renal system Flashcards
the hilum of the left kidney is located at which vertebral level ?
L1
upper pole around 11th rib
approx 3 vertebrae in length
the adrenal glands sit immediately superior to the kidneys within a separate envelope of which fascia ?
renal fascia
anatomical relations of the right kidney
posterior-quadrates lumborum, diaphragm, poses major, transversus abdominis
anterior-hepatic flexure of colon
superior-liver-adrenal gland
from anterior to posterior, what is the correct order of the structures entering the hilum?
vein, artery, ureter
lymph from kidney drains into the
para-aortic lymph nodes
GFR=Net ultrafiltration pressure
pressure is high because…
arterioles have HIGH resistance
afferent diameter>efferent
fluids and solutes are forced out of the blood
forces involved in glomerular filtration :
-hydrostatic gradient+favours filtration
-oncotic pressure-opposes
proximal convoluted tubule-reabsorption
essential nutrients
glucose 99%
WATER 65%
relies on secondary active transport of Na+
loop of henle-reabsorption and secretion
water is reabsorbed by osmosis along the descending loop(impermeable to ions)
Na+ is actively reabsorbed along the ascending loop by Na+/K+/2Cl- cotransporters
result:smaller volume of dilute(hypotonic)filtrate leaving the LOH and entering the distal tubule
allows for extra H2) reabsorption from the collecting duct
distal tubule and collecting duct-reabsorption and secretion
under hormonal control
aldosterone binds to receptors on the distal tubule and collecting duct to promote Na+ and water reabsorption and K+ secretion
ADH binds to receptors on the collecting duct to promote water reabsorption through aquaporins
ADH
short term effector
in response to dehydration
effects:
water reabsorption from collecting duct
produces more concentrated and less volume of urine
no effect in Na+ reabsorption-so no effect in K+ secretion
aldosterone
(RAAS) is a long term response to decreased ‘body fluid volume’
effects:
-Na+ and H20 reabsorption from DCT and collecting duct
-produces urine with decreased Na+ and increased K+,decreased volume of urine
juxtaglomerular cells
modified smooth muscle cells
afferent arteriole
secrete renin
ABGs
1-check pO2
2-check pH
3-pCO2
4-HCO3-
type 1 respiratory failure
- reduced ventilation and normal perfusion=PO,bronchoconstriction
- reduced perfusion with normal ventilation=PE
pathology: V/Q mismatch
Type 2 respiratory failure
hyperaemia with hypercapnia
- increased resistance as result of air obstruction(COPD)
- reduced compliance of lung tissue/chest wall
- reduced strength of respiratory muscles
- drugs acting on respiratory centre reducing overall ventilation
