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Physiology 3 > Physio test 2 > Flashcards

Physio test 2 Flashcards

1
Q

Urinary system in order of flow:

A

Kidney –> ureter –> bladder –> urethra

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2
Q

The renal system filters ____ and return most of the ____ and ____ to the bloodstream.

A

Blood, water, solutes

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3
Q

Kidney regulates blood ___ composition. What ions are they?

A

Electrolyte; Na, K, Ca, Cl, P

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4
Q

The kidney regulates blood ____ and _____. (in regards to water and electrolytes)

A

PH and osmolarity

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5
Q

The kidney regulates blood _____ level. Through what process?

A

Glucose, gluconeogenesis

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6
Q

How does kidney regulate blood volume?

A

By conserving or eliminating water (ADH involved)

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7
Q

How does kidney regulate blood pressure?

A

Secreting renin, adjusting renal resistance (aldosterone involved)

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8
Q

The kidney releases what two things that deal with endocrine function?

A

Erythropoietin (bone marrow) and calcitriol (PTH)

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9
Q

The kidney is responsible for excretion of BLANK. Including?

A

Waste & foreign substances (ammonia, urea, bilirubin, creatinine, uric acid, toxins, drugs)

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10
Q

Where is the kidney located?

A

Behind peritoneum on posterior abdominal wall on either side of vertebral column

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11
Q

What partially protects kidneys?

A

Lumbar vertebrae and rib cage

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12
Q

What kidney is slightly lower?

A

Right

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13
Q

What are the 4 parts of external anatomy of kidney?

A

Renal capsule, perirenal fat, renal fascia, hilum

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14
Q

What directly surrounds each kidney in external anatomy?

A

Renal capsule

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15
Q

What engulfs renal capsule and acts as a cushion?

A

Perirenal fat

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16
Q

What anchors kidneys to abdominal wall?

A

Renal fascia

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17
Q

What enters & exits the hilum?

A

Enter: renal a & n

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18
Q

The kidney is BLANK along with adrenal glands and ureters.

A

retroperitoneal

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19
Q

The right kidney lower is protected by?

A

11 & 12 rib

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20
Q

What is the dense, irregular connective tissue that holds kidney back to body wall?

A

Renal fascia

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21
Q

What helps protect the kidney from trauma?

A

adipose capsule / nephroptosis or perirenal fat

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22
Q

What is the transparent membrane that maintains organ shape?

A

Renal capsule

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23
Q

What composes the renal corpuscle?

A

Bowman’s capsule & glomerulus

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24
Q

What is Bowman’s capsule made of?

A

Parietal and visceral layer

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25
Q

What is the glomerulus?

A

Network of capillaries

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26
Q

What are the 2 arteriole of kidney?

A

Afferent (blood to glomerulus)

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27
Q

What are the tubules of the kidney?

A
  1. Proximal convoluted tubule
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28
Q

What are 4 main internal anatomy structures of kidney?

A

Renal corpuscle, arteriole, tubules, collecting ducts

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29
Q

What is the parenchyma of the kidney?

A

Functional part containing renal cortex and medulla

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30
Q

What is the superficial layer of internal kidney?

A

Renal cortex

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31
Q

What is the inner portion of internal kidney consisting of 8-18 cone-shaped renal pyramids separated by renal columns?

A

Renal medulla

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32
Q

What are 3 important structures of renal medulla?

A

Renal pyramids, renal columns, and renal papilla

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33
Q

What are renal pyramids separated by?

A

Renal columns

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34
Q

What points towards the center of kidney in internal anatomy?

A

renal papilla

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35
Q

Drainage system of internal anatomy of kidney fills what?

A

Renal sinus cavity

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36
Q

What fills renal sinus cavity?

A

Drainage system

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37
Q

The minor calyces of the renal sinus cavity collect urine from what?

A

Papillary ducts of papilla

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38
Q

Minor and major calyces empty into what?

A

Renal pelvis which empties into ureter

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39
Q

What converges to form renal pelvis?

A

Major calyces

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40
Q

What is the minor calyces in terms of extension?

A

Papillae extend

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41
Q

What is the functional unit of the kidney?

A

Nephron

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42
Q

What are two types of Nephrons?

A

Juxtamedullary & cortical

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43
Q

Papillary duct —> order

A

Minor calyx, major calyx, renal pelvis, ureter, bladder

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44
Q

Difference between hilum and sinus?

A

Hilum is where the structures enter & exit; sinus is the space they travel (more proximal) a hollow space

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45
Q

How much of resting cardiac output does renal arteries receive?

A

25%

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46
Q

What are 2 different capillary beds of kidney?

A

Glomerular and peritubular

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47
Q

What happens at glomerular capillaries?

A

Filtration of blood

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48
Q

What is purpose of peritubular capillaries?

A

Carry away reabsorbed substances from filtrate

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49
Q

When Glomerular capillaries vaso-constrict and vaso-dilate the A&E arteriole what occurs?

A

Large changes in renal filtration

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50
Q

What do vasa recta supply?

A

Nutrients to medulla without disrupting osmolarity

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51
Q

How does kidney vasoconstrict vessels?

A

Sympathetic vasomotor nerves that regulate blood flow and renal resistance by altering arteriole

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52
Q

How does kidney vasodilation vessels?

A

Local factors (prostaglandins)

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53
Q

The kidney has a lower/greater difference between renal arterial and venous pO₂ when compared to other organs. Why?

A

Lower; great perfusion and low tissue mass

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54
Q

What organ has the lowest arterial/venous pO₂ difference?

A

Kidneys

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55
Q

Order of blood flow into kidney

A

Renal artery

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56
Q

Order of blood flow away from the nephron

A

Peritubular capillaries and/or vasa recta

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57
Q

glomerular capillaries are formed between what?

A

Afferent and efferent arteriole

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58
Q

Efferent arteriole gives rise to?

A

Peritubular capillaries & vasa recta

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59
Q

Where does secretion and reabsorption occur in regards to blood vessels?

A

Peritubular capillaries and vasa recta

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60
Q

A nephron is composed of?

A

Renal corpuscle and tubule

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61
Q

What is site of plasma filtration?

A

Renal corpuscle

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62
Q

What is capillaries where filtration occurs?

A

Glomerulus

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63
Q

What is double-walled epithelial cup that collects filtrate?

A

Glomerular (Bowman’s) capsule

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64
Q

What drains urine to renal pelvis & ureter?

A

Collecting ducts and papillary ducts

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65
Q

What types of nephrons are mostly renal cortex?

A

Cortical

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66
Q

What nephron has short loop of Henle that is mostly in cortex & dip only into outer portion of renal medulla?

A

Cortical

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67
Q

What nephron has loop of Henle that receives blood supply from peritubular capillaries only?

A

Cortical

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68
Q

What nephron lies deep in cortex and close to medulla?

A

Juxtamedullary

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69
Q

What nephron has long loop of Henle?

