A&P Final lecture 2 Notes Flashcards
What happen to pressure as it moves through a system and encounter resistance ?
-As the blood is flowing through high resistance arteries the blood pressures decrease
-The higher the resistance the more the decrease
-Example: if we have a choke point somewhere with very high resistance and we look distal (or downstream) from that resistance expect to see a lower pressure on the other side of the resistance
What are the 4 forces of the capillary, and what environment does it affect in or outside the capillary?
-Internal forces (inside capillary)
-Blood pressure
-Oncotic Pressure
-External forces (outside capillary)
-Hydrostatic pressure
- Dissolve protein osmotic pressure
What is the net filtration pressure formula and what is the value
NFP = Pcap – Pif – 𝜋cap + 𝜋if
NFP = Net Filtration Pressure = 0.3mmhg
That take in account for the 4 startling force numbers that we address earlier last week
________ NFP = net loss of fluid moving out of the capillary (filtration)
__________ NFP = pulling fluid into the capillary (reabsorption)
Positive
Negative
What is the mean capillary pressure?
Mean Capillary pressure = 17.3 mmhg
The average pressure is a little lower than what is expected due to venous capillary side having more surface area related to vessels splitting and larger size
True or false, We have more surface area on the venus side of the the capillary bed than the arterial side?
True
What is the NFP across the entire average capillary and what does the charge of the number tells us?
- When we take in consideration the other forces the NFP across the entire average capillary is +0.3 mmhg
- Positive NFP tells us that net loss of fluid moving out of the capillary (filtration)
What is amount of excess fluid that is being excreted each day, in liters/day and what is the system that receives the fluid?
1 -2 Liters
Lymphatic system
What are the 3 compound source in largest to smallest that affect oncotic pressure and the amount that are found in the capillary?
Albumin 4.5 g/dl dissolved in the blood (22mmhg of the total of 28mmhg of protein osmotic pressure)
-Primary protein
Globulin 2.5 g/dl ( 6mmhg)
-Antibodies and immune stuff floating around that does not get through the capillary wall very easy so generate oncotic pressure
Fibrinogen 0.3 g/dl ( 0.2mmhg)
-3rd largest component with a fraction of mmhg
Which of the 3 compound is the primary compound that affect the oncotic pressure?
Albumin
How much can the lymphatic flow adapt to remove the fluid that is being excreted from the capillary, caused by what disease?
20, CHF
What is the source that is compared to regarding capillary permeablility and what is the permeability number?
water, 1.00
What are the 2 main components that can affect the capillary permeability and why?
what is the exception for one of the components?
Ions
-Extremely permeable,
-Nothing getting in the way for ions to be filtered
-One exception: Brain blood barrier
-Not open to ions like sodium and chloride
Molecular weight
-Water and small stuff are more permeable (easy to filter)
-Larger stuff is less permeable (harder to filter)
-Albumin, red blood cells, and hemoglobin do not suppose to go through the capillaries
What is the Role of the kidney: how much volume we have in the cardiovascular system uses a feedback system that tells how much filtration is happening at the level of nephron. Elevated ____ means something wrong with your kidneys.
long term blood Pressure Regulator
What is the role of the Kidney: Protons generated because of metabolism excess protons and are grabbed by the kidney and are either filtered and reabsorbed or excreted by the kidney
long term pH Regulator
What is the role of the Kidney: Produces erythropoietin. Increases _____ ______ and differentiation in _______ _______
-Regulates the production of ________
Operates via an Oxygen sensor located deep in the kidney
-If the inside of the kidney has a lower oxygen tension it releases erythropoietin
long term RBC regulator
What is the role of the Kidney: Kidneys regulate reabsorption and excretion of ________.
Short term managers: insulin and beta agonist
long term electrolyte regulator
What is the role of the kidney:
Blood calcium levels regulated by activation of Vitamin _____.
long term vitamin D regulator
What is the role of the Kidney: Regulate_______ levels by removing ________ in the kidney
Short term regulator is insulin
long term serum glucose regulator
What is the role of the kidney: Filtered and not reabsorbed ______.
