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Hubs192 > 29-33 lectures > Flashcards

29-33 lectures Flashcards

1
Q

what is the process of the filtration?

A

blood passes through the glomerlus and anything small enough can pass through like salt and water

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2
Q

how much filtrate do we carry around with us?

A

150 liters

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3
Q

what do each nephron comprise of?

A

a glomerular capsule, renal tubules and a collecting duct

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4
Q

what is each nephron associated to?

A

glomerulus and peritubular capillaries

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5
Q

what can control blood pressure of the glomerulus?

A

smooth muscle

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6
Q

what are fenestrated epithelia?

A

leaky and allow substances to pass through

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7
Q

what feeds and drains fenestrated epithelia cells?

A

arterioles

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8
Q

what type of arterioles are peritubular capillaries?

A

efferent

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9
Q

what are peritubular capillaries?

A

specialized for absorption and wrap around renal tubules

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10
Q

what do the peritubular capillaries recieve?

A

filtered blood from the glomerulus and reabsorbed filtrate from the nephrons

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11
Q

what is the vasa recta do?

A

a long straight capillaries that follows the nephron deep into the medulla and drains into the venous system

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12
Q

what are the only nephrons the vasa recta follow?

A

juxtamedullary

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13
Q

what encloses the glomerulus ?

A

the glomerular capsule

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14
Q

what is the glomerular capsule?

A

a double layer that encloses the glomerulus

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15
Q

what are the 2 layers of the glomerular capsule?

A

parietal and viceral

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16
Q

what is the visceral layer consist of?

A

podocytes

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17
Q

what is the parietal layer of the glomerular capsule made of?

A

simple squamous cells

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18
Q

what does the parietal layer of the glomerular capsule do?

A

stops liquid from leaking out

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19
Q

what do podocytes do?

A

allow fluids to pass into the celluar space

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20
Q

what is the area called beteen the 2 layers of the glomerular capsule?

A

capsular space

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21
Q

what does the capsular space do?

A

regulate blood flow and remove anything trapped in the glomerulus

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22
Q

what are the structures of podocytes?

A

branched with intertwinning foot processes

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23
Q

what are the intertwinning foot processes called of podocytes called?

A

pedicels

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24
Q

what do pedicels do?

A

interdigitate and have small spaces inbetween

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25
Q

where do filtration slits form?

A

between pedicels

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26
Q

what do filtration slits do?

A

allow things to pass based on the size

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27
Q

what is the filtration barrier known as?

A

glomerular capsular membrane

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28
Q

what does the filtration barrier do?

A

allows free passage of small molecules and water anmd restricts passage of most proteins, and RBCs

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29
Q

what are the 3 layers of the filtration barrier?

A

fenestrated endothelium
fused membrane
filtration slits

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30
Q

what shares the fused membrane of the filtration barrier?

A

podocytes and the endothelia cells
it helps with diffusion of molecules

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31
Q

what is the urine equation?

A

urine = filtered - reabsorbed + secreted

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32
Q

what is PCT?

A

proximal convoluted tubule

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33
Q

what are PCT do?

A

used for bulk reabsorbtion about 2/3

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34
Q

what are some factors of the body of the PCT?

A

proximal so close to the glomerulus and runs in random directions

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35
Q

what helps with the bulk reabsorbtion in the PCT?

A

active sodium and potassium pumps for chloride and water to be reabsorbed

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36
Q

what are some functions of the PCT structure?

A

has a brush border of microvilli to increase surface area
it is made of cuboidal epithelium cells and has a tightly folded basolateral membrane and many mitochondria for active transport

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37
Q

what is the apical surface of the PCT?

A

tight junctions that make selective to substances passing and this can make them leaky as sodium and water can easily pass through

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38
Q

where does the nephron loop go to?

A

the medulla

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39
Q

what surrounds the loop of the juxtamedullary nephrons?

A

vasa recta

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40
Q

What does the structure of the nephron loop start as?

A

thick decending lim which is cuboidal epithelia

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41
Q

what is the structure of the nephron loop?

