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BBS1002 > case 6 > Flashcards

case 6 Flashcards

1
Q

first step of urine production

A

water + solutes from plasma –> hollow tubules: nephrons.

these modify the composition of fluid. this leaves the kidney and passes into ureter.

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2
Q

ureter

A

there are 2:

leading from each kidney to urinary bladder, expels urine through urethra

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3
Q

location kidney

A

eleventh and twelfth ribs, above the waist.

below diaphragm, outside abdominal cavity , sandwiched between peritoneum.

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4
Q

renal arteries

A

branch of abdominal aorta

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5
Q

renal veins

A

carry blood from kidneys to vena cava inferior

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6
Q

cardiac output kidneys

A

receive 20-25% of cardiac output.

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7
Q

layers kidney

A
  • outer: cortex

- inner: medulla

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8
Q

hilum

A

gap where vessels, nerves + ureter pass

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9
Q

blood flow

A
  • aorta
  • renal artery
  • segmental
  • interlobar
  • arcuate
  • cortical radiate
  • afferent arteriole
  • glomerules
  • efferent arterioles
  • peritubular capillaries/vasa recta
  • cortical radiate vein
  • arcuate
  • interlobar
  • renal
  • inferior vena cava
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10
Q

vasa recta

A

long peritubular capillaries that dip into medulla.

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11
Q

renal fascia

A

layer of connective tissue encapsulating kidneys, separates renal capsule from pararenal fat.

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12
Q

deeper layers below renal fascia

A

renal capsule and parenchyma of renal cortex

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13
Q

nephron

A

ball structure: Bowman’s capsule –> surrounds glomerulus.

endothelium of Bowman is fused with glomerulus.

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14
Q

renal corpuscle

A

glomerulus + Bowman’s caspule

only found in cortex, tubules extend in medulla.

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15
Q

pathway urine

A

Bowman’s capsule –> proximal tubule –> loop of Henle –> distal tubules –> collecting duct –> renal pelvis –> ureter

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16
Q

Loop of Henle

A

two limbs:
descending limb –> impermeable to salts
ascending limb –> impermeable to water. has thin and thick segments

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17
Q

distal tubule

A

of up to 8 nephrons drain into a sigle larger tube: collecting duct

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18
Q

distal nephron

A

distal tubule + collecting duct

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19
Q

urine

A

from the renal pelvis, the filtered a modified fluid flow into ureter.

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20
Q

juxtaglomerular apparatus

A

nephron twists and folds back on itself so that the final part of the loop of Henle passes between afferent and efferent, allow paracrine communication.

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21
Q

juxtaglomerular apparatus cells

A
  1. macula densa (sensitive to NaCl)
  2. granular cells (renin)
  3. extraglomerular mesangial cells
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22
Q

2 types of nephrons

A

cortical and juxtaglomerular

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23
Q

cortical nephrons

A

located in cortex, 85% of neprhons. normally only these are used. no/short Henle’s loop

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24
Q

jaxtamedullary nephrons

A

deep in cortex, have long loops of henle.

very concentrated urine, usus this when body needs to save water. long loop of Henle

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25
Q

bladder

A

urothelium –> transitional epithelium.

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26
Q

transitional epithelium

A

lines much of urinary tract

renal pelvis, ureters, bladder, parts of urethra

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27
Q

urothelial/urothelium

A

transitional epithelium, high elasticity.

consists of 3-5 cell layers, accompanied by a thick layer of glycoprotein plaques.

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28
Q

sphincter

A

circular muscle that maintain constriction of a passage/hole. relaxes by normal conditions.

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29
Q

urethral spincters

A

two muscles used to control exit of urine in bladder
2 types:
- external urethral sphincter –> sekeltal, voluntary
- internal urethral spincter –> smooth, involuntary

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30
Q

kidney capsule

A

surrounds kidney

31
Q

histology kidney

A

consists of cortex, medulla + pelvis.

32
Q

medulla

A

10-18 pyramids.

33
Q

renal lobe

A

one pyramid + cortex

34
Q

lobules

A

lobe is further subdivided

35
Q

inter-lobular arteries

A

lobule lies between two and contains nephrons

36
Q

nephron histology

A

renal corpuscle (filtration of blood) + renal tubule

37
Q

renal papilla

A

top of the pyramid. urine is excreted here at the cribriform area

38
Q

calices

A

smaller and 2-4 larger they merge into pelvis connected to ureter

39
Q

medullary rays

A

bundles of renal tubules of the medulla penetrate the cortex.

40
Q

renal column

A

in between lobes, cortical tissue continues into medulla

41
Q

bowmans cap histology

A

outer layer is parietal layer

inner layer is visceral layer –> podocytes surround capillaries.

