Renal Physiology Overview

Question 1

3 components of glomerular filtration wall from inside to outside

Answer 1

visceral epithelial cells- podocytes
glomerular basement membrane
squamous epithelial cells- parietal epithelial cells

Question 2

glomerular filtration barrier is composed of: (3)

Answer 2

capillary endothelium
podocytes
basement membrane

Question 3

glucose renal threshold represents (160-180 mg/dL)

Answer 3

maximum range of glucose reabsorption in renal tubules

Question 4

aldosterone is involved in _____ reabsorption and is released by the _____ of the adrenal cortex

Answer 4

sodium reabsorption

zona glomerulosa

Question 5

order of cast degradation

Answer 5

cellular > granular > waxy

Question 6

green brown urine would MC co-exist with physical exam finding of:

Answer 6

murphy’s sign (cholecystitis, gallbladder/bile duct destruction)

Question 7

level of the kidneys

Answer 7

T11-L3 retroperitoneally

Question 8

layers of adrenal gland

Answer 8

capsule, adrenal cortex, adrenal medulla

or specifically capsule, zona glomerolusa, zona fasciculata, zona reticularis, adrenal medulla

Question 9

main functional unit of kidney

Answer 9

nephrons

Question 10

location and # of nephrons

Answer 10

adrenal cortex and medulla, approx 1 million or more in each kidney

Question 11

fxn of glomerulus

Answer 11

blood filtration

Question 12

part of nephron that fxn is reabsorption and secretion

Answer 12

proximal convoluted tubules
loop of henele
distal convoluted tubules

Question 13

______ nephrons are located mostly within cortex and have ____ length of loop of Henle

Answer 13

cortical

short

Question 14

_____ nephrons are located deep in medulla and have ____ length of loop of Henle

Answer 14

juxtamedullary

long

Question 15

blood passes through kidney at what rate

Answer 15

~ 1200 ml/min or 600 ml/min/kidney

Question 16

Afferent arterioles form the capillary tuft called _____

Answer 16

glomerulus

Question 17

Efferent arterioles form ______

Answer 17

peritubular capillaries (vasa recta)

Question 18

_____ surrounds each glomerulus

Answer 18

bowman capsule

Question 19

outer layer of bowman’s capsule is composed of ________, which lays on top thin ______

Answer 19

squamous epithelium (parietal epithelium)
basal lamina (type IV collagen)

Question 20

inside layer of bowman’s capsule is composed of _____

Answer 20

podocytes (visceral epithelial cells)

Question 21

____ is key indicator of kidney function and is used to monitor kidney disease

Answer 21

glomerular filtration rate (GFR)

Question 22

normal GFR is _____; older people have _____ rate

Answer 22

90-120 ml/min

lower (GFR decreases with age)

Question 23

GFR tests how much kidneys are filtering ______

Answer 23

creatinine

Question 24

waste which is a breakdown product of creatine phosphate in muscles

Answer 24

creatinine

Question 25

_____ appears in the urine when plasma concentration exceeds 160 to 180 mg/dl

Answer 25

glucose

Question 26

secretion of ____ & ____ occurs in PROXIMAL TUBULES

Answer 26

``` uric acid organic acids (antibiotics) ```

Question 27

REABSORPTION of K, NaCl, H2O, AA, glucose, HCO3- occurs in ________ **NO CREATININE REABSORPTION**

Answer 27

proximal tubules

Question 28

the only function of loop of henle is _____

Answer 28

reabsorption (NEVER secretion)

Question 29

(4) things reabsorbed by loop of henle

Answer 29

H20 NaCl Ca Mg

Question 30

____ limb of loop of henle is permeable to water

Answer 30

descending

Question 31

____ limb of loop of henle is impermeable to water but, ________ of solute WITHOUT water occurs

Answer 31

ascending | active reabsorption

Question 32

fluid leaving loop of henle has ____ osmolality than plasma because _____

Answer 32

lower | lost NaCl

Question 33

during tubular reabsorption, hydrogen ion are exchanged for the sodium ions in _____

Answer 33

sodium bicarbonate

Question 34

___% of glomerular filtrate is reabsorbed by the time it reaches the DISTAL tubule, ____ is also reabsorbed

Answer 34

90% | urea

Question 35

(2) things that are ONLY reabsorbed in PROXIMAL tubules

Answer 35

glucose | AA

Question 36

_____ accounts for removal of unneeded foreign waste substances that are not filtered by the glomerulus including toxins and medications

Answer 36

tubular secretion

Question 37

____ ions are produced as waste from metabolism and generally secreted in kidney, _____ can also be secreted, but more often is is REABSORBED to help maintain __

Answer 37

hydrogen bicarbonate pH

Question 38

main fxns of distal and collecting tubules (4)

Answer 38

- adjustment of pH, osmolality and electrolytes - regulation of substances still present in filtrate - secretion of potassium, ammonia and hydrogen ions - reabsorption of sodium and bicarbonate

Question 39

region in nephron that is important for regulating BP, body fluids and electrolytes; regulates the function of EACH NEPHRON

Answer 39

juxtaglomerular apparatus (JGA)

Question 40

(3) components of juxtaglomerular apparatus

Answer 40

macula densa of distal convoluted tubule smooth muscle cells of afferent arterioles (juxtaglomerular cells) mesangial cells

Question 41

mesangial cells secrete

Answer 41

erythropoietin

Question 42

RENIN is an _____ that is secreted by _______ ; secreted and reacts with precursor _______ to be converted to ______ in blood

Answer 42

enzyme juxtaglomerular cells angiotensinogen angiotensin I

Question 43

angiotensin I passes through _____ where enzyme ______ changes it to _______

Answer 43

lungs angiotensin converting enzyme angiotensin II

Question 44

angiotensin II results in:

Answer 44

systemic vasoconstriction (including afferent and efferent arterioles)

Question 45

angiotensin II triggers release of _______ and ______

Answer 45

aldosterone (from adrenal glands) | antidiuretic hormone aka vasopressin (from pituitary gland)

Question 46

aldosterone is secreted by _______ and fxn to _________, which in turn INCREASES blood volume as water follows salt --> ________

Answer 46

adrenal cortex (zona glomerulosa) increase blood sodium reabsorption (in distal tubules) RAISES BP

Question 47

antidiuretic (vasopressin) hormone is synthesized in _____ and stored/released in ____

Answer 47

hypothalamus | vesicles in posterior pituitary gland

Question 48

Diabetes Insipidus may be caused by (2)

Answer 48

insufficient ADH | abnormal kidney response to ADH (nephrogenic DI)

Question 49

excessive release of ADH

Answer 49

syndrome of inappropriate ADH Secretion (SIADH- syndrome)

Question 50

SIADH- syndrome is caused by _______ 80% of the time

Answer 50

small cell lung carcinoma

Question 51

SIADH- syndrome results in: (5)

Answer 51

``` high plasma volume low serum osmolarity low plasma sodium (hyponatremia) high urine osmolarity higher than normal urine sodium ```

Question 52

ADH causes _____ water retention without ______ fluid volume expansion or ______ or _____

Answer 52

increased extracellular fluid volume expansion edema HTN

Question 53

when hyponatremia is severe, may cause _____ symptoms to be more prominent

Answer 53

cerebral edema (irritability, confusion, seizures and coma)

Question 54

cells that produce and secrete renin

Answer 54

juxtaglomerular cells