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PHYS 423 > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

job of the kidney

A

filtration, reabsorption, and secretion

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2
Q

what would kill you first if there were no kidneys?

A

the lack of potassium secretion causing an increase in ECF which would cause convulsions and make the gradients less steep so AP are easier to fire

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3
Q

renal blood supply is what percentage of cardiac output

A

20-22%

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4
Q

cortex of the kidney is seen where?

A

outside

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5
Q

medulla of the kidney is located where?

A

inside

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6
Q

what is the functional unit of the kidney

A

nephron

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7
Q

two types of the nephron

A

cortical (80%) and juxtamedullary (20%)

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8
Q

cortical region of the nephron loop of henle

A

hairpin loop

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9
Q

juxtamedullary region of the nephron contains

A

the vasa recta

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10
Q

where is the juxtamedullary region found

A

deep in the medulla

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11
Q

what does the juxtamedullary region do

A

establish concentration gradient and affects concentrations of urine

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12
Q

what would happen if you did not have a juxtamedullary region?

A

you would pee to death

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13
Q

vascular component of the nephron

A
  • afferent arteriole
  • glomerulus
  • efferent arteriole
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14
Q

what is the glomerulus

A

group of capillaries that filters into bowman’s capsule

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15
Q

efferent arteriole

A

unfiltered blood leaving the glomerulus

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16
Q

parts of the efferent arteriole

A

peritubular capillaries and vasa recta

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17
Q

peritubular capillaries

A

supply renal tissues with blood and exchanges between tubular system and blood during conversion of filtrate to urine

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18
Q

bowman’s capsule

A

collects glomerular filtrate

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19
Q

proximal tubule

A

uncontrolled reabsorption and secretion of selected substances occur here

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20
Q

loop of henle of nephron

A

establish osmotic gradient in the renal medulla that is important in the kidney’s ability to produce urine of varying concentration

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21
Q

distal tubule and collecting duct (distal nephron)

A

variable, controlled reabsorption of sodium and water and secretion of potassium and hydrogen occur here; fluid leaving the collecting duct is urine which enters the renal pelvis

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22
Q

juxtaglomerular apparatus

A

produces substances involved in the control of kidney function

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23
Q

descending loop of henle

A

thin portion- squamous epithelium

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24
Q

ascending loop of henle

A

thick portion- cuboidal epithelium

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25
Q

what is the only controlled portion of the nephron

A

distal tubule and collecting duct

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26
Q

t/f: juxtamedullary nephron is long-looped and is important for establishing the osmotic gradient

A

true

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27
Q

what is the most abundant type of nephron

A

cortical nephron

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28
Q

glomerular filtration anatomy

A
  • huge fenestrated endothelium
  • basement membrane
  • podocytes with filtration slits
  • 100x more permeable
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29
Q

t/f: capillaries don’t have pores

A

false

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30
Q

what are the filtration slits in podocytes similar to (IRL example)

A

interlocking fingers and still have gaps for things to squeeze between

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31
Q

where is filtrate found

A

in the nephron

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32
Q

what is secretion

A

actively putting something into the nephron (skip filtration via glomerulus)

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33
Q

t/f: plasma proteins and RBC are filtered by the glomerular capillary

A

false

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34
Q

what substances can fit in the pores between the glomerular capillary and bowman’s capsule

A

glucose and ions

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35
Q

albumin

A

smallest plasma protein that can fit through pores but is repelled by the negatively charged glycoproteins

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36
Q

lupus

A

protein in urine

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37
Q

glomerular capillary blood pressure

A

55 mmHg

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38
Q

how much of plasma that enters the glomerulus is filtered

A

20%

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39
Q

Glomerular filtration rate

A

125 mL/min

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40
Q

how often do the kidneys filer plasma volume?

A

65 times per day

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41
Q

blood capillary blood pressure

A

37 mmHg

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42
Q

hypertensive affect on glomerular filtration

A

increase hydrostatic pressure which causes you to filter more than you should

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43
Q

inward pressures of glomerular filtration

A

plasma colloid osmotic pressure and Bowman’s capsule hydrostatic pressure

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44
Q

outward pressure of glomerular filtration

A

glomerular capillary blood pressure

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45
Q

net filtration

A

outward pressures - inward pressures

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46
Q

how much urine is produced per minute

A

1 mL/min

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47
Q

GFR equation

A

Kf * NFP

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48
Q

importance of glomerulus

A

filtration and reabsorption

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49
Q

what happens to GFR when MAP increases and why

A

increases; increased MAP causing increased glomerular capillary blood pressure (outward) which increase net filtration pressure(NFP) which increases GFR