A

Juxtamedullary

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70
Q

Unlike cortical nephrons, the ascending limb of loop of Henle of Juxtamedullary nephrons has what quality structurally?

A

thin and thick portion

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71
Q

Juxtamedullary nephrons receive blood supply from where?

A

Peritubular capillaries and vasa recta

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72
Q

Thick ascending limb

A

Cortical and juxtamedullary (portion of it)

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73
Q

Thin ascending limb

A

Juxtamedullary (portion of it, also has thick)

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74
Q

Thin descending limb

A

Both

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75
Q

The flow of fluid through cortical nephron:

A 
Bowman's capsule
PCT
Descending limb
Ascending limb
DCT
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76
Q

Are cortical nephrons or juxtamedullary more abundant?

A

Cortical 80-85%

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77
Q

Renal corpuscles of cortical nephron are in outer/inner cortex.

A

Outer

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78
Q

Loops of Henle of cortical nephron lie mainly where?

A

Cortex

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79
Q

Flow of fluid through juxtamedullary nephron

A 
Bowman's capsule, 
PCT, 
Descending limb, 
thin ascending limb
thick ascending limb
DCT
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80
Q

Renal corpuscles of juxtamedullary nephron lie close to blank.

A

Medulla

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81
Q

Long loops of Henle of juxtamedullary nephrons extend into deepest medulla enabling what?

A

excretion of dilute or concentrated urine

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82
Q

What histologically forms walls of entire tubes of nephron / collecting duct?

A

Single layer of epithelium

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83
Q

Histology of PCT

A

simple cuboidal with brush border microvilli that increase surface area

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84
Q

What is lined with simple squamous epithelium? (2)

A

descending limb of loop of Henle & thin portion of ascending limb

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85
Q

What is ascending limb of loop of henle made of histologically?

A

Simple cuboidal to low columnar

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86
Q

The ascending limb of loop of Henle forms BLANK where it makes contact with afferent arteriole.

A

Juxtaglomerular apparatus

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87
Q

What is special cells of ascending limb?

A

macula densa

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88
Q

What forms juxtaglomerular apparatus?

A

Macula densa with modified smooth muscle cells (juxtaglomerular cells) in afferent arteriole

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89
Q

What structure(s) plays a role in controlling renal BP?

A

juxtaglomerular apparatus

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90
Q

What histologically lines distal convoluted and collecting ducts?

A

simple cuboidal made of principal and intercalated cells

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91
Q

What is composed of simple cuboidal with principal/intercalated cells?

A

Distal convoluted and collecting ducts

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92
Q

What have receptors for ADH & aldosterone?

A

Principal cells (simple cuboidal) of distal convoluted & collecting ducts

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93
Q

What have microvilli to control blood pH?

A

Intercalated cells in simple cuboidal epithelium of distal convoluted & collecting ducts

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94
Q

Is the visceral or parietal layer more external in Bowman’s capsule?

A

Parietal

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95
Q

What covers capillaries to form visceral layer of Bowman’s capsule?

A

podocytes

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96
Q

What type of cells histologically form parietal layer of Bowman’s capsule?

A

Simple squamous

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97
Q

Glomerular capillaries arise from afferent arteriole and BLANK before emptying into efferent arteriole.

A

Form a ball

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98
Q

What is the structure where afferent arteriole makes contact with ascending limb of loop of Henle?

A

Juxtaglomerular apparatus

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99
Q

What cells is the thickened part of ascending limb composed of?

A

macula densa

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100
Q

What are modified muscle cells in arteriole that secrete renin?

A

Juxtaglomerular cells

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101
Q

What is another name for inner layer of Bowman’s capsule and what is it composed of?

A

Luminal, podocytes

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102
Q

What extend pedicles (foot processes) that branch extensively leaving small filtration pores? What are the small filtration pores called?

A

Podocytes, slit pores

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103
Q

Where do podocytes promote filtration?

A

A very thin slit membrane extends from one podocytes to another forming a barrier where filtration occurs

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104
Q

The filtration barrier separating blood from space in Bowman’s capsule consists of what 3 things?

A
  1. fenestrated endothelium
  2. basal lamina
  3. slit membranes (cover filtration slits)
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105
Q

3 types of capillaries?

A

Continuous, fenestrated, sinusoids

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106
Q

What type of capillary has few intercellular clefts between neighboring cells?

A

Continuous

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107
Q

Where are continuous capillaries found?

A

Skeletal & smooth, connective tissue and lungs

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108
Q

What capillary has many pores between endothelial cells?

A

Fenestrated

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109
Q

What structures have fenestrated capillaries?

A

Kidneys, small intestine, choroid plexuses, ciliary process, endocrine glands

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110
Q

What capillaries have very large fenestrations and an incomplete basement membrane?

A

Sinusoid

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111
Q

Where are sinusoid capillaries found?

A

Liver, bone marrow, spleen, anterior pituitary, parathyroid gland

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112
Q

How do nephrons change with age?

A

same, increase size of kidney increase individual nephron size

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113
Q

Are nephrons replaceable?

A

No

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114
Q

When is dysfunction evident with nephrons?

A

When it declines more than 25%

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115
Q

Removal of one kidney causes enlargement of the remaining until it can filter BLANK of normal rate of 2 kidneys.

A

At 80%

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116
Q

What are tubes which urine flows from kidneys to bladder?

A

Ureter

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117
Q

What stores urine?

A

Urinary bladder

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118
Q

What transports urine from bladder to outside of body?

A

Urethra

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119
Q

The urethra consists of what two sphincters?

A

Internal and external

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120
Q

Ureters are retroperitoneal. (True/false).

A

TRUE

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121
Q

Ureters have flow of urine due to what 2 things?

A
  1. Perstaltic contractions

2. gravity/hydrostatic pressure

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122
Q

What prevents backflow of urine from bladder into ureters - bladder wall compresses opening as it expands during filling?

A

Physiological valve of ureter

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123
Q

3 layers of ureter are

A

Mucosa, muscularis, adventitia

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124
Q

The mucosa of ureter and bladder is composed of what histologically?

A

transitional epithelium and underlying lamina propria

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125
Q

What layer of ureter has collagen, elastic fibers and lymphatic tissue?

A

Mucosa

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126
Q

Why is mucosa of ureter and bladder elastic?

A

Ureters must inflate & deflate

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127
Q

Why is mucosa of ureter and bladder full of mucus?

A

Prevents cells from being contacted by urine

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128
Q

What is mucus secreted by in ureter?

A

Goblet cells

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129
Q

How are the 2 muscularis layers of ureter orientated?

A

inner longitudinal

outer circular

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130
Q

The muscularis of ureter is composed of inner longitudinal and outer circular smooth muscle layer. How does this compare to the GI?

A

Opposite

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131
Q

Distal 1/3 of muscularis of ureter has additional what?

A

Longitudinal layer = inner longitudinal + middle circular + outer longitudinal

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132
Q

What motion of muscularis layer of ureter contributes to urine flow?

