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BioScience II > Renal Review PPT-josh > Flashcards

Renal Review PPT-josh Flashcards

(80 cards)

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1
Q

there are 2 kidneys with how many regions?

A

2

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2
Q

What are the 2 regions?

A

Cortex

Medulla

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3
Q

what is the functional unit of the kidney?

A

Nephron

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4
Q

What are 3 improtant functions of the nephron?

A

Hold filtrate

Excrete end products of metabolism

Absorb Important sunstances

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5
Q

The kidney gets what % of CO?

A

20-25%

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6
Q

how many mLs of blood does the kidney receive?

A

1100-1200 mL

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7
Q

what part of the kidney receives the most blood?

A

Cortex

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8
Q

The renal artery divides at the __1__, into several lobar arteries, they run b/t the __2__ of the medulla and turn into the __3__ then into __4__ and to the __5__.

A
  1. hilus
  2. pyramids
  3. interlobular arteries
  4. afferent arterioles
  5. glomerulus
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9
Q

Unfiiltered blood exits the kidney via what, to the venous system?

A

efferent arteriole

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10
Q

filtered blood goes where?

A

back to the body

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11
Q

waste is excreted from the kidneys as what?

A

urine

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12
Q

renal blood flow if determined by the ________ ______ ______ across the vascular bed

A

arteriovenous pressure difference

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13
Q

what is the formula to calculate renal blood flow?

A

Renal blood flow = (MAP - VP) x VR

  • MAP- mean arterial pressure
  • VP- venous pressure
  • VR- vascular resistance
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14
Q

Renal blood flow is regulated by what 2 ways?

A

intrinsic autoregulation

Neural regulation

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15
Q

Autoregulation of the kidneys is with a MAP of what?

A

75-160mmHg

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16
Q

w/ neural regulation afferent and efferent arterioles are inervated by the SNS, stimulation of which is associated w/ what? and thus should be avoided

A

vasoconstriction

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17
Q

4 main functions of the kidney?

A
  • maintenance of ECF composition
  • Maintenance of ECF volume
  • Endocrine functions
  • Regulation of Arterial BP
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18
Q

Fx of the Kidneys:

what is maintained in the maintenance of ECF composition?

A
  • Ionic composition (electrolytes)
  • Osmolality (Na+ comcentration
  • Conservation of non-ionic components (glucose, amino acids, proteins, water, vitamins)
  • Excretion of products of metabolism (urea, creatine, lactic acid, uric acid)
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19
Q

Fx of the Kidneys:

how does the kidney perform maintenance of ECF volume

A

regulation of Na+ and h2o excretion

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20
Q

Fx of the Kidneys:

what endocrine fx does the kidneys perform?

A
  • erythropoietin
  • RAAS
  • Vit D
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21
Q

What are the main structures of teh nephron? do it in order as if you were fluid going through it!

A
  • arteriole from renal artery
  • Bowman’s capsule
  • Glomerulus
  • Proximal tubule
  • Loop of henle
  • Distal tubule
  • Collecting ducts
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22
Q

What structures are in teh Cortex and what structures are in the Medulla?

A
  • Cortex
    • Renal corpuscle (bowmans capsule)
    • proximal tubule
    • Distal tubule
  • Medulla
    • Loop of henle
    • Collecting duct
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23
Q

What are the 3 steps of Urine formation and excretion

A

Glomerular filtration

Tubular reabsorption

Tubular secretion

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24
Q

Glomerular Filtration:

GFR get what % of RBF?

A

20% (125mL/min)

