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Phys 208 > Renal > Flashcards

Renal Flashcards

(107 cards)

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1
Q

What are the 3 pressures that govern filtration from glom capillaries into renal tubules?

A

hydrostatic pressure (favour), colloid osmotic (oppose), Bowman’s hydrostatic (opposes)

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2
Q

What is the normal glomerular filtration rate?

A

180L/day (plasma vol = 3L, filter 60x a day)

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3
Q

two factors that influence GFR?

A

net filtration pressure and filtration coefficient

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4
Q

renal blood flow and blood pressure

A

net filtration pressure

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5
Q

surface area of glom caps available for filtration and permeability of interface tween caps and Bowman cap

A

filtration coefficient

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6
Q

GFR is primarily regulated by renal afferent and efferent ____

A

arterioles

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7
Q

if afferent arteriole resistance is decreased and efferent stays the same, then RBF would ___, hydrostatic pressure would ___, and GFR would ____

A

all would increase

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8
Q

What are the 2 autoregulatory mechanisms that maintain a relatively stable GFR in the face of normal BP fluctuations?

A

1) myogenic response of afferent arterioles (stretch activated channels–>contract muscle)
2) tubuloglomerular feedback

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9
Q

these cells are activated by ^ NaCl, sense distal tubule flow with cilia and release paracrines affecting afferent arteriole diameter

A

macula densa

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10
Q

when is sympathetic activation affecting GFR?

A

conditions of severe dehydration or hemorrhage (will override autoregulation)

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11
Q

what are the 2 important hormones modulating arteriole resistance?

A

angiotensin 2 (constrict), prostaglandins (dilate)

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12
Q

what are the 2 types of transport involved in reabsorption?

A

transepithelial (transcellular) and paracellular

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13
Q

NaKATPase is found on ___ side, Na-Gluc symport and ENaC is found on ____

A

basolateral; apical

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14
Q

urea undergoes ___ reabsorption while plasma proteins undergo ____

A

passive; endocytosis

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15
Q

example of a receptor binding plasma protein

A

megalin

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16
Q

what is the max rate of transport that occurs when all available carriers occupied?

A

saturation

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17
Q

The transport rate at saturation is called the….

A

transport max

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18
Q

The plasma concentration of solute when first begins to appear in urine

A

renal threshold

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19
Q

condition where glucose appears in your urine

A

gluco/glycosuria

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20
Q

what is a renal corpuscle?

A

the initial blood filtering portion of nephron, consisting of glomerulus and bowman’s capsule

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21
Q

what is secretion?

A

the transfer of cules from xtracell fluid to lumen of nephron (usually active)

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22
Q

amount excreted=___

A

amount filtered-amount reabsorbed + amount secreted

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23
Q

how are organic anions removed?

A

through tertiary indirect active transport

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24
Q

penicillin is given with ___, which is preferentially secreted by OAT transporter