- Actively put into urine
drug clearance: renal & otherwise
What is the role of the kidney: removing nitrogen containing compounds. example:Urea, ammonia
Long term metabolic waste disposal
What is the role of the kidney: Kidney regulates body fluid volume and electrolytes, so the inherently controls changes in osmolarity
-Kidney can correct osmolarity changes with the help of the pituitary gland with the release of ADH
Osmolarity regulator
What is the order of the blood
Renal Artery
Segmental Arteries
Interlobar Arteries
Arcuate Arteries
Interlobular Arteries
Afferent Arterioles
Glomerular Cap’s
Efferent Arterioles
Peritubular Cap’s
Interlobular veins
Arcuate Veins
Interlobar Veins
Segmental Veins
Renal Veins
What are the main 4 blood vessels sections that are very important
Afferent Arterioles
Glomerular Cap’s
Efferent Arterioles
Peritubular Cap’s
What are the 2 capillary beds and what role do they play in the renal system?
Glomerular Capillaries (filtration)
-Immediately behind or downstream from the afferent arteriole
-Large fluid movement is due to large surface area
-Twisting ball in the bowman’s capsule
Peritubular capillaries (reabsorption)
-Surround the Loop of Henle
-Twisting and branching around
-Large fluid movement is due to large surface area
Where is the Afferent and efferent arterioles located in relation to the Glomerular capillaries.
Afferent arterioles in front
efferent arterioles in back
What is the structure: Found in the Outer Medulla and some extend deeper in the kidney
Majority of reabsorption happens in this region
Vasa Recta (VR)
-The capillaries that extend deep into the kidney
- Descending and Ascending Vasa Recta (DVR and AVR)
- 5% of are part of the Vasa Recta
Peritubular Capillaries
Where is the kidneys located?
Located in the abdomen tucked near and under the diaphragm and can be touch by other organs
kidney pain or ureter pain can be referred to as what type of pain?
lower back
External sphincter is controlled by what nerve?
Pudendal nerve
What is the structure name that we use to process waste
Renal Tubular
True or false. large surface area in the glomerular capillaries allow you to filter a lot of stuff
True
What is the supporting structure that keeps the blood vessels intact and in place?
What is the type of tissue?
podocytes
epithelium cell
How do the podcytes support the glomerular capillaries
podocytic end feet extensions support the glomerular capillaries
What are the large opening called that provide little to no resistance to movement of fluid (water) and small dissolved compounds
fenestrations
What are slit pores
-is another structure that’s supposed to keep proteins out of this area
-Openings between the podocytes end feet
-Slit pores typically have lots of negative charges and the negative charges tend to repel other things with negative charges
-So typically doesn’t really repel chloride or negatively charged ions but it does repel larger negatively charged compounds which tend to be proteins
-Proteins typically have a net negative charge having the glomerular capillaries have a in the surrounding structures it prevents those proteins from trying to squeeze through these small openings
What is the name of the rate of all of the fluid that’s being filtered, witihin the nephrons?
GFR (glomerular filtration rate)
Related to filtration/ Secretion/Reabsorption: What happens to drugs that we want to get rid of but don’t reabsorb it ?
filtration only
Related to filtration/ Secretion/Reabsorption: what happen to most compounds?
filtration and complete reabsoroption
Related to filtration/ Secretion/Reabsorption: what will be the case for a drug that only partial is needed
filtration and partial reabsorbed
Related to filtration/ Secretion/Reabsorption: body has the ability to actively grab things and move them into the tubule to put these compounds into our urine.
filtration, secretion
Related to filtration/ Secretion/Reabsorption: all the compound leaves the body
filteration
What is the formula of excretion
filtration - reabsorption + secreted
Efferent loops around and becomes the ______.
Peritiubular capillaries
How much water is reabsorb by the peritublar capillaries and how much counts as urinary content ?
124mls (98 - 99% reabsorbed)
1mls a count for urine
What is driving flow of the filtration?
capillary pressure (pCAP)
Oconic pressure
pressure of the tube
What is the NFP to allow the filtration to take place in the glomerular capillaries ?
