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Systems 2nd Year Renal > Renal Physiology 2 > Flashcards

Renal Physiology 2 Flashcards

1
Q

Progression of renal disease results in destruction of

A

Nephron Destruction and Function

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2
Q

What is Total GFR the sum of?

A

All filtration by functioning Nephrons so progression of disease would be indicated by reduction in GFR.

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3
Q

What is important plasma or urine

A

Plasma

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4
Q

What does clearance relate to in measurement of GFR

A

Volume of plasma cleared

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5
Q

what is the loading IV dose of inulin

A

polyfructose

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6
Q

Inulin gives how much clearance

A

100%

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7
Q

Where is inulin freely filtered

A

at Glomerulus

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8
Q

Why is inulin measurement a measurement of GFR

A

It is not metabolised by kidney and does not interfere with normal renal function

It is also not reabsorbed or secreted

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9
Q

Substances which are filtered and reabsorbed will have a what clearance compared to inulin

A

Lower Clearance than Inulin

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10
Q

Substances filtered and secreted will have a what clearance compared to inulin

A

higher clearance

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11
Q

What is GFR in normal man

A

125

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12
Q

GFR declines by how much per year after 30

A

1ml/min/year

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13
Q

What is used in clinical practice instead of inulin

A

51Cr-EDTA

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14
Q

What is routinely used to estimate GFR

A

Plasma Creatinine Clearance

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15
Q

Creatine is breakdown produce of what

A

Creatinine Muscle

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16
Q

Creatine is said to be endogenous or exogenous

A

endogenous

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17
Q

What factors can affect serum creatinine

A

Muscle Mass
Diet
Drugs

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18
Q

What is normal GFR

A

100mls/1.73min

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19
Q

What is glucose’s clearance rate

A

zero as all glucose reabsorbed

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20
Q

what is urea’s clearance rate

A

50ml with 50% reabsorbed and 50% excreted

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21
Q

What is used to measure real plasma flow

A

Organion anion para amino hippuric acid

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22
Q

Para Amino Hippuric Acid is freely filtered where

A

glomerulus and then remaining in plasma secreted into tubule so 90% of plasma is cleared of PAH content

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23
Q

what is the percentage of clearance of PAH from plasma

A

90%`

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24
Q

Penicillin clearance

A

More penicillin excreted than filtered. Clearance rate 150 with 0 reabsorbed

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25
Q

When filtration is greater than excretion this means

A

Net reabsorption

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26
Q

When excretion is greater than filtration this means

A

net secretion

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27
Q

when filtration and excretion are the same this means

A

No net reabsorption or secretion

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28
Q

How does urine flow form kidneys to ureters

A

via peristaltic contraction of smooth muscle of ureters

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29
Q

what type of muscle is bladder

A

dertrusor muscle

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30
Q

which muscle is mainly responsible for emptying bladder during micturition

A

detrusor muscle

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31
Q

The external urethral sphincter is

A

true sphincter made up of skeletal muscle under voluntary somatic control

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32
Q

the external urethral sphincter is under what control

A

voluntary somatic

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33
Q

the external urethral sphincter is made up of what type of muscle

A

skeletal

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34
Q

which urethral sphincter has smooth muscle and acts as a sphincter when smooth muscle relaxes

A

internal urethral sphincter

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35
Q

what type of epithelium does bladder have

A

Lined Transitional

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36
Q

Trigone of bladder has how many openings

A

2 Vesicoureteric

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37
Q

Urethral obstructions go on to be

A

bilateral renal problems

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38
Q

ureter obstruction goes on to be

A

unilateral renal problem

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39
Q

when the bladder is at rest what does the external sphincter with skeletal muscle do

A

stays contracted and internal sphincter is passively contracting

40
Q

Micturition is controlled by

A

Parasympathetic Supply

41
Q

Pressure within the bladder for micturition comes from which nerves

A

S2-4

42
Q

Sympathetic supply for micturition is from

A

Hypogastric Nerves which inhibit contraction and close internal urethral sphincter

