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BMEG 350 > Renal System > Flashcards

Renal System Flashcards

1
Q

organization of renal system

A
  • right and left kidneys
  • ureters leave kidneys and enter urinary bladder
  • urethra is the tube connecting urinary bladder to external environment
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2
Q

functions of kidney

A
  • regulates extracellular fluid volume and blood pressure
  • regulation of osmolarity
  • maintenance of ion balance
  • regulation of pH
  • excretion of wastes
  • production of hormones
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3
Q

nephrons

~ how many /kidney

A
  • functional units of the kidney
  • approx 1 million per kidney
  • found in the medulla (pink triangles) and cortex (outermost region) of the kidney
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4
Q

anatomy of nephron

A

look at slides pg 9 and 10 of slides

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5
Q

microvilli

A

increases surface area of epithelial cells of the nephron, important for absorption

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6
Q

glomerular filtration

A

amount of solute excreted = amount filtered from blood to urine - amount reabsorbed + amount seccreted

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7
Q

loss of plasma

A

20% of volume gets filtered, and 19% is reabsorbed
–> 99% of plasma entering kidney returns to systemic circulation

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8
Q

filtration barriers

A
  1. glomerular capillary endothelium
  2. basal lamina
  3. epithelium of Bowman’s capsule
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9
Q

main components of filtrate

A
  • urea
  • glucose
  • ions
  • creatinine
  • H20
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10
Q

what is GFR and what is it influenced by

A
  • glomerular filtration rate
  • volume of fluid that filters into Bowman’s capsule/time
  • approx 180 L/day
  • is influenced by pressure: hydrostatic, colloid osmotic
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11
Q

resistance changes in renal arterioles

A
  1. increased resistance in efferent (above, e comes later than a) arteriole –> increases GFR
  2. increased resistance in afferent (below, a comes first) arteriole –> decreases GFR
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12
Q

regulation of GFR

A

autoregulation
- myogenic response to bp changes: stretch due to increased pressure causes vasoconstriction of afferent arterioles
- tubuloglomerular feedback:

extrinsic regulation
- hormones
- sympathetic neurons

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13
Q

juxtaglomerular apparatus

A

macula densa cells on the ascending loop of Henle are in contact with the arterioles, and send paracrine signals that affect afferent arteriole diameter

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14
Q

tubuloglomerular feedback

A
  1. GFR increases
  2. flow through loop of henle increases
  3. flow pas macula densa increases
  4. paracrine signal from macula densa to afferent arteriole
  5. afferent arteriole constricts –> pressure changes lead to GFR decrease!!
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15
Q

reabsorption

A
  • most reabsorption happens in the proximal tubule
  • transepithelial transport: substances cross apical membrane and basolateral membrane
  • paracellular pathway: substances pass through tight junctions
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16
Q

what is reabsorption primarily driven by?

A

Na+ movement

17
Q

glucose reabsorption

A
  1. Na+ moving down its electrochemical gradient uses SGLT protein to pull glucose against its concentration gradient
  2. glucose diffuses out basolateral side of cell using GLUT protein
  3. Na+ is also pumped out basolateral membrane
18
Q

what mechanism is responsible for the BULK of Na+ reabsorption

A
  • mechanism for glucose transport
  • also applicable to amino acids and ions
19
Q

Na+ reabsorption in the collecting duct

A
  1. Na+ enters cell via ENac = epithelial Na+ channel
  2. pumped out basolateral side
    –> hormonal regulation of this mechanism is responsible for FINE TUNING Na+ reabsorption
20
Q

net filtration pressure equation

A

hydrostatic pressure (in blood) - colloid osmotic pressure (pi) - fluid pressure (in proximal tubule) = net filtration pressure from glomerulus to tubule

21
Q

maintaining water balance

A
  • kidneys conserve or remove body fluid by regulating amount of H2O reabsorbed
22
Q

arginine vasopressin (AVP)

A
  • hormone released by posterior pituitary gland to influence H2O reabsorption
  • released when: high plasma osmolarity, low blood volume, low blood pressure
  • results in increased water reabsorption and concentrated urine via adding water pores into the apical membrane of collecting duct cells
    + AVP = collecting duct is permeable to water
  • AVP = collecting duct is impermeable to water
23
Q

aldosterone

A
  • steroid hormone
  • synthesized in and released from adrenal cortex
  • acts on distal tubule and collecting duct
  • results in: increased Na+ reabsorption
24
Q

stimuli of aldosterone release

A
  • angiotensin II (when low blood pressure)
  • hyperkalemia (high K+ in plasma)
25
Q

renin secretion stimulated by low blood pressure - three routes

A
  1. reduce GFR: detected by reduced Na+ at macula densa
  2. reduced BP: detected by atrial stretch receptors
  3. reduced BP: detected directly by afferent arterioles
26
Q

3 mechanisms for maintaining pH homeostasis

A
  1. buffers
  2. regulation of ventilation
  3. kidneys: H+ secreted and HCO3- reabsorbed at proximal tubule
27
Q

can respiratory and renal systems balance out each other’s pH?

A

yes, but respiratory system functions faster in doing so

28
Q

lower urinary tract

A
  • urinary bladder, urethra, and periurethral striated muscles
    roles:
    1. continence: urine storage in the bladder
    2. micturition: effective voiding at an appropriate time
    –> controlled by sympathetic, parasympathetic and somatic nervous system
29
Q

goals and approaches for bladder management

A

goals:
1. protect upper UT
2. improve urinary incontinence
3. restore LUT function

approaches
1. pelvic floor muscle training
2. catheterization
3. drugs for overactive bladders –> but these can cause leakage
4. electrical stimulation of bladder –> but, body can get used to problem (desensitized), or pathology can change

30
Q

novel approaches to bladder problems!!

A
  • optical stimulation of bladder
  • drug delivery from within: slow release of drug within bladder (but how do we remove it?)
  • tissue engineering approach - tissue produced must be mechanically flexible
31
Q

how would we test bladder grafts?

A
  • mechanical testing: uniaxial tensile, biaxial tensile, ball burst
  • imaging to determine shape and dynamics
  • mathematical modeling
  • computational simulations to predict stress distribution
32
Q

gut-brain axis

A
  • ## includes afferent and efferent neural, endocrine, and nutrient signals between CNS and GI tract
33
Q

gut microbiota-brain axis

A
  • microbiota: bacteria, archaea, fungi, and viruses
  • gut is host to more than 500 microbial species
  • important for metabolism

BMEG 350 (14 decks)

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