A

thick decending limb of cuboidal epithelia and then a thinner decending limb of simple squamous cells then a shorter thin acsending limb of simple squamous cells and then thye rest of the loop is a thick ascending limb of cuboidal cells

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42
Q

what parts of the loop are permeable to water?

A

the thinner segments of simple squamous cells

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43
Q

what parts of the loop are permeable to sodium?

A

the thick limbs with simple cuboidal cells

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44
Q

what does DCT mean?

A

distal convoluted tubule

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45
Q

where are the DCT?

A

further from the glomerulus

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46
Q

what do the DCTs do?

A

they reabsorb less of the fitrate

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47
Q

what is the structure of the DCT?

A

lees microvilli so no brush border aswell os fewer mitochondria

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48
Q

what influences reabsorbtion in the DCT?

A

aldosterone

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49
Q

what does the collecting duct do?

A

recieves the urine from the nephrons and empties it into the calices
also does some fine tuning of the urine

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50
Q

how many DCTs can drain into one collecting duct?

A

many

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51
Q

what si the structure of the collecting duct?

A

simple cuboidal epithelium
it has principal cells for reabsorbtion of sodium and water
it has intercalated cells for acid/base balance to maintain pH

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52
Q

what influences reabsorbtion in the collecting duct?

A

aldesterone and ADH

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53
Q

what epithelium lines the bladder and the ureter?

A

transitional epithelium

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54
Q

what is transitional epitheloium made out of?

A

stratified round cells which means it is multi layered and flattens when stretched

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55
Q

what is transitional epithelium important?

A

to not let substances out of the organ and cause damage aswell as osmotic gradients in the body

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56
Q

what produces umbrella cells?

A

cytokeratin

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57
Q

what do umbrella cells have alot of?

A

tight junctions that dont allow the movement of fluid between them
and desmosomes to not pull apart

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58
Q

what can umbrella cells produce?

A

proteins that form a plaque that is waxy to protect the epithelial surface from the urine

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59
Q

where do urethers arise from?

A

the renal pelvises of the hilum of the kidneys

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60
Q

what do the ureters do?

A

they are slender tubes that take urine from the kidneys to the bladder

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61
Q

where are the ureters in the abdomen?

A

retroperitoneal

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62
Q

what helps move urine through the ureters?

A

peristalic waves

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63
Q

how do the ureters enter the bladder?

A

posteriorly and laterally

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64
Q

why do the ureters enter the bladder weird?

A

when the bladder muscles tense it closes the openings of the ureters and prevents backflow

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65
Q

what is the three layers of the ureters made of?

A

inner most layer is made of transitional epithelium
then the muscularis layer with the inner layer being longitudinal and the outer layer being circular
the last layer is the adventia which covers the outside with fibourus connective tissue

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66
Q

what is the structure of the urinary bladder?

A

a collapsable muscular sac that stores and expells urine

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67
Q

what happens when the bladder collapses?

A

it empty and collapses along the rugae flods

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68
Q

what happens when the bladder is full?

A

the bladder expands without increasing pressure

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69
Q

what do the supporting ligaments of the bladder do?

A

keeps the bladder in position

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70
Q

what gives the brain signals that the bladder is full?

A

when the rugae are flat

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71
Q

what are the 3 holes of the bladder?

A

the 2 openings of the ureters and 1 opening for the urethra

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72
Q

what does the urethra do?

A

carries the urine away from the bladder

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73
Q

what is the trigone?

A

the triangular area of the bladder between all 3 openings

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74
Q

what surround the urethra in men?

A

the prostate

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75
Q

what is the shape of an empty bladder?

A

pyramidal an lies in the pelvis

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76
Q

what is the shape of a full bladder?

A

becomes spherical and expands superiorly into the abdomenal cavity

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77
Q

where is the male bladder located?

A

anterior to the rectum and superior to the prostate

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78
Q

where does the female bladder located?

A

anterior the vagina and the uterus

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79
Q

what si the thick smooth mucsle layer of the bladder called?

A

the detrusor

80
Q

how many layers is the detrusor?

A

3

81
Q

what are the 3 layers of the detrusor?

A

longitudinal, circular and oblique fibers

82
Q

what does the detrusor muscles do?

