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BIO 242 > CH 26 > Flashcards

CH 26 Flashcards

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1
Q

Role of kidneys

A
  1. Removes waste (Toxins, muscle break down, protein break down)
  2. Regulation of pH and ions
  3. Regulation of blood volume
  4. Regulation of BP
  5. Regulation of blood osmolarity (Thickness)
  6. Production of hormones
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2
Q

Reducing blood volume also reduces

A

BP

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3
Q

If one kidney is removed, other kidney can compensate up to

A

80%

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4
Q

Retroperitoneal:

A

Describing location, posterior to peritenium, does not have membrane on the top
- Typically ribs 11-12 protect at the back (Floating ribs
- T12-L3 vertabrae is level of kidneys

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5
Q

Renal Hilum:

A

indentation in side

Central area where blood vessels and lymph comes in (Lots of bloods supply)

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6
Q

Kidneys use how much cardiac output

A

20-30%

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7
Q

3 layers of tissue around each kidney

A

i) Renal Capsule
ii) Adipose Capsule
iii) Renal Fascia

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8
Q

Renal Capsule

A

smooth dense irregular Connective Tissue (Shape and protection)

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9
Q

ii) Adipose Capsule

A

mass of fatty tissue (Protection from impact)

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10
Q

Renal Fascia

A

thin dense irregular CT (Anchors kidney in position in abdominopelvic cavity)

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11
Q

Renal Cortex

A

Outer kidney, lighter colour

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12
Q

Renal Medulla:

A

Darker red, formed into pyramids (8-18 pyramids per kidney)
- Cortex flows bw pyramids, called a column in these locations

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13
Q

Renal papilla

A

Skinny End/apex of each renal pyramid

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14
Q

Renal Columns

A

Region bw the pyramids

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15
Q

Nephron

A

Functional part of the kidney, forms and determines conc. of urine (Born with a #, don’t get any more)

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16
Q

Path of urine

A

Collecting duct – papillary duct, - minor calyx – major calyx – renal pelvis – ureter – urinary bladder (Outside the kidney)

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17
Q

What do kidneys work hard at in filteration

A

dealing with proteins

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18
Q

Path of blood flow in kidneys

A

Afferent Arterioles (Incoming, blood supply into each individual nephron)

Glomerular Capillaries (capillaries in each nephron where filtration of blood begins)

Efferent Arterioles (Blood is leaving the nephron)

Peritubular Capillaries/Vasa Recta (Capillaries that surround the nephrons – providing nephrons with their own blood supply)

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19
Q

Two parts of nephron

A

Renal corpuscle
Renal tubule

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20
Q

Renal Corpuscle

A

(where blood plasma is filtered)
- The ball-looking structure

	i) Glomerulus (capillary network)

	ii) Bowman’s Capsule (glomerular capsule) – outer capsule
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21
Q

Renal Tubules

A

Proximal Convoluted Tubule
Loop of Henle
Distal Convoluted Tubule

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22
Q

Proximal Convoluted Tubule

A
  • Closed to corpusal
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23
Q

Loop of Henle

A

Descending element of renal tubules

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24
Q

DCT

A
  • Farthest away from the capsule
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25
Q

Cortical nephrons

A

Most common (80%)

  • Most of the nephron will be in the cortex
  • Short loop of Henle is in the medulla
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26
Q
  • Juxtamedullary Nephrons
A

(Same structure as corical)
- Closer to the medulla
- Long skinny loop of Henle, significant for determining final composition of urine (Conc. Or diluted)

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27
Q

Layers of th glomerular capsule

A

Visceral layer
Parietal Layer

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28
Q

Visceral Layer of glomerular capsule

A
  • On top of the capilleries
  • Podocytes
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29
Q

Podocytes

A

 A certain cell with fingerlike extension that lays on top of capillaries in the glomularis
 Eventually have ability to determine what leaves blood and goes into urine

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30
Q

Parietal layer of Glomerular capsule

A

Capsule (bowmans) Space
- The actual space inside the capsule
- When plasma leaves capillary and enters capsular space it is called filtrate
- Plasma proteins should not be in filtrate, bc they normally cannot fit out of capillaries

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31
Q

Macula Densa cells

A

Part of the tubule (The ascending limb) that comes close to the capsule

o Touch afferent arteriole
o Play role in determining if afferent arteriole dilates or constricts

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32
Q

Juxtaglomerular Cells

A

Part of the wall of the afferent arteriole
o Basically modified smooth muscle cells
o Typically would find some in efferent arteriole as well

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33
Q

Juxtaglomerular Apparatus

A

o Macula Densa and juxtaglomerular together are referred to as juxtaglomerular apparatus – major BP regulators

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34
Q

Principal Cells

A

Found in last part of distal convoluted tubule and collecting duct

o Primarily responsible for determining final concentration of urine (Thick or thin)
o Have receptors (Protein is inserted into those cells) for antidiuretic hormone.

