Renal system Flashcards
(230 cards)
1
Q
What is the sum of all filtration rates of all functioning nephrons known as?
A
glomerular filtration rate
2
Q
What does the leaky barrier of the filtration membrane allow and prevent from passing through?
A
allows water and certain solutes while preventing plasma proteins, blood cells from getting into capsular space
3
Q
what are the cells of the bowman’s capsule that wrap around the glomerular capillaries?
A
podocytes
4
Q
what are the 3 layers of the filtration membrane starting with the innermost?
A
fenestrations of endothelial cells, basement membrane/basal lamina, and slit membranes between pedicels
5
Q
Which layer of the filtration membrane prevents blood cells from passing, but allows all other components of blood plasma through?
A
fenestrations of endothelial cells
6
Q
Which layer of the filtration membrane prevents large proteins from passing through?
A
basal lamina
7
Q
Which cells regulate the surface area available for filtration?
A
mesangial cells
8
Q
Why is the filtration pressure higher in glomeruli than in any other capillaries in the body?
A
larger surface area, larger fenestrations, and efferent arteriole has a small diameter than afferent
9
Q
What is the glomerular blood hydrostatic pressure?
A
pressure in glomerulus pushing outward into capsular space
10
Q
How is GBHP (Glomerular blood hydrostatic pressure) different from CHP (Capsular hydrostatic pressure)?
A
CHP is opposite of GBHP, pressure that pushes inward on the visceral glomerular membrane
11
Q
What filtration pressure is due to proteins in blood plasma and pulls solutes into the glomerulus?
A
BCOP (Blood colloidal osmotic pressure)
12
Q
What is the formula of NFP and what does it do?
A
NFP=BHFP-CHP-BCOP;
Promotes filtration
13
Q
NFP can still cause filtration if it is negative and lead to urine production. T or F?
A
F
14
Q
Which pressure change leads to nephrolithiasis?
A
CHP increases pushing back flow into the glomerulus
15
Q
What condition occurs when NFP is no longer supporting filtration?
A
hydronephrosis
16
Q
What is the glomerular filtration rate and is it higher in males or females?
A
this is the amount of blood filtered through the kidney’s glomeruli into the capsular space per unit time. it is higher in males (90 - 140 mL/min)
17
Q
What happens when GFR is too slow?
A
All filtrates may be reabsorbed and waste may not be excreted efficiently
18
Q
A decreasing GFR means what to your doctor?
A
A progression of a chronic kidney disease
19
Q
Which formula is used for estimating GFR?
A
Cockcroft-Gault formula
20
Q
Which factors affect the calculation of GFR?
A
Age, Race, Weight, and Gender (GRAW)
21
Q
Why is creatinine used in the calculation of GFR?
A
Because it is not reabsorbed after filtration and serum level should be at or near urine level
22
Q
What happens to serum creatinine level when urine level is low?
A
It increases
23
Q
Creatinine is a result of what process?
A
normal breakdown of muscle
24
Q
The pressures that affect net filtration pressure also affect GFR. T or F?
A
T
25
GBHP is inversely related to GFR. T or F?
F
26
What effect does dilation of the afferent arteriole have on GBHP and GFR?
increases both
27
What effect does the dilation of the efferent arteriole have on the GBHP and GFR?
decreases both
28
what effect does the constriction of the afferent and efferent arteriole have on its resistance?
increases resistance
29
What are the mechanisms that regulate GFR?
renal autoregulation, neural regulation, and hormonal regulation
30
If the renal (kidney) autoregulation occurs due to innate actions, how does neural regulation of GFR occur?
sympathetic nervous system input
31
What are the hormones of the hormonal regulation of GFR?
