More lecture 10qs Flashcards
(141 cards)
1
Q
The renal artery gives rise to how many segmental arteries?
A
5
2
Q
Where does water in urine come from?
A
Plasma
3
Q
How do the kidneys protect acid base balance?
A
By conserving or excreting H+ ions
4
Q
What do the kidneys activate?
A
Vitamin D
5
Q
How are kidneys involved with blood cell regulation?
A
Produce EPO
6
Q
What is made of striated triangles called renal pyramids?
A
Renal medulla
7
Q
One of what supplies each nephron and delivers blood to each glomerulus?
A
Small afferent arterioles
8
Q
Only place in the body where capillaries drain into arterioles rather than veins is where?
A
Glomerular capillaries
9
Q
What is the juxtaglomerular apparatus?
A
Specialized region made of vascular and tubular cells
10
Q
All nephrons originate where?
A
Cortex
11
Q
What type makes up 80% of nephrons?
A
Cortical
12
Q
The glomerulus lies in inner cortex of what nephrons?
A
Juxtamedullary
13
Q
Peritubular capillaries of ____________________ nephrons form vasa recta
A
juxtamedullary
14
Q
How much filtrate is formed each day?
A
180L
15
Q
______% of the plasma that enters glomerular capillaries is filtered into the Bowman’s capsule
A
20%
16
Q
Of the 180L of filtered plasma, 178.5L is ________________
A
reabsorbed
17
Q
What do the 3 layers fluid passes to enter Bowman’s capsule retain? What do they let pass?
A
Retain blood cells and plasma proteins, pass H2O and smaller molecules
18
Q
True or false: the fenestrations in the glomerular capillaries do not let RBCs out
A
True
19
Q
Where are glycoproteins found?
A
In the basement membrane (b/t glomerulus and bowman’s capsule)
20
Q
1% of proteins that slip through are degraded into amino acids in __________________ and reabsorbed, thus normal urine is protein free
A
proximal tubule
21
Q
Podocytes are found where?
A
Inner layer of Bowman’s capsule
22
Q
True or false: No local energy is used to move fluid across the membrane into Bowman’s capsule
A
True
23
Q
What 2 things does glomerular capillary blood pressure depend on?
A
1) Heart contraction
2) Resistance in afferent and efferent arterioles
24
Q
True or false: glomerular capillary blood pressure only depends on afferent arteriole pressure
A
False; both afferent and efferent
25
Glomerular capillary pressure is _____________ than other capillaries
higher
26
What concentration gradient establishes tendency of water to move from Bowman’s capsule into glomerulus?
Plasma proteins
27
What does increased arterial blood pressure do?
Increase blood flow into glomerular capillaries
28
What pressure tends to push fluid out of capsule (opposing filtration)?
Bowman’s capsule hydrostatic pressure
29
GFR depends on what 3 things?
1) NFP
2) Glomerular surface area
3) Glomerular permeability
30
What is a measure of how much blood passes through glomeruli each minute?
GFR
31
Can burns increase or decrease GFR?
Increase
32
Can dehydration increase or decrease GFR?
Decrease
33
Urinary tract obstruction (kidney stone, enlarged prostate) can increase what pressure?
Bowman’s capsule hydrostatic pressure
34
MAP and afferent arteriole resistance largely determine what?
Glomerular capillary blood pressure
35
The body regulates GFR by adjusting what pressure?
Glomerular capillary blood pressure
36
Two control mechanisms regulate GFR by regulating ______________________ of ________________ arterioles
radius (resistance); afferent
37
What is extrinsic control of GFR also called?
Sympathetic control
38
What prevents momentary changes in BP from changing GFR?
Autoregulation (intrinsic)
39
Extrinsic controls do what to autoregulatory responses?
Override them
40
Are baroreceptors or chemoreceptors involved in GFR control?
Baroreceptors
41
Baroreceptor reflex response achieves what?
Sympathetic control of GFR
42
1) When baroreceptors detect a fall in BP, what does the brainstem then do?
2) What two things does this then increase?
1) Initiates sympathetic stimulation of heart and vessels
2) Cardiac output and peripheral resistance (incl. of afferent arteriole)
43
Which arterioles are more sympathetically innervated?
Afferent
44
What happens when the baroreceptors detect low BP?
Sympathetic vasoconstriction is reduced
45
Substances being returned from tubular lumen into peritubular capillaries is called what?
