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Physiology > Chapter 26 > Flashcards

Chapter 26 Flashcards

1
Q

what are the functions of the kidneys

A

regulation of body fluid osmolality and volumes
regulation of electrolytes balance
regulation of acid base balance
excretion of metabolic products and foreign substances
production and secretion of hormones

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2
Q

what metabolic wastes are excreted

A 
urea (metabolism of amino acids)
creatinine (from muscle creatinine)
uric acid (from nucleic acid)
bilirubin (or other end products of hemoglobin break down)
Metabolites of hormones
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3
Q

what hormones are secreted by the kidneys

A

erythropoietin
vitamin D3
Renin

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4
Q

what is the functional unit of the kidney

A

nephron

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5
Q

describe kidney vasculature

A 
renal artery
arcuate arteries
interlobular arteries
afferent arterioles
glomerular capillaries
efferent arteriole
peritubular capillaries
venous system
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6
Q

from the efferent arteriole, blood can travel where?

A

to peritubular capillaries or descending vasa recta; then to venous system

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7
Q

afferent areteriole does what

A

carries blod to the glomerulus

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8
Q

glomerulus is what

A

tuft of capillaries that filter the plasma entering into Bowman’s capsule (is part of filtration barrier)

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9
Q

efferent arteriole is what

A

carries blood from the lomerulus to peritubular capillaries

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10
Q

peritubular capillaries are what

A

capillary network surrounding the tubular components, supply renal tissue and exchange fluids/substances with tubular components (reabsorption and secretion)

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11
Q

vasa recta

A

specialized peritubular capillaries present in juxtamedullary nephrons

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12
Q

be able to identify on chart

A

x

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13
Q

bowmans capsule does what

A

collects the filtrate from the glomerulus (part of filtration barrier)

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14
Q

proximal tubule

A

mainly uncontrolled reabsorption occurs here; secretion also

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15
Q

loop of henle

A

establishes osmotic gradient in renal medulla; crucial role in ability of kidney to form concentrated or dilute urine

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16
Q

what are the 3 parts of loop of henle

A

descending limb
thin ascending limb
thick ascending limb

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17
Q

distal tubule and collecting duct function in

A

controlled reabsorption of Na and water (ADH dependent); K secretion

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18
Q

cortical nephron

A

renal copuscle located in outer region of cortex
short loop of henle
efferent arteriole forms peritubular capillaries

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19
Q

juxtamedullary nephron

A

renal corpuscle located in region of cortex next to medulle
long loop of henle which extends deeper into medulla
efferent arteriole forms peritubular capillaries and vasa recta

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20
Q

what are the components of a renal corpuscle

A

bowmans capsule

glomerular capillaries

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21
Q

what is the function of the renal corpuscle

A

ultrafiltarion

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22
Q

what are the components of a juxtaglomerular apparatus

A

macula densa cells and juxtaglomerular cells

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23
Q

what is the function of juxtaglomerular apparatus

A

feedback mechanism

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24
Q

what are the major processes in the nephron

A
  1. filtration
  2. reabsorption
  3. secretion
  4. excretion
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25
Q

which process of the nephron is discriminating

A

secretion

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26
Q

which part is nondiscriminating

A

filtration

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27
Q

what substance undergoes filtration only (and therefore is 100% excreted)?

A

creatinine

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28
Q

what substance is filtered and partially reabsorbed

A

Na and Chloride

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29
Q

What substance is completely filtered and completely reabsorbed

A

amino acids and glucose

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30
Q

what substances are secreted

A

organic acids and bases (PAH)

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31
Q

GFR is equal to what?

A

the sum of the filtration rates of all functioning nephrons

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32
Q

monitoring GFR provides what information

A

the severity or progression of renal dysfunction

33
Q

what is the filtration barrier (the renal corpuscle) composed of?

A
  1. fenestrations in glomerular capillary
  2. basement membrane
  3. filtration slits created by the foot processes on the podocytes
34
Q

fenestrations in glomerular capillary

A

freely permeable to water and small solutes but not cells or large proteins
express negatively charged glycoproteins to repel filtration of proteins
size and charge barrier

35
Q

basement membrane

A

acellular, porous matrix of negatively charged extracellular proteins that repel the filtration of proteins
charge barrier

36
Q

filtration slits created by the foot processes on the podocytes make up the ____

A

inner layer of bowman’s capsule

37
Q

filtration slits created by the foot processes on the podocytes

A

podocytes are specialized epithelial cells

also have negatively charged glycoprotein to repel proteins

38
Q

filtrate is essentially free of what

A

proteins and cellular elements (RBC)

39
Q

Why are large amounts of solutes filtered, then reabsorbed?

A

GFR allows kidneys to rapidly remove wastes;

allows all body fluids to be filtered multiple times a day

40
Q

blood flow to the kidneys is ____ of cardiac output

A

about 25%

41
Q

what is the filtration fraction?