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35
Q
  • Intercalated Cells:
A

found mainly on collecting ducts and distal convoluted tubule.
o Monitor pH of the urine (Typically slightly acidic)
o Hanging on to bicarbonate or letting nitrate out allows for regulation of pH

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36
Q

Filtration

A

Something that was in the blood is now in the capsular spae (Now called filtrate)

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37
Q

How much filrate produced by a healthy person per day?

A

150-180L

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38
Q

How much filtrate reabsorbed into the bloodstream

A

99%

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39
Q

Stages of urine production

A

i) Glomerular Filtration
ii) Tubular Reabsorption
iii) Tubular Secretion

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40
Q

What occurs in Glomerular Filtration

A

Filtrate moves from From blood into capsular space

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41
Q

What ocurs in tubular reabsorption

A

Fluid or substances going from tubules back into the capillaries (Vasa recta or peritubular capillaries)

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42
Q

What occurs in tubular secretion

A

More things moving from the capillaries back into the tubules.

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43
Q

Hyper hydrated

A

blood volume is enough therefore more water is excreted in the urine

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44
Q
  • Glomerular Filtrate
A

Any fluid and solutes that end up in the capsular space

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45
Q
  • Filtration Fraction
A

What percentage of the blood that came into the capsule ends (from afferent arteriole) up as filtrate.

o Typically, from 16-20%

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46
Q

3 Components of filtrate membrane

A

i) Glomerular endothelial cells with fenestrations
* Mesangial Cell

ii) Basal Lamina
iii) Podocyte

47
Q

Fenestrations

A

: Holes/openings in the linings of the capillaries, fluid and some solutes can begin to pass through.

Specifically of glomerular endothelial cells

48
Q

Parts of Podocyte

A
  • Pedicels: The fingers of the podocyte
  • Filtration Slits (Space): The space bw the pedicels
  • Slit (Filtration) Membrane: Final filtration layer – small amino acids, water soluble vitamins, hormones can all make it through; proteins cannot get through this membrane
49
Q

principals of filtration

A
  • Capsular capillaries = large surface area for filtration
  • Filtration membrane is thin and porous
  • Glomerular capillary BP is high – to drive filtration: #1 factor determining how much filtrate is formed
50
Q

Glomerular filtration depends on which three main pressures?

A

Glomerular Blood Hydrostatic Pressure
Capsular Hydrostatic Pressure
Blood Colloid Osmotic Pressure

51
Q

Glomerular Blood Hydrostatic Pressure (GBHP)

A

– promotes filtration
~ 55 mmHg
- Basically your blood pressure – in the afferent arteriole

52
Q

CHP (Capsular Hydrostatic Pressure)

A

resists filtration
~ 15 mmHg
- Pressure produced by fluid already yin capsular space (Says “We’re full, we don’t want more fluid here”)

53
Q

BCOP (Blood Colloid Osmotic Pressure)

A

resists filtration
~ 30 mmHg
- Colloid is particle in plasma (plasma proteins)
- Don’t want water to leave
- Resisting filtration
- Maintaining osmolarity (Blood thickness)

54
Q

How would net filtration pressure be calculated

A

(NFP) = GBHP-CHP-BCOP
~ 10 mmHg
- Typical under resting conditions

55
Q

GFR

A

Glomerular Filtration Rate (GFR)
- Way to measure the efficiency of kidneys

Amount of filtrate formed in both kidneys (all renal corpuscles) each minute
56
Q

Average GFR in adults

A

= 125 ml/min (males)
= 105 ml/min (females)

57
Q

GFR regulation works by two main processes

A

i) Adjusting blood flow in and out of glomerulus (adjusting afferent arteriole)
- Increase blood flow in, increase GFR

ii) Altering glomerular capillary surface area for filtration.
- Allow it to filter more or less

58
Q

Renal Autoregulation of GFR

A
  • Nephrons control blood flow and therefore control GFR
  • myogenic and tubuloglomerular feedback
59
Q

Myogenic (muscle) mechanism

A
  • High BP is problem
  • Causes stretch in wall of afferent arteriole
  • This causes myogenic constriction of arteriole walls.
  • Narrows lumen
  • Reduces blood flow
  • Drops GFR back to normal (Occurs in seconds)
60
Q
  • Tubuloglomerular Feedback
A
  • Tubule creates the change
  • Slower (Minutes) than myogenic
    If high BP is problem
  • Filtrate moves quickly when high BP through tubules,
  • water and sodium cannot be reabsorbed bc of fast rate (this is monitored by macula densa cells)
  • Less Nitric Oxide (dialator) released by juxtaglumular apparatus
  • Constricts afferent arteriole, reducing blood flow, reducing rate of arteriole tubule flow
  • When flow slows down, reabsorption rate is back to normal
61
Q

What does low sodium mean in relation to BP?

