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Allie GI/Renal > 8 - Renal Physiology and Renal Clearance PPT > Flashcards

8 - Renal Physiology and Renal Clearance PPT Flashcards

1
Q

We leave GI and enter the KIDNEY. Name the functions of the kidney!

A
  1. Filters blood to remove junk
  2. Regulates blood pH, vol, pressure, osmolarity
  3. Produces hormones, namely ๐ซ๐ž๐ง๐ข๐ง

Bonus points if you can name the cartoon this gif is from

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2
Q

What is the function of hormone ๐ซ๐ž๐ง๐ข๐ง?

A

It works within the RAASystem to regulate blood pressure!

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3
Q

Review the general structure of the kidney.

A
  • Renal Hilum
  • Renal Cortex
  • Renal Medulla
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4
Q

Whatโ€™s the renal hilum?

A

Itโ€™s the indentation in the middle of each kidney and the entry and exit point for the ureter, arteries, veins, lymphatics and nerves

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5
Q

Whatโ€™s the renal cortex?

A

Just the outer portion of the kidney

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6
Q

Whatโ€™s the renal medulla?

A

It contains the renal pyramids, whose POINTY ENDS (also known as renal papilla) aim towards the center of the kidney

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7
Q

How many nephrons are in each kidney?

A

ONE MILLION NEPHRONS.

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8
Q

Whatโ€™re the components of a nephron?

A

Renal corpuscle and renal tubule

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9
Q

Where does blood filtration start in the nephron?

A

Renal corpuscle

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10
Q

The renal corpuscle contains a glomerulusโ€ฆ what the bawa is that?

A

A tuft of capillary supplied by an afferent arteriole and Bowmanโ€™s capsule

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11
Q

How does blood enter the nephron?

A
  1. Blood flows into the glomerulus from the afferent arteriole
  2. Water and solutes pass through capillary endothelium into basement membrane/epithelium
  3. From basement membrane/epithelium into Bowmanโ€™s space
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12
Q

Where does blood exit the nephron?

A

Blood enters the efferent arteriole, dividing into the peritubular capillaries, and then to venules and larger veins

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13
Q

Filtered blood leaves Bowmanโ€™s capsule and enters the renal tubule. What is the renal tubule made up of?

A
  1. Proximal convoluted tubule
  2. Loop of Henle
  3. Distal convoluted tubule
  4. Collecting duct
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14
Q

Urine from the renal tubules enters ________ โ†’ ________ โ†’ ________ โ†’ ________

A
  1. Minor calyces
  2. Major calyces
  3. Renal pelvis
  4. Ureter
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15
Q

Whatโ€™s a good way to remember which arterioles receive unfiltered/filtered blood?

A

Afferent=Unfiltered
Efferent=Filtered

Mnemonic: Arrive Ugly, Exit Fresh

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16
Q

Let me hear some functions of the Juxtaglomerular Complex!!!

A
  • Allows for communication between the tubule and blood vessels entering the glomerulus
  • Helps regulate blood pressure (BP) and glomerular filtration rate (GFR)
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17
Q

Where is the juxtaglomerular complex located?

A

Between the distal convoluted tubule and the afferent arteriole

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18
Q

What does juxtaglomerular mean?

A

โ€œNext to the glomerulusโ€

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19
Q

What three types-a cells can one find within the juxtaglomerular complex?

A
  1. Macula densa cells
  2. Extraglomerular mesangial cells (say that three times fast)
  3. Juxtaglomerular cells
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20
Q

Macula densa cells are special, why?

A

They can sense a decrease in sodium/BP, they can then signal to juxtaglomerular cells to secrete renin, which increases sodium reabsorption and constricts blood vessels, thus increasing BP through the RAASystem!

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21
Q

What is renal clearance?

A

The rate at which the kidneys clear blood plasma of substances by excretion

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22
Q

(TRUE/FALSE): Medications are excreted by the kidneys after being removed from blood plasma.

