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Summer 2020 - Physiology 2 - Renal > Renal Physiology - Quiz 2 > Flashcards

Renal Physiology - Quiz 2 Flashcards

(54 cards)

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1
Q

What is the purpose of the Glomerulus?

A

To form an Ultrafiltrate of Plasma from the blood coming in via the Afferent Arteriole

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2
Q

Where does the blood go once it enters the Glomerulus thru the Afferent Arteriole?

A

Travels thru capillaries in the Bowman’s Capsule where Plasma & Small Solutes escape thru openings in the Endothelial Wall

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3
Q

Once the blood reaches the Bowman’s Capsule, where does it go?

A

Thru the basement membrane into the Bowman’s Space, which is continuous w/ the Proximal Tubule

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4
Q

What happens when Negatively Charged proteins try to pass the Basement Membrane?

A

Repelled & Can’t Pass d/t the Basement Membrane’s Negatively Charged Composition

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5
Q

What size molecules can pass thru the Basement Membrane if they are not Negatively Charged?

A

Smaller than 50 Angstroms can pass

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6
Q

How is the Glomerular Filtration Rate (GFR) defined?

A

Total Volume per Minute that leaves the capillaries & Enters the Bowman’s Space

~ 120 mL/min (180 L/day)

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7
Q

What are the Two Major Determinants of Filtration Pressure?

A

Glomerular Capillary Pressure (PGC)

&

Glomerular Oncotic Pressure (pgc)

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8
Q

What heavily influences the Glomerular Capillary Pressure?

A

Renal Artery Pressure & Afferent/Efferent Arteriole Tone

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9
Q

How much Cardiac Output goes to Renal Blood Flow?

A

20% of Cardiac Output - 1200 mL/min

(Only the Liver gets more blood flow than the kidney)

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10
Q

What is the Vasa Recta?

A

Peritubular Capillaries deep in the Medulla & Parallel the Loops of Henle

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11
Q

If the Hct is 40%, how much is the Renal Plasma Flow?

A

~ 660 mL/min –> 120 mL/min is Filtered into Bowman’s Space & only 1% of that becomes urine

Most of what is filtered is reabsorbed

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12
Q

What are the 4 Factors that Deteremine GFR?

A
  1. Ultrafiltration Coefficient - Depends on Capillary Permeability & Surface Area
  2. Oncotic Pressure - Force that Opposes Filtration
  3. Net Hydraulic Pressure - Moves fluid from Capillaries to Bowman’s Capsule
  4. Capillary Plasma Flow Rate - High Flow = More Filtration
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13
Q

How does the body get back Filtered Plasma?

A

Glomerular Capillary Filtration & Capillary Hydrostatic Pressure decreases towards the end near the Efferent Arteriole, where there is an Increase in Oncotic Pressure.

This is where Max Reabsorption into the Vasa Recta & Peritubular Plexi happens.

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14
Q

What are the 3 Variables that determine Glomerular Hydrostatic Pressure?

A

Arterial Pressure

Afferent Arteriolar Resistance

Efferent Arteriolar Resistance

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15
Q

At what BP Range is the Kidney able to Autoregulate to keep the GFR & Renal Blood Flow constant?

A

SBP 80 - 200 mmHg

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16
Q

How does the Kidney’s Autoregulation Mechanism work?

A

Constriction/Dilation of Precapillary Sphincters in the Afferent/Efferent Arterioles

&

↑Na delivery to the Macula Densa to↓GFR

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17
Q

What are Macula Densa?

A

Special Epithelial Cells in the Distal Tubule, containing Golgi Apparatus that secrete substances toward the Afferent & Efferent Arterioles

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18
Q

How does a Sodium Decrease affect the Macula Densa?

A

↓Afferent Arteriole Resistance

&

↑Renin Release from the Juxtaglomerular Cells of the Afferent & Efferent Arterioles

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19
Q

What is the Myogenic Reflex Theory of Autoregulation?

A

↑MAP causes Afferent Arteriole to stretch, then Snap Back & Constrict by Reflex

↓MAP = Afferent Arteriole Dilation by Reflex

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20
Q

What is the Tubuloglomerular Feedback of Autoregulation?

A

↓RBF & GFR causes Less Chloride delivery to the Juxtaglomerular Apparatus, which causes..

Afferent Arteriole Dilation

&

Renin Release –> Angiotensin II –> Efferent Arteriolar Constriction

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21
Q

Excretion is the sum of ________ & _______ minus Reabsorption

A

Excretion is the sum of Filtration & Secretion minus Reabsorption

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22
Q

Reabsorption is more important than secretion, but secretion is important in controlling the amount of _______ & _____ ions that are excreted in the urine

Study These Flashcards
A

Reabsorption is more important than secretion, but secretion is important in controlling the amount of Potassium & Hydrogen ions that are excreted in the urine

23
Q

How is Renal Clearance defined?

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A

Volume of Plasma when all substance is removed per unit of time in one pass thru the kidney

24
Q

What is the Renal Clearance if a substance is neither Secreted nor Reabsorbed?