A

peristalsis

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133
Q

What is the adventitia layer responsible for in ureter?

A

Anchors urethra in place

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134
Q

What does adventitia consists of?

A

Loose connective tissue that contains lymphatic and blood vessel to supply ureter

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135
Q

Urinary bladder has what 2 anatomical features?

A

rugae & trigone

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136
Q

Rugae is responsible for?

A

Increasing surface area

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137
Q

Is the trigone a muscle?

A

NO

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138
Q

The trigone of the bladder is the smooth flat area bordered by 2 BLANK openings and one BLANK opening.

A

Ureteral, urethral

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139
Q

What are 3 layers of urinary bladder?

A

Mucosa, muscularis, and adventitia

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140
Q

The muscularis part of urinary bladder is known as?

A

detrusor muscle

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141
Q

How many layers of smooth muscle is muscularis portion of urinary bladder?

A

3 (inner longitudinal, middle circular, outer longitudinal)

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142
Q

What fibers form internal urethral sphincter?

A

Circular smooth muscle

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143
Q

What fibers form external urethral sphincter?

A

Circular skeletal muscle

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144
Q

What is layer of loose connective tissue that anchors urinary bladder in place?

A

Adventitia

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145
Q

The superior surface of adventitia has what?

A

A serosal layer (visceral peritoneum)

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146
Q

What is the hydrostatic pressure that forces urine through nephron?

A

Urine flow

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147
Q

What moves urine through ureters?

A

Peristalsis

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148
Q

What is the name for the reflex that occurs when there is a stretch of the urinary bladder causing the bladder to contract and inhibiting urinary sphincters?

A

Micturition reflex

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149
Q

What stimulates or inhibits micturition reflex?

A

Higher brain center

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150
Q

Micturition AKA

A

Urination (voiding)

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151
Q

When volume exceeds 200-400 mL the micturition reflex signals what?

A

Sacral spinal cord (micturition center, S2/3) and brain

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152
Q

The parasympathetic fibers dealing with micturition reflex cause BLANK to contract and BLANK to relax.

A

Detrusor, internal sphincter

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153
Q

The micturition reflex inhibits somatic motor neurons innervating what?

A

Skeletal muscles in external sphincter

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154
Q

Filling the bladder causes a sensation of fullness that initiates what?

A

Desire to urinate before reflex actually occurs

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155
Q

Why don’t you just pee when you bladder is full?

A

Conscious control of external sphincter; cerebral cortex can initiate micturition or delay its occurrence for a limited period of time

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156
Q

During BLANK of bladder, sympathetic control predominates, causing relaxation of detrusor muscle and contraction of internal sphincter.

A

Filling

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157
Q

During blank, parasympathetic control predominates, causing contraction of the detrusor muscle and relaxation of the internal sphincter.

A

Micturition

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158
Q

What type of receptor is in internal sphincter?

A

Alpha 1 adrenoreceptor

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159
Q

What type of receptor is in detrusor muscle?

A

Beta 2 adrenoreceptor

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160
Q

Histology of female urethra:

A

transitional changing to nonkeratinized stratified

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161
Q

Histology of male urethra:

A

• prostatic urethra, membranous urethra & spongy urethra (3 regions)

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162
Q

Male urethra passes through which 3 regions?

A

Prostate, UG diaphragm & penis

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163
Q

What is lack of voluntary control over micturition that is normal in 2/3 year old because sphincter muscle neurons are not developed?

A

Urinary incontinence

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164
Q

What is caused by increases in abdominal pressure that result in leaking of urine from bladder?

A

Stress incontinence in adults

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165
Q

Stress incontinence in adults can be because?

A

Injury to nerves, loss of bladder flexibility or damage to sphincter

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166
Q

Smokers have 2x the risk of developing?

A

Incontinence.

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167
Q

What binds excess H+?

A

Body buffers

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168
Q

What transports wastes?

A

Blood

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169
Q

What is site of metabolic recycling?

A

Liver

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170
Q

What is responsible for conversion of AA to glucose, glucose into FA or toxic into less toxic substances?

A

Liver

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171
Q

What excretes CO₂ and liberate heat?

A

Lung

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172
Q

What eliminates heat, water, salt & urea?

A

Sweat glands

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173
Q

What eliminates solid wastes, CO₂, water and salts?

A

GI tract

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174
Q

What decreases as you age with the kidneys?

A
  1. # functional nephrons
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175
Q

Kidneys decrease blood and filtration rate by how much with age?

A

50% functional change

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176
Q

Cancer of prostate is common in?

A

Elderly men

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177
Q

Renal calculi, UTI, glomerular disease, renal failure, and polycystic kidney disease are diseases of?

A

Urinary system

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178
Q

What 3 processes do nephrons and collecting ducts perform?

A

Glomerular filtration, tubular reabsorption, and tubular secretion

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179
Q

What is the bulk movement of fluid in nephron?

A

Glomerular filtration

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180
Q

In glomerular filtration a portion of the blood plasma is filtered into the kidney; what wastes are poorly reabsorbed?

A

Urea, creatinine, uric Acid & urates (clearing in filtrate important)

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181
Q

What process done by nephrons and collecting ducts is quantitatively more important?

A

Tubular reabsorption

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182
Q

What is reabsorbed by nephrons and collecting ducts?

A

Water & useful substance (electrolytes) into blood

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183
Q

What is usually lowest rate relative to other processes in the nephrons and collecting ducts?

A

Tubular secretion

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184
Q

What process is important in K+ and H+ excretion when wastes are removed from blood and go into urine?

A

Tubular secretion

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185
Q

Urine excretion (rate of excretion of any substance) =

A

Filtration rate - reabsorption rate + secretion rate

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186
Q

What force produces glomerular filtrate?

A

Blood pressure

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187
Q

What is the filtration fraction of plasma?

A

20%

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188
Q

How many gallons are filtrate a day?

A

48

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189
Q

How much filtrate is reabsorbed a day?

A

Tremendous amount to PCT leaving 1-2 qt urine

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190
Q

What 2 ways are filtering capacity enhanced?

A
  1. Thinness of membrane & large surface area of glom capillaries
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191
Q

What are three layers of filtration membrane?

A
  1. Endothelial fenestration of glomerulus
  2. Basal lamina of glomerulus ,
  3. Slit membrane between pedicels,
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192
Q

What prevents filtration of blood cells but allows all components of blood plasma to pass through?

A

Endothelial fenestration of glomerulus

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193
Q

What stops all cells and platelets?

A

Endothelial fenestration of glomerulus

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194
Q

What prevents filtration of large plasma proteins?

A

Basal lamina of glomerulus

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195
Q

What prevents filtration of medium-sized proteins not peptides?

A

Slit membrane between pedicels

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196
Q

What 3 things is glomerular filterability dependent on?

A

Size, shape, electrical charge

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197
Q

How does size effect filterability?

