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Renal System Flashcards

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1
Q

What does the word Renal mean

A

Kidney

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2
Q

Function of Kidneys (broad)

A

handle the stuff found in plasma

maintain plasma volume*

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3
Q

What is plasma composed of

A 
Water
Ions
Organic molecules
Trace elements and vitamins
Waste material
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4
Q

Functions of the kidneys (5)

A
  1. regulate blood volume and pressure
    - water conc and fluid volume
    - inorganic ion concentration
  2. acid/base balance
  3. excretion
  4. synthesis of glucose
  5. secretion of hormones
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5
Q

Gluconeogenesis

A

synthesis of glucose via the kidneys (when fasting)

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6
Q

Hormones the kidney secretes

A

Erythropoietin (EPO)
Renin
1,25-dihydroxy Vitamin D

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7
Q

Causes of fluid volume changes

A 
health disorders (dehydration)
rapid movement of water (osmosis)
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8
Q

ICF

A

Intracellular fluid - fluid inside the cell

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9
Q

Ions predominant in ECF

A

Na+, HCO3-, Cl-

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10
Q

Ions predominate in ICF

A

K+

Mg2+, Pi, Protein

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11
Q

ECF

A

extracellular fluid - fluid found outside the cell; plasma, interstitial fluid, CSF

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12
Q

Plasma

A

non-cellular part of blood, fluid inside blood vessels

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13
Q

Body Fluid Components

A

ICF
ECF
Plasma

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14
Q

What does the kidney excrete

A 
Urea
Uric acid
Creatinine (muscle metabolism)
Bilirubin (Hb breakdown)
Foreign chemicals (drugs, food additives, pesticides)
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15
Q

How does water diffuse across membrane?

A

Aquaporins - water channels

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16
Q

Water concentration

A

Osmoles - 1 osm is equal to 1 mole of solute particles

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17
Q

Osmolarity

A

number of solutes per unit volume of solution expressed in mol/L

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18
Q

T/F: Pure water has low osmolarity

A

TRUE

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19
Q

Diffusion

A

movement of molecules from one location to another as a result of random thermal motion

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20
Q

Diffusional Equilibrium

A

movement of water and solutes has equalized; water and solute concentration are equal on both sides of the petition

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21
Q

Osmosis

A

diffusion of water across a selectively permeable membrane from region of high water concentration to one with lower water concentration

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22
Q

Semi-permeable membrane

A

permeable to water, not solutes

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23
Q

Osmotic pressure

A

increases when water moves to create osmotic EQb
Pressure applied to stop movement of water
Required to stop cells from bursting

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24
Q

Tonicity

A

determined by the concentration of non-penetrating solutes of an extracellular solution relative to the intracellular environment of the cell.
The solute concentrations may influence changes in cell volume

