Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IPAP Class 21-2 > ap2 #4 renal > Flashcards

ap2 #4 renal Flashcards

1
Q

what are the 8 functions of the Kidney?

A
  1. Regulate blood ionic composition
  2. Regulate blood pH
  3. Regulate blood volume
  4. Regulate blood pressure
  5. Maintain blood osmolarity
  6. Produce certain hormones
  7. Regulate blood glucose levels
  8. Excrete wastes and foreign substances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What ions do the kidneys regulate to keep a good blood ionic composition?

A

Helps to regulate blood levels of ions like sodium (Na+), potassium (K+), calcium (Ca2+), chloride (Cl-), and phosphate (HPO42-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do the kidneys regulate blood pH?

A

Kidneys excrete variable amount of hydrogen ions (H+) into urine and conserve bicarbonate ions (HCO3-); bicarb is important buffer of H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do the kidneys regulate blood volume?

A

Adjust blood volume by conserving or eliminating water into the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do the kidneys regulate blood pressure?

A

Kidneys excrete enzyme renin, this activates renin-angiotensin-aldosterone pathway; increased renin = increased blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do the kidneys regulate blood osmolarity?

A

Separately regulates loss of water and loss of solutes in urine, kidneys maintain relatively constant osmolarity close to 300mOsm/liter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What hormones are produced by the kidneys

A

Kidneys produce the hormones calcitriol (metabolite of Vitamin D), erythropoietin (stimulates production of RBC’s), and renin (hormone/enzyme in RAAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do the kidneys regulate blood glucose levels?

A

Like the liver, the kidneys can use amino acid glutamine in gluconeogenesis, which can then release new glucose into the blood stream to help maintain normal level
Very small contribution to glucose homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what types of waste do the kidneys rid?

A

Ammonia and urea- from deamination of amino acids
Bilirubin- catabolism of hemoglobin
Creatinine- breakdown of creatine phosphate in muscle fibers
Uric acid- catabolism of nucleic acids
Metabolites from hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what types of foreign substances do the kidneys rid?

A 
From diet (asparagus, beet color, many other foods)
Drugs (amphetamines, opioids, nicotine, alcohol, etc)
Environmental toxins (pesticides, etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where are the kidneys located?

A

retroperitoneal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

kidney anatomical location

A

last thoracic and 3rd lumbar verterbrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What gives the kidneys protection?

A

11th and 12th ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the border of the kidney that faces the spinal column?

A

Concave medial border (hilum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the external layers of the kidney?

A

Renal Fascia
Adipose Capsule
Renal Capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What anchors the kidney and adrenal gland to surrounding structure and retroperitoneal wall

A

Renal fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fatty tissue surrounding renal capsule, protection and holds kidney and adrenal glands in place in cavity

A

Adipose Capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the color of renal capsule connective tissue?

A

transparent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Smooth, covering that is continuous with ureters; helps maintain shape of kidney and offers protection; found surrounding the kidneys only

A

Renal Capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

3 parts of the renal hilum

A

vein
artery
pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

4 parts of the internal anatomy of the kidney?

A

cortex
medulla
pyramid
papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Contains all of the glomeruli and convoluted tubules of nephrons
Also makes the columns that lay between pyramids

A

Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Collection of all renal pyramids comprise the _______

Contains all of the loops of Henle and collecting ducts

A

Medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How many pyramid are there per kidney?

A

8-18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

narrow apex of the pyramid

Contains the papillary duct leading to minor calyx

A

Papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the space between renal pyramids called?

A

columns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what makes up the kidney lobe?

A

Medulla+
overlaying cortex+
each adjacent column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does the minor calyx do?

A

small chambers that collect urine directly from the papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

where does the major calyx collect urine?

A

from multiple minor calyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are contained inside the renal sinus

A

adipose tissue, the blood vessels, and nerve supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

where does the ureter emerge and what is also here?

A

The hilum

with blood and lymphatic vessels, and nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

where is the first place blood flows in the kidney? and where next?

A

The corpuscle and then the glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

are things removed or added in the glomerulus?

A

removed only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what acts as a secondary filter?

A

Capillary reabsorb/secrete action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is known as filtrate

A

As blood flows through, certain substances are removed from blood and placed into the urinary tubular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

where is filtrate first found

A

Glomerular Capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

when is filtrate termed urine?

