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Flashcards in Unit 7 Deck (92):
1

BLOOD FILTRATION: location and function

Location: glomerulus
Remove waste products from blood

2

REABSORPTION: location and function

Location: nephron
Recover nutrients, ions, H2O

3

SECRETION: location and function

Location: nephron
Assists filtration by removing waste products directly from blood

4

ACTIVATION: Vitamin D

-Dehydrocholesterol → vitamin D3 by ultraviolet (UV) light @skin
-Vitamin D3 → calcitriol @kidney

5

Location where Calcitriol ↑Ca++ deposition

@bone

6

Location where Calcitriol ↑Ca++ reabsorption

@kidneys

7

Location where Calcitriol ↑Ca++ absorption

@small intestines

8

ENZYME RELEASE: Renin
(location what does renin converts to)

-Location: kidneys
-Renin converts Angiotensinogen → Angiotensin I → Angiotensin II

9

Function of Angiotensin II

-vasoconstricts (↑blood pressure)
-Causes aldosterone (hormone) release (adrenal cortex) which stimulates DCT to reabsorb salt, H2O follows the salt

10

AUTOREGULATORY LIPID RELEASE: Prostaglandins
(location and function)

-Location: kidneys
-Prostaglandins: vasodilate (↓blood pressure)

11

H+ SECRETION:

-Eliminates excess hydrogen ions
-Controls acid/base (pH) balance

12

HCO3– REABSORPTION:

-Recovers bicarbonate ions
-Controls acid/base (pH) balance

13

HORMONE RELEASE: Erythropoietin (EPO) (location and function)

Location: kidneys
EPO ↑RBC production (bone marrow)

14

Function of Renal Artery:

Transports ↑O2 blood from aorta → kidney (filtration)

15

Function of Renal Vein:

Transports filtered ↓O2 blood from kidney → inferior vena cava

16

Function of Renal Column:

-Area between renal pyramids (medulla)
-Site for blood vessel passage to the cortex

17

Function of Nephron:

-Kidney FUNCTIONAL UNIT
-Filtration, reabsorption, & secretion

18

Function of Capsule:

-Thick outer membrane
-Surround & protect

19

Function of Cortex:

-Outer layer
-Contains most of the nephron
-Filtration, reabsorption & secretion

20

Function of Medulla:

-Inner layer
-Nephron structures not located in cortex
-Salt, water & urea reabsorption

21

Function of Renal Pyramids:

-Triangle-shape
-Loops of Henle, collecting ducts, & counter-current multiplier system (concentrates salt & saves water)

22

Function of Renal Papilla:

-Renal pyramid apex
-Releases urine → minor calyx

23

Function of Minor Calyx:

-Collecting sac surrounding papilla
-Transports urine from papilla → major calyx

24

Function of Major Calyx:

-Collecting sac
-Transport urine from minor calyces → pelvis

25

Function of Renal Pelvis

Collects urine from major calyces → ureter

26

Function of Ureter

Transport urine from renal pelvis → bladder

27

Function of Urinary bladder:

-Stores urine from ureter
-Releases urine → urethra

28

Function of Urethra:

Releases urine → outside

29

Function of Afferent Arteriole:

Transports arterial blood → glomerulus (filtration)

30

Function of Efferent Arteriole:

Transports filtered blood from glomerulus → peritubular capillaries & vasa recta → renal venous system

31

Function of Glomerulus:

-Blood filtration
-Nonspecific filter
-Removes both useful & non-useful materials into filtrate

32

Function of Bowman’s Capsule:

-Sac that encloses glomerulus
-Transfers filtrate from glomerulus → Proximal Convoluted Tubule (PCT)

33

Function of Proximal Convoluted Tubule (PCT):

-Reabsorbs most of the useful substances in the filtrate: Na+ (65%), H2O (65%), HCO3– (90%), Cl– (50%), glucose (100%)
-Primary site for secretion of toxins, wastes & hydrogen ions (H+)

34

Function of Descending Limb of the Loop of Henle (DLLH):

-Counter-current multiplier system
-Permeable to H2O
-Impermeable to solutes (salts)
-Receives filtrate from the PCT; allows H2O to be reabsorbed; sends “salty” filtrate to ALLH; “Saves water & passes salt”

35

Ascending Limb of the Loop of Henle (ALLH):

-Counter-current multiplier system
-Impermeable to H2O
-Permeable to salts
-Actively transports (reabsorbs) salts (NaCl) into the interstitial fluid of the medulla; “Saves salt & passes water”
-Filtrate becomes dilute; interstitial fluid of medulla becomes hyperosmotic (salty)

36

Function of Distal Convoluted Tubule (DCT):

-Receives dilute fluid from ALLH
-If Aldosterone (hormone) is present, sodium is reabsorbed, (Cl– & H2O follow Na+); Potassium (K+) is se

37

Function Collecting Duct:

-Receives fluid from DCT
-If antidiuretic hormone (ADH) is present, collecting duct becomes porous to water
-Collecting duct H2O moves (osmosis) to the “salty” (hyperosmotic) medulla

38

Where is the LAST CHANCE to save water?