A

Filterability of solutes is inversely related to size*; larger less likely to get filtered

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198
Q

What are examples of freely filterable object?

A

Water, sodium, glucose, inulin (1.0), amino acids, all electrolytes

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199
Q

What has a harder time getting filtered?

A

Myoglobin & albumin (large proteins)

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200
Q

Are positive or negative charged molecules filtered easier?

A

Positive, because endothelial membrane / glomerular capillaries has negative charge (repel)

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201
Q

What are polysaccharides that can be manufactured as neutral molecules or with negative/positive charges & varying molecular wights?

A

Dextran

202
Q

Will a small sized negative charge molecule pass through membrane before large neutral or large + charged?

A

Yes

203
Q

What is the amount of filtrate formed in all renal corpuscles of both kidneys per minute?

A

Glomerular filtration rate (GFR)

204
Q

The average adult male rate for GFR is?

A

125 ml/min

205
Q

What requires that GFR is constant?

A

Homeostasis

206
Q

What happens if GFR is too high?

A

useful substances are lost due to speed of fluid passage through nephron

207
Q

What happens if GFR is too low?

A

sufficient waste products may not be removed from body

208
Q

Changes in net filtration pressure affect?

A

GFR

209
Q

When does filtration stop with GBHP?

A

If it drops to 45 mm Hg

210
Q

When does GFR function normally with mean arterial pressures?

A

80-180 GBHP

211
Q

GFR =

A

Kf * NFP

212
Q

Kf is?

A

Capillary filtration coefficient (permeability) a constant

213
Q

The Kf of the glomerulus is the BLANK of any capillary bed.

A

Highest

214
Q

What is NFP?

A

Net filtration pressure; sum of hydrostatic and colloid osmotic pressures

215
Q

There are 2 BLANK hydrostatic and 2 BLANK colloidal osmotic pressures.

A

Opposing

216
Q

What of the four forces of NFP promote filtration?

A

Glomerular (capillary) hydrostatic pressure and capsular colloidal osmotic pressure

217
Q

What of the four forces of NFP oppose filtration?

A

Capsular (Bowman’s) hydrostatic pressure & blood capillary colloidal osmotic pressure (BCOP)

218
Q

NFP =

A

Glom/cap HP + Cap/col OP - (Cap/Bow HP + BCOP)

219
Q

What pressure is so low under normal conditions that it is often taken as zero?

A

Capsular colloidal osmotic pressure

220
Q

Kf * (filt’n forces - reabs’n forces) =

A

GFR

221
Q

Assuming that bowman colloid osmotic pressure is zero what is the equation for GFR?

A

GFR = Kf * (cap hydr - bowman hydr - cap colloid)

222
Q

What is the total pressure that promotes filtration?

A

NFP

223
Q

What does capillary filtration coefficient do to GFP?

A

Increases it (Kf)

224
Q

Under normal conditions what does not change and thus is not used for regulation of GFR?

A

Kf

225
Q

What is reduced in some diseases including chronic HTN, DM that increases thickness of basement membrane?

A

Kf which would decrease GFR

226
Q

What does Bowman’s capsule hydrostatic pressure do to GFR? Example?

A

Increase pressure, decrease GFR; obstruction of urinary tract (kidney stones)

227
Q

What does glomerular capillary colloid osmotic pressure do to GFR? Example?

A

Increase in GCCOP decreases GFR, dehydration

228
Q

What does glomerular capillary hydrostatic pressure do to GFR? Example?

A

Increase GCHP increases GFR, systemic hypertension

229
Q

Blood osmolarity AKA?

A

BCOP

230
Q

Glomerular hydrostatic pressure AKA?

A

BHP (blood hydrostatic pressure)

231
Q

Capillary hydrostatic pressure AKA?

A

BHP

232
Q

Blood pressure AKA?

A

BHP

233
Q

Filtrate osmotic pressure AKA?

A

COP

234
Q

What 3 things determine glomerular hydrostatic pressure?

A

Arterial pressure, afferent arteriolar resistance, and efferent arteriolar resistance

235
Q

What does arterial pressure do to glomerular hydrostatic pressure (BHP)?

A

Increase in AP increases HP; blood pressure is maintained within limits

236
Q

What does afferent arteriolar resistance do to glomerular hydrostatic pressure (BHP)?

A

Reduces hydrostatic pressure

237
Q

What does efferent arteriolar resistance do to glomerular hydrostatic pressure?

A

Increases hydrostatic pressure

238
Q

What is the estimate for NFP for a healthy human?

A

10 mm Hg

239
Q

What does hypotension do to NFP?

A

Decrease

240
Q

What does hypertension do to NFP?

A

Increase

241
Q

What does liver failure do to NFP?

A

Increase, weaker BCOP

242
Q

What does breast cancer do to NFP?

A

Breast cancer spreads to lymphnodes and cannot drain excess fluid away, promoting reabsorption back into capillary

243
Q

What does proteinuria do to NFP?

A

Increase, decrease BCOP

244
Q

What do disorders that lead to overproduction of plasma proteins do to reabsorption?

A

Increase

245
Q

What happens to reabsorption with salty potato chips?

A

Gut into blood; increase blood osmolarity, BCOP increases promoting resorption

246
Q

When you promote water resorption back into capillaries what happens to pressure within the blood?

A

Increases so eating salty food increases blood pressure

247
Q

What happens if glomerular capillaires don’t have interstitium so they filter into bowman’s capsule?

A

All forces are same, but terminology changes so we have capsular fluid

248
Q

What do large proteins / salty food do to NFP?

A

Change BCOP, increase resorption, filtration decrease

249
Q

What will kidney stone do?

A

Drain away filtrate, decrease filtration because increase capsular hydrostatic pressure

250
Q

What does vasoconstriction of afferent arteriole do to filtration?

A

Decrease (blood flow decreases when you pinch hose

251
Q

What happens to renal blood flow if you vasoconstrict efferent arteriole?

A

Decrease

252
Q

What happens to filtration if you vasoconstrict efferent arteriole?

A

Blood will back up, pressure increases, increase GFR

253
Q

If you increase resistance on efferent or afferent arteriole, what happens to renal blood flow?

A

Steadily decreases for both

254
Q

RBF =

A

(Pressure of renal artery - pressure of renal vein) / renal vascular resistance

255
Q

The total renal resistance is due mostly to resistance in what?

A
  1. Interlobular artery
    2 afferent arterioles
    3 efferent arterioles
256
Q

What are all 3 resistances of renal system controlled by?

A

sympatheic nervous system, hormonal control & various renal mechanisms

257
Q

Q =

A

ΔP/R (Starling’s Law comparing to RBF)

258
Q

What is the fraction of blood plasma that is filtered by glomerular capillaries?

A

filtration fraction

259
Q

What is filtration fraction =?

A

GFR/renal plasma flow

260
Q

Filtration fraction can be increased by what 2 things?