A

Less water absorbed into blood therefore lower BP

62
Q

Neural regulation of GFR

A

Autoregulation occurs during parasymp. dominance

Increase in stress results in less blood flow to kidneys and thus lower GFR

63
Q

Hormonal regulation of GFR

A

Takes longer and lasts longer

Angiotensin ll reduces GFR by Constricting afferent and efferent arterioles

Atrial Natriuretic Peptide (ANP) (increases GFR)

64
Q

How does angiotensin ll affect GFR

A

reduces GFR by Constricting afferent and efferent arterioles

65
Q
  • Atrial Natriuretic Peptide (ANP) affect on GFR
A
  • Hormone released by heart when BV is too high, increase GFR when ANP goes up
  • Increases filtration on the filtration membrane using the mesengeal cells
66
Q

What part of the renal tubules determines final composition of urine

A

collecting duct

67
Q

What does reabsorption imply?

A

back into peritubular capillaries

68
Q

What does secretion imply?

A

From blood supply (capilleries) back into tubules

69
Q

Which part of tubule does most of the reabsorption?

A

mostly through the Proximal Convoluted Tubule with more distal tubule cells “fine tuning” – in collecting ducts.

70
Q

Paracellular reabsorption

A

Filtrate moves bw cells of tubule

71
Q

Transcellular reabsorption

A

Filtrate moves through individual cells of tubule

72
Q

Components of tubule wall

A

INNER
* Apical Membrane
- The fingers that faces into the filtrate/urine
* Tight Junctions
- Spaces that weld individual cells together
* Basolateral Membrane
- Faces interstitial fluid
OUTER

73
Q

Transport mechanisms of filtrate

A

Primary active transport
- ATP required
Secondary Active transport
- Indirectly using energy (Moving down the gradient)

74
Q

Any time a pump is present, the form of transport must be

A

Active transport

75
Q

Transport maximum

A

Cerntain # of transporters on tubule, once all are full you’ve reached the TRANSPORT MAXIMUM of the solute

therefore substance stays in the urine and is not reabsorbed (Glucose in urine in diabetes)

76
Q
  • Obligatory H2O Reabsorption
A
  • Water is absorbed along with solutes (normally sodium)
  • 90% of h20 reabsorbed done so in obligatory fashion
  • When solute is reabsorbed, water will follow
  • Reason why hypertension person tries to reduce their sodium (More sodium more blood plessure)
77
Q
  • Facultative H2O Reabsorption
A
  • Remaining 10% of any water not reabsorbed with solutes
  • Primarily collecting ducts (end of tubule)
  • Under influence of antidiuretic hormone
  • used for Fine tuning final composition of the urine
78
Q

Glucosuria

A

Glucose in urine
- Usually, a problem when all glucose transporters for reabsorption are full

79
Q

Urine formation (6 steps)

A

Step 1: Glomerular filtration produces a filtrate resembling blood plasma but containing few plasma proteins.

Step 2: In the PCT, 60-70 percent of the water and almost all of the dissolved nutrients are reabsorbed. The osmolarity of the tubular fluid remains unchanged.

Step 3: In the PCT and descending loop of Henle, water moves into the surrounding interstitial fluid, leaving a small fluid volume of highly concentrated tubular fluid.

Step 4: The ascending limb is impermeable to water and solutes. The tubular cells actively pump sodium and chloride ions out of the tubular fluid. Because only sodium and chloride ions are removed, urea now accounts for a higher proportion of the solutes in the tubular fluid.

Step 5: The final composition and concentration of the tubular fluid will be determined by the events under way in the DCT and the collecting ducts. These segments are impermeable to solutes, but ions may be actively transported into or out of the filtrate under the control of hormones such as aldosterone.

Step 6: The concentration of urine is controlled by variations in the water permeabilities of the DCT and the collecting ducts. These segments are impermeable to water unless exposed to antidiuretic hormone (ADH). In the absence of ADH, no water reabsorption occurs, and the individual produces a large volume of dilute urine. At high concentrations of ADH, the collecting ducts become freely permeable to water, and the individual produces a small volume of highly concentrated urine.