A

when the filtrate leaves the collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are the two parts of the nephron?

A

Renal Corpuscle-

Renal Tubule-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is the job of the renal corpuscle

A

It is where blood is filtered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the job of the renal tubule?

A

Controls filtered contents from blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

3 main contents inside the renal tubule.

A

Proximal Convoluted tubule (PCT)- attached to capsule

Loop of Henle (nephron loop)- middle section
Distal Convoluted tubule

(DCT)- distant from capsule, empty into collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is the only structure that extends into the renal medulla

A

Loop of Henle

Note:The collecting ducts are also in the medulla, but they are NOT part of the nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what are the two nephrons

A

Cortical, Juxtademedullary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Characteristics of the cortical nephron

A

Renal corpuscles lie in outer portion of renal cortex

Short loops of Henle

Just barely reach into outer region of medulla

Peritubular capillaries only

85% of nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Characteristics of the Juxtademedullary nephron

A

Renal corpuscles lie deep in the renal cortex

Long loops of Henle
Reach deep into medulla

Peritubular capillaries that give rise to the Vasa recta
Vasa recta: capillary bed that extends into medulla surrounding the Loop of Henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Cortical-Short Nephron characteristics

A

Renal corpuscles lie in the outermost portion of the cortex
Descending limb of loop of Henle barely dips into the renal medulla
After a hairpin turn, the ascending limb of the Loop of Henle returns to the cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Cortical-Peritubular Capillary Characteristics

A

Arise from the efferent arteriole
Intermingle throughout the proximal and convoluted tubules
These then flow into interlobular veins and eventually back into systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Juxta-Long Nephron characteristics

A

Renal corpuscles lie in the cortex

Descending limb of loop of Henle dives deep into the renal medulla

Anatomy lends to very dilute and/or concentrated urine
After a hairpin turn, the ascending limb of the Loop of Henle climbs back to the cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Juxta-Peritubular Capillary Characteristics

A

Arise from the efferent arteriole
Intermingle throughout the proximal and convoluted tubules
In the juxtamedullary nephrons only, a specialized capillary system exists coming off of these peritubular capillaries (see next slide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Juxta-Vasa Recta Characteristics

A

Coming from the peritubular capillaries, dives deep into the renal medulla
Flows side by side each of the loops of Henle
Designed to keep a constant osmotic (pressure) gradient so that things can flow in and out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Afferent

A

Into Something

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Efferent

A

Out of Something

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Afferent Arteriole Characteristics

A

Wider lumen, thicker walls

Has much more capability to constrict or dilate when compared to efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Describe the Glomerulus

A

Ball of twine-like capillary structure that buds off of the afferent arteriole

Modified simple squamous epithelial cells called podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Efferent Arteriole Characteristics

A

Brings blood with larger solutes (i.e. proteins) into the peritubular capillaries (or vasa recta) and then back into systemic circulation

Smaller lumen size, thinner walls (back-pressure sometimes needed for glomerular filtration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Leftover unfiltered blood exists the corpuscle via what?

A

efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

3 Main functions of Nephrons and Collecting Ducts

A
  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How much filtrate is reabsorbed back into the blood stream?

A

99%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the GFR

A

sum of all functioning nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What forms the “leaky” barrier in the capsule?

A

Glomerular capillaries and podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is mostly prevented from entering the capsular space?

A

plasma proteins, blood cells, platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what are the three layers of filtration?

A

Fenestrations of endothelial cells

Basement membrane/Basal lamina

Slit membranes between pedicels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what happens when mesangial cells contract?

A

reduced area available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what happens when mesangial cells contract?

A

surface area is maximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

pressure is _____ in glomeruli than in any other capillaries in the body.