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25
Glomerular Filtration: the GFR is regulated by what?
Juxtaglomerular complex
26
Glomerular Filtration: What 3 things can increase GFR?
* Increased RBF * Dilation of Afferent arteriole * Increased resistance inefferent arteriole
27
Glomerular Filtration: what 2 things can decrease GFR?
* afferent arteriole constriction * Efferent arteriole dilation
28
What reabsorbs the bulk of the glomerlar filtrate?
Proximal tubule
29
what iare the main function of the Loop of henle?
* establishes and maintains an osmotic gradient in the medulla of the kidney * regulation of water balance * Concentration/dilution of urine
30
The descending loop is highly permeable to ________ but impermeable to \_\_\_\_\_\_
Water Solutes
31
The ascending loop is nearly impermeable to \_\_\_\_\_, but highly permeable to ___ and \_\_\_\_
water Na+ and Cl-
32
The ECF is controlled by what hormone?
Aldosterone
33
ECF Volume and Osmolality: Volume is controlled by aldosterone via ______ reabsorption
Sodium
34
ECF Volume and Osmolality: where is aldosterone produced?
Adrenal Cortex
35
ECF Volume and Osmolality: Osmolality is controlled by what?
ADH
36
ECF Volume and Osmolality: osmolality is controlled by ADH via ___ reabsorption
Water
37
ECF Volume and Osmolality: ADH is released from what?
the neurohypophysis (AKA posterior putuitary)
38
\*\*\*\*\* Where does aldosterone work?
distal tubule
39
\*\*\*\*\*\* where does ADH work?
Collecting ducts
40
Osmolality: ADH explain what the body does if ADH is pressent? and also when it is absent?
* ADH present * Collecting duct is highly permeable to H20= you get small amount of very concentrated urine * ADH Absent * Collecting duct is not pearmeable to water= you get large amounts of dilute urine
41
what part of kidney os responsible for the fine tunning, makes final adjustment to urine pH and osmolality?
Distal tubule
42
what does aldosterone reabsorb? and secrete?
reabsorbs- Na+ Secretes K+
43
What is excreted in the proximal tubule?
Na+ H2O
44
What is excreted in the descending loop of henle
H2O
45
What is excreted in the ascending loop of Henle
Na+ Cl-
46
What is excreted in the Distal Tubule
Na+ H2O
47
what is excreted in the collecting ducts?
H20
48
What is the basic equaltion for Acid Base balance?
Carbonic Anhydrase CO2 + H2O ⇔ H2CO3 ⇔ HCO3_ + H+
49
refere to acid base disturbances on own I am not going over that
Know your different ranges and how to determine them
50
Mind the Gap: what is the anion gap used for?
to differentiate b/t metabolic acidosis
51
Anion Gap: Is the difference b/t the primary measured what?
* cations (Na+ and K+) and the primary measured Anions (Cl- and HCO3) in serum
52
Anion Gap: what is the equation?
Normal: (Na+ + K+) - (Cl- + HCO3) or ususally done w/o K+ as (Na+) - (Cl- + HCO3)
53
Mind the Gap: What is te normal Anion Gap
8-12mM
54
Mind the Gap: what does high Anion Gap Indicate?
* increased non-chloride acids (H+) uses more HCO3- therby Increaseing Anion Gap * Normachloremia * Lactic Acidosis * DKA
55
Mind the Gap: what does normal Anion Gap Mean?
* Decreased HCO3- from loss of body fluids (emesis/diarrhea), is replaced by Cl- resulting in no change to anion GAp * Hyperchloremia
56
Diuretics: what is a peptide hormone synthesized, stored, and secreted by teh cardiac atria
Atrial Natriuretic Factor
57
Diuretics: what is teh stimulis for ANF release?
atrial stretch, distention, or pressure
58
Diuretics: what is one of the most potent diuretics known?
ANF
59
Diuretics: ANF acs on the kidneys to increase urine flow and Na+ excretion, it antagonizes both the release and end organ effects of \_\_\_\_\_\_, \_\_\_\_\_\_, and \_\_\_\_.
* renin * Aldosterone * ADH
60
Loop Diuretics: what are 2 examples of them
lasix bumex
61
Loop Diuretics: how do they basically work?
stop reabsortion of Ions in ascending loop thus decreasing osmolality. Increass water excretion
62
Diuretics: What are ex of thiazide diuretics work?
HCTZ Zaroxoyln
63
Diuretics: what are examples of K+ sparing diuretics?
spironlactone
64
Diuretics: whare to thiazides work?
distal convoluted tubule
65
Diuretics: how do Thiazides work
Inhibit Na+ reabsorbtion thus decreasing water reabsortion
66
Diuretics: Where do K+ sparing diuretics work
i think in the collecting ducts
67
Diuretics: how do K+ sparing diuretics (spironlactone work?
competitively inhibits aldosterone increasing sodium excretion and promoting sodium retention
68
Diuretics: where do Carbonic-anhydrase inhibitors work?
Proximal tubule
69
Diuretics: what type of diuretic is impermeable to teh renal tubule and exerts osmotic force dereasing the reabsorption of water
Osmotic diuretics Mannitol
70
Describe the RAAS! (basic don't need to say that renin is released from the juxta.... blah blah blah)
* Kidney releases renin into blood * Liver releases angiotensinogen * they meet and convert into ATI * ACE from the lungs then cahnges ATI into ATII * ATII stimulates aldonsterone secretion by the adrenal cortex * aldosterone stimulates Na+ and H2O reabsorption in the nephrons (ATII also works on the neurohypophysis to release ADH and such, but the basics is above) remember from previous slides ADH works in collecting ducts, and ALdosterone works in the distal tubule
71
Blocking the actions of what can cause refractory Hypotension how?
Blocks the release of both aldosterone and ADH
72
what are the pros of Colloid?
* increased plasma volume * Less peripheral edema * Smaller volumes for resuscitation * Intravascular half-life 3-6 hrs
73
What are the advantages of Crystalloids?
* Inexpensive * Unse for maintenance fluid and inital resuscitation * restore 3rd space loss * Intravascular half-life 20-30 minutes
74
K+ controls what with the membrane potential
resting membrane potential
75
Ca++ controls what w/ the membrane potential
threshold
76
Treatment of Hyperkalemia: why give Ca++
move threshold away from resting membrane potential
77
Treatment of Hyperkalemia: whay give HCO3 and hyperventilate the pt?
decrease Concentration of H+ in the plasma (H+ from ICF to ECF, K+ back inside the cell)
78
Treatment of Hyperkalemia: why give a Beta-2 agonist (albuterol) and insulin?
to stimulate Na-K pump, drives K back into cells
79
Treatment of Hyperkalemia: why give dextrose?
to prevent hypoglycemia
80
thats it for for that next is Renal patho!!!!!
whooooo hoooooo

BioScience II (39 decks)

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