A
  1. Increasing GFR

2. decreasing renal blood flow

261
Q

Under normal conditions, BLANK% of blood plasma is filtered with easy passing through glomerular capillaries.

A

About 20%

262
Q

How are filtration fraction and blood colloid pressure related?

A

Direct, increase causes increase

263
Q

Loss of plasma proteins in urine (leaky Bowman’s capillaries) causes tissue edema. How? Other causes of Edema?

A

Lose proteins, decrease BCOP; now in regular capillary; low BCOP losing proteins in urine promoting filtration; fluid accumulating to interstitium - edema (proteins help to hold salt and water inside the blood vessels so fluid does not leak out into the tissues)

264
Q

Control of glomerular filtration and renal blood flow by what 3 things?

A

Autoregulation, neuronal, hormonal

265
Q

What mechanisms maintain a constant GFR despite changes in arterial BP?

A

myogenic mechanism and tubuloglomerular feedback

266
Q

What does myogenic mechanism detect in renal autoregulation of GFR?

A

changes in arterial pressures

267
Q

What does tubuloglomerular feedback detect in renal autoregulation of GFR?

A

changes in [NaCl] in tubular fluid

268
Q

In myogenic mechanism if you have an increase in systemic BP, it will BLANK the afferent arteriole; what then happens?

A

Stretch, smooth muscle contraction reduces diameter of arteriole returning GFR to previous level IN SECONDS

269
Q

In tubuloglomerular feedback an elevated systemic BP does what to GFR effecting what?

A

Raises GFR so fluid flows too rapidly through renal tube & Na/Cl are not reabsorbed

270
Q

What detects difference / increase in NaCl in tubuloglomerular feedback? What does it do in turn?

A

macula densa, inhibits release of NO

271
Q

What is vasodilator from juxtaglomerular apparatus?

A

NO

272
Q

Afferent arterioles constrict doing what to GFR?

A

Reduce GFR

273
Q

What can you not autoregulate?

A

urine flow during changes in renal arterial pressure

274
Q

What two things do you have autoregulation of during changes in renal arterial pressure?

A

RBF and GFR

275
Q

You (do/do not) regulate amount of urine produced.

A

Do not.

276
Q

What provides negative feedback regulation of GFR?

A

Macula densa cells of juxtaglomerular apparatus

277
Q

What does drop in renal blood pressure do to GFR?

A

Decrease it

278
Q

How do you maintain GFR during decreased renal arterial pressure?

A

Autoregulation via macula densa feedback mechanism for BHP and GFR

279
Q

A decrease in macula densa does what to renin?

A

Increase renin, increase angiotensin II, increase efferent arteriolar resistance to decrease BHP

280
Q

Blood vessels of kidney are supplied by the BLANK fibers that cause vasoconstriction of afferent arterioles.

A

sympathetic

281
Q

At rest, WHAT is maximally dilated? Why?

A

Renal BV, sympathetic activity is minimal

282
Q

At rest, renal autoregulation BLANK.

A

Prevails

283
Q

With moderate sympathetic stimulation, what happens to efferent/afferent arterioles? What happens to GFR?

A

They constrict equally; decreasing GFR only slightly

284
Q

With extreme sympathetic stimulation, what happens to arterioles? GFR?

A

Vasoconstriction of afferent arterioles reduces GFR

285
Q

During extreme sympathetic innervation what happens to urine output and blood flow to other tissues?

A

Lower urine output, and permits blood flow to other tissues

286
Q

What are examples of extreme sympathetic stimulation?

A

Exercises / hemorrhage

287
Q

What is the paradoxical feud with extreme sympathetics?

A

Parasympathetic responds to severe sympathetics and you pee your pants - subject has no control of stress NOT NORMAL

288
Q

What does ANP do to GFR?

A

Increases

289
Q

The stretching of atria causes BV to do what? Causing?

A

Increase causing hormonal release (ANP decreases BP)

290
Q

What does ANP decreasing BP do in turn?

A

relaxes glomerular mesangial cells increasing capillary surface area —> increase GFR

291
Q

What does Angiotensin II do to GFR?

A

Reduces GFR

292
Q

Renin release is stimulated by?

A

Decrease blood pressure

293
Q

Angiotensin II is a potent vasodilator/constrictor?

A

Vasoconstrictor

294
Q

Angiotensin being a potent vasoconstrictor does what to arterioles?

A

Constricts both A & E, reducing GFR somewhat

295
Q

What is renin release stimulated by? What does it do to GFR?

A

Decrease BP, decrease GFR

296
Q

Endothelin is powerful what? Doing what to GFR?

A

Vasoconstrictor, decreasing

297
Q

E/NE cause what to happen to GFR?

A

Decrease

298
Q

What does NO do to renal vascular resistance? GFR?

A

Decrease, so increases GFR

299
Q

Prostaglandins (PGE₂ and PGI₂) and bradykinins do what to GFR?

A

Increase (control smooth muscle)

300
Q

What does ANP/ANH do to GFR?

A

Increase

301
Q

Pathological cause for decrease Kf, decrease GFR?

A

Renal disease, DM, HTN

302
Q

Increase PB (capsular hydrostatic pressure), decrease GFR, what pathological causes?

A

Kidney stones

303
Q

Decrease arterial BP, decrease BHP (PG) causes?

A

Decrease arterial pressure only small effect due to autoregulation

304
Q

Decrease efferent arteriolar resistance, causing decrease BHP cause what pathophysiologic conditions?

A

Decrease angiotensin II, ACE Inhibitors (block formation)

305
Q

Increase afferent arteriole pressure causing decrease BHP does what to sympathetics?

A

Increase sympathetic activity, vasoconstrictor hormones (NE/Endothelin)

306
Q

Regulating GFR always does what to GFR? Except what?

A

Decreases, ANP (hormone regulation example), NO, prostaglandins

307
Q

What are the 3 ‘movements’ in formation of urine:

A
  1. Glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
308
Q

What types of transport are associated with reabsorption?

A

Passive, active, and cotransport

309
Q

What moves Na+ across nephron wall?

A

Active transport

310
Q

Other ions and molecules are moved across nephron wall by?

A

Contransport

311
Q

What type of transport moves water, urea, lipid-soluble, nonpolar compounds?

A

Passive transport

312
Q

Normal GFR is so high that volume of filtrate in capsular space in 30 min is (greater/less) than the total plasma volume.

A

Greater

313
Q

Nephron must reabsorb what % of filtrate.

A

99

314
Q

What does most of the work of tubular resorption and secretion with rest of nephron doing just fine-tuning?

A

PCT with microvilli

315
Q

When PCT does work with microvilli during reabsorption how are solutes reabsorbed? How does water follow? What happens to small proteins?

A

Active/passive processes

316
Q

Important function of nephron is tubular BLANK.

A

Secretion

317
Q

Tubular secretion helps control blood pH because BLANK.

A

secretion of H+.