Angiotensin II and Atrial natriuretic peptipte (ANP)
32
How does the kidney maintain a near constant GFR during renal autoregulation?
variable changes in resistance at afferent arteriole
33
Which renal autoregulation mechanism allows the transient (short) increase in GFR?
myogenic mechanism
34
How is the nephron integrity preserved with sudden increased blood pressure?
an initial reduction of GFR due to smooth muscle contraction of afferent arteriole
35
in the myogenic mechanism, an immediate increase in BP causes ___ which can cause ___?
myogenic vasoconstriction; compensatory vasodilation
36
What is the sole purpose of the juxtaglomerular apparatus (JGA)?
affect systemic blood pressure through autoregulation of tubuloglomerular feedback
37
What are the cells of juxtaglomerular apparatus (JGA)?
juxtaglomerular cells, macula densa cells, and lacis cells
38
What is another name for lacis cells?
extraglomerular mesangial cells
39
Which JGA cells are found in the walls of afferent arteriole?
juxtaglomerular cells
40
Which JGA cells are found in between afferent arteriole, efferent arteriole, and DCT?
lacis cells
41
which cells are found in the walls of the late thick ascending limb of LOH?
macula densa cells
42
juxtaglomerular cells are modified smooth muscle cells. T or F?
T
43
What are the 2 functions of the juxtaglomerular cells?
detect low blood pressure by lack of wall stretch and secrete renin to cause an increase in blood pressure
44
What are the 2 functions of the macula densa (specialized) cells?
detect increase in NaCL in filtrate; release locally acting ATP & adenosine causing contraction of afferent arteriole and reduction in GFR
45
Which JGA cell contract or relax to make small regulatory changes in response to signal from other JGA cells?
exraglomerular mesangial cells (lacis cells)
46
When the blood pressure and extracellular fluid volume is normal, the neural and hormonal regulation play a key role in maintaining constant GFR. T or F?
F
47
Blood vessels of the kidney are supplied by sympathetic nervous system fibers only. T or F?
T
48
The increase in sympathetic stimulation of the kidney causes ___ of the afferent arteriole.
vasoconstriction
49
The decrease of GFR helps to protect the ____ from rapid rise in pressure until autoregulatory compensation.
nephron
50
Which arteriole constricts first when GFR hormone, angiotensin II is activated?
efferent
51
The increase in the level of angiotensin II in the glomerular causes ____ of afferent arterioles which reduces ____?
vasoconstriction; GFR
52
The secretion of ANP by the atria and BNP by the brain is caused by a ____ in blood volume.
increase
53
How does ANP and BNP affect the afferent and efferent arteriole?
It causes dilatation of afferent and constriction of efferent
54
Increased secretion of ANP/BNP decreases GFR. T or F?
F
55
Which hormone conteracts the vasoconstricting effect of angiotensin II when BP is down?
prostaglandins
56
Which GFR hormonal regulator prevents renal ishemia?
prostaglandins
57
Which GFR hormonal regulator causes vasodilation of afferent and efferent arterioles counteracting the effect of angiotensin II?
Nitric oxide
58
Which GFR hormonal regulators are endothelial cell derived?
Nitric oxide and endothelin
59
Which GFR hormonal regulator is stimulated by angiotensin II and epinephrine to cause vasoconstriction of both afferent and efferent arterioles?
endothelin
60
Which vasodilator stimulates the release of NO and prostaglandins?
bradykinan
61
Which GFR hormonal regulator produced within kidneys causes vasoconstriction at afferent arteriole?
Adenosine
62
What is the function of angiotensin converting enzyme (ACE)?
converts angiotensin I to angiotensin II
63
Where is angiotensin converting enzyme located?
surface of endothelial cells lining afferent arteriole and glomerular capillaries
64
The RAAS is activated in response to ___ blood pressure.
low
65
RAAS is activated by the stimulation of ___ receptors found in juxtaglomerular cells.
beta 2 adrenergic
66
What change in luminal sodium chloride activates RAAS?
decrease in luminal NaCl
67
GFR is directly proportional to sodium chloride concentration. T or F?
T
68
Which hormones are released when RAAS is activated?
renin and angiotensinogen
69
If juxtaglomerular cells secrete renin, which cells secrete angiotensinogen?
hepatocytes (liver cells)
70
How is angiotensin 1 made after RAAS activation?
angiotensinogen reacts with renin to cleave off a 10-amino acid peptide
71
What happens to angiotensin-1 when it gets to the lung and kidney?