Study These Flashcards
A

Clearance = GFR

EX: Inulin

25
What is the Renal Clearance if a substance is completely Reabsorbed?
Clearance = 0 EX: Glucose
26
GFR: 125 = ? % Functioning Nephrons?
GFR: 125 = **100%** Functioning Nephrons
27
GFR: 12 - 80 = ? % of Functioning Nephrons?
GFR 12 - 80 = **10-40% Functioning Nephrons**
28
GFR: \< 12 = ? % of Functioning Nephrons?
GFR: \< 12 = **\<10% of Functioning Nephrons**
29
What are the 3 Mechanisms of Reabsorption & Secretion?
* **Active Transport** * **Passive Transpor**t * Simple - Lipid Soluble/Gas Diffusion * Facilitated - Uses Protein Channel/Carrier * **Secondary Active Transport** - Moves solute against Concentration Gradient, using _Indirect_ Energy by coupling to an energy source
30
What are the steps in the Reabsorption of Water & Solutes?
1. Transport across Tubular Epithelial Membranes into Renal Interstitial Fluid 2. Thru Peritubular Capillary Membrane back into Blood
31
Which Mechanism of Reabsorption does Glucose use?
Secondary Active Transport
32
What is the Transport Maximum?
Limit of Transport d/t Saturation of Specific Transport System when the amount of solute is delivered to the tubule exceeds the carrying capacity of the carrier proteins & enzymes.
33
How much filtrate is Reabsorbed in the Proximal Convoluted Tubule?
65% - _most_ active reabsorption of nutrients, ions, small proteins, and some urea & uric acid happens here in an _Iso-Osmotic_ fashion **PCT is only place where there is Carbonic Anhydrase Present & is the preferred site of Bicarb Reabsorption**
34
How much filtrate is Reabsorbed from the Nephron Loop?
25% - mostly water
35
What is Reabsorbed at the Distal Convoluted Tubule?
To a lesser amount than the PCT.... Sodium Chloride Bicarb Water (Reabsorption here is controlled by Aldosterone & ANP)
36
What are the 4 Areas of the Nephron?
Proximal Convoluted Tubule Loop of Henle Distal Convoluted Tubule Collecting Duct
37
What substances are secreted into the PCT?
Organic Acids via Anion Pump Diuretics Abx Organic Bases Ammonia
38
What are the characteristics of the Fluid in the PCT once all the Secretion & Reabsorption is done?
Tubular Flow = 1/3 GFR Absence of Glucose, Protein, & Amino Acids Increased Chloride Tubular Concentration
39
What are the 3 Segments of the Loop of Henle?
Descending Thin Ascending Thin Ascending Thick - **most important**
40
What are the attributes of the Descending Thin Segment of the Loop of Henle?
Highly Water Permeable - 20% H2O Reabsorption Moderate Solute Permeability Simple Diffusion
41
What substances can travel across the Ascending Thin Segment of the Loop of Henle?
Impermeable to Water Some Reabsorption of Calcium, Bicarb, and Magnesium
42
The Reabsorption capability of the Thick Ascending Limb of the Loop of Henle is comparable to what?
Sodium-Potassium ATPase Pump, which maintains a low Intracellular Sodium Concentration Considered the _Diluting Segment & Impermeable to Water_
43
Where is the Target Site of Lasix and the only site where Chloride is Actively Transported?
Thick Ascending Limb of the Loop of Henle - has a 1Na+ 1K+ 2Cl- Pump
44
What is the Intraluminal Charge of the Thick Ascending Limb of the Loop of Henle?
Positive - helps drives Magnesium & Calcium Reabsorption
45
What forms part of the Juxtaglomerular Complex to provide feedback control of GFR & Blood Flow?
First Portion of the Distal Convoluted Tubule
46
What is Reabsorbed at the Early Distal Tubule?
Sodium Chloride Calcium Magnesium
47
What are the characteristics of the Later Distal Tubule?
Controls Dilution/Concentration of Urine Water Permeability based on ADH Sodium Reabsorption & Potassium Secretion controlled by Aldosterone Secretes Hydrogen via Hydrogen-ATPase against gradient
48
What do Principle Cells do?
Regulates Hydrogen & Potassium by reabsorbing Sodium & Water and Secreting Potassium into the Lumen These cells are found in the Late Distal Tubule & Early Collecting Duct
49
What do Intercalated Cells do?
Regulate Hydrogen & Potassium by Reabsorbing Bicarb & Potassium and Secreting Hydrogen into the Lumen These cells are found in the Late Distal Tubule & Early Collecting Duct
50
Where is the Final Site of Urine Processing?
Medullary Collecting Duct
51
How much filtered Water & Sodium is Reabsorbed at the Medullary Collecting Duct?
\< 10%
52
What is the Medullary Collecting Duct permeable to?
Water depending on ADH Urea
53
What happens when Urea is Reabsorbed from the Medullary Collecting Duct into the Interstitial around it?
↑Medulla Osmolality & Contributes to forming Concentrated Urine
54
How does the Medullary Collecting Duct regulate Acid-Base Balance?
It can secrete Hydrogen Ions against a large concentration gradient

Summer 2020 - Physiology 2 - Renal (5 decks)

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