A

contract to collapse the bladder uniformly and incraese pressure to expell urine out of the urethra

83
Q

what is the urethra?

A

a thin walled muscular tube that drains urine from the bladder out of the body

84
Q

what is the changes of the epithelium of the urethra?

A

transitional near the bladder
columinar in the spongy urethra
simple squamous near the external opening of the urethra

85
Q

what does the simple squamous area of the urethra do?

A

prevents abrasion of the urethra

86
Q

what do the columinar cells of the urethra do?

A

have goblet cells to secrete mucus to prtect the underlying cells and the bacteria gets stuck in the mucus

87
Q

how long about are females urethras?

A

around 5 cm

88
Q

how long about are male urethras?

A

around 25 cm

89
Q

why are male urethras longer?

A

for reproductive purposes

90
Q

what are the 3 regions of the male urethra called?

A

prostatic
membranous
spongy/penile

91
Q

what does the internal urethral sphincter do?

A

keeped shut by the sympathetic system
this is involuntary and is made of detrusor muscle

92
Q

what does the extranal urethral sphincter do?

A

keeped shut by the parasympathetic system
is voluntary control so we arecontious of passing of urine and is made up of skeletal muscle

93
Q

what do we need kidneys for?

A

to controls whats in our blood and how much blood we have
keeps our bodies in homeostasis and controls the pH

94
Q

what are the endocrine functions of the kidney?

A

erythropoietin
activation of vitamin
renin secretions

95
Q

what are RAAS?

A

renal secretions

96
Q

what are metabolic functions of the kidneys?

A

makes new glucose through gluconeogensis

97
Q

what is EPO?

A

erythropoietin

98
Q

what does EPO have to do with the kidneys?

A

the kidneys detect how much oxygen is in the blood and if its low then it releases EPO which stimulates the red marrow to produce more RBCs which have more haemoglobin to carry more oxygen around the body

99
Q

what happens if the kidneys cant produce EPO well?

A

then it can lead to anaemia so there will be less oxygen in the blood so the body cant function aswell

100
Q

how do we control the pH of the blood through our urine?

A

we can excrete the acidic ions in the urine to control the pH of the blody

101
Q

what are the 2 main sources of acid in the body?

A

metabolism of food and drink that we consume
metabolism of carbon dioxide

102
Q

what are the 2 syystems to control the acid in the body?

A

exhaling the carbon dioxide
kidneys reabsorb bicarbonate and hydrogen ions which can then be excreted

103
Q

what is potassium important for in the body?

A

for resting membrane potentials in the cells and is involved in action potentials

104
Q

what does the build up of potassium lead to?

A

hyperkalemia which can lead to death

105
Q

what are the 2 classes of drugs?

A

hydrophillic drugs
lipophillic drugs

106
Q

what do lipophillic drugs do?

A

travel in the blood bound to a protein which is then taken to the liver to be metabolised and become hydrophillic drugs

107
Q

what do hydrophillic drugs do?

A

can be filtered in the kidneys and can become urine
goes directly to the kidneys

108
Q

what is the ECF made out of?

A

1/5 plasma
4/5 interstitial fluids

109
Q

what can the increase of plasma lead to?

A

the increase of blood pressure

110
Q

what is osmolarity?

A

the total number of solutes molecules in a solution

111
Q

what is the normal osmolarity of the ECF?

A

275-300 mosmol/L

112
Q

what is the normal osmolarity of the ICF?

A

275-300 mosmol/L

113
Q

what is isosmotic?

A

the same amount of solute molecules per liter so they have the same osmolarity

114
Q

what is hyposmotic?

A

when the water in in the ECF incraeses which means there is less solute molecules per liter so the osmolarity decreases

115
Q

what is hyperosmotic?

A

when the water in the ECF decreases which mean that there is more solute molecules per liter so the osmolarity increases

116
Q

what happens to the osmolarity if we change the isosmotic fluid

A

osmolarity doesnt change

117
Q

where is filtration of the nephron occuring?

A

in the renal capsule

118
Q

what is the plasma like filtrate?

A

the filtration in the capsular space of water and ions without the large plasma proteins

119
Q

how do the nephrons secrete substances?

