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Renal (CP) > 1 Intro + lab equations > Flashcards

1 Intro + lab equations Flashcards

1
Q

Describe the location of the kidneys

A

Abdominal cavity, retroperitoneal (adjacent to the posterior abdominal wall) between T12-L3

**right kidney lower than the left because of liver

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2
Q

What makes up a renal lobe?

A

Macroscopic subdivision consisting of the medullary pyramid (striated) and the surrounding cortex (granular)

**indistinct in adult kidneys

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3
Q

List the course an RBC would take from the aorta to the glomerulus

A
  • renal artery
  • segmental artery
  • interlobar artery
  • arcuate artery
  • interlobular artery (in cortex)
  • afferent arteriole
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4
Q

List the course an RBC would take from the glomerulus to the IVC

A
  • efferent arterioles
    • peritubular capillaries
    • vasa recta
  • interlobular vein
  • arcuate vein
  • interlobar vein
  • renal vein
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5
Q

What proportion of the total body weight are the kidneys? What percent of cardiac output do they receive?

A

1% of total body weight but receive 20-25% of cardiac output

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6
Q

What proportion of the population has an additional renal artery?

A

30%

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7
Q

Describe the innervation of the kidney

A
  • parasympathetic
    • kidneys and ureter= vagus
    • ureter and urinary bladder= pelvic splanchnic nerves
  • sympathetic
    • kidney= T10-L1
    • ureter= T11-L2
    • urinary bladder= T11-L2
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8
Q

What are the 3 most common places where kidney stones get lodged?

A
  1. ureto-pelvic junction (where ureter leaves the kidney)
  2. where the ureter crosses the pelvic brim
  3. the angled entrance of the ureter into the urinary bladder
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9
Q

Where is referred pain from the kidney and ureter perceived?

A

T10-L2 spinal cord distribution

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10
Q

What are the functions of the kidney?

A
  • excretory
    • water, ions, drugs/toxins, metabolic breakdown products
  • homeostatic
    • regulate/maintain ECF volume and composition
    • acid base balance (bicarb and H)
  • endocrine
    • monitoring O2 carrying capacity (erythropoietin)
    • regulating blood pressure (RAAS)
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11
Q

Describe the renal medulla

A
  • Striated appearance
  • Consists of 6-18 renal pyramids
  • Apex/tip called a renal papilla
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12
Q

Describe the renal cortex

A

Granular in appearance (homogenous consistency)

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13
Q

What is a Medullary ray?

A

Linear arrays of tubules extend into the cortex from the medulla

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14
Q

What is a renal lobule?

A

A microscopic subdivision consisting of a medullary ray and the cortical tissue (primarily nephrons*) on either side

*tubules of these nephrons connect with the collecting ducts within the medullary rays

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15
Q

What is the tubular plexus and vasa recta?

A

Capillary systems of the kidney…

  • tubular plexus supplies tubules of cortical nephrons
  • vasa recta (long) supplies tubules of juxtamedullary nephrons
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16
Q

What are the 4 components of the renal corpuscle?

A
  1. glomerulus
  2. visceral layer (Bowman’s)
  3. parietal layer
  4. mesangium

**only found in the kidney cortex

17
Q

What is a renal corpuscle? Where are they found?

A

Spherical double layered sac surrounding a network of capillaries (glomerulus)

**renal corpuscles are found only in the kidney cortex

18
Q

Compare the afferent and efferent arterioles

A
  • afferent
    • supplying arteriole
    • larger diameter
  • efferent
    • draining arteriole
    • smaller diameter

**difference in size creates a pressure differential that drives glomerular filtration

19
Q

What are the portions of Bowman’s Capsule?

A
  • parietal layer (simple squamous)
  • visceral layer (simple squamous) composed of podocytes
  • urinary space= space between parietal and visceral (continuous with the proximal tubule)
20
Q

Describe the components that make up the filtration barrier of the kidney

A
  1. capillary endothelium (discontinuous, 70-100 nm pores)
    **luminal surface= negative due to Heparan glycocalyx
  2. basement membrane (primary barrier preventing protein from entering filtrate)
  3. podocytes (foot processes and filtration slits)
21
Q

Describe the glomerular mesangium

A
  • physically supports the glomerulus
  • regulates glomerular blood flow
  • ECM contains fibronectin and collagen
  • specialized pericyte/smooth muscle cells
22
Q

Describe the proximal tubule

A
  • convoluted (cuboidal/columnar) portion
  • straight (cuboidal) portion aka thick decending limb of henle
  • glucose, AAs, and proteins reabsorbed through facilitated transport
  • apical brush border with glycocalyx obscures the lumen and aids in absorption
  • numerous mitochondria at base of cell provide energy for transport
23
Q

What are the 4 parts of the loop of henle?