43
Q

Internal Urethral sphincter closure is controlled by which nerves

A

Sympathetic hypogastric

44
Q

Main function of hypogastric nerves and sympathetic and L1-3 in micturition

A

is prevent reflux of semen into bladder during ejaculation

45
Q

Somatic Motoneurons (Pudental nerves) S2-4 innervate

A

Sketal Muscle that forms external Urethral sphincter

46
Q

Sensory innervation of bladder is achieved by

A

stretch receptor afferents from bladder wall

47
Q

As bladder fills what happens to discharge in afferent nerves to spinal cord

A

Increases via interneurons

48
Q

What happens to parasympathetic in sensory innervation of bladder

A

Excitation

49
Q

what happens to sympathetic in sensory innervation of bladder

A

Inhibition Inc Inhibition of Somatic Motorneurons to ext Sphincter

50
Q

which neurons stop firing in micturition

A

motor

51
Q

which sphincter relaxes in micturition

A

external sphincter

52
Q

which type of muscle contracts in migration

A

smooth

53
Q

what type of neurons fire in micturition

A

parasympathetic neurons

54
Q

Bladder contraction is caused by

A

stimulation of parasympathetic and relax external sphincter

55
Q

which neurons need to be inhibited to relax external sphincter

A

Somatic Motoneurons

56
Q

Volume of urine in bladder required to initiate spinal reflex is

A

300-350

57
Q

Delay in micturition is accomplished by

A

descending pathways

58
Q

delay micturition requires

A
  1. descending pathway
  2. inhibit parasympathetic
  3. stimulate somatic nerves to ext sphincter
59
Q

voluntary initiation in micturition involves descending pathways which

A

stimulate parasympathetic

  1. inhibit somatic motor neurons
60
Q

What does the male urethra need to expel pee

A

Contractions of bulbocavernous muscle

61
Q

Contractions of bulbocavernous muscle cause expelling of pee in which gender

A

male

62
Q

One of the most important aspects of the ECF regulated by the kidney is its

A

volume

63
Q

Can water freely cross all cell membranes

A

Yes

64
Q

What are the major ECF osmoles

A

Na+ and CI

65
Q

what are the major ICF osmoles

A

K+ salts

66
Q

Regulation of ECF volume =

A

Regulation of Body Na+

67
Q

The active transport mechanism that operates on the luminal surface of the thick ascending loop of Henle, involves

A

K+
Naci
Na+ and K+ 2CI Co Transporter

68
Q

The active transport mechanism that operates on the luminal surface of the thick ascending loop of Henle, is what type of process

A

passive process

69
Q

The active transport mechanism that operates on the luminal surface of the thick ascending loop of Henle, the energy involved comes from

A

active transport

70
Q

Where is Na/KATPase found

A

basolateral membrane

71
Q

Loop diuretics can cause

A

K+ Ion Wasting

72
Q

Any solute which remains in the tubule can cause

A

Osmotic Diuresis

73
Q

When a large volume of isotonic urine is excreted what happens to pv

A

Decreased

74
Q

Decreased PV will stimulate what

A

ADH release via baroreceptors

75
Q

Why does a hypoglycaemic coma happen

A

Inadequate glucose for the brain available

76
Q

why does a hyperglycaemic coma happen

A

inadequate BF to brain

77
Q

Reabsorption of NaCi to H20 in Renal Tubule. How much is reabsorbed from proximal tubule

A

65-75%

78
Q

How much NaCi to H20 is reabsorbed from loop of henle

A

15-20%

79
Q

How much NaCi to H20 is reabsorbed from distal tubule to collecting duct

A

5-20%

80
Q

What happens in Osmotic Diuresis of Uncontrolled Diabetes

A

Decreased Proximal Tubule Reabsorption, Loop of Henle Reabsorption, Distal Tubule Reabsorption

81
Q

In Diabetes Mellitus how much isotonic urine excreted a day

A

6-8L

82
Q

What inhibits renin release?

A

delivery of large volume of NacI to H20 at distal tubule inhibits renin release

83
Q

what are reabsorbed at distal tubule

A

NaCi and H20

84
Q

Fluid delivered to ascending limb is what in concentration

A

less

85
Q

The NaCI Pumps in ascending limb are

A

gradient limited

86
Q

Regulation of distal tubule Na+ reabsorption is under the control of the adrenal cortical steroid hormone,

A

aldosterone

87
Q

Aldosterone secretion controlled by reflexes involving

A

kidney

88
Q

Where is renin produced

A

JG Cells

89
Q

Renin acts on which large protein a2 globulin fraction of plasma proteins

A

Angiotensinogen

90
Q

Angiotensin II stimulates what

A

Aldosterone

91
Q

Aldosterone stimulates what in kidney

A

distal tubular Na+ ion reabsorption

92
Q

What controls renin release

A

Increased Renin release when P in afferent arteriole at level of JG Cells Decrease

Increased Sympathetic Nerve Activity via B1 affect

Decreased NaCI Delivery = Increased Renin

93
Q

What does ADH do to renin

A

inhibit renin relea

94
Q

Aldosterone promotes what reabsorption

A

Na+

95
Q

ANP Promotes

A

Na+ excretion

96
Q

Aldosterone does what two things at distal tubule

A

increase Na+ reabsroption and K+ secretion

Systems 2nd Year Renal (30 decks)

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