10 mmhg
What is the hydrostatic pressure in the glomerular capillaries and why ?
60 mmgh, due to not a lot of resistance from the heart
What is the name of the first part of the tubual and what is the pressure?
Bowman’s Capsule
18 mmgh
What is the glomerular colloid osmotic (oncontic) pressure and how do it becomes that number?
32 mmgh which is averages,
-As filter more fluid in capillary bed (no reabsorption happening here), lots of fluid being filtered and larger things being left behind
-The proteins are concentrated as the fluids are leaving capillary beds into the proximal tubule (proteins left behind)
-Glomerular capillary oncotic pressure starts off at 28 mmHg but as lose more and more fluid, the proteins end up being concentrated and oncotic pressure increases as go through glomerular capillary bed
What are the 3 pressures to take in consideration and the values regarding NFP?
-Glomerular blood pressure 60 mmHg
-Bowman’s capsule pressure 18 mmHg (hydrostatic pressure)
-glomerular oncontic pressure – on average 32 mmHg
What are the 2 forces that appose filtration and 1 force that favors
Favor filtration:
Glomerular blood pressure
Forces oppose filtration:
Bowman’s capsule pressure 18 mmHg (hydrostatic pressure)
glomerular oncotic pressure – on average 32 mmHg
What is the pressure that we don’t have to take in to account in regarding the NFP and why?
dissolved protein osmotic pressure in Bowman’s capsule, because there is no protein floating around to be filter so the pressure is 0.
What would happen down-stream with an increase in the afferent arteriole resistance and how would that affect the GFR?
the Glomerular capillary blood pressure decreases
GFR would decrease also decrease renal blood flow
What would happen up-stream and down - stream with an increase in the efferent arteriole resistance and how would that affect the GFR?
the Glomerular capillary blood pressure increase
GFR would increase
lower pressure down- stream that would increase the reabsorption
What arteriole auto-regulate the GFR
Efferent arterioles
Any manipulation to the afferent and efferent arterioles will affect what 2 elements in the renal system?
the GFR
Renal blood flow
True or false: If we increase the glomerular colloid osmotic pressure we will decrease the amount of fluid filtered
False
What is the blood pressure (Pc) in the peritubular capillaries and why?
13 mmhg,
because it is down stream from a 2nd resistance
What is the flood pressure outside the peritubular capillaries?
6 mmgh
What is the onconic pressure outside the peritublar capillaries
15 mmgh
What is the net reabsorption pressure in the peritublar capillaies?
10 mmgh
True or false the reabsorption needs energy to function
True
What is renal clearance?
a number that tells us how much fluid that has been cleared of a compound per unit time.
What is the formula for clearance and what does the abbreviation means?
Cx = (V * Ux)/ Px
V = urine flow rate
Ux = urinary concentration of this compound
Px = Plasma concentration of this compound
The what is the measurements for renal clearance?
volume / time
ml /minute
After the fluid is filtered by the glomerular, it moves down the peritublar where it comes into contact with cells outside the tubular, What are there two jobs?
aid in reabsorption
and serection
How is the glucose reabsorbed back into the peritubuar
-Glut 2 transporters, which is a secondary active transporter
-Goes back across the instistium
back in to the peritubular capillaries
how much fluid do we reabsorb form the filtration
124 ml of volume
How much glucose would be left in the 1ml of urine if you reabsorb 100mg/ml of glucose and is the clearance rate high or low
0 mg,
clearance rate is low
True or false. In order to have renal clearance we do not have to have the same compound
False,
in order to have renal clearance you most have the same compound
What is the rate of plasma fluid and blood flow through a kidney in a person that is completely healthy?
660 ml/min
1100 ml/min
Why is renal plasma fluid and renal blood flow rate separated ?
because red blood cells can’t be filtered, so their volume isn’t included in this filtration fraction formula.
What is the percentage amount of renal plasma we filter through the kidney?
19%
What is the filtration fraction formula?
GFR/ RPF = FF
125/660 = 0.19
which is 1/5 of the plasma flowing through kidney
What is the HCT for our class
0.40
