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Genitourinary > renal physiology > Flashcards

renal physiology Flashcards

1
Q

function of kidney

A

maintain balance of salt and water
excrete waste
endocrine function

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2
Q

renal and urine flow

A

renal is 1L per min

urine is 1ml per min

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3
Q

renal blood supply

A

Left and right renal artery

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4
Q

what are podocytes

A

they help to filter out harmful substances

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5
Q

where does glomerular filtration happen

A

distal part of nephron

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6
Q

fenestration capillary enodthelium

A

first barrier

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7
Q

3 components of barrier

A

fenestration capillary endothelium
gbm
podocytes

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8
Q

what determines filtration barrier

A 
Pressure
Size of the molecule
Charge of the molecule
Rate of blood flow
Binding to plasma proteins
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9
Q

what is nephroticsyndrome

A

damage to filtration barrier can lead to protein leak

caused by immune conditions genetic abnormalities

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10
Q

define gfr

A

is the filtration volume per unit time (minutes) from the glomerulus to the bowman’s space

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11
Q

autoregulation with regards increasing to pressure

A

Pressure within afferent arteriole rises  stretches vessel wall  triggers contraction of smooth muscle  arteriolar constriction

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12
Q

role of macula densa cells

A

detect nacl arrival
release prostaglandins in response to nacl delivery
acts on granular cells triggering renin release activiating RAAS system

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13
Q

how to work out filtration fraction

A

Filtration fraction = GFR / renal plasma flow

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14
Q

what is renal clearance

A

The volume of plasma from which a substance is completely removed by the kidney per unit time (usually a minute)

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15
Q

what is gfr determined by

A

hydrostatic and oncotic pressure, surface area and permeability

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16
Q

what is needed for lower urinary tract function

A

urine storage

urine emptying

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17
Q

average plasma flow daily through nephrons

A

180L PERD DAY

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17
Q

histology of tubules

A

single epithelial layer

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18
Q

function of proximal tubule and location

A

in renal cortex
bulk reabsorption: na water and ions 90% bicarobinate glucose and amino acids
Has microvilli

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19
Q

how is glucose reabsorbed in PCT

A

sodium glucose transporter 2

sodium potassuim pump to make a conc grad

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20
Q

function of loop of henle

A

Ascending : na,k, and cl reabsorbed
Water impermeable
Thick

Descending : h20 reabsorption , water permeable
Thin

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21
Q

function of distal tubule

A

fine regulation of na k ca pi , seperation of na from H20

Has macula sense which detects na concentration

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22
Q

hc03- reabsorption process

A

bicarbonate reacts with h+ forming carbonic acid in lumen
carbonic acid is split by carbonic anhydrase to water and co2
Water and co3 dissociate into hco3- and h+ in cell
Hco3- enters the blood and h+ is recycled

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23
Q

function of collecting ducts

A

important for water reabsorption
principal cells- for salt and water absrob
and potassium removal
Intercalated cells for reabsorbing HCO3- and secreting H+

24
Q

kidney function with regards to acid and base

A

regulate acid base balance in the body by regulating h

+ altering plasma

25
Q

what do the kidneys do in response to acidosis

A

kindeys decrease excretion of HC03-

produce new hc03- which is added to plasma

26
Q

Define an acid and base

A

Acid accept hydrogen ions

Base donates hydrogen ions

27
Q

Bicarbonate buffer equation

A

Co2 + h20 ~> h2co3

H2co3~> h+ + hc03-

28
Q

urinary phosphate buffer system

A

H+ from dihydrogen phosphate (h2po4-) ions are actively transported into lumen via hydrogen atp-ase
Excess luminal phosphate can bind to a large portion of hydrogen ions , buffering them as h2po4- before excretion
Excretion increases blood ph

29
Q

urinary ammonia buffer system

A

Glutamine is converted to glutamate and ammonium in pct
Ammonium dissociates allowing it to pass through the lumen
Once in lumen it reforms ammonium
Excreted to increase blood ph

30
Q

summary of respiratory acidosis

A

Low ph
Low hc03-
high pco2

31
Q

summary of metabolic acidosis and alkalosis

A

acid- low ph, low hc03- low pc02

alka- opposite

32
Q

EPO function

A

stimulates bone marrow which promotes RBC maturation

inhibits apoptosis

33
Q

How to measure gfr

A

Use of a marker substance

Clinically we can use creatinine- free filtered , not metabolised , not secreted

34
Q

Factors affecting gfr

A 
Hydrostatic pressure out of capillary 
Hydrostatic pressure out of bc
Oncotic pressure in capillary
Surface area 
Capillary permeability
35
Q

Equation to work out gfr

A

GFR= NFP x kf

36
Q

How do the kidneys control water and blood pressure

A

Regulation of osmolality
RAAS system
ANP

37
Q

Action of adh

A 
Produced in hypothalamus 
Binds to avpr2 receptors 
Activates a G protein inside the cell 
ATP-> cAMP
causes more aquaporin 2 to be released 
More aqp2 to embed into the cells 
More water into the blood
38
Q

How does raas system affect BP

A

Juxtoglomerular cells detect drop in bp and release renin
Causes angiotensinogen to be converted to ANG1
Ang1->ang2 by ace in lungs

39
Q

Importance of angiotensin 2

A

Increase release of adh causes more aquaporins to reabsorb more water
Adh acts on smooth muscle cells to constrict which increase the peripheral resistance

40
Q

Which segment of the nephron does adh act on

A

Principal cells in the collecting duct

41
Q

When is anp released

A

When the atrial wall stretch is too high

42
Q

Actions of anp

A

Blocks sodium channels in collecting duct
Inhibits aldosterone release via renin inhibition
Vasodilation of afferent arteriolar

43
Q

Function of parathyroid hormone

A

Regulates serum calcium concentrations

44
Q

Function of aldosterone

A

Ion balance
Sodium in
K out

45
Q

What hormones do the adrenal glands release

A 
Aldosterone 
Cortisol 
Corticosterone
DHEA
Androstenedione
46
Q

Precursor to all corticosteroids ?

A

Cholesterol

47
Q

How is the cortex of adrenal gland separated

A

Zona glomerulosa
Zona fasiciculate
Zona reticularis

48
Q

Will problems with pituitary gland and hypothalamus affect aldosterone

A

No

49
Q

Role of Zona glomerulosa -mineral corticoids

A

Main one released is aldosterone

50
Q

What does Zona fasciculata do

A

Important effects on glucose metabolism and secretes cortisol in response to stress

51
Q

Normal functions of cortisol

A 
Maintain normal bp
Maintain blood glucose 
Inhibit inflammation 
Control cell damage 
Decrease capillary permeability
52
Q

Basic stress function of cortisol

A

Increases organic metabolism and uses their energy to increase plasma cons

53
Q

Where is epo produced

A

Peritubular cells of right cortical interstitium

54
Q

where are m3 muscarinic and b3 receptors located

A

on detrusor muscle

55
Q

where are nicotinic receptors located

A

external sphincter

56
Q

where are alpha 1 receptors located

A

internal sphincter

57
Q

too much or too little epo what can happen

A

too much- viscous blood

too little anaemia

Genitourinary (6 decks)

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