318
Q

Tubular secretion helps BLANK certain substances. What are they?

A

Eliminate; NH4+, creatinine, K+

319
Q

What substance is 100% excreted?

A

Creatinine

320
Q

How much water is reabsorbed a day? Excreted?

A

178-9 liters, 1-2 liters

321
Q

What are two reabsorption routes?

A

Paracellular and transcellular

322
Q

What is paracellular reabsorption?

A

50% reabsorbed material moves between cells by diffusion in some parts of the tubule

323
Q

What is transcellular reabsorption?

A

Material moves through both the apical and basal membranes of the tubule cell by active transport.

324
Q

What two membranes of tubule cells have different types of transport proteins?

A

Apical and basolateral

325
Q

Na+/K+ ATPase pumps sodium from tubule cell cytosol through what membrane?

A

Basolateral only

326
Q

Water is only reabsorbed by?

A

osmosis

327
Q

What occurs when water is told to follow the solutes being reabsorbed?

A

Obligatory water reabsorption

328
Q

What type of water reabsorption occurs under the control of ADH?

A

Facultative

329
Q

Where does obligatory water reabsorption occur?

A

PCT & loop of Henle (descending limb)

330
Q

Where does facultative water resorption occur?

A

Collecting duct

331
Q

What Na transporters are present in proximal PCT? Specifically what side of membranes?

A

Basolateral:

332
Q

Cotransport refers to?

A

Secondary active transport

333
Q

The Na/K ATPase pump is considered what type of transport?

A

Primary active transport

334
Q

What help reabsorb materials from tubular filtrate in 1st half of PCT?

A

Na+ symporters

335
Q

Na+ is moved in PCT by what two systems?

A

Cotransport and Primary Active Transport

336
Q

What is COMPLETELY REABSORBED IN 1st half of PCT?

A

Nutrients (glucose, aa, lactate, citrate, phosphate, water-soluble vitamins)

337
Q

What does the Na/K pump do to intracellular sodium levels in first part of PCT?

A

Keeps it low

338
Q

What is glucosuria? Specifically what structure is impacted in apical membrane?

A

Renal symporters cannot reabsorb glucose fast enough if blood glucose level is above 200 mg/ml (some glucose remains in urine)

339
Q

Common cause of glucosuria

A

DM bc insulin activity deficient & blood sugar too high

340
Q

What is the rare genetic disorder that causes glucosuria do?

A

Produces defect in symporter reducing its effectiveness

341
Q

What does glucosuria do to filtration and reabsorption?

A

Increase GFR, Increase Blood Circulating Volume, Decrease Reabsorption

342
Q

What transport are nutrients reabsorbed apical vs basolateral side of PCT?

A

Apical: cotransport

343
Q

What side of the membrane does Na/K pump take place on for proximal PCT? What type of transport?

A

Basolateral - primary active transport

344
Q

Na+ antiporters reabsorb BLANK and secrete BLANK in proximal PCT.

A

Na+, H+

345
Q

PCT cells produce BLANK and release BLANK into peritubular capillaries.

A

H+, bicarbonate (important buffer system)

346
Q

What stimulates the Na+/H+ pump resulting in HCO3- reabsorption?

A

Angiotensin II

347
Q

For every H+ secreted into tubular fluid, one BLANK eventually returns to the blood. This is process of?

A

Bicarbonate; reabsorption of filtered bicarbonate

348
Q

What is the cause of passive reabsorption of other solutes in 2nd half of PCT?

A

Electrochemical gradients from symporters/antiporters

349
Q

What passively diffuses into peritubular capillaries in 2nd half of PCT?

A

Cl, K, Ca, Mg

350
Q

The 2nd half of PCT promotes what process? Due to what?

A

Osmosis, Aquaporin-1 channels

351
Q

The late proximal tubule is quite different from early tubule because no Glu, AA, Bicarbonate…. However what is still high? What does this cause?

A

Cl-, NaCl

352
Q

What is poisonous waste product of protein deamination in liver that is converted to urea?

A

Ammonia (NH3)

353
Q

Both ammonia and urea are __________.

A

Filtered

354
Q

Urea is BLANK out of PCT and into peritubular capillaries.

A

reabsorbed

355
Q

Ammonia is BLANK into PCT.

A

Secreted

356
Q

PCT cells BLANK in a process that generates both NH3 and new HCO3-.

A

deaminate glutamine

357
Q

What is the hallmark of PCT?

A

isosmotic reabsorption

358
Q

How does osmolarity change as you move along PCT?

A

It doesn’t, stays the same.

359
Q

What drives the reabsorption of isosmotic fluid?

A

high oncotic (colloid/protein) osmotic pressure

360
Q

What is the water channels allowing easy water reabsorption?

A

Aquaporin-1

361
Q

Tubular fluid leaving the PCT has similar BLANK, but different blank.

A

Osmolarity to plasma, composition

362
Q

BLANK1 of tubular fluid in loop of Henle is quite different from plasma. Since many nutrients were reabsorbed as well, BLANK2 of tubular fluid is BLANK3.

A

Composition, osmolarity, close to that of plasma

363
Q

what sets the stage for independent regulation of both volume and osmolarity of body fluid?

A

Having consistent osmolarity throughout PCT

364
Q

Thin descending limb of Henle are permeable to?

A

Small solutes and water (Na, Cl, Urea)

365
Q

The thin descending, NOT THICK ascending, is permeable to?

A

Water

366
Q

Is a water soluble or lipid soluble molecule have a higher diffusion rate?

A

Lipid soluble

367
Q

Permeability and movement of solutes (in/out) in the thin limbs are BLANK processes, as opposed to the PCT.

A

Passive

368
Q

Thick ascending limb has what transport?

A

Na+/K+/2Cl- symporter

369
Q

What does the Na+/K+/2Cl- symporter do in thick ascending limb?

A

Reabsorb these ions (25% Na+ reabsorbed here)

370
Q

What leaks back into tubular fluid leaving interstitial fluid and blood with negative charge dealing with thick ascending limb? What channel?

A

K+, K+ channels

371
Q

What passively move to vasa recta in thick ascending limb?

A

Cations

372
Q

Reabsorption of what continues in the early DCT? What travel?

A

Na+/Cl- through Na/Cl symporters

373
Q

What is the major site where PTH stimulates resorption of Ca2+?

A

DCT

374
Q

Where is water not reabsorbed? Why?

A

DCT & thick ascending loop of Henle, they aren’t permeable to water

375
Q

In the early distal tubule how are Na & Cl reabsorbed on basolateral side?

A

Na pumped out by Na/K ATPase & Cl diffuses into interstitial fluid via chloride channels

376
Q

What is reabsorbed and secreted in the distal portions of DCT and cortical collecting tubules?

A

NaCl reabsorption and K+ secretion

377
Q

How does Na enter and exit the cell in NaCl reabsorption in distal DCT?