A
  1. striaght portion of the proximal tubule (thick descending limb)
  2. thin descending
  3. thin ascending
  4. straight portion of the distal tubule (thick ascending limb)
24
Q

Describe the loop of henle

A
  • located in the medulla
  • length is determined by location of corpuscle
    • cortical= short loops (only a descending thin limb)
    • juxtamedullary= long loops (ascending and descending thin limbs)
  • thick= cuboidal, thin= simple squamous
  • thin ascending= impermeable to water
25
Q

Describe countercurrent multiplier

A
  • carried out through the loops of henle
  • the process of urine concentration through differential reabsorption of water
  • yields hypotonic fluid in the distal tubule (thin ascending limb is impermeable to water)
26
Q

Describe countercurrent exchanger

A
  • carried out by the vasa recta
  • the process of maintaining the osmotic gradient established by countercurrent multiplier
  • arterioles have continous endothelium and venules are fenestrated (preserve gradient while still supplying blood)
27
Q

Describe the straight portion of the distal tubule

A
  • aka the thick ascending limb of the loop of henle
  • lined with cuboidal epithelium with scant microvilli and efficient tight junctions
  • abundant mitochondria
  • impermeable to water
  • Na, Cl resorbed, H secreted
28
Q

Describe the convoluted portion of the distal tubule

A
  • aka early distal tubule
  • lined with cuboidal epithelium with scant microvilli
  • fewer basal interdigitaions and mitochondria
  • Na, Cl resorbed, K secreted
29
Q

Describe the collecting tubules

A
  • aka late distal tubule (just before the collecting duct)
  • cuboidal epithelium contains principle cells
  • ADH dependent (Na reabsorbed, K secreted)
30
Q

Describe the collecting duct

A
  • distinct cell borders between cuboidal (or columnar) cells
  • principal cells= light
    • primary cilium (flow sensor)
      • mediated by polycystin 1 and 2
    • ADH sensitive aquaporins
      • water flows out of duct into renal interstitium in the presence of ADH
  • intercalated cells= dark
31
Q

Describe the juxtaglomerular apparatus

A
  • renin producing (JG) cells
    • specialized smooth muscle in the wall of the afferent arteriole
    • respond to macula densa signaling (alter filtration rate via RAAS)
  • extraglomerular mesangial (lactis) cells
    • connected to JG cells via gap junctions
  • macula densa
    • columnar cells in the distal convoluted tubule
    • detect Na and Cl concentrations for JG cells
32
Q

Describe the layers of the calyces/pelvis/ureters

A

mucosal layer:

  1. transitional epithelium
  2. lamina propria (abundant elastic tissue)

muscularis layer:

  1. smooth muscle

adventitia layer (fibrous connective tissue)

33
Q

Describe the layers of the urinary bladder

A

Transitional epithelium + 3 layers of smooth muscle

(empty= thick, full= thin/stretched)

34
Q

What is the calculation for renal clearance?

A

C= (U x UF)/P

**the volume of plasma that is completely cleared of the substance by kidneys per unit time (building/room analogy)

  • C= clearance
  • U= urine concentration
  • UF= urine flow rate
  • P= plasma concentration
35
Q

What is the calculation for osmolar clearance?

A

Same as renal clearance, but looking at the clearance of all osmotically active substances (not just one specific one)

C(osm)= (Uosm x UF)/Posm

36
Q

What is the calculation for free water clearance?

A

C(H2O)= UF - C(osm)

**the rate at which solute-free water is excreted by the kidneys (usually negative because urine osm is higher than plasma)

  • C(H2O)= free water clearance
  • UF= urine flow
  • C(osm)= osmolar clearance
37
Q

How can you quantify renal excretion?

A

Looking at the excretion rate of a specific substance:

Excretion= U x UF

(U= urine concentration, UF= urine flow)

38
Q

What is fractional excretion?

A

FE=(U x UF)/(P x GFR)

**The percentage of a substance filtered by the kidney which is excreted in the urine

(helps us understand the tubular activity; damage can decrease reabsorption which would increase FE)

Renal (CP) (16 decks)

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