A

(TRUE)

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23
Q

What does the rate of renal clearance depend on?

A
  1. Glomerular filtration rate (GFR)
  2. Tubular filtration rate
  3. Secretion rate
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24
Q

How can renal clearance rate be affected?

A

It can decrease gradually with age, and also experience acute changes due to pathology

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25
Q

To filter the blood and remove any unwanted substances from the body, the first step in blood filtration occurs atโ€ฆ

A

โ€ฆ the glomerulus

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26
Q

What is the glomerulus?

A

A tuft of capillaries surrounded by Bowmanโ€™s capsule

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27
Q

The glomerular filtration barrier is made up of how many layers, and what do they do?

A

3 layers, they separate the blood inside the glomerular capillaries from the fluid inside the Bowmanโ€™s capsule.

28
Q

The slits within the barrier allow which solute from plasma to enter the Bowmanโ€™s space?

A

Sodium

29
Q

Inversely, the barrier slits prevent which negatively-charged/large particles from entering?

A

Proteins and RBCs

30
Q

After the fluid has been filtered, what is its name?

A

Pre-urine (the prequel to the hit series โ€œUrineโ€)

31
Q

What does our beloved pre-urine travel through after filtration?

A

It leaves the Bowmanโ€™s space and travels through the nephron

32
Q

What are the two functions possible within the different nephron sections?

A

They either reabsorb substances back into systemic circulation OR actively secrete them into the nephron to be excreted in urine!

33
Q

Good news, we donโ€™t need to know the formula for calculating renal clearance. However, we must know these ratios!

A

Okay then, show me! Out with it man!

34
Q

If urine concentration is high but plasma concentration is low, that meansโ€ฆ

A

โ€ฆ a lot of stuff was removed from the blood and set to be excreted, leading to a ๐ก๐ข๐ ๐ก ๐ซ๐ž๐ง๐š๐ฅ ๐œ๐ฅ๐ž๐š๐ซ๐š๐ง๐œ๐ž.

35
Q

If the ratio (of urine concentration to blood plasma concentration) is ๐ž๐ช๐ฎ๐š๐ฅ ๐ญ๐จ ๐Ÿ, what does that mean?

A

The substance is ๐Ÿ๐ซ๐ž๐ž๐ฅ๐ฒ ๐Ÿ๐ข๐ฅ๐ญ๐ž๐ซ๐ž๐ ๐›๐ฎ๐ญ ๐ง๐จ๐ญ ๐ฌ๐ž๐œ๐ซ๐ž๐ญ๐ž๐.

36
Q

If the ratio is ๐ ๐ซ๐ž๐š๐ญ๐ž๐ซ ๐ญ๐ก๐š๐ง ๐Ÿ, what does that mean?

A

The substance is ๐Ÿ๐ซ๐ž๐ž๐ฅ๐ฒ ๐Ÿ๐ข๐ฅ๐ญ๐ž๐ซ๐ž๐ ๐š๐ง๐ ๐ฌ๐ž๐œ๐ซ๐ž๐ญ๐ž๐.

37
Q

If the ratio is ๐ฅ๐ž๐ฌ๐ฌ ๐ญ๐ก๐š๐ง ๐Ÿ, what does that mean?

A

The substance is ๐ง๐จ๐ญ ๐Ÿ๐ซ๐ž๐ž๐ฅ๐ฒ ๐Ÿ๐ข๐ฅ๐ญ๐ž๐ซ๐ž๐ ๐š๐ง๐/๐จ๐ซ ๐ข๐ฌ ๐ซ๐ž๐š๐›๐ฌ๐จ๐ซ๐›๐ž๐.

38
Q

What is Osmoregulation?

A

The regulation of body fluid solute concentration!

39
Q

What are the main components of blood plasma osmolarity?

A

Sodium, glucose and urea

40
Q

(TRUE/FALSE): Changes in hydration affect plasma osmolarity and blood pressure.

