Renal 1 Flashcards
(131 cards)
1
Q
secretion vs. reabsorption
A
secretion: moving from system into glomiluar filtrate
reabsorption: from renal tubule into system
2
Q
secretion vs. reabsorption
A
secretion: moving from system into glomiluar filtrate
reabsorption: from renal tubule into system
3
Q
Renal activity major influencer of ____ and ____ fluid compartments
A
ECF and ICF
4
Q
filtrate not urine until hits
A
ureter
5
Q
Total boday water TBW broken into 2 categories
A
ECF 1/3
ICF 2/3
6
Q
ECF broken into 3 categories
A
- interstitial fluid 3/4
- plasma 1/4
- transcellular fluid .5 liters
7
Q
provides immediate environment around cell
A
ECF–responsible for health of individual cells
8
Q
_____ plays major part in composition of ECF
A
kidneys
9
Q
7 rolls of kidneys
A
- excretion of metabolic waste
- regulation of H2O/ electrolyte balance
- Regulate body fluid osmolarity
- Regulate arterial pressure
- Regulate acid/base balance–excretion of “fixed” acids
- Regulate erythrocyte production via erythropoietin- ^ HgB
- Influence Ca/ Phosphorus/ Vit D metabolic pathways
10
Q
arterial pressure regulated by
A
- varying levels of Na+/H2O
2. direct and indirect effect of the Rennin-angiotensin-aldo system
11
Q
Gen Kidney Functions 8
A
- osmotic press and volume
- ions
- Acid/Base
- BP
- waste removal
- Toxic compounds
- hormone production
- degrade hormones
12
Q
Ca and Phosphorus move in ______ ________ in blood
A
opposite direction–seasaw
13
Q
Functional unit of kidney
A
the nephron
14
Q
____ kidney a little higher
A
left
15
Q
outer layer of kidneys
A
cortex
16
Q
______ and ______ calyx
A
major and minor
17
Q
nephron composed of
A
- glomerulus–accompanying eff/aff arterial surrounded by Bowman’s capsule
- Renal tubules–
18
Q
number of nephrons/ kidney
A
million
19
Q
glomerulus produces
A
ultra filtrate of blood
20
Q
renal tubules lined w/
A
epithelial cells function in reabsorption/ secration of:
water
electrolytes
and waste products
21
Q
7 Areas of tubules
A
- proximal convoluted tubules
- proximal straight tubules
- thin descending limb of the loop of Henley
- thick ascending limp of LofH
- Early distal tubule and Macula densa
- distal convoluted tubule
- collection duct
22
Q
second capillary network in the unusual arrangement of two capillary beds in series
A
peritubular capillary beds
23
Q
kidneys engage in ________-allowing for consistant blood flow
A
autoregulation of blood flow–from roughly 60-180 torr–even for transplanted kidneys (not reliant on ANS)
24
Q
**_______ ________ allows for autoregulation–watch video
A
jutaglomerular apparatus–macula densa cells at glomerular capillaries
25
_____% of blood presented to glomerulus is filtered
20%
26
filtrate is identical to serum plasma except missing
protein and other larger substances in serum plasma
27
GFR
glomerular filtration rate
| ml/minute
28
renal pathophys
1. DIABETES (main cause)
2. HTN hypertension (^ African Americans--> kidney failure)
3. glomerulunephritis
4. UTI
29
if protein in urine
problem with glomerulus likely--podocytes damaged--> proteinuria
30
leakage of very large amounts of protein (albumin) from glomerulus resulting in massive proteinuria
nephrotic syndrome --> edema (lower oncotic pressure)
31
fenestrated filtering cells of glomerulus
podocytes
32
molecule used to test GFR
Inulin--Fick principle
33
small rises in serum creatinine may indicate
impairment or loss of function of majority of nephrons
34
constrict afferent blood flow
lower RBF
lower GFR
& visa versa for dilation
35
constrict efferent blood flow to glom
lower RBF
raise GFR
and visa versa for dilation
36
Renal activity major influencer of ____ and ____ fluid compartments
ECF and ICF
37
filtrate not urine until hits
ureter
38
Total boday water TBW broken into 2 categories
ECF 1/3
| ICF 2/3
39
ECF broken into 3 categories
1. interstitial fluid 3/4
2. plasma 1/4
3. transcellular fluid .5 liters
40
provides immediate environment around cell
ECF--responsible for health of individual cells
41
_____ plays major part in composition of ECF
kidneys
42
7 rolls of kidneys
1. excretion of metabolic waste
2. regulation of H2O/ electrolyte balance
3. Regulate body fluid osmolarity
4. Regulate arterial pressure
5. Regulate acid/base balance--excretion of "fixed" acids
6. Regulate erythrocyte production via erythropoietin- ^ HgB
7. Influence Ca/ Phosphorus/ Vit D metabolic pathways
43
arterial pressure regulated by
1. varying levels of Na+/H2O
| 2. direct and indirect effect of the Rennin-angiotensin-aldo system
44
Gen Kidney Functions 8
1. osmotic press and volume
2. ions
3. Acid/Base
4. BP
5. waste removal
6. Toxic compounds
7. hormone production
