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Urinary Exam 1 > Renal Physiology and AKI (Week 2): Normal Renal Physiology > Flashcards

Renal Physiology and AKI (Week 2): Normal Renal Physiology Flashcards

1
Q

What is a good indicator of good kidney function?

A

Concentrated Urine, remember though that the mechanism to dilute and concentrate are intertwined

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2
Q

Glomerulus makes an ultra-filtrate that has the same solute concentration as the ______

A

blood

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3
Q

Where does the ultra-filtrate become diluted?

A

In the Thick loop of Henle
- continues in the distal tubule

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4
Q

What happens if there is no ADH present?

A
  • The ultrafiltrate is going to stay approximately the same concentration as when it left at the distal tubule
  • Excreting a Dilute Urine
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5
Q

What happens if there is ADH present?

A
  • ADH is going to put aquaporins into the membrane and this is going to allow water to leave the ultra-filtrate and move into the Interstitium
  • Concentrates the Urine
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6
Q

The ultra-filtrate gets _____________ on the way down, it gets ___________ on the way up and then the change is variable in the collecting duct depending on the presence or absence of ___________

A

concentrated, diluted, ADH

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7
Q

What regulates blood pressure?

A

Heart
Kidneys
Brain
Vessels

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8
Q

How does the kidney have the long term control of blood pressure?

A

By regulating sodium and water

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9
Q

Kidneys are key players in maintaining homeostasis of numerous substances like:

A

Potassium
Phosphorus
Acid-base

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10
Q

What are the two organs that play a big role in detoxifying and eliminating substances?

A

Kidneys
Liver

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11
Q

If dehydration is so severe that the blood volume is decreased, the kidneys may not get enough blood flow to filter all the waste. Creating waste build up in the blood, even though the kidneys are still doing their job of concentrating the urine. This situation is known as?

A

pre-renal azotemia

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12
Q

Filtration in the glomerulus is based on what?

A

Balance of hydrostatic and oncotic (protein) pressure in the glomerular capillary and Bowman’s space

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13
Q

The renal artery feeds the _____________, which branch off to the nephron

A

arcuate arteries

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14
Q

What plays a role in the concentrating and diluting of the urine?

A

Vasa recta

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15
Q

The filtration barrier is composed of 3 layers:

A
  • Capillary Endothelium
  • Glomerular Basement Membrane
  • Visceral Epithelial Cells (called Podocytes)
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15
Q

The filtration barrier is composed of 3 layers:

A
  • Capillary Endothelium
  • Glomerular Basement Membrane
  • Visceral Epithelial Cells (called Podocytes)
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16
Q

What things can NOT get into the ultra-filtrate of the glomerulus?

A
  • Proteins
  • Cells
  • Other Large things
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17
Q

Is the rate at which substances are removed from the blood

A

Clearance

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18
Q

Is determined by hydrostatic pressure in the glomerular capillary and opposed by colloid oncotic pressure in the glomerular capillary

A

GFR

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19
Q

Are the combination of hydrostatic pressure and colloid oncotic (protein) pressure that control movement of fluid out of a capillary

A

Starling Force

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20
Q

What are the Two main mechanisms for renal auto-regulation ?

A
  • Myogenic Mechanism
  • Tubuloglomerular Feedback
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21
Q

is an automatic response to stretching the vessel

A

Myogenic Mechanism

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22
Q

Affects the tone of the afferent arteriole, using the renin-angiotensin-aldosterone system

A

Tubuloglomerular feedback

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23
Q

is a key part of controlling sodium, water, and blood pressure

A

RAAS

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24
Q

Where does much of the action of the RAAS occurs?

A

Juxtaglomerular Apparatus

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25
Q

RAAS is big part of ________________ feedback

A

tubular glomerular

26
Q

These cells are cuboidal which allows them to fit in lots of mitochondria to make energy.
These cells also have an extensive brush border with lots of microvilli so there is plenty of luminal surface area for all this reabsorption to take place.

A

Proximal Tubule Cells

27
Q

Water is reabsorbed in the _______________ part, and since that is passive, those cells are thin as they don’t have as many mitochondria as some of the more energy-intense parts of
the nephron

A

descending

28
Q

The __________________ of the loop of Henle is very metabolically active, reabsorbing sodium, chloride, potassium, along with other things like calcium and magnesium

A

ascending thick limb

29
Q

What helps blunt changes in pH and are fast-acting but limited incapacity?