42
Q

pareital and visceral layers

A

connect close to vascular pole, between the layers is the urinary space

43
Q

urinary pole

A

filtrate collected where is enters proximal tubule

44
Q

vascular pole

A

blood vessels enter/leave.

45
Q

distal tubule histology

A

close contact with afferent arteriole, this area of the wall has macula densa and juxtaglomerular cells

46
Q

visceral layer

A

covers all capillaries. consists of podocytes, enclose capillaries with pedicles, between thses are filtration slits.

47
Q

filtration barrier Bowman

A

fenestrated endothelial, basement membrane and filtration slits into urinary space

48
Q

ultrafiltration

A

fluid is pressed through filtration barrier and through the slits into urinary space.
water, urea, glucose and AA are filtered.

49
Q

mesangial cells

A

regulate capillary diameter by contraction. also support tissue and have immunological function.

50
Q

tubular part of nephron

A

primary urine: renal proximal tubule –> convoluted part + straight part.
secondary urine: loop of Henle, thin descending, thin ascending, thick ascending (also known straight part of distal tubule). convoluted part passes close to vascular pole.
finally: collecting duct in medullary ray and ending as papillary duct at inner medulla/papilla.

51
Q

filtration

A

movement of fluid blood –> lumen nephron. only in renal corpuscle. only in wall glomerular capillaries + Bowman cap are modified bulk flow

52
Q

reabsorption

A

moving substances in the filtrate back into blood flowing through peritubular capillaries
70% is reabsorbed.

53
Q

secretion

A

removes selected molecules from blood and add them to filtrate in tubule lumen. more selective than filtration. uses membranes and transport proteins.

54
Q

filtration proximal tubule

A

same osmolarity before and after. reabsorption of isosmotic fluid.

55
Q

Loop of Henle filtration

A

more solutes absorbed than water. filtrate becomes hypoosmotic.

56
Q

distal tubule + collecting duct filtrate

A

regulation of salt + water balance with hormones. 1.5 L/ day

57
Q

filtration fraction

A

percentage of total plasma volume that filters into tubules.

- not all blood plasma is filtrated. only 1/5.

58
Q

3 filtration barriers

A
  • glomerular capillary endothelium
  • basal lamina
  • epithelium of Bowman’s capsule
59
Q

glomerular capillary endothelium

A

fenestrated, with alrge pores. negatively charged proteins help repel negatively charged plasma proteins

60
Q

basal lamina

A

acellular layer of extracellular matrix. negatively charged glycoproteins, collagen, others. coarse sieve

61
Q

epithelium of Bowman’s capsule

A

podocytes, long cytoplasmic extensions –> foot processes. wrap around glomerular capillares. leaving the filtration slits.

62
Q

glycosaminoglycans

A

long unbranches polysaccharides consisting of disaccharide unit. highly polar and attract water. useful as a lubricant/ shock absorber

63
Q

starling forces

A

passive exchange of water between capillary and interstitial fluid. determine direction and rate.

direction: hydrostatic and colloid osmotic pressure.
rate: permeabilit of capillary

64
Q

capillary hydrostatic pressure (Ph)

A

caused by blood flowing through glomerular capillaries. forces fluid through endothelium. higher at arterial than venous.

65
Q

glomerular colloid osmotic pressure (pi)

A

favors fluid movement back into capillaries. at arterial end hydrostatic is higher than colloid. venous other way around.

66
Q

Net filtration

A

= CHP- COP

67
Q

bowman’s capsule pressure (Pfluid)

A

opposes fluid movement into capsule. enclosed space so hydrastatic pressure.

68
Q

glomerular filtration rate (GFR)

A

volume of fluid that filters into Bowman’s capsule per unit time.
determined by net filtration and filtration coefficient. –> 2 components surface area and permeability

69
Q

GFR autoregulation

A

local control process. kidney maintains constant GFR. protects filtration barriers from high blood pressure

70
Q

myogenic respone (GFR)

A

ability of vascular smooth muscle to respond to pressure changes. affects afferent arterioles
smooth muscle streches of increased blood pressure. muscle cells depolariz, opens Ca2+.

71
Q

tubuloglomerular feedback (GFR)

A

paracrine, through which changes in fluid flow trhoug Henle influence GFR.

72
Q

granular cells

A

secrete renin, involved in salt + water balance. when NaCl increases as a result of increased GFR macula densa cells send paracrine signal to afferent arteriole. constricts increasing resistance.

73
Q

2 signals macula densa

A

can result in dilation afferent and constrict efferent arterioles. lead to higher hydrostatic pressure + increase GFR. regulates production of renin by granular cells.

BBS1002 (10 decks)

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