A

higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

GBHP

A

Glomerular Blood Hydrostatic Pressure,
push
outward from the glomerulus into capsular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

BCOP

A

Blood colloid osmotic pressure,
Pulls
on fluid/solutes to keep them in the glomerulus if possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What does NFP =

A

GBHP - CH - BCOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is a normal NFP for the kidneys

A

10 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Homeostasis of body fluids requires a ____ _______ GFR

A

near constant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

how does renal blood flow indirectly determine GFR

A

Modifying the rate of solute and water reabsorption by proximal tubule
Participates in concentration/dilution of urine
Delivers oxygen, nutrients, hormones to cells along the nephron
Delivers waste for excretion in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Constriction of afferent arteriole does what to GFR ? and RBF

A

decreases ,

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Constriction of efferent arteriole does what to GFR

A

increases ,

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

5 stages of kidney failure

A
  1. Kidney damage (protein in the urine) with normal GFR
  2. Kidney damage with mild decreases of GFR
  3. Moderate decrease of GFR 45 to 59 mmHg 3b= 30-44mmHg
  4. Severe reduction in GFR 15-29mmHg
  5. Kidney failure Less than 15
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is considered when calculating GFR

A 
Age
Race
Weight/body size 
Gender
Creatinine levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Why is Creatinine used to calculate GFR

A

the kidney neither reabsorbs nor metabolizes this substance

Should FREELY pass through the filtration membrane and be urinated out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

3 mechanisms that regulate GFR

A
  1. Renal autoregulation
  2. Neural regulation
  3. Hormonal regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is the main reason GFR can remain constant in high blood pressure situations

A

This is usually accomplished by variable changes in resistance at the afferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Explain the Myogenic mechanism-

A

Response to to changes in blood pressure

The acute increase in BP causes stretching of the afferent arteriole
Allows for a very brief (millisecond) increase in RBF and GFR

Renal blood flow reduced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what blood pressure turns on myogenic regulation

A

This occurs automatically between the systolic blood pressures of 90 and 180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Tubuloglomerular feedback

A

Responds to changes in sodium-chloride (NaCl-) and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

what happens to the tubules when GFR increases

A

rate through the tubules increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is the role of macula densa cells when GFR is high

A

macula densa cells release ATP and adenosine which has direct action upon receptors at the mesangial cells and afferent arteriole.

Causes both to constrict which then lowers GFR to normal level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Role of JGA

A

A complex structure that has the ability to affect systemic blood pressure through the autoregulation of tubuloglomerular feedback

one per nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

3 types of cells in hte JGA

A 
Juxtaglomerular cells (aka granular cells)
-walls of the afferent arteriole

Macula densa cells
-walls of the late thick ascending limb of LOH

Extraglomerular mesangial cells (aka Lacis cells)
-between afferent arteriole, efferent arteriole, and DCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

2 functions of granular cells

A

Detect when blood pressure is too low (by sensing the lack of stretch of the afferent arteriole wall)

They synthesize, store, then secrete hormone/enzyme Renin (described later in RAAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

2 functions of macula densa cells

A

Detect increase in NaCl (Sodium Chloride) concentrations in the filtrate

In response to this concentration check, these cells release

88
Q

Function of Extraglomerular Mesangial cells(Lacis cells)

A

Contract or relax to make small regulatory changes in response to the signals that the other JGA cells are sending

89
Q

When blood pressure or ECFV changes, the systems that have a larger role in attempting to maintain constant GFR are ?

A

Nervous system

Endocrine hormones

Paracrine hormones

90
Q

What type of fibers feed blood vessels of the kidney

A

sympathetic nervous system fibers only

91
Q

what is sympathetic stimulation when a person is at rest as long as ECFV is normal

A

low

92
Q

As sympathetic stimulation increases….

A

ECFV begins to reduce (fluid being used in increased metabolism)

93
Q

sympathetic stimulation (exercise, fight/flight) causes what?

A

This triggers sympathetic system to tell adrenal medulla to release epinephrine / norepinephrine

Vasoconstriction of the afferent arteriole

Blood flow decreases into glomerulus

GFR decreases until the kidney compensates with autoregulation

94
Q

3 characteristics of angiotensin 2?

