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A&P I (Fall 2022) > Renal Physiology (Final Exam) > Flashcards

Renal Physiology (Final Exam) Flashcards

1
Q

What is the role of the kidney in long-term blood pressure regulation?

A

Expansion of blood volume through fluid & electrolyte retention.

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2
Q

What is the role of the kidney in long-term pH regulation?
Where is HCO₃⁻ produced?
Why can’t pH be regulated using just the lungs?

A
  • Kidneys determine whether to retain HCO₃⁻ or not.
  • Kidneys
  • CO₂ can be exhaled but H⁺ can’t be disposed of by the pulmonary system.
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3
Q

What is the role of the kidney in long-term RBC regulation?
How does this occur?

A
  • Hematocrit regulation
  • Kidney reacts to internal low deep tissue O₂ levels & secrete Epoietin (Epo) to cause the bone marrow to produce RBCs.
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4
Q

What is the role of the kidney in long-term electrolyte regulation?

A
  • Kidneys reabsorb filtered ions.
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5
Q

How much of our renal plasma flow is filtered?

A

1/5 of RPF (Renal Plasma Flow)

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6
Q

How much Renal Blood Flow do we have in a healthy patient?

A

1000mL/min

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7
Q

RBF (Renal Blood Flow) is approximately _____% of CO.

A

20%

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8
Q

Renal Plasma Flow (RPF) is _____% of RBF.

A

60%

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9
Q

What is the role of the kidney in long-term regulation of Vitamin D?

A
  • Activation of cholecalciferol through hydroxylation with two -OH groups into 125-Dihydroxycholecalciferol
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10
Q

What is the chemical name for Vitamin D?

A

125-Dihydroxycholecalciferol

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11
Q

Under normal conditions, what occurs with glucose and the kidneys?

A
  • Glucose is filtered and reabsorbed.
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12
Q

When chronically hyperglycemic, what occurs with glucose and the kidneys?

A
  • Glucose is filtered and the kidneys allow a portion of this glucose to be urinated out rather than be reabsorbed.
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13
Q

What metabolic waste products does the kidney dispose of? Which is the most important?

A
  • Nitrogenous Waste Products
  • Urea
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14
Q

How does the renal system regulate blood osmolarity?

A
  • Through filtration & reabsorption of electrolytes
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15
Q

What three hormones secreted by the kidney (discussed in lecture) regulate osmolarity?
How does each do so?

A
  1. Aldosterone - H₂O & salt retention
  2. Angiotensin II - Conserves sodium, H₂O follows.
  3. ADH - reabsorption or secretion of H₂O alone. No electrolytes involved.
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16
Q

What muscle sits right above the kidneys?
What sits on top of the kidneys themselves?

A
  • Diaphragm
  • Adrenal Glands.
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17
Q

What structure is denoted by 1 on the figure below?

A

Renal Artery

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18
Q

What structure is denoted by 2 on the figure below?

A

Segmental Arteries

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19
Q

What structure is denoted by 3 on the figure below?

A

Interlobar Arteries

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20
Q

What structure is denoted by 4 on the figure below?

A

Arcuate Arteries

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21
Q

What structure is denoted by 5 on the figure below?

A

Interlobular Arteries

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22
Q

Where does blood go to from the interlobular arteries?

A
  • Glomerulus (Afferent Arterioles specifically)
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23
Q

Describe the blood flow path of the glomerulus.

A
  1. Afferent Arterioles
  2. Glomerular Capillaries
  3. Efferent Arterioles
  4. Peritubular Capillaries
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24
Q

Describe the flow of blood through the kidneys as the blood exits the peritubular capillaries.

A
  1. Interlobular Veins
  2. Arcuate Veins
  3. Interlobar Veins
  4. Segmental Veins
  5. Renal Vein
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25
Q

Which four components of the cardiovascular system are found in the nephron?

