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Human Form & Function > Renal Physiology > Flashcards

Renal Physiology Flashcards

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1
Q

why does renal physiology matter to dentistry?

A

-You will write prescriptions, the kidneys are a major excretion route for pharmaceuticals
-Local anesthetics are excreted through kidneys
-Patients with kidney failure need to be monitored closely and certain precautions should be made for them
-A lot of patients are on blood pressure medications
—–Limits of max BP you can treat pts
—–Clinic policy? 160/100

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2
Q

kidneys are a major _______ route for pharmaceuticals

A

excretion

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3
Q

local anesthetics are excreted through the …

A

kidneys

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4
Q

kidney medulla contains _____

A

pyramids

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5
Q

kidney pyramids have _____ that connect to renal pelvis

A

papilla

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6
Q

kidney pelvis drains to the _____ and then the ____

A

ureter
bladder

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7
Q

kidney nephrons are the ________

A

the functional unit of kidneys

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8
Q

how many kidney nephrons?

A

~1 million

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9
Q

what are the components of the kidney nephron?

A

renal tubule
glomerulus

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10
Q

Kidneys:
“dirty” blood goes in through the ____
“clean” blood leaves through the ____

A

arteries
veins

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11
Q

afferent vs efferent arterioles of kidneys

A

afferent = blood going into the glomerulus
efferent = blood leaving glomerulus

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12
Q

glomerular filtration creates a …

A

plasma-like filtrate of the blood

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13
Q

homeostasis

A

regulation of the volume of blood plasma, blood pressure, and pH

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14
Q

blood volume ___L

A

5 L

fluid in both plasma and RBC

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15
Q

changes in fluid will result in changes of ____

A

pressure

increase urine output can help relieve pressure

restricted urine output can maintain pressure (dehydration)

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16
Q

changes in fluid volume will start with ____

A

plasma

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17
Q

fluid in body ~__ L

A

~42 L

plasma, interstitial fluid, intercellular fluid

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18
Q

ways the body excretes fluid

A

breathing
sweat
crying
feces

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19
Q

metabolic waste products (kidneys)

A

urea
creatinine
bilirubin
uric acid

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20
Q

foreign substance waste products (kidneys)

A

drugs/medications
food additives
toxins

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21
Q

simple: how do kidneys regulate pH

A

simple: excrete or retain an acid or base

excrete or retain H+ ions (hydrogen ions)
excrete or retain HCO3- (bicarbonate)

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22
Q

kidney processes (3)

A

filtration
modification
excretion

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23
Q

blood flow of kindeys

A

Renal artery -> afferent arterioles -> glomerular capillaries -> efferent arterioles -> peritubular capillaries -> renal vein and out

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24
Q

urine flow of kineys

A

Glomerulus -> proximal tubules -> Loop of Henle -> distal tubule -> collecting duct -> renal pelvis -> ureters