A

Very potent vasoconstrictor

At low concentration levels (when RAAS just activated), efferent arterioles constrict first

As levels of hormone continue to rise, causes vasoconstriction of afferent arterioles

95
Q 
Natriuretic peptide (ANP/BNP) 
 hormone regualtion can do what?
A

Secreted by the atria (ANP) or the brain (BNP)*
Usually secreted in response to increase in volume (pressure)
Both dilate the afferent arterioles but constrict the efferent arteriole
GFR increases to hopefully offload more fluid to help lower systemic blood pressure

96
Q

Prostoglandin hormone regualtion

A

Secreted by the atria (ANP) or the brain (BNP)*
Usually secreted in response to increase in volume (pressure)
Both dilate the afferent arterioles but constrict the efferent arteriole
GFR increases to hopefully offload more fluid to help lower systemic blood pressure

97
Q

Helps to counteract vasoconstriction caused by angiotensin II and certain catecholamine’s

A

Nitric Oxide (NO)

Much more dilation at afferent arteriole compared to efferent

98
Q

Endothelin

A

Potent vasoconstrictor released by endothelial cells of renal vessels, mesangial cells, and distal tubular cells
Stimulated by angiotensin II, bradykinin, epinephrine

99
Q

Bradykinin

A

Vasodilator that stimulates subsequent release of NO and prostaglandins

100
Q

what is the effect of Bradykinin on GFR

A

increases

101
Q

Produced within kidneys (Tubuloglomerular feedback)

Causes vasoconstriction at afferent arteriole

A

Adenosine

102
Q

what is the effect of Adenosine GFR

A

Decreases

103
Q

Located on surface of endothelial cells lining afferent arteriole, glomerular capillaries, and lungs
Converts angiotensin I to angiotensin II (which is a vasoconstrictor)

A

Angiotensin converting enzyme (ACE)

, reduces GFR

104
Q

what do granular cells secrete

A

renin

105
Q

when is renin released

A

Activated in response to low afferent arteriolar pressure

106
Q

low afferent arteriolar pressure =

A

low perfusion pressure

107
Q

Explain Sympathetic nervous system activation

A

beta-1 adrenergic receptors found at juxtaglomerular cells are stimulated (beta-1 adrenergic receptors found at juxtaglomerular cells are stimulated )

108
Q

Explain Tubuloglomerular feedback

A

Activated by a decrease in luminal sodium chloride concentration at the macula densa cells (renin gets released)

109
Q

What two things happen when RAS is activated

A

Causes the juxtaglomerular (granular) cells to secrete the hormone/enzyme renin into the bloodstream

Angiotensinogen is released by hepatocytes (liver cells) into the blood at regular intervals

110
Q

What happens to Angiotensin 1 in the lungs

A

angiotensin-I is converted to angiotensin-II by lung endothelial angiotensin converting enzyme (ACE)

111
Q

what is the active form of Angiotensin

A

Angiotensin II

112
Q

What happens to Angiotensin 1 in the kidneys

A

angiotensin-I is converted to angiotensin-II by kidney endothelial angiotensin converting enzyme (ACE)

113
Q

4 functions of Angiotensin II

A
  1. Decreases GFR by causing stronger vasoconstriction of afferent arteriole, minor vasoconstriction of efferent arteriole
  2. Enhances Na+, Cl- and water reabsorption in the PCT
  3. Stimulates the adrenal cortex to release aldosterone
  4. Simulates posterior pituitary gland to release ADH
114
Q

what does reabsorption and secretion throughout the nephron determine

A

volume and composition of urine

115
Q

what 4 things are controled by the kidneys?

A

volume, osmolality, composition, and pH of extracellular and intracellular fluid compartments

116
Q

what mediates reabsorption and secretion

A

Transport proteins positioned in cell membranes

117
Q

what in the cell membrane is a good target for pharma drugs

A

transport proteins

118
Q

what lines the renal tuble for reabsoprtion

A

Epithelial cells

119
Q

________ cells make the largest contribution to reabsorption

A

proximal convoluted tubule (PCT) cells

120
Q

what cells fine tune the reabsorption process

A

Loops of Henle, DCTs, Collecting ducts

121
Q

what happens if small proteins are passed through the Glomerular filter

A

They are usually reabsorbed by pinocytosis

122
Q

what are two ways reabsoprtion can occur?