A
  1. Afferent Arterioles
  2. Glomerular Capillaries
  3. Efferent Arterioles
  4. Peritubular Capillaries
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26
Q

What controls blood flow into the glomerulus?

A

Afferent Arteriole

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27
Q

What influences pressures in the glomerulus & peritubular capillaries?

A

Efferent Arteriole

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28
Q

Where is 99% of filtrate reabsorbed?
Does filtrate go directly from Loop of Henle into this structure?

A
  • Peritubular Capillaries
  • No, fluid goes from nephron lumen → ISF → peritubular cap’s.
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29
Q

What percentage of nephrons are cortical nephrons?

A

90-95%

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30
Q

What percentage of nephrons are medullary nephrons?

A

5-10%

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31
Q

What is the name for deep peritubular capillaries found in medullary nephrons?

A

Vasa Recta

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32
Q

Differentiate descending vs ascending vasa recta by their purposes. (Besides the obvious that one goes down and one goes up).

A
  • More Ascending Vasa Recta (AVRs) than descending. This helps ↓ blood velocity thus slowing blood leaving the medulla.
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33
Q

What quadrants are the kidneys found in?

A

Right & Left Upper Quadrants

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34
Q

Why are renal cancer rates typically lower?

A
  • Less cell neogenesis occurs in the kidneys thus less chance of cancer cell formation.
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35
Q

What is denoted by 1 in the figure below?
What about 2?

A
  • 1 = Renal Pelvis
  • 2 = Right Ureter
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36
Q

What surface region is indicated by 1 below?

A

Left Suprarenal Gland (Left Adrenal Gland)

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37
Q

What surface region is indicated by 2 below?

A

Left Renal Gastric Surface

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38
Q

What surface region is indicated by 3 below?

A

Left Renal Splenic Surface

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39
Q

What surface region is indicated by 4 below?

A

Left Renal Pancreatic Surface

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40
Q

What surface region is indicated by 5 below?

A

Left Renal Descending Colic Surface

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41
Q

What surface region is indicated by 10 below?

A

Right Renal Colic Flexure Surface

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42
Q

What surface region is indicated by 12 below?

A

Right Renal Hepatic Surface

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43
Q

What surface region is indicated by 13 below?

A

Right Suprarenal Gland (Adrenal Gland)

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44
Q

Why are points of organ contact pertinent in regards to the kidneys?

A

Points of contact are important because of cancer transference.

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45
Q

What are kidneys stones composed of?
Where is pain from kidney stones usually felt?

A
  • “Aggregated salts”
  • Lower back due to dermatome affected.
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46
Q

Between males & females, who typically has a larger bladder capacity?

A

Males

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47
Q

Where is the “chokepoint” in the male urinary tract system?
What have most men developed by age 70 in relation to this organ?

A
  • Prostate
  • BPH
48
Q

Which spinal nerves regulate the emptying & closing of both the rectum and the external sphincter of the urinary tract?
What occur if these spinal nerves are messed with?

A
  • S2 - S4
  • Incontinence
49
Q

What structure is indicated by 1 on the figure below?

A

Bowman’s Capsule

50
Q

What structure is indicated by 2 on the figure below?

A

Proximal Convoluted Tubule

51
Q

What structure is indicated by 3 on the figure below?

A

Proximal Straight Tubule

52
Q

What structure is indicated by 4 on the figure below?

A

Descending Thin Limb of the Loop of Henle

53
Q

What structure is indicated by 5 on the figure below?

A

Ascending Thin Limb of the Loop of Henle

54
Q

What structure is indicated by 6 on the figure below?

A

Thick Ascending Limb of the Loop of Henle

55
Q

What structure is indicated by 7 on the figure below?

A

Distal Convoluted Tubule

56
Q

What structure is indicated by 9 on the figure below?

A

Initial Portion of the Cortical Collecting Duct

57
Q

What structure is indicated by 10 on the figure below?

A

Cortical Collecting Duct

58
Q

What structure is indicated by 11 on the figure below?

