

OSMOLARITY

97
Q

Osmometers:

A
  1. Freezing Point Osmometers
  2. Vapor Pressure Osmometers
98
Q

Normal Serum Osmolarity:

A

275 to 300 mOsm

99
Q

Normal Urine Osmolarity:

A

50 to 1400 mOsm

100
Q

Normal Urine to Serum Osmolarity Ratio is

A

1:1 to 3:1

101
Q

 evaluates the ability of the kidney to respond to the body’s state of hydration

A

FREE WATER CLEARANCE

102
Q

FREE WATER CLEARANCE

Interpretation of Results:
(-):

A

less water is being excreted

103
Q

FREE WATER CLEARANCE

Interpretation of Results:
0:

A

no renal concentration or dilution

104
Q

FREE WATER CLEARANCE

Interpretation of Results:
(+):

A

excess water is being excreted

105
Q

 Determine solution measured the by freezing point supercooling amount of of sample approximately 27C

A

FREEZING POINT OSMOMETERS

106
Q

 1 Osm or 1000m Osm/kg of H2O will lower the freezing of point H2O by 1.86C

Clinical osmometers use solutions of known NaCl concentration as their reference standards because a solution of partially ionized substances is more representative of urine and plasma composition

A
107
Q

The by depression solute of dew point temperature by solute parallels the decrease in vapor pressure, thereby providing a in vapor measure this colligative property

uses microsamples of less than 0.01 mL; therefore, care must be taken to prevent any evaporation of the sample prior to testing

Used primarily to analyze serum and sweat microsamples for disorders not related to renal function, such as cystic fibrosis

A

VAPOR PRESSURE OSMOMETERS

108
Q

 Non-toxic substance loosely bound to plasma proteins

A

p-Aminohippuric Acid Test

109
Q

 Completely removed as the blood passes through the peritubular capillaries

A

p-Aminohippuric Acid Test

110
Q

 Historically used to evaluate tubular secretion and renal blood flow

A
  1. Phenolsulfonphthalein Test
111
Q

 Obsolete, hard to interpret

A
  1. Phenolsulfonphthalein Test
112
Q

 Evaluates the ability of the kidneys to produce an acid urine

A

Titrable Acidity and Urinary Ammonia

113
Q

 Sample required: fresh or toluene-preserved urine collected at 2-hour intervals

A

Titrable Acidity and Urinary Ammonia

114
Q

 Patient is primed with an acid load of oral ammonium chloride

A

Titrable Acidity and Urinary Ammonia

115
Q

 Amount of free H+ and total acidity is determined

A

Titrable Acidity and Urinary Ammonia

116
Q

 Evaluates unilateral kidney disease-Involves the intravenous administration of 100 mg indigo carmine

A

Indigo Carmine Test

ANURBF (7 decks)

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