A

Paracellular reabsorption - between adjacent tubule cells

Transcellular reabsorption - through the tubule cell itself

123
Q

Apical membrane-

A

the lumen side of the cell

124
Q

Basolateral membrane-

A

the interstitial side of the cell

125
Q

90% of actual water reabsorption by the kidneys occurs with the reabsorption of

A

Sodium (Na+)
Chloride (Cl-)
Glucose

126
Q

what segments are always permeable to water

A

PCT and the descending limb of the loop of Henle

127
Q

Reabsorption of the remaining 10% of water occurs by

A

facultative water reabsorption

128
Q

2 features of facultative water reabsorption

A

Regulated by ADH

Occurs in the late DCT and collecting ducts

129
Q

Secreted substances include (but not limited to)

A 
Hydrogen ions 
Potassium 
Ammonium ions
Creatinine
Certain drugs like penicillin
130
Q

WHAT TYPE OF CELL FORMS THE wall of the glomerular capsule, renal tubule, and ducts

A

A single layer of epithelial cells

131
Q

PCT- proximal convoluted tubule

A

Simple cuboidal epithelial cells with prominent microvilli brush-border facing lumen (apical surface)

132
Q

what do microvili do?

A

increase surface area for absorption and secretion

133
Q

(LOH) Loop of Henle

A

(thin descending and thin ascending limb portions)-
Simple squamous epithelial cells

(thick ascending limb portion)-
Simple cuboidal to low columnar epithelial cells

134
Q

DCT- distal convoluted tubule

A

Most of DCT – simple cuboidal epithelial cells
with the last part containing :

Principal cells- receptors for ADH and aldosterone

Intercalated cells- help play a role in blood pH

135
Q

Collecting Duct

A

Simple cuboidal epithelial cells that also contain

w/ Principle cells and Intercalated cells

136
Q

Acidosis

A

when acids are added faster than they are excreted

137
Q

Alkalosis

A

when acid excretion exceeds addition

138
Q

pH varies when either what two things happen

A

bicarb (HCO3-) or the partial pressure of carbon dioxide (PCO2 ) is altered

139
Q

When change in pH is caused by HCO3- , it is termed
___________________
When change in pH is caused by PCO2, it is termed
___________________

A

“metabolic”… KIDNEYS

“respiratory”… LUNGS

140
Q

First “line of defense” against acid-base abnormalities

A

extracellular and intracellular buffer systems

141
Q

Second line of defense is the_______

A

the respiratory system

142
Q

Blood PCO2 and pH are important regulators

A

of ventilation RATE

143
Q

What signals a change in the ventilatory rate to compensate for either acidosis or alkalosis

A

Chemoreceptors near the brain and in the periphery sense a change in PCO2 and pH

144
Q

Third line of defense is________

A

the renal system

145
Q

Certain tubule portions allow for secretion of hydrogen ions which will ______ the pH

A

raise

146
Q

why can we never get a net-charge equilibrium of water and solutes

A

There is a constant turnover of new blood coming into the kidney’s

The body signals the need for certain elements to be reabsorbed or secreted based on an attempt for homeostasis

147
Q

The constant movement of IF between tubules and capillaries does what?

A

Generates an osmotic gradient as well as an electric gradient (+/-)

Allows the kidney to engage in exchange

148
Q

where does the largest amount of solute and water reabsorption from filtered fluid occur?

A

PCT

149
Q

As Na+ moves into peritubular capillaries/vasa recta, this creates what?

A

a much more positively charged environment

150
Q

what helps balance the charges

A

Chloride (Cl-) ions

151
Q

when sodium and chloride move into the interstitium in large numbers, what happens?

A

water is obligated to move out of filtrate and into interstitium

water always follows

152
Q

protein water channels that increase the rate of water movement

A

aquaporin-1 channels

153
Q

solvent drag

A

The osmosis of water bringing often bring K+ and Ca++

154
Q

what parts of the nephron are impermeable to urea

A

Thick ascending limb LOH, proximal DCT,

155
Q

when are the Distal portion of DCT and collecting ducts impermeable to urea

A

only under the influence of ADH

156
Q

3 parathyroid actions of the PCT

A

stimulates cells in the PCT to secrete phosphate

stimulates calcitriol (active form of Vitamin-D) to be made in PCT cells and then be absorbed into blood

stimulates cells in the DCT to reabsorb more calcium

157
Q

The entire LOH is _____ regulated

A

independently

158
Q

what is happening in the Descending limb of the LOH

A

mostly water reabsorption and solute secretion (concentrates the filtrate)

159
Q

what is happening in the Ascending limb of the LOH

A

no water reabsorption, but reabsorption of solutes occurs (dilutes the filtrate)

160
Q

This region is passively permeable to water and solutes

A

Descending Limb LoH

161
Q

(hyperosmotic)

A

More solutes and less water causes the “first” concentration of filtrate inside the tubule