A

the proportion of the plasma that enters the glomerulus and is subsequently filtered is ~20%; the remainder continues on through the glomerular capillaries to the efferent arteriole and peritubular capillaries

42
Q

filtration fraction is equal to

A

GFR/RBF

43
Q

What forces favor filtration

A

glomerular hydrostatic pressure

colloid oncotic pressure of bowmans capsule would if it existed

44
Q

what forces oppose filtration

A

glomerular colloid osmotic pressure

bowmans capsule hydrostatic pressure

45
Q

What is the Kf

A

the product of hydraulic conductivity and surface area of glomerular capillaries

46
Q

increase in Kf causes

A

increase in GFR

47
Q

increase in bowmans capsule hydrostatic P causes

A

decrease in GFR (urinary tract obstruction)

48
Q

increase in glomerular capillary coloid osmotic pressure causes

A

decrease in GFR (decrease in RBF, increase in plasma proteins)

49
Q

increase in glomerular capillary hydrostatic P causes

A

increase in GFR (decrease in arterial P, decrease in sympathetic activity, decrease angiotensin II)

50
Q

decrease Kf causes

A

decrease GFR (renal dz, diabetes mellitis, hypertension)

51
Q

what happens to colloid osmotic pressure in glomerular capillaries when there is an increase in the filtration fraction (GFR or RBF)

A

there is an increase in the rate at which plasma colloid osmotic pressure rises along the glomerular capillary (decrease in filtration fraction has opposite effect)

52
Q

glomerular hydrostatic pressure is determined by

A

arterial pressure
afferent arteriolar resistance
efferent arteriolar resistance

53
Q

an increase in resistance of afferent arteriole does what

A

reduces glomerular hydrostatic pressure and decreases GFR

54
Q

dilation of afferent arteriole does what

A

increases GFR

55
Q

Constriction of efferent arterioles does what

A

increases glomerular hydrostatic pressure and as long as the increase in efferent resistance does not reduce renal blood flow too much, GFR increases

56
Q

what would happen if efferent arteriole resistance increased too much

A

a rise in colloid osmotic pressure exceeds increase in glomerular capillary hydrostatic pressure and GFR decreased

57
Q

renal blood flow indirectly determines ____

A

GFR

58
Q

Kidneys regulate blood flow by adjusting what

A

vascular resistance

59
Q

what are the major resistance vessels in the kidney

A

afferent and efferent arteriole and interlobular artery

60
Q

what are the hormones that control renal blood flow

A 
norepinephrine
epinephrine
endothelin
angiotensin II
endothelial-derived nitric oxide
prostaglandins
61
Q

norepinephrine and epinephrine have what effect on gfr

A

decreases gfr

62
Q

endothelin does what to gfr

A

decreases gfr

63
Q

angiotensin II does what to GFR

A

prevents decrease of gfr

64
Q

endothelial derived nitric oxide does what to GFR

A

increases gfr

65
Q

what does prostaglandin do to GFR

A

increases GFR

66
Q

How does angiotensin II prevent decrease in GFR

A

it increases glomerular hydrostatic pressure while reducing renal blood flow; by constricting efferent arterioles, angiotensin II helps prevent decreases in GFR

67
Q

what arterioles are more susceptible to vasoconstriction

A

efferent arterioles are more susceptibel than afferent arterioles

68
Q

what is the function of prostaglandins

A

to dampen vasoconstrictor effects of sympathetic nerves and angiotensin II;

69
Q

what is the net effect of prostaglandins

A

to increase RBF without a change in GFR; prevents severe and potenitally harmful vasoconstriction and renal ischemia

70
Q

prostaglandin synthesis can be stimulated by

A

dehydration
stress
sympathetic nerve outflow
angiotensin II

71
Q

why do you need to be careful when administering NSAIDs

A

NSAIDs block prostaglandin formation and thus block the protective effects they have

72
Q

what are the 2 mechanisms of autoregulation

A

myogenic mechanism

tubuloglomerular feed back mechanism

73
Q

what is the myogenic mechanism

A

ability of blood vessels to resist stretching during increased arterial pressure (by raising vascular resistance because vessels arent stretching, prevents excessive increases in renal blood flow and GFR)

74
Q

tubuloclomerular feed back mechanism

A

macula densa cells sense changes in volume delivery

75
Q

what are the steps in tubuloglomerular feedback

A 
decreae in arterial pressure causes
decrease in glomerular hydrostatic pressure, causes
decrease in GFR, causes
decrese in macula densa Na Cl, causes
increase in renin, causes
increase in angiotensin II, causes
increase in efferent arteriolar resistance,
decrease afferent areteriolar resistence
76
Q

despite autoregulation, RBF and GFR can be changed by

A

hormones and sympathetic nerve activity

77
Q

RBF is a determinant of ___ so both are regulated by same mechanisms

A

GFR

78
Q

What is filtered load

A

total amount filtered into bowmans capsule (mass/time)

79
Q

filtered load is equal to

A

GFR x Plasma concentration

Physiology (4 decks)

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