8. degrade hormones
45
Ca and Phosphorus move in ______ ________ in blood
opposite direction--seasaw
46
Functional unit of kidney
the nephron
47
____ kidney a little higher
left
48
outer layer of kidneys
cortex
49
______ and ______ calyx
major and minor
50
nephron composed of
1. glomerulus--accompanying eff/aff arterial surrounded by Bowman's capsule
2. Renal tubules--
51
number of nephrons/ kidney
million
52
glomerulus produces
ultra filtrate of blood
53
renal tubules lined w/
epithelial cells function in reabsorption/ secration of:
water
electrolytes
and waste products
54
7 Areas of tubules
1. proximal convoluted tubules
2. proximal straight tubules
3. thin descending limb of the loop of Henley
4. thick ascending limp of LofH
5. Early distal tubule and Macula densa
6. distal convoluted tubule
7. collection duct
55
second capillary network in the unusual arrangement of two capillary beds in series
peritubular capillary beds
56
kidneys engage in ________-allowing for consistant blood flow
autoregulation of blood flow--from roughly 60-180 torr--even for transplanted kidneys (not reliant on ANS)
57
**_______ ________ allows for autoregulation--watch video
jutaglomerular apparatus--macula densa cells at glomerular capillaries
58
_____% of blood presented to glomerulus is filtered
20%
59
filtrate is identical to serum plasma except missing
protein and other larger substances in serum plasma
60
GFR
glomerular filtration rate
| ml/minute
61
renal pathophys
1. DIABETES (main cause)
2. HTN hypertension (^ African Americans--> kidney failure)
3. glomerulunephritis
4. UTI
62
if protein in urine
problem with glomerulus likely--podocytes damaged--> proteinuria
63
leakage of very large amounts of protein (albumin) from glomerulus resulting in massive proteinuria
nephrotic syndrome --> edema (lower oncotic pressure)
64
fenestrated filtering cells of glomerulus
podocytes
65
molecule used to test GFR
Inulin--Fick principle
66
small rises in serum creatinine may indicate
impairment or loss of function of majority of nephrons
67
constrict afferent blood flow
lower RBF
lower GFR
& visa versa for dilation
68
constrict efferent blood flow to glom
lower RBF
raise GFR
and visa versa for dilation
69
loop of Hennley dips into
medulla
70
inflammation of nephron
leads to scarring --> nonfunctioning
71
Highest portion of renal tubules for reabsorption of nutrients from glomerular filtrate
proximal convoluted tubules (90 L/day)
72
saturation kinetics
in relation to glucose reabsorption in proximal convoluted tubules--glucosuria when glucose transporters saturated
73
descending loop of Henley main function
highly permeable to water-->concentrates filtrate as is descends through pyramids--pumps --
74
proximal tubules less permeable to
waste products such as urea
75
inner renal medulla is very ________
hyperosmolar--sucks water from the tubules of osmosis --> ^ solute concentration in filtrate
76
THIN ascending loop of Henle ______ to H20
impermeable--permeable to NaCl-->medulla pulls salt out--CYCLE to keep gradiant high in medulla
77
THICK ascending loop of Henle _____ to H2O. Actively transports large amounts of ___ ___ and ____, making urine _____
impermeable-
Na, Cl, K-
HYPOtonic
78
test of GFR--minimally altered by glomerulus
creatinine clearance test-- freely filtered--tests sum-total of creatine cleared--TESTS GFR
79
site of action of Loop Diuretics
Thick ascending loop of Henle--impair Na, Cl, K pumps
80
osmolarity
concentration of solutes in solution
81
juxtaglomerular complex located in
early portion of distal renal tubule--part of feedback control for GFR
82
Ascending loop of henle is the ________ portion
filtrate diluting
83
descending loop of henle is the _______ portion
filtrate concentrating
84
distal renal tubules are ______ to H2O. Avidly ____ ions
impermeable --
| reabsorb
85
ADH (vasopresin) ______ pores
opens---in area btwn cortex and medulla
86
areas of final precessing of glomerular filtrate
late distal renal tubule and cortical collecting tubules
87
compound released by JG changes angiotensin I --> angiotensin II (jobs: vasoconstriction arterial, releases aldo from adrenal cortex, and ^ proximal renal tubule reabsorbtion of Na)
renin
88
permeability of late distal renal tubules and cortical collecting ducts controlled by
ADH--
89
hyperkalemia
^ potassium
90
in distal renal tubule and cortical collecting tubules, which cells absorb Na and H2O and secrete K
"Principle Cells"
| Also increases Na absorption here--trades for K
91
area of final urine processing
medullary collecting ducts
92
Medullary collecting duct's permeability to H2O controlled by? Secretes ___ against ______ gradient.