162
Q

Thin portion

A

This region is passively permeable to small solutes, but impermeable to water (no water reabsorption occurs here)

163
Q

Thick portion

A

Active reabsorption (movement out of tubule) of Na+, K+, Cl- occurs here, but this region is still impermeable to water

164
Q

By the time filtrate reaches this portion, 90-95% of filtered solutes/water have been reabsorbed and returned to interstitium/bloodstream

A

Late portion of the DCT

165
Q

Specialized cells found intermixed in the DCT and throughout the collecting ducts

A

Principal cells

Intercalated cells

166
Q

what controls the amount of reabsorption of solutes and water

A

Hormonal (ADH, Aldosterone, Atrial Natriuretic Peptide, etc)

Osmoreceptors throughout the body

167
Q

how does water flow through the DCT

A

water does not follow Na+ via osmosis

selectively absorb/reabsorb water

168
Q

what does ADH do to principle cells

A

causes principal cells in the DCT and collecting ducts to become permeable to water

Triggers these cells to generate aquaporin-2 channels in the apical membrane

169
Q

, in the presence of ADH, we produce

A

a small quantity of highly concentrated urine

170
Q

where does ADH target?

A

principal cells in the DCT and collecting ducts

171
Q

When blood pressure/volume stabilizes

ADH levels decline causing what?

A

The aquaporin-2 molecules to be removed from principal cells

Normal volume of normal to dilute urine produced

172
Q

influence of aldosterone, principal cells cause what?

A

Sodium reabsorption (usually brings water with it)

Potassium secretion

173
Q

What causes aldosterone to be released?

A

Hyperkalemia

Presence of angiotensin II

174
Q

What stimulates intercalated cells?

A

various osmoreceptor readings in reference to pH and potassium levels

175
Q

Type A

Intercalated Cells

A

Causes secretion of hydrogen (H+) ions

Causes reabsorption of bicarb

Causes reabsorption of potassium (K+)

176
Q

Type B

Intercalated Cells

A

Causes reabsorption of hydrogen (H+) ions

Causes secretion of bicarb

Causes secretion of potassium (K+)

177
Q

Stretached atrial/ventricular cells increase bp and/or blood volume and realease_______

A

ANP

178
Q

What are the two direct actions of ANP/BNP on the cells located in the DCT and the Collecting Ducts?

A
  1. Inhibits the reabsorption of sodium and water

2inhibits the renin-angiotensin-aldosterone system

179
Q

how does the Descending limb of LOH

regulate plasma osmolarity and volume?

A

Permeable to water mostly, therefore concentrating the filtrate

180
Q

how does the Thick ascending limb of LOH

regulate plasma osmolarity and volume?

A

Impermeable to water only, therefore diluting the filtrate

181
Q

how do the DCT + Collecting Ducts

regulate plasma osmolarity and volume?

A

this is Where final dilution/concentration occurs

Where the majority of ADH has its action

182
Q

Who is responsible for the regulation of plasma osmolarity and volume

A

the Loop of Henle, the DCT, and the collecting ducts

183
Q

What controls th Dilution/Concentration in the DCT and the collecting ducts

A

presence or absence of ADH :

In absence of ADH,
Urine is diluted

In presence of ADH,
Urine is concentrated

184
Q

Explain the odor of urine

A

mildly aromatic, becomes ammonia-like with time

Bacteria turning urea back into ammonia

185
Q

pH range of urine

A

from 4.6-8.0, average is 6.0, varies with diet, high protein increases acidity, vegetarian increases alkalinity

186
Q

Specific gravity-

A

density (ratio of weight of solutes vs water) usually 1.001-1.035 (the higher the solutes the higher the value)

187
Q

Urine is mostly _____

A

water

188
Q

where does uric acid come from?

A

breakdown of nucleic acids

189
Q

where does urobilinogen come from ?

