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Physiology 208 > 16. Chapter 19- Renal > Flashcards

16. Chapter 19- Renal Flashcards

1
Q

What are the 4 ways to determines someone’s health from urine?

A
  1. Colour- yellow, pale straw, red, black (black water fever)
    Shows hydrated or not
  2. Clarity- froth (high protein content can be seen from lack of clarity through it)
  3. Odor- can indicate bacterial infection
  4. Taste- olden days they tasted urine (diabetes was called honey urine disease)
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2
Q

What is the main function of the kidneys and the other 6 side ones?

A

Homeostatic regulation of water and ion content of the blood (fluid electrolyte balance)

  1. Regulated extracellular fluid volume and blood pressure
  2. Regulates osmolarity (re absorbs or gets rid of water)
  3. maintenance of ion balance (ions meed to be maintained in a narrow window)
  4. Homeostatic regulation of pH
  5. Excretion of wastes (metabolic wastes that aren’t CO2 will be filtered at kidneys, xenobiotics refers to substances outside body like medicine)
  6. Production of hormones

Only need half of one kidney to function normally defintely one kidneys okay

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3
Q

Study picture of urinary system on slide 7 Jan 23

A

Okay

Left and right renal vein bring blood back to systemic circuit

1/5 of blood goes to kidneys

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4
Q

What are nephrons?

A

Functional unit of the kidneys
80% cortical nephrons
20% juxtamedullary
Create osmotic gradient

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5
Q

What is the order of travel through the kidneys (vascular components)?
What does afferent and efferent mean?

A

Renal artery-afferent arterioles-glomerulus (capillaries)-efferent arterioles-peritubular capillaries-renal vein

Afferent means close
Efferent means far away
Vasa recta are the paritubular capillaries (fancy name)

Slide 9 Jan 23

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6
Q

What are the four main processes in the kidneys?

A

Filtration, reabsorption, secretion, excretion
Slide 10 Jan 23
Slide 12 Jan 23

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7
Q

What is the tubular component and it’s steps of transport?

A

It is a zoomed portion of the nephron
Bowman’s capsule-proximal tubule-descending loop of henle-ascending loop of henle-distal tubule-collecting duct

Loop of henle has descending and ascending limb

Anything that exits collecting duct is removed through urine
Slide 11 Jan 23

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8
Q

What is filtration, reabsorption, secretion and excretion?

A

Filtration- movement from blood to lumen, occurs at first capillaries in Bowman’s capsule and glomerular
Reabsorption- from lumen to blood, in proximal tube
Secretion- from blood to lumen, selective movement via protein transporters
Excretion- from lumen to outside the body, whatever leaves via urine

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9
Q

Where is fluid reabsorption occurring and solute reabsorption occurring?
How much plasma filtered through kidneys per day?

A

Fluid- descending limb
Solute- ascending limb

180L of plasma is filtered per day
99% is reabsorbed

Slide 13 Jan 23

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10
Q

What is the equation using the amount filtered, amount reabsorbed, amount secreted, and amount excreted?

A

Amount of solute excreted = amount filtered-amount reabsorbed+amount secreted

Slide 14 Jan 23

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11
Q

What is the first step of urine formation?

How is it done?

A

Filtration
Rbc’s and plasma proteins remain in blood, plasma and dissolved solutes make up filtrate

Of all plasma that enters Bowman’s capsule, 20% is filtered (filtration fraction), 80% continues to peritubular capillaries

Slides 15-16 Jan 23

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12
Q

What is the renal corpuscle?

What is the triple filtration barrier?

A

Slide 17 Jan 23

  1. Capillary endothelial cells (fenestrated)
  2. Basal lamina (extracellular matrix)
  3. Podocyte endfeet

Mesangial cells can alter blood flow

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13
Q

What are the 3 pressures that govern filtration from glomerular capillaries into the renal tubules?

A
  1. Hydrostatic pressure- of blood in the glomerular capillaries favours filtration
  2. Colloid osmotic (oncotic) pressure- of blood is the pressure gradient due to the presence of plasma proteins and opposes filtration
  3. Bowman’s capsule hydrostatic pressure (fluid pressure) opposes filtration

Slide 18 Jan 23

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14
Q

What is the glomerular filtration rate (GFR)?

What is our plasma volume?

A

Volume of fluid that filters from the glomerular capillaries into the Bowman’s capsules per unit time
Normally 125mL/min or 180L/day
Plasma volume is about 3L meaning kidneys filter our entire plasma volume about 60 times per day (if it wasn’t reabsorbed we would run out of plasma in 24 mins)
This is relatively constant
Slide 8 Jan 25-26

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15
Q

What are the 2 factors that influence GFR?

A

Net filtration pressure- renal blood flow and blood pressure
Filtration coefficient- surface area of the glomerular capillaries available for filtration and permeability of interface between capillaries and Bowman’s capsule

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16
Q

How is GFR regulated?

A

Regulated by renal arterioles (afferent renal arterioles)

Slide 9 Jan 25

17
Q

How does glomerular filtration rate (GFR) effect renal blood flow (RBF)?

