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x2 - Urinary > Anatomy and physionlogy > Flashcards

Anatomy and physionlogy Flashcards

1
Q

Definition and effects of hyperkalaemia

A

> 5.5mmoles/l

Depolarisation –> Ventricular fibrillation –> death

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2
Q

Definition and effects of hypokalaemia

A

<3.5mmoles/l

Hyperpolarisation –> cardiac arrhythmias –> death

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3
Q

Normal potassium concentration

A

4mmoles/l

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4
Q

Where does reabsorption occur

A

Proximal tubule
Loop of Henle
Distal tubule
Collecting duct

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5
Q

Where does secretion occur

A

Proximal tubule
Distal tubule
Collecting duct

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6
Q

Specialised afferent arteriole smooth muscle cells

A

Juxtaglomerular cells

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7
Q

Functions of the juxtaglomerular cells

A 
Renal baroreceptors
Release renin (in response to low pressure)
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8
Q

Specialised cells of the distal tubule

A

Macula densa

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9
Q

GFR is estimated using…

A

Serum creatine

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10
Q

Renal plasma flow (RPF) is…

and is calculated using…

A

A measure of all the plasma flowing through the kidneys at a given time
PAH (para-amino-hippuric acid) clearance

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11
Q

Equation to calculate plasma clearance of X

A

Cx = [Ux]V / [Px]

Ux = urine conc. of X
V = urine flow rate
Px = plasma conc. of x
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12
Q

Vertebral level of the kidneys

A

T12 - L3

Hilum at L1 (transpyloric plane)

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13
Q

Muscles posterior to the kidney

A

Quadratus lumborum

Psoas major

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14
Q

Autonomic nerve supply to the kidneys

A

Sympathetic: From T12 - L1 through the coeliac ganglia
Parasympathetic: Derived from the vagus nerve

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15
Q

Lymphatic drainage of the kidneys

A

To the para-aortic lymph nodes around the origin of the renal arteries

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16
Q

The ureter lies on which muscle as it descends

A

Psoas major

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17
Q

Peritonisation of the kidneys and ureters

A

retroperitoneal

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18
Q

What structures cross the ureter superiorly (male and female)

A

Female: ovarian artery
Male: ductus (vas) deferens

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19
Q

The three constrictions of the ureters

A

pelviureteric junction
Pelvic brim
vesicoureteric junction

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20
Q

The median umbilical ligament attaches to which part of the urinary bladder?
and then attaches to which structure?

A

The apex of the bladder
to
the umbilicus

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21
Q

The median umbilical ligament is a remnant of which umbilical structure?

A

The allantois (drains the urinary bladder through the umbilical cord)

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22
Q

The bladder walls are made of…

A

Detrusor (smooth) muscle

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23
Q

The superior surface of the urinary bladder is lined by…

A

Parietal peritoneum

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24
Q

What kind of epithelium lines the urinary bladder and ureter?

A

Transitional epithelium

allows the bladder to expand as it fills

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25
Q

what divides part of the allantois and cloaca from the gut tube? and what does this divided section become?

A

Divided by the urorectal septum,

they become the urogenital sinus which forms the urinary bladder and urethra

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26
Q

Early in the 4th week of development, the intermediate plate mesoderm in the neck region becomes the…

A

Pronephros (rudimentary kidney)

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27
Q

Late in the 4th week, the intermediate plate mesoderm in the thorax forms the…

A

mesonephros

28
Q

What is the final fate of the mesonephros?

A

Becomes the gonad

29
Q

The mesonephros is drained into the cloaca by the…

A

Mesonephric duct

30
Q

The mesonephric duct develops form what?

and what does it eventually form?