80
Q

How much filtrate produced in glomerular filtration

A

120-180L

81
Q

Hormones causing a reabsorption of electrolytes

A

Angiotensin ll
Aldosterone

82
Q

Hormones causing H2O Absorption

A

ADH (Antidiuretic hormone)
Aldosterone

Both have minor effects

83
Q

What is the active from of angiotensin and how is it converted to this?

A

Angiotensin ll is the active from, converted by Angiotensin converting enzyme (ACE)

84
Q

RAA

A

Renin Angiotensin ALdosterone system

85
Q

Job of Aldosterone

A

Decrease ADH = dilluted urine

86
Q

Affects of angiotensin ll

A

Stimulates release of ADH (reabsorption of H2O)

Stimulates Aldosterone

Reabsorption of solutes and water in PCT

Decreases GFR via vasoconstriction of afferent arteries

87
Q

Atrial Natriuretic Peptide affects

A

) Inhibition of H2O reabsorption in PCT and collecting duct
2) Decreased aldosterone release
3) Decreased ADH release

ALL stimulate secretion of Na into urine and therefore increase output

88
Q

What hormone is primarilly responsible for facultative reabsorption

A

Antidiuretic hormone (Vasopressin)

89
Q

Vasopressin AKA

A

Antidiuretic hormone

90
Q

How does Antidiuretic hormone work

A

Increase in osmolarity (stimulus)

Osmoreceptors in hypothalamus detect change

increase ADH release in blood

Increase permeabiilty of cells in DCT and collecting duct (by increasing aquaporin -2)

Facultative Water reabsorption

osmolarity normal

91
Q

Parathyroid hormone (PTH)

A

Decreased blood calcium

parathyroid releases PTH

Causes:
- DCT reabsorb more Ca into blood
- Inhibits HPO4 reabsorption into PCT = increased phosphate excretion

92
Q

Where does the antidiuretic hormone work?

A

Collecting ducts

93
Q

How does osmolarity change throughout renal tubule

A

Increase decending loop of Henle

Decrease ascending loop of Henle

decrease along rest of the pathway

94
Q

How does ADH affect permeabiliy of collecting ducts

A

When ADH is low, ducts are impermeable to H2O so tubular fluid becomes more dilute

95
Q

Why would urine become conc.?

A

Fluid Intake is low or loss is high

kidneys conserve H2O but still rid excess wastes and ions

ADH critical

96
Q

BUN

A

Blood Urea Nitrogen blood test

  • Increase in blood N means GFR has come down
97
Q

Plasma Creatine blood test

A
  • If blood creatinine level went up dramatical GFR level is not as functional/efficient as it should be
98
Q

Renal Plasma clearance

A

“Volume of blood cleaned of a specific substance per unit of time”

Every substance has different renal plasna clearance

99
Q

Hemodialysis

A

“Artificial blood cleansing by separating elements through a semi permeable membrane”

must happen every 2-4 days in cases of kidney failure

100
Q

CAPD

A

(Continuous ambulatory Peritoneal Dialysis)

  • Peritoneal cavity is viewed as membrane for filtering (filter put in cavity which cleanses blood)
101
Q

Urine transportation from kidneys

A

Collecting ducts - papillary ducts - Minor Calyces - Major calyces - Renal pelvis - Ureters - Urinary Bladder - Urethra

102
Q

Wall of bladder

A

Detrusor muscle

  • Begins to contract when certain level of urine is reached
103
Q
  • Trigone
A

Part of bladder, triangle before the exit to exterior

104
Q
  • Internal Urethral sphincter
A
  • Under parasympathetic control (non voluntary)
105
Q
  • External Urethral Sphincter
A
  • Voluntary control
  • Where is urethra is leaving internal and becoming external
106
Q

Micturition Reflex

A

Bladder contraction

107
Q

Describe process of Micturition Reflex

A

When volume of urine greater than 200-400 mL

Stretch receptors send signals up spine to Micturition center (S2-S3) triggering reflex

PS reflex cause contraction of detrusor muscles and relaxation of internal urethral sphicter

Simultaneously somatic motor neurons in external sphincter are inhibited

108
Q

What occurs to kidneys with agin

A

Shrink, decreased renal blodo flow (50%)
Decline in filtration rate

109
Q

Thirst and age

A

Thirst sense diminishes, not as sensitive (osmoreceptors and hypothalamus)

110
Q
  • Polyuria
A

Excessive urination

111
Q
  • Dysuria
A

Pain during urination (infection, disease, UTI)

112
Q
  • Stress Incontinence
A

Unwanted release of urine due to coughing, laughing, sneezing, excersise

113
Q

UTI

A

Bladder, urethra – link bw bladder infection and kidney infection with decline in cognition

BIO 242 (17 decks)

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