A

from the peritubular capillaries

120
Q

what happens to the filtrate that is reabsorbed?

A

goes into the blood so it is not excreted

121
Q

what happens to substances that are screted by the peritublar capillaries?

A

it adds substances that are still in the blood to the fitrate being excreted and is excreted with it

122
Q

where is the main area where scretion occurs from the peritublar capillaries?

A

PCT

123
Q

where is the main area where reabsorbtion occurs from the nephron?

A

PCT
nephron loop
fine tuning in the collecting duct and DCT

124
Q

what are the 3 things that determine glomerular filtration?

A

filtration barrier
renal bloodflow
driving force

125
Q

what is the filtration barrier?

A

allows small substances to be freely filtered and large substances to not be filtered

126
Q

what is the renal blood flow?

A

the kidneys recieve about 20% of the cardiac output
they need this much blood to filter the plasma and helps with the bulid up of toxins and changes in water concentration

127
Q

what is the driving force of the glomerular filtration

A

the reason to move

128
Q

what are the 2 types o driving forces?

A

hydrostatic pressures
colloid osmotic pressure

129
Q

what is hydrostatic pressure?

A

how much volume of fluid there is in the renal capsule which can lead to high pressure
the more fluid in the capsule, the more the fluid is pushed back

130
Q

what is colloid osmotic pressures?

A

caused by proteins as they pull fluid towards itself

131
Q

what are positive pressure?

A

favour filtration so it pushes fluid where it wants to go

132
Q

what is negative pressure?

A

oppose filtration so its pushing fluid in the wrong direction

133
Q

what are the 4 forces in glomerular filtration?

A

glomerular hydrostatic pressure
blood colloid osmotic pressure
capsular hydrostatic pressure
capsular colloid osmotic pressure

134
Q

what is GHP?

A

glomerular hydrostatic pressure
how much blood and pressure there is in the glomerular capillaries

135
Q

what is BCOP?

A

blood colloid osmotic pressure
its albumin which pulls fluid towards itself back from the capsule into the glomerulus

136
Q

what is CsHP?

A

capsular hydrostatic pressure
its the pressure from the filtrate already present

137
Q

what is CsCOP?

A

capsular colloid osmotic pressure
usually zero as protein cant pass through the fitrating barrier

138
Q

what is filtration fraction?

A

how much of the kidneys plasma flow is filtered

139
Q

how do we calculate the filtration fraction?

A

glomerular fitration rate (GFR)
over
renal plasma flow (RPF)

140
Q

what si the glomerular filtration rate?

A

the amount of plasma being filtered per minute

141
Q

what is the GFR normally?

A

125ml/minute

142
Q

how much urine do we produce each day?

A

around 1.5 L

143
Q

what is the renal filtered load?

A

how much substavnce is fitered per minute

144
Q

how do we calculate the renal filtered load?

A

GFR * solute plasma conc

145
Q

what is renal clearance?

A

how much plasma is cleared or emptied of a particular substance
the clearance is the volume (ml) of plasma that is cleared of a substance by the kidneys per unit of time

146
Q

what is the renal clearance of creatinine and insulin?

A

freely filtered, not secreted, not reabsorbed

147
Q

what si the renal clearance of medications and toxins?

A

freely filtered, entirely secreted, not reabsorbed

148
Q

what is PAH?

A

medications and toxins

149
Q

what happens to all the PAH that is passing through the kidneys?

A

it is all secreted and excreted with the urine

150
Q

what is the renal clearance of glucose?

A

freely filtered, not secreted, fully reabsorbed in the proximal tubule

151
Q

should there be glucose in a healthy person urine?

A

no

152
Q

what is the renal clearance of sodium?

A

freely filtered, not secreted, almost fully reabsorbed so small amount is excreted in the urine

153
Q

how do we calculate the clearance?

A

(concentration of X in urine (Ux) (times) volume of urine produced per unit of time (V))
over
concentration of X in plasma (Px)

154
Q

what is Px?

A

concetration of X in plasma

155
Q

what is Ux?

A

concentration of X in urine

156
Q

what 2 substances can we use to eliminate GFR?