A
  1. Na enter cell through special channels
378
Q

What competes with aldosterone for binding sites in the cell? What does this cause and where does it occur in?

A

Aldosterone antagonists; inhibits the effect of aldosterone to stimulate sodium reabsorption and potassium secretion in distal DCT

379
Q

What do Na channel blockers do? In what part of tubule?

A

Directly inhibit entry of sodium into sodium channels; distal portions of DCT

380
Q

By the end of the DCT, BLANK% of solutes and water have been reabsorbed and returned to the bloodstream.

A

95

381
Q

What cells in the collecting duct make the final adjustments?

A

principal and intercalated cells

382
Q

What do principal cells do in collecting duct?

A

reabsorb Na & secrete K

383
Q

What do intercalated cells do in collecting duct?

A

reabsorb K+ & bicarbonate & secrete H+

384
Q

How does Na+ enter principal cells?

A

Leakage channels

385
Q

Na+ pumps in principal cells keep concentration of Na in cytosol of cell (low/high).

A

Low

386
Q

Principal cells secrete variable amounts of BLANK, to adjust for BLANK.

A

K+, dietary changes in K+ intake

387
Q

What goes down concentration gradient due to Na/K pump in principal cells?

A

secreted K+

388
Q

What is aldosterone’s role with principal cells?

A

Increases Na+ (and water resorption) & K+ secretion by stimulating synthesis of new pumps/channels

389
Q

What can intercalated cells secrete against a concentration gradient so urine can be 1000x more acidic than blood (3 pH units)?

A

H+ using H+ATPases

390
Q

What move bicarbonate ions into blood with intercalated cells?

A

Cl-/HCO3- antiporters

391
Q

What is urine buffered by in intercalated cells? What do they then combine with?

A

Phosphate and ammonia, both which combine irreversibly with H+ & are excreted

392
Q

Collecting duct

A

65, 15, 10-15, 5-10 w/ ADH

393
Q

Dilute/concentrated urine has not had enough water removed, although sufficient ions have been reabsorbed.

A

Dilute.

394
Q

What is secreted by posterior pituitary and increases water permeability in distal tubules and collecting ducts?

A

ADH

395
Q

What is produced in adrenal cortex and affects Na/Cl transport in nephron and collecting ducts?

A

Aldosterone

396
Q

What is produced by kidneys, and causes production of angiotensin II?

A

Renin

397
Q

What is produced by the heart when blood pressure increases?

A

ANP

398
Q

What inhibits ADH production and reduces ability of kidney to concentrate urine?

A

ANP

399
Q

Angiotensin II and Aldosterone decrease BLANK by vaso(constricting/dilating) afferent arteriole.

A

GFR, constricting

400
Q

Angiotensin II and Aldosterone enhance absorption of what 2 components?

A

Na & Bicarbonate

401
Q

Angiotensin II increase secretion of BLANK, activating what?

A

Acid, Na/H antiporters in PCT

402
Q

Angiotensin II promotes BLANK production which causes principal cells to reabsorb more Na & Cl.

A

Aldosterone

403
Q

What stimulates thirst centers in hypothalamus? How?

A

AT II & Aldosterone starting by increasing H2O reabsorption

404
Q

ANP increases filtration how?

A

By relaxing mesangial cells

405
Q

ANP inhibits resorption of what in PCT?

A

Na and water

406
Q

ANP suppresses secretion of what 2 things?

A

Aldosterone and ADH

407
Q

ANP increases excretion of BLANK which increases BLANK output and decreases blood volume.

A

Na+, urine

408
Q

ADH increases water permeability of BLANK cells, thus regulating what?

A

Principal, facultative water reabsorption

409
Q

ADH stimulates insertion of what channels into membrane, causing water molecules to move more rapidly.

A

Aquaporin-2

410
Q

ADH is secreted when osmolarity of plasma & interstitial fluid is (increased/decreased). And what as a result increases?

A

Increases, facultative water reabsorption

411
Q

With ADH & Nephron, what triggers the increase of water channels to increase permeability of membrane to water?

A

CAMP

412
Q

What stimulates activity of Na/H antiporters in proximal tubule cells?

A

Angiotensin II

413
Q

What enhances activity of Na/K pumps in basolateral membrane?

A

Aldosterone

414
Q

What enhances activity of Na channels in apical membrane of principal cells in collecting duct?

A

Aldosterone

415
Q

What stimulates insertion of water channel proteins (aquaporin-2) into the apical membranes of principal cells?

A

ADH/vasopressin

416
Q

What suppresses reabsorption of Na and water in proximal tubule and collecting duct; also inhibiting aldosterone and ADH secretion?

A

ANP

417
Q

What increases excretion of Na in urine (natriuresis) and increases urine output (diuresis) thus decreasing blood volume?

A

ANP

418
Q

What hormone increases facultative resorption of water decreasing osmolarity of body fluids?

A

ADH/Vasopressin

419
Q

When large volume of water consumed kidneys produce? Eliminate?

A

Large amount dilute urine, eliminate excess without losing large amounts of electrolytes

420
Q

Have an:

A

NAME?

421
Q

If one drinks 1 L of seawater, the max urine concentration is only 1200 mOsm/L, that person BLANK of urine causing a deficit of 1 L AKA BLANK.

A

Must excrete 2 L, dehydration

422
Q

What controls whether dilute or concentrated urine is formed?

A

ADH

423
Q

If you have a lack of ADH, urine is diluted/concentrated.

A

Diluted (high ratio of water to solutes).

424
Q

What are 2 requirements for excreting concentrated urine?

A
  1. High level of ADH - increases water reabsorption in DCT & CD
425
Q

How does renal medulla become hyperosmotic (3)?

A
  1. Anatomical arrangements & differential secretion ability (loops, VR, PC)
426
Q

What are 4 major factors contributing to solute bulidup in the renal medulla?

A
  1. Active transport of Na out of Thick ALOH into Medullary interstitium
427
Q

Where does active NaCl transport occur?

A

Proximal Tubule (PT), Thick AL, Distal tubule (DT), Cortical collecting tubule (CCT), Inner medullary collecting duct (IMCD)

428
Q

Where is NaCl permeable?

A

PT, Thin AL & DL

429
Q

Where is Urea permeable?

A

PT, Thin AL & DL, and IMCD

430
Q

Where is water permeable with presence of ADH only?

A

DT, CCT, IMCD

431
Q

Where is water permeable without presence of ADH?

A

PT and thin DL

432
Q

What limb is very permeable to water? Why?

A

Descending; high osmolarity of interstitial fluid outside the descending limb causes water to move out of tubule by osmosis

433
Q

What limb is impermeable to water?

A

Ascending

434
Q

What do symporters do in ascending limb that is impermeable to H₂O so osmolarity drops to 100 mOsm/liter?

A

Remove Na & Cl

435
Q

Vasa recta blood flows in (same/opposite) direction than loop of Henle. Why?