A

Overall resistance determines renal blood flow

Slide 10-11 Jan 25

18
Q

What are the 2 ways of glomerular filtration rate autoregulation?

A
  1. Myogenic response of the afferent arterioles
    Slide 12-13 Jan 25
  2. Tubuloglomerular feedback- local control pathway in which fluid flow through the tubule portion of the nephron influences GFR
    Slides 14-15 Jan 25
19
Q

Can sympathetic neurons influence GFR?

Can hormones?

A

Yes
Integrating systems outside the kidneys can override local control mechanisms by altering resistance or filtration coefficient
Sympathetic activation only really alters GFR when there is a shark rapid drop in blood
Slide 16 Jan 25
Yes hormones can alter filtration coefficient, can alter size of filtration that alters permeability
Slide 17 Jan 25

20
Q

Why do our bodies filter 180L if we only excrete 1% of it? (Why don’t we just filter out what needs to be excreted and excrete it)

A

Many foreign substances are filtered into the tubules but not reabsorbed, rapid eat ti remove unwanted materials
Frequent filtration of ions and start into the tubules simplifies regulation and allows it to occur rapidly

21
Q

What are the 2 types of transport in re absorption?

A
  1. Transepithelial (transcellular) transport- substance cross the apical and basolateral membrane of the tubules to enter into ecf
  2. Paracellular transport- substance pass through the cell to cell junctions between two adjacent tubule cells
22
Q

How is Na+ actively transported basolaterally and by what enzyme?
Primary transport and secondary transport

A

Slide 5 Jan 28
Primary transport
1. Na+ enters cell through different membrane proteins (goes down electrochemical gradient)
2. Na+ is pumped out of the basolateral side of cell by Na+-K+-ATPase (enzyme)
Secondary transport
1. Na+ moving down electrochemical gradient uses SGLT protein to pull glucose into cell against conc gradient
2. Glucose diffuses out basolateral side of cell using SLGT
3. Na+ is pumped out by Na+-K+-ATPase

23
Q

What is passive reabsorption and endocytosis?

A

Passive reabsorption- urea (nitrogenous waste product)
Endocytosis- very small plasma proteins or peptides

Slide 6 Jan 28

24
Q

What is saturation in renal transport?

A

Maximum rate of transport that occurs when all available carriers are occupied
The majority of substances transported in the nephron use membrane proteins
Slide 7-8 Jan 28

25
Q

What is secretion?

A

Transfer of molecule from extracellular fluid into the lumen of the nephron
Depends on membrane transport proteins
Active process requiring movement of substances against their concentration gradient
Slide 11 Jan 28

26
Q

What was the problem with penicillin in the 1930s?

A

In 30s leading death was infection, penicillin was in high demand but hard to keep up with demand cause it was initially isolated from bread mold
All penicillin ingested would be excreted within 3-4 hours
Then penicillin was given with probenecid (competitor)
slide 12 Jan 28

27
Q

How is clearance a noninvasive way to measure GFR?

A

Clearance of X= excretion rate of X (mg/min)/[X]plamsa (mg/mL plasma)
Clearance of a solute is the rate at which a solute disappears from the body by excretion or metabolism
Clearance is expressed as the volume of plasma passing through the kidneys that has been totally cleared of that solute in a time
Slide 15-16 Jan 28

28
Q

What is creatinine? How can it measure GFR?

A

Product of phosphocreatine breakdown, produced and broken down at relatively stable levels in the body
Secreted in very small amounts, creatinine clearance slightly overestimates GFR
Clearance of X= excretion rate of X (mg/min)/[X]plasma (mg/mL plasma)
Slide 17-18Jan 28

29
Q

How can we use clearance to find net renal handling?

A

Once we know GFR we can see how kidneys handle any solute by measuring the solutes plasma concentration
Filtered load of X = [X]plasma x GFR
By comparing filtered load with its excretion rate
Compare GFR to clearance
Slide 21 Jan 28

30
Q

Study table slide 22 Jan 28

A

Okay

31
Q

What is the micturition reflex?

What are 3 steps? (slide 2 Jan 30)

A

Filling of the bladder activated stretch receptors which initiates micturition reflex
Slide 1 Jan 30
1. Stretch receptors fire
2. Parasympathetic neurons fire (motor neurons stop firing)
3. Smooth muscle contracts. Internal sphincter is passively pulled open, external sphincter relaxes
Slide 2 Jan 30

32
Q

When does the urge to urinate appear? (mL)

What happens at 500mL?

A

Urge to urinate at 200mL
Once exceeding 500mL the internal sphincter is forced open which leads to reflexive openings of external sphincter and loss of voluntary opposition to urination
Slide 3-4 Jan 30

33
Q

What is incontinence?
Cause in infants?
Other causes?

A 
The inability to control urination voluntarily
In infants, corticospinal connections necessary for voluntary control have yet to be established
Damage to internal or external sphincter
Spinal cord damage
Aging
Loss of muscle tone
Stroke, alzhiemers
Prostate growth in males

Physiology 208 (22 decks)

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