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Pathophys II MHM - Exam 2 > Renal Module 1 > Flashcards

Renal Module 1 Flashcards

(92 cards)

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1
Q

What is the renal capsule?

A

Directly surrounds each kidney

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2
Q

What is the renal fascia?

A

Surrounds kidney and fatty mass

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3
Q

What does the renal cortex contain?

A
  • Glomeruli

- PCTs and DCTs

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4
Q

What does the renal medulla contain?

A

Straight segments of PCT and DCTs

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5
Q

What are renal pyramids?

A

Functional arrangement for collection

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6
Q

What are renal papilla and where do they drain into?

A
  • Apex of renal pyramid

- Drains into minor calyces

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7
Q

Function of minor calyces

A

Collect urine form renal pyramids

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8
Q

Function of major calyces

A

Collect urine from 2-3 minor calyces

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9
Q

What is renal pelvis and its function?

A
  • Funnel shaped duct that becomes continuous with ureter

- Collects urine from major calyces

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10
Q

What is the ureter and its function?

A
  • Smooth muscular tube 25-30 cm long

- Drains urine from renal pelvis and descends into bladder

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11
Q

What are the renal collecting system components (calyces, pelvis, ureters) composed of?

A

Smooth muscle

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12
Q

What regions have the most potential for kidney stones to lodge?

A
  1. Ureteropelvic junction
  2. Where ureter passes over pelvic brim
  3. As ureter enters bladder
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13
Q

Functional unit of the kidney?

A

Nephron

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14
Q

Types of nephrons

A
  1. Superficial cortical (85%, extend partially into medulla)
  2. Mid-cortical (short and long loops)
  3. Juxtamedullary (extend deep into medulla)
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15
Q

Which type of nephron is responsible for urine concentration?

A

Juxtamedullary

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16
Q

What is the site of renal filtration?

A

Renal corpuscle

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17
Q

What makes up the renal corpuscle and what is its function?

A
  • Glomerulus, Bowman’s capsule, Mesangial cells

- Site of filtration

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18
Q

What is the site of renal capillary filtration?

A

Glomerulus

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19
Q

How is the glomerulus composed?

A

Glomerular capillaries that extend into Bowman’s capsule

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20
Q

Layers of the glomerular filtration membrane

A
  1. Capillary endothelium (fenestrated wall)
  2. Basement membrane (negative charge which plays role in filtration)
  3. Capillary epithelium (podocytes)
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21
Q

What are podocytes?

A
  • Cells of the capillary epithelium of the glomerular filtration membrane
  • Foot like projections that form matrix of filtration slits
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22
Q

Glomerular blood flow through efferent arteriole:

A
  • Glomerulus capillaries drain into efferent arteriole
  • Blood then travels to peritubular capillaries
  • Allows for reabsorption and secretion along tubules of nephron
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23
Q

What is the juxtaglomerular apparatus composed of?

A

Juxtaglomerular cells + macula densa

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24
Q

Where are juxtaglomerular cells located?