It is converted to angiotensin II by endothelial ACE
72
Angiontensin_II decreases ___ by causing ___ vasoconstriction of afferent arteriole and ___ vasoconstriction of efferent arteriole
GFR; major; minor
73
Angiotensin-II enhances __, __, & __ reabsorption in the PCT
water, sodium and chlorine ions
74
Angiotensin-II stimulates the adrenal cortex to release an hormone which stimulates principal cells in collecting ducts to reabsorb more sodium and chlorine ions and secrete more potassium. what is the hormone?
aldosterone
75
What effect does the increased reabsorption of water, sodium and chlorine ion have on blood volume and pressure?
increases
76
Which hormone that causes more water reabsorbtion does angiotensin-II release in the posterior pituitary gland?
ADH
77
Which condition is an ACE inhibitor used to treat?
hypertension
78
How does ACE inhibition help reduce blood pressure?
ensures that angiotensin-II does not stimulate aldosterone and ADH
79
What are the differences btw active and passive transport?
passive does not ATP while active requires ATP to occur; passive is from high conc. to low while active is vice versa
80
Glomerular filtration is an example of ___ movement
passive
81
Sodium/potassium pumps is an example of ___ movement
active
82
In addition to the efforts of the renal tubule and ducts, ____ cells makes the largest contribution to reabsorption.
proximal convoluted tubule (PCT)
83
Which distal cells "fine tune" the reabsorption process?
LCD; loop of henle, collecting duct and distal convoluted tubule (DCT)
84
By what process are small proteins and peptides reabsorbed after passing through glomerular filter?
pinocytosis
85
The apical membrane is the ___ side of the cell and the basolateral membrane is the ___ side of the cell.
apical; interstitial
86
What is the difference between tubular paracellular and transcellular reabsoption?
paracellular is btw tubule cells and transcellular is within the same tubule cell
87
Which tubular reabsorption method accounts for 50% of reabsorption?
paracellular reabsorption
88
obligatory water reabsorption is the reabsorption of water by ___ reabsorption via ___
solute; osmosis
89
90% of reabsorption occurs in which part of the kidney?
PCT and descending limb of the loop of henle
90
10% of water reabsorption is occurs by ___ water reabsorption.
facultative
91
Where does facultative water reabsorption occur?
late DCT and collecting ducts
92
Which hormone regulates facultative water reabsorption?
ADH
93
What leads to glucosuria?
a high concentration of plasma glucose which cannot be reabsorbed quickly enough; instead lost through urine
94
___ is the transfer of materials from the capillaries, interstitial spaces, and tubule cells into the filtrate.
tubular secretion
95
Can anabolic steroids, hCG and hGH be detected by urinalysis test?
Yes
96
Erythropoietin and amphetamines cannot be detected by urinalysis. T or F?
F
97
A ___ layer of ___ cells forms the entire wall of the glomerular capsule, renal tubule and ducts
single; epithelial
98
What type of epithelial cells are found on PCT?
simple cuboidal with prominent microvilli
99
What is the function of microvilli on the epithelilal cells of PCT?
increase surface area for reabsorption and secretion
100
What type of epithelial cells are found on LOH (thin descending and ascending limb portions)?
simple squamous
101
All parts of the renal tubule is made up of simple cuboidal epithelial cells except ___?
LOH (thin ascending and descending limb portions)?
102
which parts of the renal tubule contain principal cells and intercalated cells?
DCT and collecting duct
103
tubular secretion of ___ ions helps to regulate pH
hydrogen
104
Principal cells have receptors for ___ and ___
ADH; aldosterone
105
Intercalated cells play a role in ___
blood pH
106
The constant movement of things across the membranes (tubule cell; interstitial fluid; capillary) leads to an ___ gradient and ___ gradient
osmotic and electric
107
___ is a nitrogenous waste created from protein catabolism
ammonia
108
___ is more toxic substance than ___ that must be deadly when left to accumulate instead of excreted.
Ammonia and urea
109
Ammonia is converted into ___ in the ___ and excreted as ___ by the ___
urea; liver; urine; kidney
110
Which disease is caused by urea in the blood instead of excretion through the kidney (kidney failure)?