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25
nephrons are supplied by ____
glomerular capillaries (filtration occurs here) single direction
26
peritubular capillaries: ____ & _____ occurs
reabsorption secretion multi-direction
27
study
28
cortical nephrons compose __%
70%
29
juxtamedullary nephrons compose __%
30%
30
all nephrons are composed with the same things but they are _____
located in different places
31
cortical nephrons are mainly in the ___
cortex with Loop of Henle in the medulla *shorter
32
juxtamedullary nephrons span across the ___
medulla
33
juxtamedullary nephrons are ____ cortical nephrons are ____ (length)
juxtamedullary nephrons are LONG cortical nephrons are SHORT
34
juxtamedullary nephrons have different blood supply, called
Vasa Recta
35
Kidneys receive ____ L of blood/min
~1.2 L
36
Substance is filtered but none is reabsorbed= Substance is filtered and partially reabsorbed= Substance is filtered and totally reabsorbed= Substance is filtered and added back via secretion=
Substance is filtered but none is reabsorbed. -creatine Substance is filtered and partially reabsorbed. -water (maintain homeostasis in times of dehydration) Substance is filtered and totally reabsorbed. -glucose (none in urine) The substance is filtered and added back via secretion. -hydrogen ions H+ (help with homeostasis)
37
rate of filtration equation
38
Hydrostatic pressure is _____ in glomerular capillaries rather than peritubular capillaries.
higher creates concentration gradient
39
what will cause the contraction of mesangial cells?
histamine angiotensin norepinephrine
40
what causes the relaxation of mesangial cells?
dopamine for relaxation
41
Glomerular filtration rate (GFR) is typically ____ L/Day
~180 L/Day
42
how to modify GFR (Glomerular filtration rate)
modify the diameter of the afferent/efferent arterioles Decreased diameter of afferent = decreased pressure in the glomerulus and decreased GFR. Dilation is the opposite constriction of efferent = increased resistance to leave glomerulus and increase GFR. (minor)
43
Major constriction will cause blood to be trapped (with proteins) and ____ oncotic pressure and ____ GFR.
increases oncotic pressure decreases GFR
44
What does the sympathetic nervous system do to GFR and Renal Blood Flow (RBF)?
fight or flight
45
angiotensin II
???? slide16
46
Prostaglandins and NO
????? slide 16
47
Autonomic Regulation (GFR)
Macula Densa (Distal Tubule) --Detects changes in Na+ --Initiates release of renin
48
study
49
high Na levels = want filtration to be less because we want to retain water contraction of mesangial cells release of renin release angiotensin
??? slide 16
50
what detects Na+ changes?
Macula Densa (distal tubule)
51
contraction of mesangial cells will contract the ____ and does what
glomerulus slows filtration rate
52
study
53
fluid going to the proximal tubule is similar to _____
plasma in blood
54
reabsorption is _____ and in ____ quantities
reabsorption is selective and in large quantities (water/solutes)
55
reabsorption depends on the osmolarity of the body which is
the hydration state of the body
56
waste products are ___ reabsorbed while glucose and electrolytes are ____ absorbed
waste products = poorly absorbed glucose/electrolytes = well absorbed
57
osmolarity is high =
more concentrated urine
58
active transport of reabsorption
sodium-potassium pump uses ATP and sets up a gradient Co-transport also known as secondary active transport
59
passive transport of reabsorption
Passive: diffusion down the concentration gradient
60
____ is a large proponent to what is reabsorbed
Sodium
61
waste products like _____ generally do not reabsorb
pharmaceuticals
62
study
63
proximal tubule has __% water and sodium reabsorbtoin
~65%
64
____ is absorbed with sodium in the proximal tubule
chlorine
65
loop of henle controls ______ of urine
concentrations of urine
66
loop of henle is the _____ loop and more conentrated
longer
67
two parts that make up the Renal counter-current exchange
thin descending aquaporins thich ascending active transporters *loop of henle
68
at the apex of loop of henle (deep in the medulla) there are very ____ osmolarity levels
high
69
distal tubule two cells
principal cells: P-reabsorb Na+ and secrete k+ intercalated cells: reabsorb k+ and hCO3- and secrete H+
70
secrete means ____ to _____
blood to urine
71
ADH regulation occurs at the
distal tubule collecting duct ADH: antidiuretic hormine (not urinating)
72
high blood pressure pts will take a ____ blocker to help them urinate more
ADH blocker
73
in the collecting duct, medullary collecting ducts are ___ permeable to urea
more
74
collecting duct can can pump ___ into the lumen
H+
75
excretion rate =
ER= (Filter rate – reabsorption) + secretion rate
76
Filter = Reabsorb = Secrete = Excrete =
Filter: What enters the kidney tube system at the beginning Reabsorb: Out of kidney tube system back into the body Secrete: From the body into the kidney tubes Excrete: out of the body in general
77
common electrolytes found in the body
Sodium Potassium Magnesium Calcium Chlorine Organic anions Proteins
78
urea is formed in the ___
liver
79
urea is the end product of ____ ____
protein metabolism
80
urea maintains ______ in the medulla
hyperosmolarity
81
urea is secreted into the very beginning of the _____ _____
ascending loop
82
T/F: urea maintains water levels in loop of henle
true
83
urea is passively reabsorbed from the
proximal tubule collecting duct
84
kidneys can create ____ (hormone)
erythropoietin (EPO)
85
kidneys can aid the liver in ______ and retention of glucose
gluconeogenesis
86
adrenal glands are ____ (location)
on top of kidneys
87
adrenal glands produce ... (3)
sex hormones cortisol homeostasis hormones (ie: aldosterone, vasopressin, renin, adrenaline, etc)
88
kidneys have lymphatic drainage, and drains via the ____ ___
thoracic duct
89
lymphatic trunk and ducts run near the
Lymphatic trunks and ducts flow following the bloodstream
90
lymphatics relieves the blood steam of ___
toxins
91
the lymphatic system has an abundance of _____ cells
immune cells
92
kidney disease/kidney failure reasons (4)
Uncontrolled hypertension diabetes CVD chronic medication abuse
93
measure ___ in pts with kidney problems
Measure eGFR (filtration rate) ability to filter waste and proteins
94
stages of kidney disease (5)
1. Normal function but evidence of damage 2. Work well and sometimes hindered function 3. Filtering is not ideal and can manifest in health problems 4. Last stage before full kidney failure (dialysis start?) 5. Failure (non-working) – waste builds up in blood. Need dialysis.
95
common kidney problems (4)
kidney stones (ureter or kidney - build-up of solutes) cancers (bladder, kidney, adrenal gland which spreads) lupus (chronic inflammation causes kidney failure) diabetes (high sugar levels)
96
nephrotoxic medications (7)
NSAIDS Diuretics ACE inhibitors Zoledronic Acid Acyclovir HIV medications Drug abuse
97
changes to dental tx in relation to Kidneys
amide anesthetics codeine-based analgesics bleeding risk infection risk (regular prophylactic visits, more frequent post-op visits)
98
Kidneys filter a lot of blood daily producing ____
Kidneys filter a lot of blood daily producing urine
99
kidneys are essential for
homeostasis

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