A

Adjacent to afferent glomerular arteriole

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25
What is the macula densa, where is it located, what is its function?
- Part of JGA - Cells in DCT located adjacent to afferent and efferent arterioles - Function as NaCl receptors
26
What does the JGA regulate?
- Renal blood flow - Glomerular filtration - Renin secretion
27
What are mesangial cells? Where are they located and what is their function?
- Matrix of smooth muscle and phagocytic cells - Located b/w glomerular capillaries and Bowman's capsule - Regulation of filtration
28
What is the function of Bowman's space?
(space inside Bowman's capsule) | -Collects filtrate from glomerular capillaries
29
What is the PCT?
- Continuation from Bowman's capsule | - 15 mm long single layer of cells along wall with microvilli (brush border)
30
Function of the PCT?
Major site of Na reabsorption as filtrate travels through tubules
31
What is the Loop of Henle composed of?
Descending and ascending loops
32
Describe Loop of Henle in juxtamedullary nephrons
- Extends deep into medulla | - Plays critical role in concentrating urine
33
Describe Loop of Henle in superficial cortical and mid-cortical nephrons
- Short, only partially extend into medulla | - Do NOT play role in concentrating urine
34
Where does the DCT begin and end?
- Begins at macula densa | - Ends at connection to collecting duct
35
Functions of early and late DCT?
- Early DCT: continues to dilute filtrate as reabsorbs Na | - Late DCT: begins to concentrate the fluid as it enters collecting duct
36
What drains into a single collecting duct?
DCTs from many nephrons
37
Location of collecting duct
- Descends to renal papilla | - Drains into minor calyces
38
Function of collecting duct
Final concentration of urine
39
Pathway of blood to kidney
Descending aorta to renal arteries, branches form afferent glomerular arterioles to glomerular capillary beds
40
What is unique about the renal circulation?
2 successive capillary networks
41
Describe peritubular capillary beds of nephrons - location, function
- Past the efferent arteriole - Surround PCT, DCT and some of short loop of Henle - Secretion and reabsorption of filtrate throughout the tubules of the nephron
42
Describe vasa recta of medullary nephrons - location, function
- Run parallel to long loops of Henle | - Concentration of urine and regulation of concentration gradients along loop of Henle
43
Pressure in glomerular capillary beds is:
HIGH - To encourage filtration - Starts at 45 mm Hg, drops 1-3 by the end
44
Pressure in peritubular capillaries is:
LOW - To encourage exchange - Starts at 8 mm Hg, drops to 4
45
What is renal blood flow (RBF) defined as and what is its approximate value?
- Volume of blood that flows through the glomerular capillaries of both kidneys per minute - 1.2 L/min (approx 20-25% resting CO)
46
What is renal plasma flow (RPF) defined as and what is its approximate value?
- Volume of plasma that flows through the glomerular capillaries of both kidneys per minute - 600-700 mL/min
47
How can RPF be calculated?
RBF x (1 - hematocrit)
48
What is glomerular filtration rate (GFR) and what is its approximate value?
- Volume of plasma that is filtered into Bowman's capsule per unit of time - 120 mL/min
49
How can GFR be calculated?
20% x RPF
50
Approximately how much RPF will filter into Bowman's capsule?
20% of RPF
51
If approximately 20% of RPF is filtered into Bowman's capsule, where does the remaining 80% go?
Travels to peritubular capillaries/vasa recta
52
How much glomerular filtrate is reabsorbed back into the blood stream?
99% is reabsorbed into peritubular capillaries
53
How much glomerular filtrate remains in the nephron to form urine?
Around 1% remains in the tubules and is excreted as urine through collecting duct
54
How is urine output calculated?
GFR x 1.5%
55
What is the filtration fraction?
Ratio of GFP to RPF | -Tells us how much plasma is filtered into Bowman's out of total plasma flow
56
Average urine output per day?
1-2 L/day
57
How is GFR related to RBF?
Directly
58
How is RBF/GFR regulated?
1. Autoregulation 2. Neuroregulation 3. Hormonal feedback mechanisms * The net result of all 3 mechanisms determines "actual" RBF/GFR
59
How does autoregulation maintain constant GFR?
- If systemic pressures INCREASE: afferent arteriole constricts to decrease RBF which prevents an increase in GFR - If systemic pressures DECREASE: afferent arteriole dilates to increase RBF which prevents a decrease in GFR
60
What are the mechanisms of autoregulation in the kidneys?
- Myogenic mechanism (stretch feedback) | - Tubuloglomerular feedback
61
What is the myogenic mechanism of GFR?
- Autoregulation - "Stretch" feedback - Smooth muscle of afferent arteriole wall is sensitive to stretch - If systemic pressures cause stretch then muscle constricts which limits RBF
62
What is the tubuloglomerular feedback mechanism of GFR?
- Autoregulation via JGA - Macula densa located in DCT sensitive to flow rate and Na levels - Changes in Na and flow rates will signal constriction or dilation of afferent arterioles * Increased NaCl = afferent constricts, RBF slows which decreases GFR
63
Describe neuroregulation of GFR
- Sympathetic nervous system if systemic BP DECREASES | - Stimulates arterioles to constrict, limiting RBF which either maintains or decreases GFR
64
How is GFR affected by exercise? What regulates this?
- Decrease in GFR (and RBF) | - Controlled by sympathetic mechanism
65
Why does the sympathetic nervous system mechanism aim to decrease GFR?
- It is activated upon decreased systemic pressure | - Decreased GFR means less Na/water is excreted (water is retained) which increases BV and BP
66
How does hemorrhage affect GFR?
- Sympathetic mechanism is stimulated | - Decreased RBF/GFR to promote increased BV and BP
67
What are the major hormone mechanisms regulating GFR?
- RAAS | - Natriuretic peptides
68
How does RAAS affect GFR?
- Decreases GFR | * This causes increased BV and BP
69
How do natriuretic peptides affect GFR?
- Increases GFR | * This causes increased fluid excretion so lower BP
70
Liver's role in RAAS?
Produces pre-angiotensin
71
Kidney's role in RAAS?
Releases renin
72
Where is renin synthesized and released?
- Juxtaglomerular cells of JGA | - Released into afferent glomerular arteriole
73
Renin in the blood stream's role in RAAS?
Converts pre-angiotensin to angiotensin I
74
Lungs role in RAAS?
Produce ACE
75
Function of ACE in RAAS?
Converts AT I to AT II
76
Stimulus of renin release and the goal of RAAS
- Stimulus: decreased BV/BP, sympathetic activity, decreased NaCl flow through macula densa - Goal: increase BV/BP
77
Actions of AT II
- Vasoconstriction - Stimulate thirst centers in brainstem - Enhances sympathetic function by promoting release of NE - Stimulate adrenal cortex to release aldosterone - Stimulate posterior pituitary to release ADH
78
Action of aldosterone in distal nephron?
Increases Na/Cl reabsorption
79
Action of ADH in distal nephron?
Increases water/fluid reabsorption
80
How does AT II affect peritubular capillary hydrostatic pressure?
Decreases (promotes fluid reabsorption)
81
How does AT II affect mesangial cells?
Stimulates contraction of mesangial cells (resulting in decreased GFR)
82
What is the long term action of AT II?
Stimulates vascular hypertrophy
83
Net result of RAAS?
Increased BV/BP
84
What inhibits renin release?
- Increased GFR or Na/Cl flow - Increased systemic/glomerular BP - Negative feedback of increased AT II and ADH
85
Goal of natriuretic peptides?
Counteract RAAS
86
What are the natriuretic peptides?
- ANP - BNP - CNP - Renal natriuretic peptide (urodilatin)
87
Where is CNP produced/secreted from?
Vascular endothelium and heart
88
Where is renal natriuretic peptide (urodilatin) secreted from?
DCT/collecting ducts
89
Where is BNP produced and secreted from?
-Right ventricle | and brain where it was originally identified
90
Functions of ANP/BNP:
- Promote Na/water excretion (increase GFR) - Inhibit secretion of renin and aldosterone - Inhibit Na/water reabsorption
91
Function of CNP?
Promotes vasodilation of blood vessels
92
Function of renal natriuretic peptide?
Promotes Na/water excretion in DCT/collecting ducts

Pathophys II MHM - Exam 2 (4 decks)

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