AAP Urinary System 2 Flashcards
What are the main functions of kidneys?
- excretion of wastes and toxins
- regulation of extracellular fluid volume to ensure an adequate blood supply to vital organs
- regulation of osmolarity
- regulation of ion concentrations (pH)
- production of hormones (Erythropoietin, EPO, –> stimulates bone marrow for RBC production
What are the three main steps of urine formation?
- glomerular filtration
- tubular reabsorption
- tubular secretion
What happens during urine formation?
- the kidneys filter unwanted substances from the blood and produce urine to excrete them
How is glomerular filtrate formed?
high blood pressure in the glomerular capillaries forces some plasma out of the capillaries and into the capsular space of Bowman’s capsule
Describe the structure of the glomerular capillaries.
- contain many large openings, known as fenestrations, in the capillary endothelium
- fenestrations are not large enough to allow blood cells or large proteins to pass through
Describe glomerular filtration.
- glomerular capillaries contain many large openings, known as fenestrations, in the capillary endothelium
- fenestrations are not large enough to allow blood cells or large proteins to pass through
- it facilitates more fluid to leave the bloodstream
- glomerular filtrate is similar to plasma except that it contains no proteins
- the speed of filtration is determined by the glomerular filtration rate (GFR)
- high blood pressure in the glomerular capillaries forces some plasma out of the capillaries and into the capsular space of the Bowman’s capsule, and becomes glomerular filtrate.
What is the purpose of kidney reabsorption?
- ensures the body gets back the small useful molecules from the filtrate (in the tubule)
What happens during kidney reabsorption?
- substances to be reabsorbed pass through the tubular lumen
- and enter interstitial fluid (in tissue space –> interstitial space)
- and then pass through tubular wall and capillary wall into the blood circulation
- this is achieved by either passive diffusion and/or active transport
- 65% of reabsorption takes place in the PCT, the remaining reabsoption takes place in the DCT and LOH
- 80% of water, sodium, chloride, and bicarbonate is reabsorbed
- 100% of the glucose and amino acids are reabsorbed
Sodium reabsorption
- sodium can be reabsorbed by active transport, where transporter protein carry sodium through epithelial cell in the PCT
- sodium ions are also reabsorbed in the LOH and DCT (as exchange for hydrogen, ammonium, or potassium ions)
Glucose and amino acid reabsorption
- glucose and amino acids are transported and absorbed by similar process as sodium in the PTC
Potassium and calcium reabsorption
- takes place mainly in the PCT
- most of the potassium and calcium are reabsorbed by passive diffusion
- reabsorption of calcium is modulated by vitamin D, parathyroid hormone (PTH) and calcitonin (by thyroid)
Chloride reabsorption
- chloride diffuses through in response to electrical imbalance created by absorption of (Na+)
- chloride moves by following the movement of sodium
- water is absorbed by following osmosis once sodium, glucose, amino acids and chloride have left the tubular filtrate, water molecules follows
What is secretion?
- the process by which the substances move into tubules (urine) from blood capillaries
- many substances that are not filtered from blood are eliminated by this process
(such as extra amt of hydrogen, potassium, ammonia, urea, certain drugs and other wastes) - occurs in PCT, LOH, DCT
What hormones control the urine volume regulation?
- antidiuretic hormone (ADH) from pituitary gland
- aldosterone from adrenal cortex
What do ADH and aldosterone do?
- ADH acts on the DCT (and CT) to promote water reabsorption back into blood
- aldosterone acts on the DCT to increase reabsorption of sodium
- causes osmotic imbalance that encourages water to follow sodium back into the blood