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
bladder
urothelium --> transitional epithelium.
26
transitional epithelium
lines much of urinary tract | renal pelvis, ureters, bladder, parts of urethra
27
urothelial/urothelium
transitional epithelium, high elasticity. | consists of 3-5 cell layers, accompanied by a thick layer of glycoprotein plaques.
28
sphincter
circular muscle that maintain constriction of a passage/hole. relaxes by normal conditions.
29
urethral spincters
two muscles used to control exit of urine in bladder 2 types: - external urethral sphincter --> sekeltal, voluntary - internal urethral spincter --> smooth, involuntary
30
kidney capsule
surrounds kidney
31
histology kidney
consists of cortex, medulla + pelvis.
32
medulla
10-18 pyramids.
33
renal lobe
one pyramid + cortex
34
lobules
lobe is further subdivided
35
inter-lobular arteries
lobule lies between two and contains nephrons
36
nephron histology
renal corpuscle (filtration of blood) + renal tubule
37
renal papilla
top of the pyramid. urine is excreted here at the cribriform area
38
calices
smaller and 2-4 larger they merge into pelvis connected to ureter
39
medullary rays
bundles of renal tubules of the medulla penetrate the cortex.
40
renal column
in between lobes, cortical tissue continues into medulla
41
bowmans cap histology
outer layer is parietal layer | inner layer is visceral layer --> podocytes surround capillaries.
42
pareital and visceral layers
connect close to vascular pole, between the layers is the urinary space
43
urinary pole
filtrate collected where is enters proximal tubule
44
vascular pole
blood vessels enter/leave.
45
distal tubule histology
close contact with afferent arteriole, this area of the wall has macula densa and juxtaglomerular cells
46
visceral layer
covers all capillaries. consists of podocytes, enclose capillaries with pedicles, between thses are filtration slits.
47
filtration barrier Bowman
fenestrated endothelial, basement membrane and filtration slits into urinary space
48
ultrafiltration
fluid is pressed through filtration barrier and through the slits into urinary space. water, urea, glucose and AA are filtered.
49
mesangial cells
regulate capillary diameter by contraction. also support tissue and have immunological function.
50
tubular part of nephron
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
filtration
movement of fluid blood --> lumen nephron. only in renal corpuscle. only in wall glomerular capillaries + Bowman cap are modified bulk flow
52
reabsorption
moving substances in the filtrate back into blood flowing through peritubular capillaries 70% is reabsorbed.
53
secretion
removes selected molecules from blood and add them to filtrate in tubule lumen. more selective than filtration. uses membranes and transport proteins.
54
filtration proximal tubule
same osmolarity before and after. reabsorption of isosmotic fluid.
55
Loop of Henle filtration
more solutes absorbed than water. filtrate becomes hypoosmotic.
56
distal tubule + collecting duct filtrate
regulation of salt + water balance with hormones. 1.5 L/ day
57
filtration fraction
percentage of total plasma volume that filters into tubules. | - not all blood plasma is filtrated. only 1/5.
58
3 filtration barriers
- glomerular capillary endothelium - basal lamina - epithelium of Bowman's capsule
59
glomerular capillary endothelium
fenestrated, with alrge pores. negatively charged proteins help repel negatively charged plasma proteins
60
basal lamina
acellular layer of extracellular matrix. negatively charged glycoproteins, collagen, others. coarse sieve
61
epithelium of Bowman's capsule
podocytes, long cytoplasmic extensions --> foot processes. wrap around glomerular capillares. leaving the filtration slits.
62
glycosaminoglycans
long unbranches polysaccharides consisting of disaccharide unit. highly polar and attract water. useful as a lubricant/ shock absorber
63
starling forces
passive exchange of water between capillary and interstitial fluid. determine direction and rate. direction: hydrostatic and colloid osmotic pressure. rate: permeabilit of capillary
64
capillary hydrostatic pressure (Ph)
caused by blood flowing through glomerular capillaries. forces fluid through endothelium. higher at arterial than venous.
65
glomerular colloid osmotic pressure (pi)
favors fluid movement back into capillaries. at arterial end hydrostatic is higher than colloid. venous other way around.
66
Net filtration
= CHP- COP
67
bowman's capsule pressure (Pfluid)
opposes fluid movement into capsule. enclosed space so hydrastatic pressure.
68
glomerular filtration rate (GFR)
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
GFR autoregulation
local control process. kidney maintains constant GFR. protects filtration barriers from high blood pressure
70
myogenic respone (GFR)
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
tubuloglomerular feedback (GFR)
paracrine, through which changes in fluid flow trhoug Henle influence GFR.
72
granular cells
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
2 signals macula densa
can result in dilation afferent and constrict efferent arterioles. lead to higher hydrostatic pressure + increase GFR. regulates production of renin by granular cells.