A

creatinine and insulin

157
Q

what is an indicator of kidney function?

A

plasma creatinine conc

158
Q

what should the plasma conc of creatinine be if both kidneys are working well?

A

low

159
Q

what happens when GFR is less than 25ml/min?

A

plasma creatinine conc incraeses as the kidneys ability to clear waste products from the blood is reduced

160
Q

what happens to nephrons as you get older?

A

die and stops working as you get older meaning there is a build up of things like toxins and medications in the blood and can lead to medical effects

161
Q

what percentage of reabsorbtion of water occurs in the PCT?

A

66%

162
Q

what percentage of reabsorbtion of water occurs in the decending limb?

A

25%

163
Q

what percentage of reabsorbtion of water occurs in the colloecting duct?

A

2-8%

164
Q

why does bulk reabsorbtion of water occur in the PCT and the decending klimb?

A

because it has leaky epithelium can pass cells paracellularly

165
Q

what do aquaporins do?

A

allow transcellular pathway of water

166
Q

where does regulation of water reabsorbtion happen and why?

A

collecting duct
because it is made of tight epithelium so water cant pass paracellular

167
Q

what hormones regulate water reabsorbtion in the collecting duct?

A

anti-diuretic hormone

168
Q

what does ADH mean?

A

anti-diuretic hormone

169
Q

what does ADH do?

A

the more you have the less urine you make as it bind to the cells in the collecting duct and activate the transcelular pathway of reabsorbing water using aquaporins

170
Q

what percentage of reabsorbtion of sodium occurs in the PCT?

A

66%

171
Q

what percentage of reabsorbtion of sodium occurs in the acsending limb?

A

25%

172
Q

what percentage of reabsorbtion of sodium occurs in the collecting duct?

A

2-3%

173
Q

what hormone regulates the reabsorbtion of sodium?

A

aldosterone

174
Q

what is RAAS?

A

aldosterone

175
Q

what drives the reabsorbtion of sodium in the PCT?

A

NA+
water follows other solutes, where the osmolarity is higher

176
Q

glucose is transported out of the cell how?

A

via the glucose transporter

177
Q

what pumps sodium out of the cell?

A

Na+/K+ ATPase

178
Q

what does chloride follow and why?

A

sodium as chloride is negative and sodium is positive

179
Q

what is the decesnding limb made of?

A

leaky epithelium

180
Q

what is HOMG?

A

hyper-osmotic medullary gradient

181
Q

what is the HOMG do ?

A

the deeper we go into the medullary the higher the osmolarity outside of the nephron loop

182
Q

what are the only nephron affected by the HOMG?

A

juxtamedullary

183
Q

what percentage of reabsorbtion of sodium occurs in the DCT?

A

7-8%

184
Q

what regulates the reabsorbtion of sodium in the DCT and the collecting duct?

A

aldesterone (RAAS)

185
Q

what does the TBW change alter?

A

the plasma osmolarity (ECF)

186
Q

what detects the plasma osmolarity change?

A

osmoreceptors in the hypothslamus

187
Q

what do the osmoreceptors do?

A

stimulates the pituatary gland to screte more/less ADH

188
Q

what is the basic function of ADH?

A

alters the permeablity of the collecting duct so water can be obtained/excreted to balance any change in TBW

189
Q

what are aquaporins doing in the cells?

A

they are in bubbles, when the ADH binds to the apical membrane it increases permeability

190
Q

what is the driving force of water in the collecting duct?

A

HOMG

191
Q

what does ANP do?

A

makes pee more isosmotic fluid and will return solutes to the plasma

192
Q

what does the gain or lose of isosmotic fluid effect?

A

the ECF

193
Q

what does normal urine consist of?

A

95-98% water, creatinine, urea, uric acid, H+, Na+, medications, toxins

194
Q

what does pathological urine consist of?

A

glucose, proteins especially albumin, blood, haemoglobin, WBCs, bacteria

195
Q

what is the pH of a vegeterians urine?

A

around 8

196
Q

what is the average pH of the average persons urine?

A

6-7.5

197
Q

what is the pH of a person who has a high protein diets urine?

A

4.6

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