A

Medullary Collecting Duct

59
Q

Where is Glomerular Filtration Rate (GFR) determined?

A
  • Juxtaglomerular Apparatus
60
Q

Where is the Macula Densa located?

A
  • End of the TAL of the loop of Henle; Beginning of the DCT.
61
Q

What determines efferent arteriole dilation/constriction?

A
  • Filtrate running through urinary lumen at the Macula Densa. (specifically quantity of Na⁺ & Cl⁻ @ the MD)

verify

62
Q

How much reabsorption of filtrate occurs in the PCT?

A

2/3rds

63
Q

How many nephrons does a healthy human (who has never lost any) have?

A

2 million (1million per kidney)

64
Q

What percentage of Filtrate is reabsorbed? How much becomes urine?

A
  • 98-99% reabsorption
  • 1-2% → urine
65
Q

What two structures are the primary determinants of filtration?

A
  • Afferent & Efferent Arterioles
66
Q

What is a healthy GFR?

A

125cc/min or 1.25dL/min

67
Q

How is secretion different than filtration?

A

Secretion is the active pumping of ions/drugs/stuff out of blood & into tubular system.

68
Q

What is the PCAP of the Glomerulus?

A

60mmHg

69
Q

What is the πCAP of the glomerulus?

A

32mmHg

70
Q

What is PTUBE?

A

This is the pressure exerted by the filtrate in Bowman’s Capsule.

71
Q

What is the PTUBE of the glomerulus?

A

18mmHg

72
Q

What is the πTUBE of the glomerulus? Why is this?

A
  • 0 mmHg
  • No proteins are filtered into filtrate.
73
Q

How is NFP of the Glomerulus calculated?

A

NFP = PCAP - PTUBE - πCAP

74
Q

Would πCAP increase or decrease after filtration occurs at the glomerulus? Why?

A
  • πCAP would increase due to an increased proportion of the fluid being composed of unfiltered proteins.
75
Q

What would one expect for πCAP increase to be closer to the afferent arteriole?
What about closer to the efferent arteriole?
What causes this change?

A
  • Afferent ~ 28mmHg
  • Efferent ~ 36 mmHg
  • Increased due to higher protein concentration from fluid being filtered out.

card needs verification

76
Q

Renal Blood Flow (RBF) is controlled by ______ ______ tone.

A

Afferent Arteriole

77
Q

During hypertension what occurs to the afferent arterioles?

A

AA constrict to decrease RBF.

78
Q

During hypotension what occurs to the afferent arterioles?

A

AA dilate to increase RBF.

79
Q

Good RBF regulation results in good ____ regulation.

A

GFR.

80
Q

What is the formula for clearance?

A

C = (V · U) / P

C = Clearance
V = Urinary Flow Rate
U = Urine Concentration
P = Plasma Concentration

81
Q

How is Filtration Fraction (FF) calculated?

A

GFR/RPF = FF

(125/600) = 20%

82
Q

What percentage of RBF is red blood cells?
Approximately how many mL’s is this?

A
  • 40%
  • 400mL
83
Q

What will systemic vasodilatory drugs do to the GFR and UO?
Why is this?

A
  • ↑GFR & ↑UO
  • AA dilation thus ↑flow
84
Q

What is the best compound for determination of renal function?
Why is it not used?
What is second best and why is it used more?

A
  • Inulin (not used due to being exogenous)
  • Creatinine (endogenous and thus more convenient to use)
85
Q

What is secretion?

A
  • Physical removal of substance into urinary lumen via pumping (drugs, K⁺, etc.)
86
Q

What should renal clearance of glucose be in a healthy person?

A

0 (glucose reabsorbed)

87
Q

What is the GFR of someone who is healthy?

A

125mL/min or 1.25dL/min

88
Q

What capillary bed specializes in bulk reabsorption?
How much fluid is reabsorbed per minute?

A
  • Peritubular Capillary Bed
  • 124 mL/min
89
Q

Dilation of the efferent arteriole will ________ hydrostatic pressure in the glomerulus.