The collecting duct

39

Function of Peritubular Capillaries:

Transport reabsorbed materials from PCT & DCT → renal veins

40

Function of Vasa recta:

-Blood vessels of the peritubular capillary network
-Surround descending & ascending loops of Henle

41

Filtration Structures of Glomerulus:

-Filtration site
Screen-like:
-Fenestrated glomerular capillaries (podocytes w/ pedicels)
-Allows passage of H2O & solutes smaller than plasma proteins

42

Net filtration pressure of blood hydrostatic pressure (BHP)

60 mm Hg (out)

43

Net filtration of colloid osmotic pressure (COP)

-32 mm Hg (in)

44

Net filtration of capsular pressure (CP)

-18 mm Hg (in)

45

Total net filtration pressure (NFP)

10 mm Hg

46

What does the Juxtaglomerular Apparatus (JGA) contain?

-Macula densa cells (DCT)
-Granular cells (afferent arteriole)

47

Function of Juxtaglomerular Apparatus (JGA)

maintain blood pressure

48

What does Granular cells detect and release?

detect ↓pressure; release renin

49

What does Renin convert?

Renin converts angiotensinogen → angiotensin I → angiotensin II

50

What does Macula dense monitors?

blood salt

51

What does macula dense do when high blood salt content occurs?

-macula densa inhibits granular cells
-Inhibits renin release, which
-Inhibits Angiotensin II (causing vasodilation & ↓blood pressure)
-Aldosterone inhibited (↓blood volume & ↓blood pressure)

52

Summary of Granular cells

↑Blood volume & ↑BP

53

Summary of Macula Densa

(inhibit granular cells)
↓Blood volume & ↓BP

54

Ascending limb of loop of Henle (ALLH): (counter-current mechanism)

-Reabsorbs salt (active transport) → interstitial tissue of the medulla
- Makes medulla hyperosmotic (salty)

55

What leaves Ascending limb of loop of Henle (ALLH) during counter-current mechanism

Salt (NaCl)

56

Osmolarity of Ascending limb of loop of Henle (ALLH) fluids

Osmolality of ALLH fluid decreases from 1200 to 100 milliosmoles/L (mOsm/L)
- ALLH is impermeable to H2O
-Remove salt from filtrate
-Accumulate salt in medulla

57

Accumulated salt in medulla is used to “draw-out” water (osmosis) from:

1) DLLH (H2O permeable, salt impermeable)
2) Collecting duct

58

Is DLLH permeable to H20?

-DLLH is H2O permeable & loses H2O to the medullary interstitial tissue
- H2O is reabsorbed by medullary blood vessels
-Osmolality of DLLH fluid changes from 300 to 1200 mOsm/L
- Saves H2O

59

Where does ALLH transfer salt into?

-ALLH actively transfers salt into medulla
-Medullary salts attract H2O out of DLLH

60

Hyperosmotic (salty) medulla

-Hyperosmotic (salty) medulla will also “pull-out” H2O from the collecting duct if ADH (hormone) is present
-H2O moves out of collecting duct (urea follows)
- Urea contributes to ↑osmolality of the medulla

61

What makes ADH?

Hypothalamus

62

Where is ADH stored and causes?

-ADH stored in posterior pituitary & released (if dehydration)
- ADH causes collecting duct “pores” to open
- H2O moves from collecting duct → medulla

63

As H2O leaves the collecting duct:

-Collecting duct fluid becomes more concentrated (↑osmolality of collecting duct fluid 100 to 1200 mOsm/L)
- If ADH is not present, H2O is lost in dilute collecting duct fluid (100 mOsm/L)

64

Vasa recta is permeable to:

salts and water

65

How does vasa recta vessels flow?

- flow counter-current to loop of Henle fluid (counter-current exchange)
- Blood flowing through vasa recta absorbs H2O (not salts)
- Vasa recta return H2O back to body & leave salts (maintain hyperosmotic medulla)

66

Equation of excretion and why does the difference mean?