A

probenecid

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25
Clearance of X=
excretion rate of X (mg/min) / [X] plasma (mg/mL plasma)
26
inulin is completely ___ and not ___
filtered; reabsorbed
27
GFR=
excretion rate inulin / inulin plasma lvl
28
using inulin is impractical, so clinicians use ______ to measure GFR, although it slightly ____ GFR
creatinine; overestimates
29
urea has net ___ while penicillin has net ___
reabsorption; secretion
30
filling the bladder activates stretch receptors, initiating the ___ reflex
micturition
31
internal sphincter is __ muscle while external sphincter is ___ muscle. At rest they are ___
smooth; skeletal; contracted
32
_____ and ____ determine ECF volume and osmolarity
H2O and Na+
33
The ___ lose water and help remove H+ and ___ by excreting CO2
lungs; HCO3
34
__ balance can cause probs with cardiac/muscle function
K+
35
in hypotonic solution, cell is ____, in hypertonic solution, cell is ___
lysed; shrivelled
36
fluid/electrolyte balance is integrative, involves ____, ___, ___ systems and __ responses
respiratory, cardiovascular, renal; behavioural
37
water makes up ____ of body weight; ___ in intracell, __ in xtracell
50-60%; 1/3; 2/3
38
what is insensible water loss?
non-urinated or fecal water loss, evaporation from skin, exhalation from lungs
39
what is diuresis?
removal of XS urine
40
what are the two hormones in the distal tubule that affect permeability to water and solutes?
aldosterone and vasopressin
41
vasopressin controls ___ reabsorption by adding or removing ____
water; water pores
42
how does AVP induce AQP2 ?
vasopressin leaves brain, binds to G-protein coupled receptor-->cyclic AMP phosphorylate aquaporins in storage vesicles, exocytosis of these vesicles
43
What stim control vasopressin secretion?
mainly increased plasma osmolarity, also decreased volume and pressure of blood--happens more when sleeping so don't have to get up to pee
44
where is AVP produced and secreted?
Magnocellular neurosecretory cells | cell body of neuron-->vesicles transported down axon and stored in posterior pit.->release to blood
45
what affects the AP firing rate?
stretch sensitive neurons
46
high osmolarity in ____ _____ necessary to create concentration gradient moving water out of collecting duct; this is obtained through _______ systems
medullary interstitium; countercurrent exchange systems
47
countercurrent xchange sys found in ________ of mammals and birds to reduce ____
flippers, tails, wings; heat loss
48
the loop of henle is referred to as the ________ and the peritubular capillaries of the ___ nephrons are referred to as _______
countercurrent multiplier; juxtmedullary; countercurrent exchanger
49
the ____ transporter moves Na, K, and 2 Cl into the ___ cells
NKCC2; epithelial
50
why is NKCC2 a target of loop diuretic drugs?
prevents the generation of hypertonic interstitial space
51
why doesn't water entering interstitium dilute hypertonic medulla?
vasa recta pick up solute to create hypertonic blood, so the water moves into blood instead of interstitial space
52
about half the solute in medulla interstitium is ___ | due to reabsorption in the ___ portion of nephron, creating a recycling loop
urea; distal
53
thirst regulator located in ____ of brain
hypothalamus
54
unknown receptors in ______ respond to water by decreasing thirst and decreasing VP release
mouth/pharynx
55
which hormones increase desire to ingest Na?
aldosterone, angiotensin 2
56
when would ^ volume and ^ osmolarity happen?
eating salty foods and drinking liquids at same time (salt>water)
57
when would ^ volume but no change in osmolarity happen?
if salt and water ingested is = to isotonic solution
58
when would ^ volume and v osmolarity occur/
drinking pure water without ingesting (kidney can't excrete pure water)
59
when would no volume change and ^ osmolarity occur?
eat salt without drinking water (kidneys concentrate urine)
60
when would no volume change and v osmolarity happen?
in exercise, through sweat
61
when would v volume and ^ osmolarity happen?
heavy exercise or diarrhea (extreme dehydration)-->inadequate perfusion
62
when would v volume and no change in osmolarity happen?
hemorrhage (need IV/transfusion)
63
when would v volume and v osmolarity happen?
uncommon-->incomplete compensation for dehydration
64
what are the three homeostatic responses to severe dehydration?
