Anatomy Flashcards
Kidney taken during donor transplantation
Left kidney
Reason left kidney taken during donor transplantation
Longer renal vein
Vessels used to attached new kidney in transplantation
Iliac artery and vein
Structure that may be damaged during ligation of uterine or ovarian vessels
Ureters
Consequence of damage to ureters during ligation of uterine or ovarian vessels
Obstruction or leakage
Components of glomerular filtration barrier
Basement membrane, podocytes, endothelial cells
Cells that detect sodium and stimulate JG cells to secrete renin
Macula densa cells
Cells stimulated by macula densa cells to secrete renin
JG cells
Location of macula densa cells
Inside distal convoluted tubule
Location of JG cells
Between distal convoluted tubule and afferent arteriol
Cells that function to clean debris from the glomerulus
Mesangial cells
Renal vein drains into what major vessel
Inferior vena cava
Major vessel renal arteries branch from
Abdominal aorta
Structures ureters pass under
Uterine artery or vas deferens
Urine path
Pyramids - calyces - renal pelvis - ureter - bladder
Renal blood flow
Renal artery - segmental artery - interlobar artery - arcuate artery - interlobular artery - afferent arteriole - glomerulus - efferent arteriole - vasa recta/peritubular capillaries - venous outflow
Total body water percentage
60%
Compartment made up of interstitial fluid and plasma
Extracellular compartment
Percentage of ECF that makes up interstitial fluid
75%
Fraction of total body water that makes up ECF
2/3
Percentage of total mass of person that makes up ECF
40%
Percentage of total mass of person that makes up ICF
20%
Normal hematocrit percentage
45%
Formula for calculating HCT %
HCT % = 3 x [Hb] in g/dL
Method for measuring plasma volume
Radiolabeling albumin
Method for measuring extracellular volume
Inulin or mannitol
Formula for measuring ECF volume
ECF = grams infused/equilibrium concentration
Can be inulin or mannitol
Fraction of total body water that makes up ICF
20%
Responsible for filtration of plasma according to size and charge selectivity
Glomerular filtration barrier
Type of collagen found in glomerular filtration barrier
Type IV collagen
Layer of glomerular filtration barrier podocytes are found in
Epithelial layer
Components of basement membrane
Type IV collagen chains and heparan sulfate
Type of endothelium found in glomerular filtration capillaries
Fenestrated capillary endothelium
Glomerular filtration charge barrier properties
Negative charged glycoproteins prevent positive charge molecule entry
Glomerular filtration barrier structure preventing entry of > 100nm molecules and/or blood cells
Fenestrated capillaries
Glomerular filtration barrier structure preventing entry of > 50-60 nm molecules
Slit diaphragm
Structures that make up slit diaphragm in glomerular filtration barrier
Podocyte foot processes interposed with basement membrane
Volume of plasma from which a substance is completely cleared per unit time
Renal clearance (Cx)
If clearance of substance is less than GFR
Net tubular reabsorption
If clearance of substance is more than GFR
Net tubular secretion
If clearance of substance is equal to GFR
No net tubular secretion or reabsorption
Formula for renal clearance
Cx = UxV/Px Ux = urine concentration of substance X Px = plasma concentration of substance X V = urine flow rate (ml/min)
Substance used to calculate GFR because it is freely filtered and is neither reabsorbed or secreted
Inulin
What is normal GFR
100 ml/min
Substance that is an approximate of GFR
Creatinine
Incremental reductions in GFR define what disease
Chronic kidney disease
Formula for GFR
GFR = U(inulin) x V/P(inulin) = Clearance(inulin)
Substance used to measure effective renal plasma flow
para-aminohippuric acid (PAH) clearance
Effective renal plasma flow formula
eRPF = U(PAH) x V/P(PAH) = Clearance(PAH)
Formula for renal blood flow
RBF = RPF/(1 - Hct)
Formula for calculating plasma from Hct
Plasma = 1 - Hct
Measurement that underestimates true renal plasma flow slightly
Effective renal plasma flow
Measurement that overestimates GFR
Creatinine clearance
Formula for calculating filtration fraction
GFR/RPF
What is the normal filtration fraction (%)
20%
Formula for calculating filtered load (mg/min)
GR x plasma concentration
GFR can be best estimated with what measurement
Creatinine clearance
RPF can be best estimated with what measurement
PAH clearance
Lipid compounds that dilate afferent arteriole
Prostaglandins
Drugs that prevent constriction of efferent arteriole
ACE inhibitors
Peptide hormone that preferentially constricts efferent arteriole
Angiotensin II
Effect of ACE inhibitor
Blocks angiotensin II, increases renin, dilates efferent arteriole
Effects of afferent arteriole constriction
Decreased GFR, RPF
No change in FF
Effects of efferent arteriole constriction
Increased GFR, FF
Decreased RPF
Effect of increased plasma protein concentration
Decreased GFR, FF
No change in RPF
Effect of decreased plasma protein concentration
Increased GFR, FF
No change in RPF
Effect of constricting ureter on glomerular dynamics
Decreased GFR, FF
No change in RPF
Effect of dehydration on glomerular dynamics
Decreased GFR and severe decrease in RPF
Increased FF
Drugs that inhibit prostaglandin synthesis
NSAIDs
Glomerular arteriole that is affected by NSAIDs
Afferent arteriole
Effect of NSAIDs on glomerular arteriole
Vasodilates afferent arteriole
Formula for calculating excretion rate
V x [U] of substance
Formula for reabsorption rate
Reabsorption rate = filtered - excreted
Formula for secretion rate
Secretion rate = excreted - filtered
Formula for calculating fraction of excreted sodium
Fe(Na) = P(cr)/U(cr) x U(Na)/P(Na)
Section of renal tubule that reabsorbs glucose
Proximal convoluted tubule
Percentage of glucose reabsorption in healthy individual
100%
Plasma glucose concentration glucosuria begins
200 mg/dL
Rate at which all glucose transporters are saturated
375 mg/min
Mechanism of gestational diabetes
Decreased ability of PCT to reabsorb glucose
Glucose transporter located in proximal convoluted tubule
SGLT2
Drugs that inhibit SGLT2 and permit glucosuria at glucose plasma concentrations < 200 mg/dL
Flozin drugs
The region of substance clearance between threshold and glucose transporter saturation
Splay
Section of renal tubule that contains brush border
Early PCT