Tubular reabsorption
46
To leave tubular fluid, a substance must cross what?
Luminal membrane [of tubular cell]
47
What is within tubular cells?
Cytosol
48
What part of tubular cells must be crossed to enter IF?
Basolateral membrane
49
How do substances enter plasma?
Diffusing through IF, then penetrating capillary wall
50
List 3 things that require active transport during reabsorption
Glucose, amino acids, electrolytes
51
80% of the energy spent by kidneys is used for ______ transport
Na+
52
True or false: all segments of the tubules transport the same amounts of Na+
False; different segments of the tubules transport differing amounts of Na+
53
Where is the Na-K ATPase pump?
Basolateral membrane of tubular cells
54
How is Na+ reabsorbed?
Na-K pump transports Na+ out of tubular cell into lateral space where it builds up
55
Once it's pumped out for reabsorption, sodium diffuses _[up/down]___concentration gradient into interstitial fluid and then peritubular capillary
down
56
Na+ and Cl- account for _____% of ECF osmotic activity
90%
57
When Na+ load is __high/low___, it “holds” water and fluid volume expands
high
58
Expansion of ________ volume increases BP, reduction decreases BP
plasma
59
Na+ regulating mechanisms regulate what pressure?
Arterial blood pressure
60
The renin-angiotensin-aldosterone system (RAAS) is the most important system for the regulation of what molecule?
Na+
61
What secretes renin?
Juxtaglomerular apparatus
62
True or false: the kidneys don't have any baroreceptors
False; have intrarenal baroreceptors
63
Baroreceptor reflex sympathetic activity stimulates _______ secretion
renin
64
Falling NaCl, fluid volume, and BP trigger the kidneys to secrete what?
Renin
65
What produces angiotensinogen?
Liver
66
What converts angiotensinogen into angiotensin I?
Renin
67
What converts angiotensin I into angiotensin II? Where does it come from?
Angiotensin converting enzyme from lungs
68
1) What does angiotensin II do to the heart? (2 things)
2) What does it increase outside the heart? (3 things)
1) Increases HR and contractility
2) Vasopressin, thirst, and arteriolar vasoconstriction
69
What does aldosterone do?
Increase Na+ reabsorption by tubules (Cl- follows)
70
Someone with a high BNP usually has what?
HF
71
ANP and BNP are produced by the heart and inhibit what?
Na+ reabsorption
72
ANP and BNP are released when heart muscles detect what?
stretch
73
The concentration at which tubular maximum is reached is called ______________
renal threshold
74
True or false: Plasma membrane carriers are specific to the substance being transported
True
75
Once transported into tubular cell, what passively diffuse down gradients into plasma?
Nutritionally important molecules
76
What osmotically follows Na+?
H2O
77
What is reabsorbed down electrical gradient created by Na+?
Cl-
78
Urea has a limited permeability of which only allows ____% of urea to be reabsorbed
50%
79
Urea is from ____________ breakdown
protein
80
What are the 4 most important things that are secreted into tubules?
H+, K+, organic anions and cations
81
Increased acidity increases ______ ion secretion.
H+
82
What ion is tightly controlled by the kidneys?
K+
83
What do prostaglandin and epinephrine have in common?
They're organic ions that are secreted into tubules (tubular secretion) because they need to be removed to avoid prolonged activity
84
Many foreign compounds are organic ions including what 3 things?
Food additives, drugs, environmental pollutants
85
Is flow in the vasa recta the same as in the loops of henle or not?
Not the same; countercurrent
86
What allows water to be reabsorbed?
Vertical osmotic gradient
87
Countercurrent multiplication is a _________ feedback loop that ends with a high concentration at the ___________ of the loop of Henle
positive; bottom
88
What part of the loop of Henle has Na-K pumps?
Ascending limb
89
Why does water leave the descending limb?
Because of the sodium that leaves the ascending limb
90
Does the ascending or descending limb have higher concentration?
Descending
91
What direction does high concentration fluid in the loop of henle go?
Down
92
What ascends the ascending loop of henle?
Less concentrated fluid
93
What is secreted when ECF is too concentrated (H2O deficit)?
ADH/ vasopressin
94
What two things are only permeable to H2O in the presence of vasopressin?
Distal and collecting tubules
95
What detects hypertonicity?