A

Opposite, provide nutrients/oxygen without affecting osmolarity of interstitial fluid

436
Q

What limb has higher concentrated water & why?

A

Descending limb (permeable to water)

437
Q

With high ADH levels, the osmolarity of urine is about the same as the osmolarity where?

A

Renal medullary interstitial fluid in papilla

438
Q

What 2 normal mechanisms can cause concentrated urine?

A

Low water intake or heavy perspiration

439
Q

Urine can have up to BLANK osmolarity than plasma.

A

4 times greater

440
Q

When can principal cells and ADH remove water from urine to great extent?

A

If interstitial fluid surrounding LOH has high osmolarity

441
Q

What makes countercurrent mechanism possible?

A

Long loop of juxtamedullary nephrons having high osmolarity

442
Q

Na/K/2Cl symporters reabsorb Na AND Cl from tubular fluid to create:

A

Osmotic gradient in the renal medulla

443
Q

Cells in collecting ducts reabsorb more water and urea when BLANK is increased.

A

ADH

444
Q

BLANK causes a buildup of urea in the renal medulla.

A

Urea recycling

445
Q

Through what structures is urea recirculated?

A

Medullary CD

446
Q

The recalculation of urea helps to trap urea in the renal medulla and then contributes to?

A

Hyperosmolarity of renal medulla

447
Q

What segments are not very permeable to urea?

A

Thick ascending loop of Henley to medullary ducts

448
Q

What is definition of dilute urine?

A

Having fewer solutes than plasma

449
Q

What condition is characterized with dilute urine?

A

Diabetes insipidus

450
Q

Filtrate and blood have (different/same) osmolarity in PCT.

A

Same

451
Q

Where is water/ions reabsorbed to create a filtrate more dilute than plasma for urine?

A

Water reabsorbed in thin limb, but ions reabsorbed in thick limb

452
Q

Principal cells do not reabsorb water if what is low?

A

ADH

453
Q

Urine can be BLANK as dilute as plasma.

A

4x

454
Q

The failure to reabsorb BLANK and continued resorption of BLANK leads to a large volume of dilute urine.

A

Water, solutes

455
Q

Where does tubular fluid become very dilute?

A

ALOH

456
Q

In the DT and CT, tubular fluid is further diluted by?

A

Resorption of NaCl and failure to reabsorb water when ADH is low

457
Q

What preserves hyperosmolarity of renal medulla?

A

Countercurrent exchange in vasa recta

458
Q

Plasma flowing down the DL of vasa recta becomes more hyperosmotic because?

A

Diffusion of H2O out of blood and diffusion of solutes from renal interstitial fluid into the blood.

459
Q

In the AL of vasa recta, what happens to solutes and water?

A

They both diffuse back into vasa recta

460
Q

Without the U shape of vasa recta capillaries what would happen?

A

Large amounts of solute lost from renal medulla

461
Q

What do diuretics do?

A

Slow renal absorption of water and cause diuresis

462
Q

What is diuresis

A

Increased urine flow rate

463
Q

What does caffeine do?

A

Inhibits Na+ reabsorption (diuretic)

464
Q

What does alcohol do?

A

Inhibits secretion of ADH

465
Q

If you have a prescription medicine that’s a diuretic what will it act on?

A

PCT, LOH or DCT

466
Q

What is the analysis of volume and properties of urine?

A

Urinalysis

467
Q

In a urinalysis what should urine be free of, consist of?

A

protein free

468
Q

What measures urea in blood?

A

BUN test (blood urea nitrogen)

469
Q

If BUN rises steeply, what happens to GFR?

A

It decreases

470
Q

PH of normal urine is between?

A

4.6-8; average 6

471
Q

When the kidney function is severely impaired and blood must be cleansed artificially by separation of large solutes from smaller ones with selectively permeable membrane?

A

Dialysis therapy

472
Q

What directly filters blood because blood flows through dialysis tubing surrounded by solution, and cleansed blood flows back into the body?

A

artificial kidney machine performing hemodialysis (dialysis)

473
Q

Plasma clearance is?

A

volume of plasma cleared of a specific substance each minute

474
Q

Determines what?

A

GFR

475
Q

Tubular load is?

A

Total amount of substance that passes through filtration membrane (glomeruli) into nephrons each minute

476
Q

The volume of plasma that is completely cleared of the substance per unit time?

A

Renal clearance

477
Q

Renal clearance equation is?

A

C = U(substance in urine)*V(urine flow)/P (substance in plasma)

478
Q

Urinary excretion rate =

A

UV mg/min

479
Q

In 1 minute time an amount of urea is removed from plasma that is equivalent to the amount of urea in 50 ml of plasma is example of?

A

Clearance value

480
Q

Measurement of GFR through what two things?

A

Inulin or creatinine

481
Q

BLANK can be used to determine glomerular filtration rate (GFR).

A

Plasma clearance rate

482
Q

What is the “gold standard” for measurement of GFR?

A

Inulin

483
Q

Why is inulin the gold standard?

A

Freely filterable, not reabsorbed/secreted/synthesized/destroyed/stored, nontoxic, concentration determined easily

484
Q

For inulin, Filtered load (amount filtered per unit time) =

A

Rate of inulin excretion (C = GFR)

485
Q

If a substance is freely filtered, then the rate at which it is excreted in the urine is equal to?

A

Filtration rate

486
Q

GFR = C = ?

A

UV/P

487
Q

What are drawbacks of inulin?

A

Must be infused intravenously and bladder is catherized because urine collection is over short time

488
Q

What is alternative to inulin, a natural (endogenous) substance?

A

Creatinine

489
Q

What is a derivative of muscle creatine phosphate?

A

Creatinine

490
Q

What is continuously produced by body, it is excreted in urine, and its levels are relatively constant over long periods (no categorization needed); measurement is simple?

A

Creatinine

491
Q

If GFR is reduced by 50%, what happens to creatinine?

A

Creatinine plasma concentration doubles

492
Q

At low GFR, small absolute changes in GFR result in?

A

Much greater changes in plasma [creatinine]

493
Q

High plasma [creatinine] indicates?

A

low GFR = diagnostic tool

494
Q

What is a completely reabsorbed substance?

A

Glucose

495
Q

At normal Glu levels (100), all filtered glucose is?

A

Reabsorbed (none excreted)

496
Q

At elevated Glu (200 and above), Glu appears where?

A

Urine (excreted) = Glu threshold

497
Q

As plasma Glu is increased further, more is BLANK. However, reabsorption reaches BLANK.

A

Filtered, max due to saturation of Glu transporters

498
Q

As plasma Glu increased further, how does excretion and filtration relate?

A

Excretion rises in proportion to amount filtered

499
Q

What is the transport maximum?

A

Maximum rate at which glucose can be reabsorbed from the tubules

500
Q

What refers to the filtered load of glucose at which glucose first begins to be excreted in the urine?

A

Threshold for glucose

Physiology 3 (2 decks)

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