1) conserving fluid 2) trigger cardio reflexes ^ BP 3) stimulate thirst
65
what are the 4 compensatory mechanisms that overlap to overcome dehydration?
1) cardio mechanisms 2) renin-angiotensin system 3) renal mechanisms 4) hypothalamic mechanisms
66
H+ concentration of normal arterial plasma is very ___ and is expressed on a ____ scale
low; logarithmic
67
normal pH of body is ___
7.40, slightly alkaline
68
this condition depresses the CNS
acidosis
69
this condition causes neurons to become hyperexcitable, and can cause sustained contractions paralyzing muscles
alkalosis
70
what is the largest source of acid on a day to day basis?
CO2 from aerobic metabolism
71
pH homeostasis depends on these three mechanisms:
1) buffers (first line of defence) 2) ventilation (75% of disturbances) 3) renal regulation of H+ and HCO3 (slowest)
72
includes proteins like hemoglobin, phosphate ions and HCO3 (cules that moderate but don't prevent changes in pH)
buffer systems
73
plasma bicarbonate concentration approx ____ times concentrated as plasma H+
600 000
74
extracellular buffer system is ____, intracellular is ____
bicarbonate; cell proteins, phosphate ions, hemoglobin
75
hypoventilation results in ___ shift; hyperventilation results in ___ shift
right; left
76
_______ chemoreceptors sense change in plasma H and PCO2, signal to ____ to adjust ventilation
peripheral and central; respiratory control centre
77
kidney handles ____% of pH disturbances both directly and ____
25; indirectly (changing rate at which HCO3 buffer is reabsorbed or excreted)
78
H+ cannot be ___, it enters the tubule via ___ only
filtered; secretion
79
during acidosis, XS H is buffered by ____ in tubule cells or _____ in lumen
ammonia phosphate ions
80
the ___ tubule secretes H+ back into nephron and ____ HCO3
proximal; reabsorbs
81
____ is metabolized to ammonium and HCO3
glutamine
82
the ___ nephron controls acid excretion
distal
83
Type A intercalated cells for ____; Type B intercal cells for ____
acidosis; alkalosis (getting rid of base/buffer)
84
intercal cells have lots of ___, bicarbonate chloride transporter, 2 kinds H+ATPase
carbonic anhydrase | this is not a super important concept
85
acidosis can result in _______, alkalosis in ____
hyperkalemia; hypokalemia
86
once disturbance causes change in plasma pH, buffers are ineffective so need to rely on ____ and ___ compensation
respiratory; renal
87
occurs when alveolar hypoventilation results in CO2 retention
respiratory acidosis
88
what causes resp acidosis?
asthma, skel muscle disorders (muscular dystrophy), COPD, emphysema
89
compensation for respiratory acidosis/alkalosis must happen via ____
renal mech (HCO3 and H+)
90
why breathe into paper bag when hyperventilate?
rebreathe exhaled CO2 to ^ plasma CO2 lvl
91
occurs when diet/metabolic input H+ exceeds H+ excretion
metabolic acidosis
92
two kinds of metabolic acidosis?
lactic acidosis (anaerobic metabolism), ketoacidosis (xcess breakdown fat/a.a. in low carb diets)
93
metabolic acidosis can occur from excessive HCO3 loss, through ____
diarrhea
94
metabolic acidosis/alkalosis can be resolved through ____ and ____ mechanisms
respiratory; renal
95
metabolic alkalosis can be caused commonly by:
excess vomiting, excess ingestion of antacids (bicarbonates)
96
what are the kiney functions?
homeostatic reg of water/ions, xcell fluid vol, BP, osmolarity, produce hormones, pH, waste excretion
97
what gives urine yellow colour?
urobilinogen
98
urinary system receive ____ cardiac output
20-25%
99
what is the functional unit of kidney?
nephron
100
80% nephrons are _____, 20% are _____
cortical; juxtamedullary
101
the interactions between the bowman's capsule and proximal tubule is called:
juxtaglomerular apparatus
102
2 capillary beds arranged in series is referred to as a :
portal system
103
order of vascular components?
renal artery-->afferent arterioles-->glomerulus-->efferent arterioles-->peritubular capillaries-->renal veins
104
order of tubular component?
bowman's cap-->prox tubule-->descending loop of Hen-->ascending loop of Hen-->distal tubule-->collecting duct
105
____ is responsible for creating dilute urine
loop of Henle
106
70% of reabsorption occurs here:
prox tubule
107
what is the triple filtration barrier/
capillary endothelial cells, basal lamina, podocyte endfeet

Phys 208 (10 decks)

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