1.1. Basic Renal Process - Filtration Flashcards

1
Q

What is the process if the filtration?

A

The formation of an essentially protein-free filtrate of plasma

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2
Q

Where does the process of filtration occur?

A

At the glomerular capillaries

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3
Q

How much of the plasma, from the afferent arterioles, is filtered through the glomerular capillaries?

A

20%

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4
Q

Where is the plasma filtered from / into?

A

From - The glomerular capillaires

Into - Bowman’s capsule

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5
Q

What happens to the remainder of the plasma, which isn’t filtered into the Bowman’s Capsule?

A

It passed into the efferent arterioles

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6
Q

Where does the blood, which passes into the efferent arterioles, travel to?

A

The peritubular capillaries

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7
Q

What are the three layers of the glomerular capillary wall?

A
  1. Endothelial Cells
  2. Basal Lamina
  3. Podocytes
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8
Q

What is special about the Glomerular Endothelial Cells?

A

It is fenestrated as to prevent blood cells from being filtered, but allowing smaller components of plasma

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9
Q

What is special about the Glomerular Basal Lamina?

A

This prevents larger proteins from being filtered, but allowing smaller components of plasma

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10
Q

What is special about the Glomerular Podocytes?

A

They form a Slit Membrane between Pedicles of the Podocytes, which prevent medium sized proteins from being filtered, but allowing smaller components of plasma

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11
Q

How does glomerular filtration occur?

A

Through the balance of:
1. Hydrostatic Forces
2. Oncotic Pressure
Note - This is the same method as fluid filters through capillaries

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12
Q

What force favours filtration?

A

Hydrostatic forces

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13
Q

What force favours reabsorption?

A

Oncotic pressure (Starling’s Forces)

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14
Q

Is the pressure in the Glomerular Capillaries high or low?

A

High

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15
Q

What is responsible for the high glomerular capillary pressure?

A
  1. The afferent arteriole

2. The efferent arteriole

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16
Q
  1. How are the afferent arterioles described?

2. What is the result of this?

A
  1. Short and Wide
  2. This offers little resistance to Flow, allowing for a high hydrostatic pressure to arrive at the glomerular capillaries
17
Q
  1. How are the efferent arterioles described?

2. What is the result of this?

A
  1. Long and Narrow

2. This offers high resistance to Flow, allowing for increased pressure upstream (in the Glomerular Capillaries)

18
Q

What happens as a result of the high glomerular capillary pressure?

A

The hydrostatic forces exceed the oncotic pressure - favouring filtration

19
Q
  1. What is the Glomerular Filtration Rate?

2. Is this high or low?

A
  1. 125ml/min

2. High

20
Q

What does the Glomerular Filtration Rate allow the kidneys to do?

A

Precisely regulate Extra-Cellular Volume

21
Q

What percentage of the renal plasma will become Glomerular Filtrate?

A

19%

22
Q

What equation which can show the percentage of renal plasma which will become glomerular filtrate?

A

Plasma = 55% of the total blood volume
Total blood volume = 1200ml/min
Therefore Renal Plasma Flow = 55% of 1200 = 660ml/min
Glomerular Filtration Rate = 125ml/min
Therefore the Filtration Fraction = 125/660 x 100 = 19%

23
Q

What is responsible for regulating the Glomerular Filtration Rate?

A
  1. Afferent Arteriolar Diameter

2. Efferent Arteriolar Diameter

24
Q

What are the extrinsic controls of the Afferent / Efferent Arteriole Diameter?

A
  1. Sympathetic Vaso-Constricting Nerves
  2. Circulating Catecholamines
  3. Angiotensin II
25
Q

What are the Sympathetic Vaso-Constricting Nerves responsible for?

A

The constriction of both the afferent and efferent arterioles, but there is a greater sensitivity for the afferent

26
Q

What are the circulating Catecholamines responsible for?

A

The constriction of primarily the afferent arterioles

27
Q

What is Angiotensin II responsible for?

A
  1. Constriction of the efferent arteriole at low concentrations
  2. Constriction of both afferent and efferent arterioles at high concentrations
28
Q

What is a special feature of renal vasculature? And what is it’s name?

A

It exhibits a well-developed intrinsic ability to adjust its resistance in response to changes in arterial blood pressure - Autoregulation

29
Q

What is the function of Autoregulation?

A

This keeps the blood flow, and therefore the Glomerular Filtration Rate constant over a range of mean blood pressure

30
Q

Over what mean blood pressure can autoregulation keep the Glomerular Filtration Rate constant?

A

60mmHg - 130mmHg

31
Q

How is autoregulation related to nerves and hormones?

A

It isn’t - it works independently of these and so will occur at the same time

32
Q

What happens below a mean blood pressure of 60mmHg?

A

Glomerular Filtration Rate falls

33
Q

What happens below a mean blood pressure of 50mmHg?

A

Glomerular Filtration Rate ceases all together

34
Q

What happens if there is an increase in mean arterial pressure?

A

There is an automatic increase in afferent arteriolar constriction, preventing a rise in Glomerular Capillary Pressure

35
Q

What happens if there is severe volume compromise (i.e. haemorrhage)?

A

There is an interaction between intrinsic and extrinsic controls

36
Q

What happens in the interaction between intrinsic and extrinsic controls in situations of severe volume compromise?

A
  1. There is an activation of vaso-constricting nerves and Angiotensin II. This overrides autoregulation
37
Q

What is the purpose of the vaso-constriction and release of Angiotensin II in times of severe volume compromise?

A

This overrides autoregulation, liberating more blood for more immediately important organs

38
Q

How much blood is freed up by the overriding of autoregulation?

A

800mls per minute

39
Q

What happens if the blood is diverted away from the kidneys over long periods of time?

A

Renal damage occurs