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50
Q

what does vasoconstriction do to GFR and why

A

decrease GFR; less blood flow to glomerulus

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51
Q

what does vasodilation do to GFR

A

increase GFR; more blood flow to glomerulus

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52
Q

autoregulation mechanisms of GFR

A

myogenic mechanism and tubuloglomerular feedback mechanism

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53
Q

tubuloglomerular feedback mechanism

A

macula densa

  • release vasodilator if flow is too slow
  • release vasoconstrictor if flow is too fast
54
Q

what is adenosine?

A

vasoconstrictor

55
Q

t/f: adenosine is potentially potent

A

true

56
Q

sympathetic stimulation of kidneys affects GFR how

A

constricts arterioles

57
Q

mesangial cells

A

hold glomerular capillary in position and control the size of the filtration pore

58
Q

transepithelial transport

A

places substances back into the peritubular capillaries

59
Q

barriers of tubular reabsorption

A
  • membrane of tubular cells
  • cytosol of tubular cell
  • membrane at lateral space
  • interstitial fluid
  • capillary wall
60
Q

active tubular reabsorption

A

at least one step requires energy - goes against electrochemical gradient

61
Q

passive tubular reabsorption

A

no steps require energy - with/down concentration gradient

62
Q

t/f: majority of the filtrate is reabsorbed per day

A

true

63
Q

how much glucose is reabsorbed (%)

A

100%

64
Q

how much water is reabsorbed? (%)

A

99%- almost all

65
Q

how much sodium is reabsorbed? (%)

A

99.5%- not all of the salt from the diet is reabsorbed

66
Q

how much energy does sodium require?

A

80% of all energy used by kidneys

67
Q

how much sodium is reabsorbed in the proximal tubule?

A

67%

68
Q

the proximal tubule plays a pivotal role in reabsorbing what substances?

A

glucose, amino acids, water, chloride, and urea

69
Q

how much sodium is reabsorbed in the loop of henle?

A

25%

70
Q

what does the sodium reabsorption in the loop of henle create?

A

osmotic gradient

71
Q

what does the loop of henle affect?

A

chloride reabsorption, water conservation, urine variations in concentration and volume

72
Q

how much sodium is reabsorbed in the distal and collecting tubules?

A

8%

73
Q

what does the distal and collecting ducts affect?

A

regulate ECF volume linked to potassium secretion

74
Q

how is the distal nephron controlled?

A

hormones

75
Q

How is sodium brought from the lumen into the tubular cell?

A

with glucose through the SGLT2 carrier

76
Q

t/f: sodium potassium pumps are required to exchange sodium and potassium from the ISF and tubular cell

A

true

77
Q

hormonal influences on distal nephron

A
  • RAAS
  • decrease in salt and BP cause granular cells to release renin
  • renin converts angiotensin to angiotensin 1
  • ACE converts angiotensin 1 to angiotensin 2 (LUNGS)
78
Q

What does the RAAS system respond to

A

decrease in NaCl, ECF volume, and arterial BP

79
Q

macula densa

A

contains sensor for sodium to release renin when too much sodium is passing by

80
Q

how does arterial BP increase renin secretion?

A

baroreceptors activate sympathetic activity which stimulates the granular cells to secrete more renin (juxtamedullary apparatus cells)

81
Q

what does an increase in arterial BP do to plasma volume

A

increase

82
Q

how is plasma volume restored

A

osmotically inducing water retention

83
Q

where is ACE found

A

high in the pulmonary capillaries- high in lungs because 100% of cardiac output goes through the lungs and is the easiest way to disperse

84
Q

treatments for hypertension and congestive heart failure

A

ACE inhibitors and aldosterone receptor blockers

85
Q

Angiotensin 2

A

Arteriolar constriction

  • stimulate thirst
  • release ADH
  • release aldosterone from adrenal cortex
86
Q

aldosterone

A

increase sodium reabsorption at distal tubules via PRINCIPAL CELLS
- increase sodium leaky channels in luminal membrane and increase Na+K+ pumps in the basolateral membranes

87
Q

what happens when sodium load, ECF and plasma volume, and arterial pressure are above normal?