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25
Three conditions of tonicity
1. Isotonic (isosmotic) - same osmolarity outside and inside the cell - shape stays constant shape 2. Hypertonic (hyperosmotic) - outside envrionment has higher osmolarity than inside the cell - cell would shrink 3. Hypotonic (hypoosmotic) - lower osmolarity than inside the cell - cell would swell/bulge
26
Changes in cell volume
27
fate of the RBC: Hypotonic solution Isotonic solution Hypertonic solution
Hypo - cell bulge/swell Iso - no change Hyper - cell shrinkage
28
Penetrating solute
urea | can cross cell membranes
29
What is given in an emergency
Isotonic saline
30
Absorption
movement of solute/water INTO blood (plasma)
31
Filtration
Movement of solute/water OUT of blood (plasma)
32
Net filtration pressure
Startling Forces
33
Capillary hydrostatic pressure (Pc)
pushes fluid OUT OF capillary into interstitial fluid
34
Interstitial fluid hydrostatic pressure (Pif)
fluid push INTO capillary from interstitial fluid
35
Pic
Osmotic force INTO capillary | due to plasma protein concentration
36
Pi IF
Osmotic force OUT OF capillary | due to interstitial fluid protein concentration
37
Arterial end of capillary
Favours FILTRATION - fluid pushed out of capillary
38
Venous end of capillary
Favours ABSORPTION - fluid flows INTO capillary
39
Homeostasis
Total body balance of any substance Fixed volume of water in body Gain- ingestion, metabolism product Loss- excretion, metabolized
40
Kidneys - retroperitoneal Ureter - drain urine from kidneys Bladder Urethra
41
micturition
release of urine outside body (urination)
42
Anatomy of the Kidney
``` Outer cortex Inner cortex Nephron --> renal corpuscle --> renal tubule ```
43
Structure of a Nephron
Bulb like renal corpuscle
44
Components of Renal Corpuscle
Glomerulus | Bowman's Capsule
45
Components of Renal Tubule
``` convoluted - twisted Proximal convoluted tubule (PCT) Loop of Henle Distal convoluted tubule (DCT) Collecting duct ```
46
Loop of Henle segments
descending limb - downward | Ascending limb - upwards
47
Renal Corpuscles
Initial blood filtering component | First making of urine
48
Glomerulus
Interconnected capillaries in the renal corpuscle | First filtration of blood
49
Development of Renal Corpuscle
Parietal and Visceral layers important**
50
Glomerular capillary
- fenestrated endothelial layers - basement membrane - podocyte (foot) with filtration slits
51
Two types of nephrons:
Cortical (85%) - closer to cortex | Juxtamedullary (15%) - closer to medulla, corpuscle is in cortex
52
T/F: blood flow to kidney is LOW
FALSE: very high blood flow to kidney via renal artery
53
Three types of capillaries (around nephron)
1. glomerular 2. peritubular 3. vasa recta - capillaries associated with juxtamedullary nephron) highly vascularized organ
54
Three basic renal processes
1. Glomerular filtration 2. Tubular secretion 3. Tubular reabsorption
55
Urine formation
water is brought in via drinking and metabolism Blood is brought to kidney via renal artery enters glomeruli via afferent arteriole
56
Substances that a re reabsorbed
Glucose
57
Amount excreted
amount filtered + amount secreted - amount reabsorbed
58
Filtration layers
1. fenestrated endothelial layer 2. Basement membrane 3. Podocytes with filtration slits
59
Why are PROTEIN or ALBUMIN held back
- pores are not large enough to allow passsage - pores and BM have negative charged proteins - podocyte slits are covered with semipros membranes
60
What is filtered through the glomerulus
everything except large proteins (held back in blood)
61
What is ultrafiltrate
same concentration as plasma | cell-free fluid in bowman's space.
62
What is proteinuria
condition where proteins are able to pass through the barrier (show up in urine) NOT SUPPOSED TO OCCUR infection, inflammation in golmerular site Protein escape into pores and pass into ultrafiltrate
63
T/F: Net glomerular filtration pressure is always POSITIVE
TRUE
64
What does Glomerular Filtration pressure initiate? how?
Urine formation | forcing protein-free filtrate from plasma, out of glomerulus, into Bowman's space
65
5 steps of Filtration Fraction
66
T/F: Increased blood pressure increases GF
TRUE
67
Decreased plasma volume decreased filtration rate
68
Glomerular Filtration Rate
Volume of fluid filtered from the glomerulus into the Bowman's capsule 125 ml/min; 180 L/day
69
Kidneys:
Clean up and clear stuff from plasma | --> plasma passes through 60 times a day
70
Factors influences GFR
Blood pressure --> net GFR Neural and endocrine control Permeability of corpuscular membrane Surface area for filtration
71
Autoregulation
1. GFR remains constant (despite large changes in arterial or renal blood flow) 2. Regulated by changes in the myogenic reflex 3. Occurs by changing renal blood vessel resistance to compensate fro changes in pressure
72
Mean Arterial Blood pressure
pressure driving blood into the tissues | equal to diastolic pressure + 1/3 systolic pressure
73
Arteriolar Resistance and GFR
Resistance to changes in renal arterioles alter renal blood flow and GFR
74
what causes decreased GFR
Vasoconstricton - decreased amount of renal blood flow
75
Control of GFR
76
GFR Regulation
Myogenic response - similar to autoregulation (arteriole smooth muscle) Hormones and autonomic neuron - change resistance in arterioles Tubuloglomerular feedback - role for juxtaglomerular apparatus (JGA) - paracrine control of afferent arteriole resistance
77
Juxtaglomerular Apparatus (JGA)
located ext to the glomerulus
78
Macula dense
cells on wall of distal tube cense increased fluid flow through distal tubule secretes vasoactive compounds by paracrine effect, changes afferent arteriolar resistance signals to JG cells
79
Juxtaglomerular cells
granular cells on wall of the afferent arteriole SECRETE RENIN
80
Renin
control afferent arteriole resistance
81
Mesangial cells