uremia
111
Checking the ___ levels and ___ levels can give a provider a good picture of a patient's uremic state
blood urea nitrogen; creatinine
112
Urea in the blood reverting back to ammonia will lead to a ___
septic state
113
In what form is bicard reabsorbed in the PCT?
carbonic acid after reaction with hydrogen ion
114
bicard serves as an important ___ in the body
buffer
115
In what form does bicard diffuse into the tubule cell?
carbonic acid dissociates into carbon dioxide and water before entering the cell
116
for every ___ ion secreted into tubular lumen, one ___ and one ___ ion are absorbed
hydrogen;bicarb; sodium
117
largest amount of solute and water reabsorption from filtered fluids occurs in the ___
PCT
118
100% of glucose, amino acid, and vitamins are reabsorbed in the PCT. T or F
T
119
What substances co-transported during sodium ions active transport from tubule into intersitial fluid?
amino acid and glucose
120
Which ions are passively introduced into interstitial fluid to balance sodium ions?
chloride ions
121
movement of sodium and calcium into interstitial fluid causes an osmotic imbalance resolved by movement of ___ from filtrate into interstitum
water
122
The cell lining of PCT and the ___ LOH possess ___ channels which aids water permeability.
descending; aquaporin-1
123
the osmosis of water will often bring pottasium and calcium ion in a process called?
solvent drag
124
PTH stimulates cells in the PCT to secrete ___ and ___
phosphate; cacitriol (vitamin D)
125
cacitriol (vitamin D) causes ___ to be absorbed from digestive system
calcium
126
PTH stimulates cell in the DCT to reabsorb ___
calcium
127
___ reabsorption occurs at the descending limb of LOH and ___ reabsorption occurs at the ascending limb of LOH
water;solute
128
hyperosmosis is caused by more ___ and less ___
solute;water
129
no water reabsorption occurs at the thin and think portion of the ascending limb LOH. T or F?
T
130
thin portion of the ascending LOH is ___ permeable to solutes and the thick portion of the ascending LOH is ___ permeable to solutes.
passively;actively
131
macula densa cells are formed in the ___
think portion of the ascending LOH
132
the amount of solute/water reabsorption is dependent on the feedback from ___ and ___
hormones; osmoreceptors
133
DCT and PCT reabsorb sodium ion through ___
active transport
134
Although normally impermeable to water, ___ hormone causes principal cells of DCT and collecting ducts to become permeable to water by generating ___ channels
ADH; aquaporin-2
135
In the presence of ADH when more water is reabsorbed (creating an osmotic imbalance), urea is also reabsorbed at the ___ ducts migrates through interstitial fluid and gets secreted in the ___
distal collecting; descending limb of the LOH
136
aquaporin-2 functions in the presence of ___, while aquaporin-1 function ___ in the PCT/LOH
ADH; independently
137
hypekalemia causes ___ to be released
aldosterone
138
aldosterone causes principal cells to reabsorb ___ and secret ___
sodium (with water); potassium
139
type A of intercalated cells causes secretion of ___ and the reabsorption of ___ and ___
hydrogen ions; bicarb and potassium ions
140
type B of intercalated cells causes secretion of ___ and ___ and the reabsorption of ___
potassium ions and bicarb; hydrogen ions
141
ANP is stimulated by what change in blood pressure?
increased blood pressure
142
ANP inhibits ___, ___ and ___
sodium ion, water, and RAAS
143
The regulation of plasma osmolarity is the responsibility of ___, ___, and ___
LOH, DCT, and collecting ducts
144
descending limb of LOH ___ urine, ___ ascending limb of LOH ___ urine
concentrates; think;dilutes
145
the final dilution/concentration of urine controlled the presence/absence of ___ occurs at ___ and ___
ADH; DCT; collecting ducts
146
what is the volume of urine produced in a 24 hr period?
1-2 liters
147
what is the normal color of urine and what causes blood in urine?
yellow to amber; kidney stones
148
what is the turbidity of urine?
transparent at first; cloudy with time
149
what is the odor of urine?
mildly aromatic
150
what is the normal pH range and average of urine?