A

decrease

90
Q

Dilation of the afferent arteriole will ______
hydrostatic pressure at the glomerulus.

A

increase

91
Q

Constriction of the afferent arteriole will ______
hydrostatic pressure at the glomerulus.

A

decrease

92
Q

Constriction of the efferent arteriole will ______
hydrostatic pressure at the glomerulus.

A

increase

93
Q

Efferent constriction will decrease renal blood flow. T/F?
What would this do to filtration?

A
  • True
  • Increase Filtration
94
Q

What would the beginning pressure of the efferent arteriole be?
What would the pressure be at the end of the efferent arteriole?

A
  • Beginning = 60 mmHg
  • End = 13 mmHg
95
Q

Constriction of the efferent arteriole would _______ intravascular pressure downstream.

A

decrease

96
Q

What two factors will lead to an increased filtration fraction?

A
  • ↑GFR
  • ↓RPF
97
Q

What two factors will will lead to an decreased filtration fraction?

A
  • ↓GFR
  • ↑RPF
98
Q

An increased filtration fraction would be associated with what change in downstream colloid concentration?

A
  • ↑ colloid concentration
99
Q

What would a normal, healthy adult’s serum creatinine levels be?
How would this concentration change for the fluid in Bowman’s capsule?

A
  • 1mg/dL
  • It wouldn’t change (1mg/dL) no fluid reabsorbed yet.
100
Q

Why is creatinine easily filtered at the glomerulus?

A
  • Creatinine is a small molecule.
101
Q

What would the nephron’s response to hypochloremia & hyponatremia seen at the macula densa be?

A

↑ GFR by:
- Dilating afferent arteriole
- Constrict efferent arteriole

102
Q

What would the macula densa see, in terms of chloride & sodium concentrations, with an increased GFR?
How would the nephron respond to this?

A
  • ↑ serum Na⁺ & Cl⁻
  • ↓GFR by constricting afferent arteriole & dilating efferent arteriole.
103
Q

What are the layers of the glomerulus?

A
  1. Endothelium
  2. Basement Membrane
  3. Epithelium
104
Q

What anatomical feature, unique to the glomerulus, helps provide structure needed to withstand the elevated hydrostatic pressures?

A
  • Epithelial/Podocyte Layer
105
Q

What two anatomical features does the glomerulus have that promote filtration?

A
  • Endothelium fenestrations.
  • Epithelial slit pores.
106
Q

What characteristic of the glomerulus prevents protein filtration?

A
  • Glomerulus (each layer) is negatively charged.
107
Q

How would chronic hypertension or infection affect the glomerulus?

A
  • Open up slit pores & fenestrations so much that proteins leak through.
108
Q

How would chronic leaking of proteins affect the nephron?

A
  • Proteins chronically in the nephron will damage it by getting stuck in the tubule.
109
Q

Large molecules will _______ filterability.

A

decrease

110
Q

_________ charges will lower filterability.

A

negative

111
Q

_________ charges will increase filterability.

A

positive

112
Q

What forces favor reabsorption in the peritubular capillaries?

A
  • PISF = 6 mmHg
  • πCAP = 32 mmHg
113
Q

What forces disfavor reabsorption in the peritubular capillaries?

A
  • PCAP = 13 mmHg
  • πISF = 15 mmHg
114
Q

How is NRP (Net Reabsorption Pressure) calculated?

A
  • NRP = PISF + πCAP - PCAP - πISF.
115
Q

How much of a pressure loss occurs from the glomerulus to the peritubular capillaries?
What is the cause of this pressure loss?

A
  • 47 mmHg (60mmHg - 13 mmHg)
  • Efferent arteriole
116
Q

What does PAH stand for?
What is its significance?

A
  • Para-aminohippurate
  • PAH is heavily secreted & PAH clearance will = RPF.

A&P I (Fall 2022) (17 decks)

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