Flashcards in Renal Structure And Glomerular Filtration Deck (31):
What are the Primary Functions of the Kidney?
1. Excretion of waste products: urea, uric acid, creatinine
2. Water and electrolyte balance
3. Avid/base balance
4. EPO and renin secretion
5. 1,25-dehydroxi-Vit D
This part of the kidney is more susceptible to isquemia and is due to slow blood flow (⬇️PO2) ?
What are the 4 renal processes of the kidney?
Where is plasma filtrated in the kidney?
Through what transport mechanism does secretion usually occur?
1. Active Transport
How do you calculate the excretion rate (Er)?
Er = (Filtration - Reabsorption) + Secretion
Nerve necessary for bladder filling phase ?
1. Hypogastric nerve.
2. Sympathetic NS
3. B3–> detrusor relaxation
4. Alpha-1: internal sphincter contraction
Filling of the bladder activates and deactivates the following systems?
2. ⬆️Parasympathetic (Pelvic nerve) —> M3 receptor —> Detrusor contraction
How is the external sphincter controlled, for contraction ?
1. Pudendal Motor Nerve (Nicotinic)
2. Void—> it’s inhibited
2 mechanisms by which the kidney auto regulates ?
1. Myogenic response: ⬆️compliance—> ⬆️contraction
2. Tubuloglomerular feedback (TGF)
TGF: what happens to RBF and GFR with ⬆️MAP?
TGF: what happens to RBF and GFR with ⬆️Na delivery to the macula densa ?
2. ⬇️RBF and GFR
TGF: what happens to RBF and GFR with ⬇️Na delivery in macula densa ?
2 ⬆️RBF and GFR
In order to maintain an ⬆️GFR, what will be the afferent/efferent interactions?
1. Afferent vasodilation (⬆️downstream pressure )
2. Efferent vasoconstriction (⬆️upstream pressure )
Relationships between afferent/efferent arterioles to ⬇️GFR?
1. Afferent vasoconstriction (⬇️downstream pressure )
2. Efferent vasodilation (⬇️upstream pressure )
What renal capillaries have ⬇️ hydrostatic pressure ?
1. 120 ml/min
Main starling force for GFR?
1. Glomerular Capillary Hydrostatic Pressure
Main starling force that drives reabsorption in the tubules ?
1. Tubular capillary Oncotic Pressure
Both capillary endothelial cells and GBM have this property that repels protein filtration?
1. Negatively (-) charged proteins and particles
Plasma concentration/filtered concentration ratio for a substance freely filtered by kidney?
How do you calculate filtration fraction ?
FF= .20 or 20%
What does an ⬆️FF do to the peritubular capillary oncotic pressure?
What does a ⬇️FF due to peritubular capillary oncotic pressure ?
1. ⬇️⬇️Oncotic pressure
What does an ⬆️ in sympathetic function produce in renal function tests?
1. Vasoconstriction of AA>EA
2. ⬇️GFR < ⬇️⬇️RPF
4. ⬆️peritubular capillary oncotic pressure
5. ⬆️tubular reabsorption
6. ⬇️Glomerular capillary hydrostatic
7. ⬇️peritubular capillary hydrostatic
What does angiotensin II cause to the renal function tests?
1. AA ⬆️< EA ⬆️⬆️ vasoconstriction
2. ⬆️GFR / ⬇️RPF
4. ⬆️Hydrostatic Capillary Pressure
5. ⬆️Peritubular Oncotic Pressure
6. ⬇️Peritubular Hydrostatic Pressure
7. ⬆️Peritubular reabsorption
What does a combination of both sympathetic and angiotensin II do to kidney function?
1. ⬇️GFR/ ⬇️⬇️RPF
3. ⬆️Peritubular Oncotic Pressure
IN A FEW WORDS:
⬇️GFR and ⬆️reabsorption
Endogenous substances that protect kidney from ischemia during stress?
1. PGD’s —> protect kidneys countering sympathetic vasoconstriction in AA
Uses of ACE inhibitors and ARB in kidney conditions?
2. Nephrotic Syndrome
ACE inhibitors and ARB contraindications?
1. AKF (⬇️GFR) -> 😵
2. Bilateral Renal Stenosis
(⬇️⬇️GFR) —> death
GFR depends on EA vasoconstriction. If you inhibit ACE or AII—> 😵