4.6 - 8.0; 6.0
151
protein increases the ___ of pH and vegetables increases ___ of pH
acidity; alkalinity
152
what is the usual specific gravity of urine?
1.001 - 1.035
153
the ____ the concentration of solutes, the higher the specific gravity
higher
154
normal urine contains protein. T or F?
F
155
what accounts for majority of urine?
water
156
solutes such as urea is from the breakdown of ___, uric acid is from the breakdown of ___, and urobilinogen is from the breakdown of ___
proteins; nucleic acid; hemoglobin
157
fatty acids, pigments, and enzymes are solutes found in urine. T or F?
T
158
What are the 2 blood tests that provide information on kidney function?
Blood Urea Nitrogen and plasma creatinine
159
creatinine is reabsorbed in the kidney. T or F?
F
160
When GFR ___, BUN increases?
reduces
161
renal clearance is the ___ that can be completely ___ of a substance per unit time
volume of plasma; cleared/excreted
162
___ is a great measure of GFR because it is easily filtered and excreted completely (100%) through urine
inulin plant polysaccharide
163
creatinine is a ___ estimate of GFR and the lab values needed to complete it are 24 hr ___ and ___
urine collection and plasma concentration
164
collecting ducts -- ? --papillary ducts -- ? -- major calyces -- ? -- ureters -- ? -- urethra
papillary: minor calyces; renal pelvis; urinary bladder
165
urine is transported by ___ from the renal pelvis to urinary bladder
peristalsis
166
ureters are ___ walled, ___, and retroperitoneal
thick, narrow, retroperitoneal
167
ureter passes ___ into ___ aspect of bladder
obliquely; posterior/inferior
168
the physiologic valve of the ureter ___ the bladder ___ to close the "valve" avoiding backflow. This process is also known as ___
pulls; down; anti-reflux mechanism
169
What are the 3 layers of the ureter starting with the innermost?
mucosa (globlet cells), muscularis (inner longitudinal smooth muscle), and adventitia
170
the urinary bladder is ___ when empty and pear-shaped when ___
collapsed; pear-shaped
171
The urinary bladder is ___ of the rectum (males) and vagina (females)
anterior
172
The urinary bladder is ___ to pubic symphysis and ___ to uterus in females
posterior; inferior
173
What holds the urinary bladder in place?
peritoneal folds
174
what is the difference in the muscularis of the ureter and bladder?
the ureter version is made of smooth muscle while bladder version is made of detrusor muscle
175
What happens when the detrusor muscle of the muscularis layer of the bladder is relaxed and contracted?
bladder is filled during relaxation and contraction forces urine into the urethra
176
Comparing the ureter and bladder layers, what is the extra outer layer on the bladder and what does it cover?
serosa covers superior surface and visceral peritoneum
177
the smooth triangular area in the bladder floor is known as?
trigone
178
the bladder is ___ to the urethra
superior
179
the internal urethral sphincter is involuntary and made of ___ and the external urethral sphincter is ___ and made of skeletal muscle
smooth muscle; voluntary
180
the internal urethral sphincter is located ___ to the bladder and ___the prostrate in males
inferior; above
181
where is the external urethral sphincter located in males and females
below prostrate in males; at the opening of the external urethral orifice
182
__ 4-5x longer than female version, dual function (semen, urine), and consists of mucosa and muscularis layers
mare urethra
183
the longest region of the male urethra passing through the penis is the ___
spongy
184
___ is the shortest region of the male urethra forming the external urethral sphincter
membranous
185
___ contains smooth muscle that forms internal urethral sphincter (male urethra) and ducts that transport prostatic fluids and sperm
prostatic
186
spongy urethra (in males) contains ___ that delivers alkaline fluid to help neutralize acidity of urethra
bulbourethral (cowper's gland)
187
female urethra is ___ to pubis symphysis
posterior
188
female urethra runs ___ from the bladder neck and and to the vaginal vestibule
inferior/anterior
189
what renal organ is btw the clitoris and vaginal orfice?
female urethra
190
mucosa layer of female urethra is ___ epithelium near bladder, ___ columnar in the middle, and ___ near external urethral orfice
transitional; pseudostratified; non-keratinized stratified
191
the involuntary contractions of detrusor muscle causing the ___ sphincter to open
internal urethral
192
what causes the voluntary contraction that prevents urination?
external urethral sphincter
193
micturition is the discharge of urine. T or F?