A

(TRUE)

41
Q

Which receptor detects changes in plasma osmolarity, and where is it located?

A

Osmoreceptors, theyโ€™re located in supraoptic nuclei of the anterior hypothalamus

42
Q

Which receptor detects changes in blood pressure, and where is it located?

A

Baroreceptors, theyโ€™re located in the cardiovascular system

43
Q

Osmo/baroreceptors regulate production of which hormone in the hypothalamus?

A

Antidiuretic hormone (ADH)

44
Q

How does overhydration affect osmoregulation?

A
  • Plasma osmolarity decreases, blood pressure increases
  • Osmo/baroreceptors fire less and less ADH is produced
  • Little to no water is reabsorbed
45
Q

How does dehydration affect osmoregulation?

A
  • Plasma osmolarity increases, blood pressure decreases
  • Osmo/baroreceptors fire more, more ADH is produced
  • More water is reabsorbed from kidney
46
Q

What is antidiuretic hormone (ADH)?

A

Itโ€™s a peptide hormone that prevents excessive urine production by reabsorbing more water from kidneysโ€ฆ duh

47
Q

What does ADH allow the body to do?

A

Control the amount of fluid retained

48
Q

What is ADHโ€™s alter ego called, since it causes smooth muscle cells in arteries to constrict?

A

Vasopressin

49
Q

Where is ADH stored?

A

Posterior pituitary gland

50
Q

Where does ADH bind after its released to the kidneys?

A

V2 Receptors (aka AVPR2) on principle cells in the collecting duct within the nephron

51
Q

What does AVPR2 convert ATP to?

A

cAMP

52
Q

This cAMP conversion opens __________ to pull water from the lumen of the ducts into the interstitium for reabsorption into circulation

A

aquaporin channels

53
Q

What are some causes of a large decrease in blood volume that would result in a large drop in blood pressure?

A
  • Massive hemorrhage
  • Third degree burn
54
Q

What receptors detect this huge change and signal the hypothalamus to increase ADH secretion?

A

Baroreceptors

55
Q

Where are baroreceptors located?

A

Specifically, in the carotid artery and the arch of the aorta

56
Q

Where else might we find the beloved baroreceptors?

A

Within the afferent artery under the name โ€œjuxtaglomerular cellsโ€

57
Q

Whatโ€™s the function of juxtaglomerular cells?

A

They detect the changes in blood pressure and signal to the kidneys to secrete renin

58
Q

What is renin and what is its relation to angiotensinogen, a secretion of the liver?

A

Renin is an enzyme that enters the blood plasma and binds to angiotensinogen, where it just hacks off a chunk of angio-T, leaving behind ANGIOTENSIN-I!!

59
Q

Angiotensin-I floats around until it reaches various ___________ in the body.

A

capillaries

60
Q

What enzyme do endothelial cells in the lungs have particularly for angiotensin?

A

Angiotensin converting enzyme (ACE) (get whoever named that one a promotion)

61
Q

What is the product after angiotensin converting enzyme (ACE) cleaves two amino acids off angiotensin-I?

A

Angiotensin-II (crazy!!!)

62
Q

What is the function of angiotensin-II?

A

It stimulates the hypothalamus to make more ADH

63
Q

Angiotensin-II also acts directly on blood vessels to do what?

A

Stimulate vasoconstriction

64
Q

Angiotensin-II also acts on the adrenal gland to stimulate the release of what?

A

Aldosterone

65
Q

What are the two ways ADH can increase blood pressure?

A
  1. ADH increases # of aquaporin 2 in the distal tubule/collecting duct, which reabsorbs water from urine and replenishes plasma vol.
  2. ADH acts on smooth muscle cells in the arteries causing them to constrict, increasing peripheral vascular resistance and BP.
    - When that happens, baroreceptors detect the BP change and tell the hypothalamus to stop ADH secretion!

Allie GI/Renal (18 decks)

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