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P1: Ren > Structure And Function Of The Renal Tubule > Flashcards

Structure And Function Of The Renal Tubule Flashcards

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1
Q

What happens in the renal tubule?

A

→ Filtered fluid is converted to urine

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2
Q

What is the composition of glomerular filtrate?

A

→Same composition as plasma except that there are no cells and very little protein

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3
Q

When does urine formation begin?

A

→ large amounts of fluid that is free of protein is filtered from the glomerular capillaries into the Bowman’s Capsule.

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4
Q

What is the glomerular filtrate?

A

→ An ultrafiltrate of plasma

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5
Q

What is reabsorption?

A

→moving from the tubular lumen into the peritubular capillary
→ returning wanted substances into the blood

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6
Q

What is secretion?

A

→ moving from the peritubular capillary plasma into the tubular lumen

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7
Q

What is the pathway substances have to take to be reabsorbed?

A

→cross the luminal membrane
→ diffuse through the cytosol
→ across the basolateral membrane
→ into the blood

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8
Q

What is co-transport?

A

→ Movement of one substance down its concentration gradient

→ allows the transport of another substance against its concentration gradient

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9
Q

What is the sodium-glucose transporter called in the kidney?

A

→ SGLT-2

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10
Q

What is the effect of SGLT-2 inhibitors?

A

→ don’t allow glucose to be carried across with sodium into the peritubular capillaries

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11
Q

What are the techniques used to investigate tubular functions in humans?

A

→ Clearance studies

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12
Q

What are the techniques used to investigate tubular functions in animals?

A

→ Micropuncture & isolated perfuse tubule

→ Electrophysiological analysis

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13
Q

How is micropuncturing done?

A

→ isolate the nephron

→ sample tubular fluid in different parts of the nephron

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14
Q

How is the electrical potential measured?

A

→ Micropipettes are inserted into the cell

→PD is measured across the whole cell epithelium

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15
Q

What is patch clamping for?

A

→The current flow through an individual ion channel is measured

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16
Q

What cells is the nephron made from?

A

→ a single layer of epithelial cells resting on a basement membrane

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17
Q

What are the 7 parts of the nephron?

A 
→ PCT
→Thin Descending limb
→ Thin ascending limb
→ Thick ascending limb
→ DCT
→ Collecting duct
→ Medullary collecting duct
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18
Q

What are the two types of nephron?

A

→ Cortical nephron

→Juxta-medullary nephron

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19
Q

What do juxta medullary loops do?

A

→ they have a long loop of Henle

→ They are better at concentrating urine

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20
Q

What percentage of each type of nephron do humans have?

A

→ 85% cortical

→ 15% juxta medullary

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21
Q

What are the efferent arterioles in the juxtamedullary nephrons divided into?

A

→ Specialized capillaries (vasa recta)

→ they extend downward into the medulla and lie side by side with loops of Henle

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22
Q

Where is the PCT?

A

→ Adjacent to the Bowmans capsule

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23
Q

What are the adaptations of the PCT for transport?

A

→ Mitochondria for active transport

→ Brush border on the luminal side which gives a large surface area for rapid exchange

→Enzymatic proteins and carriers

→ the PCT has a high permeability

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24
Q

How much is filtered at the PCT?

A

→ 65-70% of the filtered load

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25
What is Fanconi's syndrome?
→ Proximal tubule reabsorptive mechanisms are defective so glucose, amino acids, Na+, K+ are all found in the urine
26
What are the 3 functional segments of the loop of Henle?
→ Thin descending → Thin ascending → Thick ascending
27
What is the structure of the thin ascending & descending loops?
→ Thin epithelial cells → No brush border → few mitochondria → low metabolic activity
28
What is the structure of the thick ascending loop?
``` → Thick epithelial cells → Extensive intracellular folding → Few microvilli →Many mitochondria → High metabolic activity ```
29
What is the function of the loop of henle?
→ role in diluting and concentrating urine | → adjusts the rate of water secretion/absorption
30
What are the permeabilities of the loop of henle?
→ Only the descending limb is permeable to water | → the other two are impermeable to water
31
What do the loop diuretics do?
→ act causing 20% of filtered Na+ to be excreted
32
Describe how the countercurrent multiplier works
→on the ascending limb side there are a lot of Na+/K+ pumps → They pump Na+ out all the time → Salt accumulates in the interstitial space around the loop of Henle → It pulls water out of the descending limb via osmosis →water cannot be reabsorbed by the ascending limb → as fluid flows down the osmolality increases → all the fluid is more concentrated →as the fluid moves out it is hypo-osmotic
33
What maintains the medullary osmotic gradient?
→the vasa recta forms in a countercurrent to the loop of henle →water can diffuse into the blood → Salts can diffuse into the loop of henle
34
What is the first part of the DCT and what is it linked to?
→ Macula densa | → Juxtaglomerular complex
35
What does the macula densa do?
→ provides feedback control of the GFR
36
What are the functions of the DCT?
→ Solute reabsorption without H2O absorption → high Na+/K+ ATPase activity in the basolateral membrane → dilution of tubular fluid → Role in acid base balance via the secretion of NH3
37
How can you make the DCT permeable to water?
→ using ADH
38
What are the collecting ducts formed from?
→ joining collecting tubules
39
What are the 2 types of cells in the collecting ducts?
→ intercalated cells | → principal cells
40
What kind of epithelium is in the collecting duct?
→ cuboidal epithelia
41
What is the collecting duct permeable to?
→ urea | → made permeable to H2O by ADH
42
What do intercalated cells do?
→ Involved in acidification of urine and acid-base balance
43
What do principal cells do?
→ Play a role in Na balance and ECF volume regulation
44
Where is ADH made and stored?
→ In the hypothalamus | → In the pituitary gland
45
How does ADH concentrate urine?
→ triggering the kidney tubules to reabsorb water back into bloodstream
46
What is the most important effect of ADH?
→ conserve body water by reducing the loss of water in the urine
47
What is the most important variable in regulating ADH secretion?
→ Plasma osmolality
48
What are changes in osmolality sensed by?
→ osmoreceptors in hypothalamus
49
What happens when an osmoreceptor detects changes in osmolality?
→triggers ADH secretion from the posterior pituitary → taken to the kidneys → make the collecting duct permeable to water
50
How does ADH/ vasopressin cause the collecting duct to be more permeable to water?
1) ADH binds to its V2 receptors on the peritubular capillary wall 2) it leads to the insertion of aquaporins into the luminal membrane near the collecting duct 3) water is removed from the urine 4) it stimulates the synthesis of new aquaporins
51
How does urea enter the glomerular filtrate?
→ It filters freely through the glomerulus and passes down the tubule
52
How is urea reabsorbed from the collecting duct?
→ as water is reabsorbed from the CD → Urea is concentrated so that it moves out → absorbed into the surrounding capillaries and into the interstitial of the medulla → contributes to the osmotic gradient around the loop of Henle
53
What do increasing urea levels in the kidney indicate and why?
→ pre-renal failure | → reabsorption is enhances
54
How are urea levels in the kidney monitored?
→ Blood urea nitrogen test
55
What happens to the collecting duct during water deprivation?
→ ADH acts → Aquaporins are inserted into the luminal membrane → small urine volume - less dilute →Water reabsorption increases the CD urea concentration and ADH increases the duct permeability to urea and therefore its reabsorption is increased → osmolarity is greater than hypoosmotic fluid
56
What happens to the collecting duct during water excess?
→ no ADH acts → water remains in the CD → large urine volume - more dilute →osmolarity is lower than hypoosmotic fluid that entered the duct
57
What kind of fluid enters the collecting duct?
→ Hypo-osmotic fluid
58
What are the 4 factors that allow the medullary osmotic gradient to be maintained?
→ Active transport of Na+ and co-transport of K+ and Cl- out of the thick ascending limb into the medullary interstitium → Active transport of ions from collecting duct into the interstitium → Facilitated diffusion of urea from collecting ducts into the medullary interstitium → Little diffusion of water from ascending limbs of tubules into medullary interstitium
59
What is polycystic kidney disease?
→ genetic disorder characterized by growth of numerous cysts in the kidney
60
What are diseases of the glomerulus called?
→ glomerulonephritis
61
What happens in diseases of the glomerulus?
→ inflammation of glomeruli or some or all of the nephrons | → can be primary or secondary to things like diabetes
62
What are the two diseases of the tubules?
→ Obstruction | →Impairment of transport functions
63
How can hypertension lead to kidney damage?
→ Kidneys regulate ECF and influence BP | → compensatory mechanisms in response to high BP leads to chronic kidney damage
64
How can congestive cardiac failure lead to kidney damage?
→ Fall in cardiac output → renal hypoperfusion → registered as hypovolaemia → compensation results in pulmonary oedema
65
How does diabetic nephropathy lead to kidneys being damaged?
→ Filtering system of the kidneys get destroyed over time
66
What does lithium treatment result in?
→acquired nephrogenic diabetes insipidus | → reduced aquaporin 2 expression
67
What is the role of the vasa recta?
→ The vasa recta is permeable to both H2O and salts and could disrupt the salt gradient established by the loop of Henle. → To avoid this, the vasa recta acts as a counter-current multiplier system as well. → As the vasa recta descends into the renal medulla, water diffuses out into the surrounding fluids, and salts diffuse in. → When the vasa recta ascends, the reverse occurs. the concentration of salts in the vasa recta is always about the same, and the salt gradient established by the loop of Henle remains in place. → Water is removed by VR, so doesn’t dilute longitudinal osmotic gradient.
68
Why is it important that the medullary blood flow in vasa recta is slow?
sufficient to supply the metabolic needs of the tissue, but minimize solute loss from the medullary interstitium.

P1: Ren (13 decks)

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