not a part of JGA contraction of these cells reduce surface area of glomerular capillaries GFR is decreased
82
Tubuloglomerular Feedback: Role of Macula Densa
83
Filtered Load
Total amount of non-protein or non-protein bound substance filtered into Bowman's space GFR x [substance in plasma]
84
Glucose Filtered Load
[glucose] = 1 g/L GFR = 180 l/day Glucose filtered load = 180 g/day
85
Substance excreted in urine < filtered load
REABSORPTION has occurred
86
Substance excreted in urine > filtered load
SECRETION has occurred
87
Filtration of 3 substances
filtration + secretion filtration + partial reabsorption filtration + complete reabsorption
88
Renal handling of Four Substances
Filtration only - waste products (urea) Filtration + partial reabsorption - electrolytes Filtration + complete reabsorption - glucose, amino acids filtration + secretion - organic acids
89
inulin
polysaccharide found in vegetable/plants, handled by kidneys
90
creatinine **
behaves like inulin
91
Values of Filtration and Reabsorption
92
Tubular epithelium and reabsorption
mediated by: - diffusion across tight junction (paracellular) MINOR - mediated transport (transepithelial) MAJOR
93
sodium transport is mediated (uses a protein to assist)
TRUE
94
Reabsorption of Na+ by Mediated Transport
95
Reabsorption of Na+
Occurs in the proximal tube Filtrate ---> Interstitial Fluid (mediated transport) ---> Blood Plasma (diffusion and bulk flow)
96
Reabsorption of Glucose
glucose clearance is ZERO all filtered glucose is reabsorbed Active transport on luminal sides via SGLT protein --> mediated transport Facitiliated diffusion (basolateral side) carrier protein GLUT
97
Glucosuria
Above renal threshold, glucose appears in urine | Diabetes
98
Sodium-linked glucose reabsorption
Na+/K+-ATPase | [Na+] is high outside the cell, low inside the cell
99
Transport Maximum
Limit of a substance that can be transported per unit time BINDING SITES of TRANSPORT PROTEINS become SATURATED Filtered load exceeds the limit of reabsorption
100
A - Glucose filtration and plasma glucose is linear B - linear until Tm is reached, plateu (no more reabs) SGLT are saturated C - Excretion rate vs plasma glucose D - composite of all
101
Diabetes mellitus
Capacity to reabs glu is normal - filtered load is greatly increased & beyond the threshold level to reabs glucose by tubules
102
Renal Glucosuria
Benign glucosuria or familial renal glucosuria | Genetic mutation of the Na+/glucose cotransporter, normally meditates active reabs of glucose in proximal tubes
103
Reabsorption of UREA
waste product freely filtered at glomerulus REABS of urea is DEPENDENT ON WATER REABSORPTION
104
Mechanism of ADH/Vasopressin
Collecting ducts Binds to cell receptor to activate adenylate cyclase cAMP activates phosphokinaseA Protein phosphorylation AQP2 protein is upregulated (by ADH) H2O moves outside of cell (into interstitial fluid)
105
Diuresis
large volume of urine is produced
106
Diabetes Insipidus
Large amounts of urine
107
Diabetes Insipidus
Large amounts of urine | Water Diuresis - collecting duct is impermeable to water, cause large amount of urine
108
Absence of ADH
Not enpough Aquaporin2 channels | cells are impermeable to wear
109
Central diabetes Insipidus
Failure of ADH release from posterior pituitary
110
Nephrogenic diabetes inspidius
body does not respond to ADH
111
When is ADH increased
shock, pain, warm/hot weather, water deprivation lots of water is reabsorbed low urine quantity
112
ADH is decreased
cold, humid environment alcohol Pee lots
113
Water deprivation
High plasma osmolarity (increased concentration) | Increase plasma ADH --> thirst/water intake and anitdiuresis (renal water retention)
114
High water intake
Low plasma osmolarity AHD block, decreased plasma ADH increased urination
115
Water Diuresis
water volume is large only water is excreted (no solute) D. Insipidus
116
Osmotic diuresis
excess solute in urine with high levels of water excretion | Uncontrolled diabetes mellitus (glucose in the urine)
117
Na+ level regulation
closely associated with water levels | NEVER SECRETED INTO RENAL TUBULES
118
Mechanism of Na+ level regulation
Low [Na+] in plasma - short term (Baroreceptors regulate GFR) - aldosterone (Na+ reabsorption) ----> renin, angiotensin 2 for aldosterone secretion High [Na+] in plasma - Atiral Natriuretic peptide (ANP) ----> regulated GFR, inhibiting Na reabsorption ----> inhibit aldosterone actions
119
NaCl intake
0.05 - 25 g /day
120
Baroreceptors (short term [Na+] regulation)
Respond to pressure changed in cardiovascular system - plasma volume Low plasma volume = low Na+ levels Nerve endings sensitive to stretch INTRARENAL (juxtaglomerular cells of JGA) Processed in medulla oblongata Decrease GFR
121
Longe term regulation of Low Na Levels
Aldosterone (steroid hormone) secreted from adrenal cortex regulated Na+ reabsorption Distal tubule and cortical collecting duct Na+ transport proteins Na+ reabsorption K+ is given out in the process
122
regulation of Aldosterone
Sodium content in diet High NA - low aldosterone Low NA - high aldosterone Angiotensin 2 acts on adrenal cortex
123
Renin is secreted from:
kidney
124
ACE inhibitor
used to lower blood pressure
125
Macula densa
chemoreceptors that sense low sodium passing through distal convoluted tubule
126
What determines [Renin] in plasma
JG cells receive 3 inputs: 1. sympathetic input from external baroreceptors 2. intrarenal baroreceptors 3. signals from macula densa
127
Atrial netriuretic peptide
synthesized and secreted by cardiac atria works on tubular segments Inhibit Na+ abs Increases GFR and Na+ excretion ATRIAL DISTENSION - true sensor - increases secretion of ANP - Aldosterone levels decrease - decrease Na+ reabs -
128
Regulation of K+ levels
important for intracellular fluid small, constant range regulated in last part of cortical collecting duct
129
HYPERKALEMIA
excess K+ in blood

Physiology (3 decks)

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