-Excretion = Filtration – Reabsorption
-Difference between filtration & reabsorption determines how much of a substance kidneys eliminate per unit of time

67

Filtration: 16 grams of NaCl per day Reabsorption: 14 grams of NaCl per day
WHAT IS THE EXCRETION?

Excretion: 2 grams of NaCl per day
Amount Excreted =
Amount Filtered – Amount Reabsorbed
2g NaCl/day =
16g NaCl/day – 14g NaCl/day

68

_______________ = 100g of glucose – 100g of glucose
Find the missing value

0.0g

69

100g of glucose = _____________ – 300g of glucose
Find the missing value

400g

70

200g of glucose = 400g of glucose – _____________
Find the missing value

200g

71

Renal Plasma Clearance Rate (RPCR) definition

amount of plasma cleared of a substance per minute

72

Kidneys conduct clearance through:

-Filtration
-Reabsorption
-Secretion

73

How does filtration affect clearance?

-Filtration directly affects clearance
-↑Filtration → ↑material removed from blood plasma

74

How does reabsorption affect clearance

-Reabsorption indirectly affects clearance
- ↑Reabsorption → ↓material removed from blood plasma

75

How does secretion affect clearance

-Secretion directly affects clearance
- ↑Secretion → ↑material removed from blood plasma

76

C = (V x U) ÷ P
What does the C mean?

C = clearance rate (mL/min)

77

C = (V x U) ÷ P
What does the V mean?

V = urine production rate (mL/min)

78

C = (V x U) ÷ P
What does the U mean?

U = substance conc. in urine (mg/mL)

79

C = (V x U) ÷ P
What does the P mean?

P = substance conc. in plasma (mg/mL)

80

After a dose of inulin, urine has 30 mg/mL & plasma has 0.5 mg/mL of inulin (urine production rate (V) is 2.0 mL/min)
What is inulin clearance rate?
C = (V x U) ÷ P

120 mL/min of inulin
120 mL/min = (2 mL/min x 30 mg/mL) ÷ 0.5 mg/mL

81

Renal calculi (kidney stones) cause and effect:

-Cause: crystallization of calcium (Ca++), magnesium (Mg++), uric acid salts
-Precipitate w/in renal pelvis
-Calculi become large & travel down the ureter
-Effect: intense pain radiates from lower back to anterior abdominal wall (same side as renal calculus)

82

Cystitis (bladder infection) cause and effect:

-Cause: bacteria from anal region, sexually transmitted disease (STD), & chemicals
-Effect: inflammation, pain, fever, ↑urination

83

Glomerulonephritis (Bright’s Disease) cause and effect

-Cause: abnormal immune response (autoimmune)
-Inflammation of glomeruli
-Streptococcal antibody complexes
-Effect: abnormal filtration, renal failure

84

Incontinence cause and effect:

-Cause: old age, emotions (laughing), pregnancy, nerve damage, stress, excessive coughing
-Effect: loss of voluntary micturition

85

Gout (Gouty Arthritis) cause and effect:

-Cause: uric acid crystals in the soft tissues of joints (base of great toe)
-↑Uric acid intake
-↓Uric acid excretion (genetic)
-Effect: bone ends fuse & immobilize the joint
***Note: humans, apes, dalmatians lack enzyme uricase (breaks down uric acid)

86

Gouty Arthritis Treatment

-Nonsteroidal anti-inflammatory drugs (NSAIDs)
-Glucocorticoids (cortisol)
-Avoid foods rich in organ tissue (liver, kidney, etc.)
-Recommendation: avoid processed meats, & organ meats rich in nucleic acids (purines)

87

Hemodialysis uses a ________ to transfer a patient’s blood plasma through a _____________ tube (permeable to selected substances)

machine, semi-permeable

88

Dialysis machine contains a dialysis fluid that produces a ________ gradient (↑ to ↓)

diffusion

89

Gradient allows abnormal substances to diffuse from blood plasma (produces a “________” effect)

cleansing

90

Def of dialysis

process to artificially remove metabolic wastes from blood plasma

91

What does dialysis therapy compensate for renal failure lead to?

-↑Nitrogenous wastes (urea & ammonia)
-Ion imbalances
-pH imbalances
-Breathing imbalances
-Convulsions
-Coma
- Death

92

Key Aspects of dialysis therapy

-Blood is transferred from an artery (arm)
-Blood returns to a vein
-Blood is heparinized (prevent clotting)
- Dialysis sessions 3 times/week
-Each session = 4-8hrs
-Can lead to thrombosis (blood clots), infection & death of tissue (necrosis) around a shunt (access site in arm)