A

breakdown of hemoglobin

190
Q

The 2 blood tests that provide urine function information

A
  1. Blood Urea Nitrogen (BUN)- measures urea (uremia)

2. Plasma creatinine- catabolism of creatine phosphate in skeletal muscle

191
Q

Renal Plasma Clearance of Glucose

A

the clearance of glucose is normally zero because normally 100% of glucose is reabsorbed, nothing gets excreted

reported in mL/min

192
Q

Drugs with high RP clearance =

A

the dosing of the medication must be high to be effective

193
Q

Inulin

A

plant polysaccharide, easily passes through the filter and is excreted in urine 100%
Great measure of true GFR

194
Q

why is the inulin test difficult

A

inulin is not produced in the body

195
Q

Creatinine Clearance

A

As creatinine is filtered, not reabsorbed, its clearance is a good estimate of GFR

196
Q

Urine Transportation

A

Collecting ducts –papilla - papillary ducts - minor calyces – major calyces – renal pelvis – ureters – urinary bladder – urethra – toilet

197
Q

what action performs urine transport

A

peristalsis

198
Q

Location and morphology of ureters

A

Ureters are 10-12in long

Ureters are thick walled, narrow (1-10mm lumen)

Ureters are retroperitoneal

199
Q

anti-reflux mechanism

A

When the bladder fills with urine, it pulls the bladder down which closes these valves so no “backflow” occurs

200
Q

3 layers of ureters

A

Adventitia- anchors ureters to surrounding tissues, contains blood vessels, nerves, lymphatic vessels

Muscularis (peristalsis)-outer circular, inner longitudinal smooth muscle

Mucosa-transitional epithelium with goblet cells that secrete mucous (to protect mucosa from acidity)

201
Q

Location of ureters in females

A

Posterior to pubic symphysis

Inferior and slightly anterior to uterus in females

Held in place by peritoneal folds

202
Q

Location of ureters in males

A

Immediately anterior to rectum in males

Held in place by peritoneal folds

203
Q

3 layers of urinary bladder wall

A
  1. Serosa
  2. Muscularis(Detrusor muscle)
  3. Mucosa(uroepithelium)
204
Q

Difference between serosa and adventitia

A

Serosa: covers superior surface, visceral peritoneum

Adventitia: covers posterior and inferior surfaces,
continuous with the ureters

205
Q

3 layers of the detrusor msucle

A

Inner longitudinal
Middle circular
Outer longitudinal

206
Q

How doe the detrusor work

A

When the detrusor is relaxed, it allows for filling

When the detrusor is contracted, it forces urine into the urethra

207
Q

2 parts of the Mucosa/uroepithelium

A

Rugae: allows bladder to expand when it is filling
Transitional epithelium – shape of these epithelial cells changes with the degree of stretch placed on them

Trigone: smooth, triangular area in bladder floor
ureteral openings in posterior corners
internal urethral orifice in anterior corner

208
Q

Internal urethral sphincter

A

(inferior aspect of bladder)

Circular smooth muscle (extension of the detrusor muscle) near internal urethral orifice

209
Q

External urethral sphincter

A

Skeletal muscle (composed of deep perineal muscles/pelvic floor)
Voluntary
Sits just below the prostate (in males)
Is at the opening of the external urethral orifice (in females)

210
Q

Male urethra characteristics

A

4-5x longer than female, dual function (urine, semen), consists of mucosa (deep) and muscularis (superficial)
In total, urethra is usually 8in long

Prostatic - urine and sperm transport (smooth muscle)

Membranous - shortest region skeletal muscle forms EXTERNAL SPHINCTER

Spongy- longest region , Bulbourethral (Cowper’s gland)-delivers alkaline fluid to help neutralize acidity of urethra

211
Q

Female urethra characteristics

A

Short tube that conveys urine from bladder to exterior

located between clitoris and vaginal orifice

Mucosa: consists of epithelium and lamina propria
Muscularis: circular, smooth muscle

212
Q

What type of reflex is the micturation

A

Parasympathetic reflex

213
Q

what does micturation cause

A

Involuntary contractions of the detrusor muscle
Internal urethral sphincter to open

[This causes the sensation that we perceive as our body telling us we need to urinate soon]

214
Q

How is urine held vs. released

A

Held-voluntary contraction of the external urethral sphincter helps to prevent urination until the appropriate time
Released-Voluntary relaxation of this sphincter allows the flow of urine to occur

215
Q

what are the reasons for Increased incidence of calculi, acute and chronic renal inflammation, urinary tract infections

A

Thought to be due to loss of thirst sensation as people age

216
Q

What are the reasons for urine retention with age?

A

BPH and prostate cancer, hematuria (kidney stones), dysuria (UT infection, kidney stones)

IPAP Class 21-2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions