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Renal > Physiology > Flashcards

Physiology Flashcards

1
Q

what is the main function of the kidney

A

maintenance of plasma volume and plasma osmolarity

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2
Q

what is the basic functional unit of the kidney

A

the nephron

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3
Q

what are the 3 functional mechanisms that occur throughout the nephron

A

filtration
tubular reabsorption
tubular secretion

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4
Q

what is the function of the juxtaglomerular apparatus

A

maintenance of normal blood pressure

quality control mechanism to ensure correct glomerular filtration occurs

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5
Q

list the three components of the juxtaglomerular apparatus

A

macula densa - patch of tubal cells
extraglomerular mesangial cells
granular cells (found in the afferent arteriolar wall)

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6
Q

what do the granular cells secrete

A

renin

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7
Q

what is urine

A

modified filtrate of the blood

filtration, reabsorption and secretion must occur for urine to be produced

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8
Q

outline how renal blood flow moves into and out of the nephron

A

the afferent arteriole brings blood into the nephron at the glomerulus, blood that is not filtered will leave via the efferent arteriole

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9
Q

describe the flow of fluid through the nephron

A 
Bowmans capsule/glomerulus 
proximal convoluted tubule 
descending limb loop of Henle 
loop of Henle 
ascending limb loop of Henle 
distal convoluted tubule 
collecting duct
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10
Q

what is the formula to calculate rate of excretion of a substance

A

rate of filtration + rate of secretion - rate of reabsorption

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11
Q

what is glomerular filtration

A

first process of filtering the blood before removing waste products

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12
Q

what are the three filtration barriers that prevent substances from passing through

A

glomerular capillary endothelium
basement membrane
slit processes of podocytes
must pass through all 3 layers

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13
Q

what are 4 forces that comprise net filtration pressure

2 up 2 down

A

glomerular capillary BP = 55mmHg, Bowmans oncocytic pressure = 0mmHg DOWN
Bowmans capsule hydrostatic pressure = 15mmHg, capillary oncocytic pressure (30mmHg) UP
55 - (15+30) = 10mmHg overall

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14
Q

what is glomerular filtration rate

A

rate at which protein free plasma is filtered from glomeruli into Bowmans capsule per unit time

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15
Q

how is GFR controlled extrinsically

A

sympathetic control via baroreceptor

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16
Q

how is GFR controlled intrinsically

A

myogenic mechanisms

tubuloglomerular feedback mechanism

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17
Q

how does a rise in arterial BP affect GFR

A

increase in arterial BP - increases blood flow to the glomerulus - increases glomerular capillary BP - increases net filtration pressure
also causes vasodilation of the afferent arteriole allowing more blood in

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18
Q

what is plasma clearance

A

the volume of plasma completely cleared by a particular substance per minute - also how well the kidneys are working

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19
Q

how is clearance of a substance measured

A

rate of excretion/plasma concentration of substance

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20
Q

give an example of a substance that is freely filtered at the glomerulus

A

insulin

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21
Q

why is measuring insulin useful for assessing GFR

A

it is not absorbed or secreted just passes through therefore useful to assess GFR

22
Q

if clearance < GFR the substance is reabsorbed, secreted or neither

A

reabsorbed

23
Q

if clearance = GFR the substance is reabsorbed, secreted or neither

A

neither, freely filtered

24
Q

if clearance > GFR the substance is reabsorbed, secreted or neither

A

secreted

25
Q

reabsorption and filtration are both specific true/false

A

false - filtration is not specific to any substance

26
Q

why is reabsorption of substances important

A

GFR = 125ml/min which equals 180L of fluid a day

kidneys must reabsorb fluid and electrolytes to maintain homeostasis

27
Q

how is glomerular filtrate different from blood

A

it is a modified filtrate of the blood, does not contain any RBCs but contains all the same ions at the same concentrations

28
Q

what substances are reabsorbed at the proximal convoluted tubule

A 
glucose
amino acids 
sulphate
lactate
phosphate
29
Q

what substances are secreted at the proximal convoluted tubule

A 
hydrogen ions 
hippurates 
neurotransmitters 
uric acid 
drugs 
toxins
30
Q

what type of channel is essential for Na reabsorption at the basolateral membrane

A

dependent Na K ATPase transporter

31
Q

how is glucose reabsorbed at the basolateral membrane

A

through Na-Glucose co-transporter

32
Q

what is the function of the Loop of Henle

A

to generate cortico-medullary solute concentration gradient - generates hypertonic urine

33
Q

what substances are reabsorbed at the ascending limb of loop of henle

A

Na and Cl

the ascending limb is impermeable to water

34
Q

what substances are reabsorbed at the descending limb of Loop of Henle

A

water

descending limb is highly permeable to water but not salt

35
Q

which transporter moves Na and Cl into the interstitial fluid at the ascending limb

A

triple co-transporter

36
Q

explain the mechanism of the triple co-transporter at the ascending limb

A

the transporter moves Na, Cl and K into the interstitial fluid then potassium is recycled

37
Q

which type of drug blocks the triple co-transporter

A

Loop Diuretics

38
Q

tubular fluid leaving the Loop of Henle entering the distal tubule is hypo or hyper-osmotic to plasma

A

hypo-osmotic

39
Q

what is the main function of the distal tubule and collecting duct

A

major sites for ion regulation and water balance

40
Q

what is the function of ADH

A

reduces urine output by increasing water reabsorption in the distal tubule

41
Q

what is the function of aldosterone

A

increases Na reabsorption

increases K and H secretion

42
Q

which hormone works against aldosterone by decreasing Na reabsorption

A

atrial natriuretic hormone

43
Q

in the collecting duct, permeability to water and urea increases or decreases in response to ADH

A

increases in response to ADH so more water is being retained in the body

44
Q

the distal tubule can be split into early and late tubule, what is reabsorbed in the early tubule

A

Na, K and Cl via triple co-transporter

45
Q

what is reabsorbed and secreted in the late distal tubule

A

Ca reabsorption and H secretion

Na and K is dependent on levels of circulating aldosterone

46
Q

the late collecting duct has low permeability to ions and water true/false

A

false

low permeability to ions but not water or urea

47
Q

what effect does ADH have on water permeability in the collecting duct

A

increases water permeability
ADH binds to vasopressin receptors which raises cAMP allowing more water channels to open at apical membrane
this moves water from the tubule to the peritubular capillary

48
Q

high ADH produces hypertonic or hypotonic urine

A

hypertonic urine and high water permeability

as more water is absorbed the urine contains more ions per volume

49
Q

where is aldosterone secreted from

A

the adrenal cortex

50
Q

in terms of Na and K levels, when is aldosterone secreted

A

rising K or falling Na, activates the RAAS

51
Q

what is the effect of aldosterone in terms of Na, Cl and H2O

A

increased Na and Cl reabsorption

H2O conserved

52
Q

state 2 ways the aldosterone increases Na reabsorption

A

increases the number and availability of NaKATPase channels

increases the expression of apical sodium channels

Renal (1 decks)

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