Hypothalamus
96
The bladder is richly supplied with _____________________ fibers which cause contraction which empties urine via urethra
parasympathetic
97
What is the last part of the bladder called?
Internal urethral sphincter
98
What does parasympathetic action inhibit?
Motor neurons of external urethral sphincter
99
Give 3 side effects of uremic toxicity (a symptom of kidney failure)
Platelet dysfunction, nerve damage, GI symptoms
100
Inability to secrete H+ causes what?
Metabolic acidosis
101
Blood pressure issues (edema (excess) or hypotension/ shock (deficiency)) can all result from what effect of kidney failure?
Sodium imbalance
102
What increases cardiac and neural excitability?
K+ retention (renal failure side effect)
103
The “internal pool” of a substance is the amount of that substance in the ECF, or ICF?
ECF
104
______ composes 2/3rds of body water, ________ 1/3rd
ICF; ECF
105
Plasma and IF are both types of what?
ECF
106
True or false: lymph and transcellular fluids (CSF, synovial fluid, pleural fluid, etc.) are major considerations in fluid balance
False; they're minor
107
ECF components (plasma and IF) are separated by walls of what?
Blood vessels
108
Transfer of H2O between plasma and IF is governed by what?
Imbalances across the capillary walls
109
Hydrostatic pressure of what are low and fairly constant?
ECF and ICF
110
All exchanges of H2O between ICF and external world must occur through what?
ECF
111
If plasma’s volume or composition is changed, then the volume and composition of what is also changed?
IF
112
Control mechanisms acting on plasma indirectly regulate what?
IF (and thus ECF volume as a whole)
113
What are the two factors in regulating fluid balance in the body?
ECF volume and osmolarity
114
ECF ___________ is controlled by salt balance
volume
115
ECF ___________ is controlled by water balance
osmolarity
116
Increased ECF osmolality causes what to be secreted?
Vasopressin
117
What are the short term and long term controls of ECF volume?
Short term controls: baroreceptor reflex, automatic fluid shifts between plasma and IF due to hydrostatic pressures
Long term controls: kidneys regulate output, thirst regulates input
118
What are responsible for ICF osmolarity?
K+ and anionic proteins
119
Loss of ECF H2O will lead to ________tonic ECF
hypertonic
120
True or false: Any change of H2O (that is not accompanied by a comparable change in solutes) will lead to a change in ECF osmolarity
True
121
How does the body regulate ECF osmolarity? (2 ways)
Vasopressin and fluid shifts
122
True or false: water input and output should be equal
True
123
What stimulates thirst and vasopressin?
Angiotensin II
124
What can suppress/stimulate vasopressin and thirst?
Left atrial volume receptors
125
Increased ECF osmolarity leads to increased thirst and increased vasopressin because of what receptors?
Hypothalamic osmoreceptors
126
Elevated renal capillary hydrostatic pressure increases _____ ion excretion
Na+
127
Sodium deprivation does not lead to _____ ion loss by the kidneys
K+
128
Diuretics promote ____ ion excretion by the kidney
Na+
129
What is regulated by the renin-angiotensin-aldosterone system and atrial natriuretic peptide?
Extracellular Na+
130
What ion balance is sensitive to blood chemistry, hormones, drugs and pathological conditions?
K+
131
Thiazide diuretics increase the reabsorption of what ion?
Ca+
132
True or false: Most of the Ca2+ filtered through the glomeruli is reabsorbed in the proximal convoluted tubule
True
133
High plasma ________ levels have a sedative effect and may cause cardiac arrest.
Mg2+
134
Control of Ca+ excretion occurs where? (2 places)
The loop of Henle and distal nephron
135
What is the major site for the reabsorption of filtered Mg2+? What does 25% of it?
Loop of Henle; PCT does 25%
136
Low plasma ______ ion concentration causes neuromuscular hyperirritability and cardiac arrhythmias
Mg2+
137
The PCT is the major site of reabsorption of what ions?
Ca2+ and phosphate
138
99% of ____ is in bones, and so is 80% of _______
Ca2+; phosphate
139
PTH inhibits the reabsorption of _______________ but stimulates the reabsorption of ___________________
phosphate; calcium
140
What in the urine is an important pH buffer?
Phosphate
141
Chronic renal disease often leads to an elevated plasma __________ and decreased plasma __________
phosphate; calcium