ADH-
| H+, gradient (IMP for acid/base regulation)
93
fixed acid
anything but CO2 for our purposes
94
system that controlles release of aldo
renin-angiotensin-aldosterone system
95
bicarbonate is ______ --generated by kidneys
basic
96
If osmolarity of body fluids is increased, the hypothalamus will stimulate pituitary to release ____.
ADH-increases reabsorption of H2O
97
hormone that inhibits reabsorption of Na+, H2O. (opposite of aldo)
atrial natriuretic peptide-
| distention of atria (too much preload) ANP is released
98
hormone released by ____ ____ in response to low serum Ca?
parathyroid gland-
| parathyroid hormone
99
parathyroid hormone increases _____ ___ _______, and decreases _____ _____ _______
renal Ca reabsorption-
| renal phosphate reabsorption
100
kidney sends message with ______. Receives messages by way of _______, _____, _____,
Renin-
| ADH, aldo, atrial natriuretic peptide
101
Kidney role in acid/base dynamic
1. synth and reabsorb HCO3
| 2. excrete fixed acids i.e. NH4+
102
2 terms for buildup of nitrogen based waste products in body from inadequate renal function (renal failure)
1. uremia
| 2. azotemia
103
RAPID decline in renal function
Acute renal failure--primarily result of decline in GFR
104
renal failure from lack of blood flow to kidneys
pre-renal failure
105
(acute) problem with kidney its self
intrinsic acute renal failure--i.e. toxin
106
(acute) obstruction in kidney output (bladder obsturction, prostatic hypertrophy, tumor, etc.)
post renal failure--backs urine up--no filtration
107
3 ACUTE liver failures--often reversible
pre-renal
intrinsic
and post-renal failure
108
non-reversible, decline in GFR over months-years--loss of nephron mass
chronic renal failure CRF
109
causes of chronic renal failure
HTN, Diabetes melitus, obstruction, infection
110
end stage chronic renal failure
anuria
111
Signs/ symptoms of chronic renal failure
- uremia
- hyperkalemia
- metabolic acidosis
- anemia
- osteoporosis
- volume overload-CHF
- pheripheral neuropathy
- anorexia
- endocrine disturbances
112
abnormal constituents of urine on urinalysis
1. glucose
2. proteinuria
3. hematuria (RBCs or HgB)
4. presence of WBCs
5. ^ # of crystals (microscopically)
6. Casts ("cast" of renal tubule--should never see i.e. blood)
7. Bilirubin
113
measure of urine concentration by urinalysis
specific gravity--roughly 1035 (concentrated) - 1001 (dilute)
114
pH of urine
5-9, depending on diet
115
Renal function serum (blood) test (3)
1. creatinine
2. Blood urea nitrogen BUN
3. creatinine clearance
116
prevent ARF and CRF
adequate treatment of streptococcal infections
117
specific gravity of ____ is apx isotonic with normal serum osmolarity
1010
118
afferent:
efferent:
in--larger
| out--smaller
119
BUN vs. creatinine clearance
BUN not as useful--too much mod/reuptake of blood uria nitrate
120
one "unit" of blood
one pint = 450 mL
121
diarhea as from dissentery or cholera--water comes from
circulating blood volume-->no cardiac preload (pre-renal failure)-->heart collapse-->death
122
pancreas makes
- bicarb to neutralize stomach acid
| - enzymes to break down foodstuffs
123
As it pertains to ADH action on:
V1 receptors:
V2 receptors:
V1 = vasoconstriction (hence the name “vasopressin”)
| V2 receptors mediate water reabsorption
124
Angiotensin II ______ efferent vessels to greater degree than _______ vessels
constricts,
| afferent
125
Prostaglandins cause __________ of afferent arterioles
vasodilation
126
SNS ______ afferent arterioles to greater degree than efferent
constricts
127
_______ and _____ ____ are completely reabsorbed
glucose and aa's
128
loope of Henle responsible for _____ ______, hyperosmolar gradiant set by ascending pulls water from descending
countercurrent multiplication
129
________ ______ _______ secrete H+ against _____ _____
medullary collecting ducts,
| large gradient
130
Aldosterone production directed by _____ ______, secretion directed by ____________________
pituitary gland,
| renin-angiotensin-aldosterone system
131
renal hypoperfusion as from hypovolemia example of:
PRERENAL azotemia
