renal physio Flashcards

(74 cards)

1
Q

what is the primary goal of the kidney

A

maintain homeostasis and renal function

- constantly changing and dynamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the kdiney regulate exactly

A
  • water and salt balance (Na, K, Ca); balancing intake and excretion
  • remove metabolic waste, drugs, other foreign chemicals
  • gluconeogenesis
    Production of hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what hormones are made by he kidney

A

Erythropoietin
Renin
1,25-dihydroxyvitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the roll of erythropoietin

A

acts in the bone marrow to stimulate synth of new erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the roll of renin

A

Part of renin-angiotensin-aldosterone cascade to regulate blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the roll of 1,25-dihydroxyvitamine D

A

regulate calcium absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

does the kidney process and see a lot of the water that the body has

A

only a small portion/compartment of the total body water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

do changes in one compartment in the body change water presence in the other parts of the body

A

can change other compartments of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is end stage renal disease

A

a reduced ability to elimiate nitrogenous wastes (urea) and excess nitrogen is converted to ammonium
- extra ammonium has direct effects on health
= alkalized blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the signs and symptoms of End stage renal disease

A

Ammonia breath
Gingival enlargement
xerostomia
tooth problems (premature loss, narrowing pulp chamberes, necrosis beneath filling/crowns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the contraindication for ESRD patients

A
Nephrotoxic drugs (tetracycline, acyclovir, aspirin, NSAIDS)
Increased susceptibility due to descruction of platelets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

where is the kidney located

A

retroperitoneal oran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the functional unit of the kidney

A

Nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what part of the nephron does filtration

A

renal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what part of the kidney does concentration and collection of urine

A

Renal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how many nephrons are in the kidney

A

1.2x10^6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is a nephron made of

A
renal corpuscle (glomerulus+ capsule)
proximal (convoluted) tubule
Loop of Henle
Distal (Convoluted) Tubule
Collecting duct ( shared by multiple nephrons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how thick is the tubulues of the kindey

A

one cell layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the two types of nephrons based on the location of the renal corpuscle and length of the medullary tubules

A

Superficial or cortical nephrons

Juxtamedullary nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is filtration

A

Solute and water pass from blood into the tubular fluid in the renal capsule (Bowman’s space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

where does filtration occur

A

Glomerular capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what percent of the plasma is filtered

A

15-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what happens to the blood after it leaves the glomerular capillaries

A

Flows into peritubular capillaries (vasa recta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is secretion

A

Substances are transported from the blood in the peritubular capillaries into tubular fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is reabsoprtion
substance are transported from the tubular fluid into the blood in the peritubular capillaries
26
what are the 3 renal processes to regulate blood composition
Filtration Secretion Reabsorption
27
what does the composition of tubular fluid vary with
The location of the tube
28
what can happen to filtered subsances
secreted and no reasborbed some secreted and some reasborbed completed reabsorbed
29
what is a renal corpuscle made of
glomerulus and renal capsule
30
where does filtration occur
glomerulus (dense capillary bed)
31
what is the roll of the renal capsule
Collect the filtrate from the blood entering vai the afferent arterioles
32
what regulates flood flow throught the glomerulus
Smooth msucel contraction in afferent or efferent arterioles response of the JUxtaglomerular apparatus SNS
33
where is the juxtaglomerular apparatus
intersection of the macula densa and dital tubule with afferent and eferent arterioles
34
what is the importance of the juxtaglomerular apparatus
secretes renin
35
what does renin do
regulates systemic blood pressure and glomerular blood flow
36
what drains the renal capsule
proximal tubule
37
what does the proximal tubule do
reabsorb 2/3 of filtered salt and water | reabsorbed all filtered flucosa and amino acids
38
where do diurectics act
some act in the proximal convoluted tubule very powerful diuretics work in the loop of henle some in distal convoluted tubule some in collecting duct
39
what are the 3 limbs of the loop of henle
Thin descending limb thin ascending limb thick ascending limb
40
where does countercurrent multiplication done
in the loop of henle
41
what is the importance of the loop of henle
needed to produce concentrated urine but loop itself actually produces dilute filtrate
42
what drains the loop of henle
distal convoluted tubule
43
what happens inthe distal convoluted tubules
Contrinued reabsorption of solute | regulate ca
44
what is the action of the colecting duct
collect fluid from multiple nephrons
45
where does the colecting duct extend
from cortex through the medulla
46
what does the collecting duct do
regulates Na, K, and H2O
47
what is renal clearance
rate of excretion of a solute through the kidney as a unit of time - the volume of plasma from which all of a particular substance is removed to the urine
48
what is the imporance of renal clearance
monitor renal function(glomerular filtration rate)
49
what is glomerular filtration rate
amount of blood filtered by the kidney in unit time
50
when can Glomerular filtration rate be used
the substance must be free filtered by glomerulus substance is not sereted substance is not reabsored
51
what is Glomerular iltration rate in a normal kidney
125ml/min for females | 90-140ml/min in males
52
what substances are used to meaure renal cleance
Inulin | Creatinine
53
what is inulin
A small polysaccharide freely filtered and not secreted orabsorbed
54
what is creatinine
Product of muscle metabolism, freely filtered, not reabsorbed, almost no secretion
55
what is the normal and unnormal creatinine level
less han 1+- .5mg/dl normal | greater than 10= dialysis
56
what allows shit to leave th Glomerular capilaries
Fenestration
57
what is the space between the podocytes of the capillariation
filtration slits
58
what is not in the filtrate
Acellular protein free anything greater than 42 angustrum
59
what is freely filtered
less than 20 angstrum glucose Salts Amino acids
60
how does charge affect glomerular filtration
Basal lamina is negative so hard to filter moderately sized, negative solute
61
what causes filtration
pressure differences between blood in the capillaries and fluid in the capsule (starling forces)
62
what are the 2 sources of pressure in the filtration
Hydrostatic pressure | Oncotic pressure
63
what is hydrostatic pressure
pressure due to fluid
64
what is oncotic pressure
pressure due to solutes(including those not dissolved
65
is hydrostatic pressure greater in the capilaries or capsule
greater in the capillaries( increases filtration)
66
is oncotic pressure greater in the capillaries greater or capsule fluid
greater in the capillaries (decreases filtration)
67
what does net filtration pressure favor
filtration from blood into capule fluid
68
what changes glomerular filtration rate
Blood flow into and out of glomerulues | Pressure gradient between capillary blood and tubular fluid
69
does renal blood flow change with systemic blood pressure
No, remains fairly constant
70
what are the methods of autoregulation of blood through the glomerulus
Myogenic mechanism | Tubuloglomerular feedbackk
71
what is the myogenic mechanism for autoregulation of the bloodflow through the glomerulus
Vascular smooth muscle contracts when stretched and relaxes when not stretched - has inverse effects on afferent and efferent arterioles
72
what is the tubuloglomerular feeback mechanism for autoregulation
feedback from the justaglomarular apparatus adjusts afferent arteriole diameter and Glomerular filtration rate
73
what is the tubuloglomerular feedback mechanism in response to increase Glomerular filtration rate
1. increase in GFR 2. increase NaCl in tubular fluid 3. increase NaCl at macular densa 4. increased resistance in afferent arterioles 5. decreased GFR
74
what are the extrinsic factors that regulate on renal blood flow and glomerular filtration rate
``` Diet Dehydration Hemorrhage sympathetic nervous system Angiotensin II aldosterone Natriuretic peptide ```