A
  • renin is inhibited
  • no aldosterone
  • sodium excreted in urine (large loss of sodium after multiple days)
88
Q

natriuretic peptide (ANP)

A

inhibits sodium reabsorption (excrete more sodium)

inhibits RAAS

89
Q

when is ANP released?

A

when heart muscle cells are mechanically stretched by an expansion of circulating plasma volume when ECF volume increases which is caused by sodium and water retention that increases BP

90
Q

inhibiting RAAS does what to sodium reabsorption

A

inhibit sodium reabsorption and increase excretion (along with H2O)

91
Q

t/f: inhibiting RAAS will inhibit actions of vasopressin (ADH)

A

true

92
Q

what is the problem with using natriuretic peptide? how is the problem solved?

A

more sodium is passing the macula densa (more sodium being excreted) along with water which decreases blood volume
- ACE inhibitor used to combat this

93
Q

transport maximum of glucose

A

375 mg/min

94
Q

t/f: kidneys don’t regulate chloride

A

true

95
Q

GLUT transporter

A

facilitate glucose and amino acids across basolateral membrane

96
Q

t/f: phosphate and calcium reabsorption can be regulated by parathyroid hormones

A

true

97
Q

what does ADH do for water reabsorption?

A

increase aquaporin channels (AQP2) to increase water reabsorption

98
Q

how much urea is excreted? how much is reabsorbed?

A

50%, 50%

99
Q

t/f: tubular secretion is controlled by systemic pH

A

true

100
Q

What does aldosterone do to K+ secretion?

A

reabsorb more K+ than we secrete

101
Q

what do secretion of drugs, metabolites, and pollutants do to the excretion of them?

A

increase elimination

102
Q

what ions are secreted?

A

hydrogen and potassium

103
Q

aldosterone up-regulate mechanisms

A
  1. add more Na+K+ pump
  2. add more K+ carriers (K+ back into lumen)
  3. add more sodium channels (Na+ into distal nephron)
104
Q

short term regulation of secretion

A

insulin- push K+ into the cell, keep ECF levels regulated

105
Q

t/f: reabsorption is controlled in the proximal tubule

A

false

106
Q

plasma clearance

A

volume of plasma cleared of specific substance per minute

107
Q

t/f: plasma clearance depends on the concentrations that are cleared out

A

false

108
Q

plasma clearance formula

A

PC = (Xurine * UFR)/ (Xplasma)

109
Q

What does it mean when PC= GFR?

A

Excretion ONLY– no reabsorption or secretion

- measures arteriolar and glomerular health

110
Q

two substances that have a PC=GFR

A

inulin and creatine

111
Q

What does it mean when PC < GFR?

A

REABSORPTION– not secreted

112
Q

substance that has a lower PC than GFR

A

urea

113
Q

What does it mean when PC > GFR?

A

secreted but not reabsorbed

- determine health of nephron

114
Q

substances that have PC greater than GFR?

A

Hydrogen and PAH

115
Q

isotonic urine: _______ BP

A

normal

116
Q

hypotonic urine: _______ BP/BV

A

decrease (hypertensive)

117
Q

hypertonic urine: _______ BP/BV

A

increase in response to hypotension

118
Q

t/f: hypotonic urine releases more water

A

false

119
Q

t/f: hypertonic urine releases more water

A

true

120
Q

Descending loop of henle: iso, hypo, or hyper tonic

A

hypertonic

121
Q

Ascending loop of henle: iso, hypo, or hyper tonic

A

hypotonic

122
Q

ISF: iso, hypo, or hyper tonic

A

isotonic

123
Q

ADH

A

produced by hypothalamus
acts at basolateral membrane in distal nephron
- opens AQP2
- concentrates the urine

124
Q

What kind of urine is produced without ADH

A

hypotonic

125
Q

What kind of urine is produced with low levels of ADH

A

isotonic

126
Q

t/f: ADH os water soluble

A

true

127
Q

how do arterioles balance osmolarity

A

pick up salt and lose water at first, then before leaving to the veins, pick up water and lose salt

128
Q

micturition

A

spinal reflex

129
Q

Parasympathetic activity of micturition

A

initiates contraction of smooth muscle- detrussor muscle

initiates relaxation of smooth muscke- Internal urethral sphincter

130
Q

Somatic control of micturition

A

relaxation of urethral sphincter (skeletal muscle)

131
Q

t/f: somatic control of micturition can override the parasympathetic contraction by the detrussor muscle

A

true

132
Q

t/f: in micturition, parasympathetic will always win

A

true

PHYS 423 (3 decks)

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