A

Pronephric duct

  • -> mesonephric duct
  • -> Rete testes
31
Q

The tubules, collecting ducts, calyces, renal pelvis and ureters are formed from the…

A

Ureteric bud
(grows off the mesonephric duct)
Branches to form all these structures

32
Q

The metanephros (definitive kidney is formed from the…

A

Ureteric bud

Metanephric mesoderm

33
Q

The nephrons are formed from the…

A

Metanephric mesoderm (develops from the intermediate plate mesoderm in the lumbar region)

34
Q

Normal arterial pH =

A

7.4

35
Q

Normal Pco2

A

40mmHg

36
Q

Normal [HCO3-]

A

34mmoles

37
Q

To maintain pH, [HCO3-] : [H2CO3] ration must be…

A

20:1

38
Q

actions of interneurons activated by the micturition reflex

A
  1. *Excitation pf parasympathetic outflow
  2. inhibition of sympathetic outflow
  3. *inhibition of somatic motoneurons to external urethral sphincter
  4. sensation of fullness ascends to bladder

*=influenced by higher centres

39
Q

parasympathetic control of bladder

nerves + actions

A

S2 - 4 (pelvic nerves)

contraction of detrusor muscle

40
Q

Sympathetic control of bladder

nerve + actions

A

Hypogastric nerves

inhibits bladder contraction

41
Q

Substances reabsorbed by carrier mediated transport

A

Phosphate + sulphate (conc. regulated by Tm)

Amino acids + glucose (Tm way above health levels)

42
Q

Tm

A

Maximum transport capacity of a carrier protein

sets the maximum amount of a substance that can be reabsorbed into the blood

43
Q

Reabsorption of sodium is by…

A

Na/KATPase

pumps Na into ECF, creating a gradient into the tubule cell that Na follows (bringing glucose with it through SGLTs)

44
Q

reabsorption of Cl- is by…

A

passive diffusion following the electrical gradient created by the active transport of Na

45
Q

reabsorption of H2O is by…

A

passive diffusion following Na (active transport) and Cl

46
Q

Reabsorption of K, Ca and urea is by…

A

passive diffusion, following water

the reabsorption of water leaves the contents of the tubule very concentrated

47
Q

Substances that are secreted

A 
Protein bound substances (too large for filtration)
Harmful substances)
K+ (stimulated by aldosterone)
Na+
H+
48
Q

renal threshold

A

plasma concentration at which carrier saturation occurs

49
Q

juxtaglomerular cells produce renin in response to…

A

sympathetic discharge (fired due to low pressure at carotid baroreceptor)

low afferent arteriole pressure

low NaCl at macula densa

50
Q

Juxtaglomerular production of renin is inhibited by…

A

ADH

ANP

51
Q

ANP production is stimulated by

A

increased atrial stretch

52
Q

Angiotensinogen is produced by…

A

the liver

53
Q

Action of renin

A

catalyses conversion of angiotensinogen to angiotensin I

54
Q

Action of ACE

A

catalyses conversion of angiotensin I to angiotensin II

55
Q

Actions of angiotensin II

A

increases CV response
increases vasoconstriction*
stimulates aldosterone release
stimulates thirst and ADH release (in severe hypovolaemia) from hypothalamus

*efferent arteriole constriction –> decreased peritubular hydrostatic pressure –> increased H20 and NaCl reabsorption in proximal tubule

56
Q

Actions of aldosterone in nephron

A

increases H2O and NaCl reabsorption in distal tubule

57
Q

actions of macula densa

A

detects low NaCl –> stimulates juxtaglomerular cells

detects increased flow –> constricts afferent arteriole –> decreased GFR

58
Q

Autoregulation

A

Maintains GFR over changes in BP
(independent of nerves/hormones)

alters afferent arteriole constriction

59
Q

the descending limb of the loop of henle is…

A

permeable to H20
impermeable to NaCl

H20 leaves, concentrating the tubule contents, and is then removed by the vasa recta (this maintains the gradient)

60
Q

the ascending limb of the loop of henle is…

A

impermeable to H2O
actively transports NaCl out

this “dilutes” the tubule contents

61
Q

Permeability of the collecting duct is…

A

under ADH control

recruits AQP2 pores and increases permeability to urea

62
Q

the mechanism creating a concentration gradient in the interstitium in the medulla (driven by the Na/KATPase)

A

the counter-current multiplier

63
Q

hypothalamic osmoreceptors are stimulated by…

A

high osmolarity (high NaCl concentration)

–> ADH release

64
Q

ADH is released in response to…

A

high osmolarity (hypothalamic osmoreceptors)
decreased atrial stretch
low BP detected by carotid + aortic baroreceptors

65
Q

Actions of ANP

A

inhibits renin production
inhibits ADH secretion
inhibits aldosterone secretion
decreases CV response

x2 - Urinary (2 decks)

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