A

buffers like bicarbonate or proteins

30
Q

can buffer volatile acids (i.e. those in gas form), but it requires kidneys to excrete fixed acids (non-volatile) which come from diet and normal metabolism

A

respiratory system

31
Q

What is another thing the kidney must be able to do, other than reabsorbing all the bicarbonate?

A
  • Kidneys must also be able to secrete Hydrogens into the ultra-filtrate
  • The secreted hydrogen is buffered by phosphate or ammonia in the urine.
32
Q

about 65% of the Sodium is reabsorbed, along with 65% of the Chloride, and 65% of the Water. This is happening in the?

A

Proximal Tubule

33
Q

Does the osmolality in the proximal tubule change when the volume is reduced to about 1/3 of what it was?

A

The osmolality doesn’t change

34
Q

NaCl reabsorbed, water stays, diluted

A

Ascending thick loop

35
Q

NaCl reabsorbed, water stays, further dilution

A

Distal tubule

36
Q

The interstitium, which is the space outside the tubular lumen and outside the tubular epithelial cells, is what compared to the tubular lumen?

A

Hyperosmolar

37
Q

In a dog, we would consider a urine specific gravity over __________ to be well concentrated

A

1.030

38
Q

It needs to be over _________ to be considered well concentrated in a cat

A

1.035

39
Q

Concentrating is an _________ process

A

active

40
Q

AKI impairs ____________ ability

A

concentrating

41
Q

Diluting is an __________ process

A

active

42
Q

Hyposthenuria takes _____________ kidneys

A

functional

43
Q

What is it called when the kidney can minimize ups and downs in the renal blood flow, which keeps GFR fairly constant?

A

Renal Autoregulation

44
Q

What is known as a automatic response to stretching the vessel?

A

Myogenic Mechanisms

45
Q

What are the two mechanisms for renal autoregulation?

A
  • Tubuloglomerular Feedback
  • Myogenic Mechanisms
46
Q

What causes the Afferent Arteriole to dilate, delivering more blood to the glomerular capillary, which increases RBF, and it causes the Efferent Arteriole to constrict, which increases glomerular capillary pressure, thus preventing a drop in GFR?

A

Tubuloglomerular Feedback

47
Q

___________________ in the glomerulus drains into the proximal tubule, and that tubule loops around, and when it turns into the distal tubule, it is nestled in an angle between the afferent and efferent arterioles of its glomerulus.

A

Bowman’s space

48
Q

renal sensor elements that detect changes in distal tubular fluid composition and transmit signals to the glomerular vascular elements

A

Macula Densa Cells

49
Q

A decrease in arterial pressure initially leads to a decrease in ________ pressure

A

glomerular

50
Q

The decrease in glomerular pressure decreases _________.

A

GFR

51
Q

The decreased GFR will decrease delivery of ________ to the macula densa.

A

NaCl

52
Q

What decreases flow to the macula densa, other than the decreased GFR?

A

Increased proximal tubule NaCl absorption

53
Q

What stimulates the release of renin, which leads to formation of angiotensin II, which increases resistance in the Efferent Arteriole?

A

Decreased flow in the Macula Densa

54
Q

Increased resistance in the _______________ helps to increase glomerular hydrostatic pressure.

A

Efferent Arteriole

55
Q

What also happens when there is decreased flow in the macula densa?

A

It decreases resistance in the Afferent Arteriole

56
Q

What stimulates the
renin-angiotensin-aldosterone (RAAS) system to cause
VasoConstriction of the
Efferent Arteriole to maintain adequate hydrostatic pressure
to maintain GFR and it
causes VasoDilation of the Afferent Arteriole to restore blood flow to the kidney?

A

Low blood flow

57
Q

It accounts for about 50% of autoregulation

A

Myogenic control

58
Q

is a key regulator of Sodium, volume, and pressure.

A

RAAS

59
Q

How much blood would need to be filtered to remove a substance if the kidneys were 100% efficient, describes?

A

Clearance

60
Q

The Na+K+ATPase pump uses energy to move sodium inside the _____________ cell into the blood, decreasing the sodium concentration in the cell compared to the ultrafiltrate in the lumen

A

tubular

61
Q

The concept of autoregulation is:

A

The glomerulus can maintain a fairly constant renal blood flow over a wide range of systemic blood pressure

62
Q

What is the end result of RAAS activation?

A

Restoration of renal perfusion by increasing Sodium and water retention and increasing Blood Pressure

Urinary Exam 1 (11 decks)

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