T
194
the increased incidence of calculi, renal inflamation, polyuria, nocturia, and dysuria is caused by ___ deterioration after ___
nephron; aging
195
the kidney is partially protected by the ___ ribs
11th and 12th
196
the kidney is located btw the ___ and ___ vertebrae in the ___ space
last thoracic and 3rd lumbar; retroperitoneal
197
the ___ border of the kidney faces the spinal column
cocave medial
198
what is the innermost layer of the kidney with smooth connective tissue?
renal capsule
199
What is the middle layer of the kidney and what type of tissue does it have?
adipose; fatty tissue
200
renal fascia is the ___ layer of the kidney with ___ connective tissue
outermost; dense
201
What part of the kidney contains all of the glomeruli and convoluted tubules of nephron?
cortex
202
the narrow apex of the pyramid is known as?
papilla
203
a unit of a medulla is known as the ___
pyramid
204
what part of the kidney contains the loops of henle and collecting ducts
medulla
205
minor calyx collect urine from ___ while major calyx collect urine from ___
papilla; minor calyx
206
spaces btw renal pyramids are known as
columns
207
a functional region of the kidney is known as a ___?
lobe (pyramid++cortex+1/2 each adjacent column)
208
where do the major calyces of the kidney drain into?
renal pelvis
209
the spaces in the kidney where blood vessels and nerve supply pass through are known as?
renal sinuses
210
___ is the indentation of the kidney where the ureter emerges with blood and lymphatic vessels
renal helium
211
What is the acronym for the blood supply to the kidney that starts with aorta and ends with inferior vena cavae?
ARSI/AI/AGE/PV/IAIRA
212
The blood supply starts from goes from the arteries, to arterioles, to glomerulus, capillaries, and veins. T or F?
T
213
The glomerulus allows filtration and reabsorption. T or F?
F (strictly filtration)
214
blood enters through the ___ to get filtered by the glomerulus and exits through ___ to proceed to the capillary system
corpuscle (2x)
215
The ___ capillary acts as a secondary filter which can reabsorb and secrete
peritubular
216
filtrate is first found in ___ from where it flows into the ___ then into the collecting ducts
bowman's capsule (glomerular capsule); tubules
217
filtrate becomes urine after leaving the ___
collecting duct
218
a functional unit of the kidney is known as?
nephron
219
the 2 parts of the nephron are ___ where blood is filtered and ___ where filtered blood goes
renal corpuscle; renal tubule
220
Renal corpuscle is made of GG and renal tubule is made of PLD. What do the acronyms mean?
GG; glomerulus, glomerular capscule |
| PLD; PCT, LOH, and DCT
221
which part of the renal tubule is connected to the renal corpuscle?
PCT
222
of the parts of the nephron, which one is only found in the renal medulla?
LOH
223
what are the 2 types of nephrons?
cortical and juxtamedullary nephron
224
Which type of nephron is the most common and found on the outer portion of the renal cortex?
cortical nephron
225
which type of nephron has long loops of henle and has peritubular capillaries that give rise to ___ recta?
juxtamedullary nephron; vasa
226
The anatomy of the ___ of the juxtamedullary nephrons that lends to very dilute or concentrated urine
long nephrons
227
the short and long nephron start and end in the ___
cortex
228
the component of the juxtamedullary nephron that is very important for maintaining constant osmotic gradient is known as?
vasa recta
229
___ arteriole brings blood into the corpuscle possessing wider and thicker walls for constriction and dilation
afferent
230
the smaller lumen size and thinner walls of the ___ arteriole aids in back-pressure sometimes needed for glomerular filtration
efferent
