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NA 1 > Chapter 32 Renal anatomy/physiology/pathophys & A managment > Flashcards

Chapter 32 Renal anatomy/physiology/pathophys & A managment Flashcards

1
Q

main function of kidneys

A

excreting end products of metabolism and controlling the concentration of constituents of body fluids

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2
Q

kidney facts

A
  • extend from 12th thoracic vertebrae to the 3rd lumbar vertebrae
  • weighs approx. 125-170 g in men & 115-155g in women
  • 11.25 cm long
  • 5 to 7.5 cm wide
  • 2.5 cm thick
  • d/t hepatic displacement the right kidney’s position is slightly lower than the left
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3
Q

what structures enter or exit the kidney at the hilus

A

renal artery & vein, nerves, lymphatics, and urters

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4
Q

pyramids have a striated appearance d/t

A

presence of the loop of Henle and collecting ducts of the nephron

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5
Q

medulla is divided into how many triangular wedges called __

A

8 to 18 pyramids

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5
Q

the base of the pyramids is directed toward the renal cortex, and the apexes converge toward the

A

renal pelivis

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6
Q

apex of each pyramid is called the

A

papilla

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7
Q

papillary ducts empty into

A

minor calyx –> several minor calyces empty into –> major calyces —> come together to form renal pelvis

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8
Q

functional unit of the kidney

A

nephron

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9
Q

how many nephrons reside in each kidney

A

1,250,000

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10
Q

filtered blood flows through the nephrons, which, in turn, retained filter fluid know as

A

filtrate

through this process, end-products of metabolism are excreted, and metabolically important substances like water and electrolytes are reabsorbed as needed

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11
Q

formation of urine begins with the

A

nephron

begins in the cortex at the glomerulus and ends where the tubule joins the collecting duct at the papilla

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12
Q

glomerulus

A

tuft of capillaries derived from afferent arteriole

blood is transported to the glomerulus via the afferent arteriole

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13
Q

blood that is not filtered in the nephron returns to

A

the systemic circulation via efferent arteriole

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14
Q

the filtrate from the glomeruli enters the __ __ or __ __

A

bowman capsule; capsula glomeruli

then flows through a torturous pathway in the proximal convoluted tubule, to the loop of Henle, the distal convoluted tubule, and finally to the collecting duct

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15
Q

cortex contains:

A

bowman capsule, glomerulus, & proximal and distal tubules

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16
Q

descending loop of Henle comes from

A

the proximal tubule and extends toward the pyramid

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17
Q

kidneys have 2 types of nephrons:

A

cortical nephrons:
- extend only partially into the medulla

juxtamedullary nephrons:
- lie deep in the cortex and extend deep into the medulla
- compromise 1/5 to 1/3 of total nephrons
- important role in the concentration of urine !!

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18
Q

how much blood per minute do the kidneys recieve?

A

1,100 - 1,200 mL of blood

or 20% to 25% of the cardiac output

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19
Q

renal artery divides into several __ arteries and then subdivides again into __ arteries, which run between the pyramids

A

lobar; interlobar

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20
Q

interlobar arteries reach the __ zone, they make well-defined arches over the bases of the __

A

corticomedullary; pyramids

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21
Q

arcuate arteries divide into a series of arteries known as

A

interlobular arteries

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22
Q

where do interlobular arteries terminate?

A

may terminate as an afferent arteriole or as a nutrient artery to the tubule

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23
Q

the afferent arterioles form the

A

high-pressure capillary bed within the bowman capsule that is called the glomerulus

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24
Q

little or no O2 is removed in the __, blood that is not filtered begins its passage to the __ __ via the __ __

A

glomerulus; venous system; efferent arteriole

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24
Q

T/F the efferent arteriole is smaller than the afferent arteriole

A

true

thereby affording some resistance to blood flow

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25
Q

efferent vessel becomes a plexus of capillaries AKA

A

peritubular capillary bed

low-pressure bed

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26
Q

the cardiac output portion that passes through the kidney is called the

A

renal fraction

normal renal fraction of CO is between 20% & 25%

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27
Q

T/F renal medulla has a larger distribution of renal blood flow compared to the renal cortex

A

FALSE

renal cortex receives larger distribution of renal blood flow

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28
Q

blood flow to any organ is determined by

A

the arteriovenous pressure difference across the vascular bed

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29
Q

RPF

A

renal plasma flow

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30
Q

how is renal blood flow regualed

A
  • intrinsic autoregualtion
  • neural regulation: the sympathetic nervous system innervates afferent & efferent arterioles, acute sympathetic stimulation will have associated vasoconstriction & can decrease renal blood flow
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31
Q

if mean systemic pressure falls below 50 mm Hg

A

filtration ceases

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32
Q

T/F direct relationship between RBF & glomeruli filtration

A

true

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33
Q

reduction of glomerular filtration leads to dilation of

A

afferent arteriole

an increase in blood flow to the glomerulus returns glomeruli filtrations to normal

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34
Q

myogenic mechanisms

A

arterial pressure rises, the arterial walls are stretched, the vessel constricts, & blood flow remains normal

  • when arterial pressure decreases the opposite effect occurs
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35
Q

renal physiology:

A

filtration, reabsorption, and tubular secretion

36
Q

filtration

A

results from pressures forcing fluids and solutes through the glomerulus, is the first step in the formation of urine

37
Q

GFR

A

quantity of glomerular filtrate formed each minute in all nephrons

38
Q

filtration fraction

A

quantity of renal plasma flow that becomes filtrate and is defined as GFR divided by the flow to one kidney

39
Q

regulation of GFR

A
  • the pressure inside the glomerular capillaries
  • the pressure in the bowman capsule
  • the colloid osmotic pressure of the plasma proteins
40
Q

pressure of the glomerulus

A

60 mm Hg

is an outward force

41
Q

colloid osmotic pressure

A

28 mm Hg

created by proteins and is an inward force that tends to hold fluid within the glomerulus

42
Q

pressure in the bowman capsule

A

18 mm Hg

opposes filtration

43
Q

filtration pressure is the pressure that forces __ through the __ __ and is equal to the glomeruli pressure minus the sum of the glomerular colloid osmotic pressure and the capsular pressure

A

fluid; glomerular membrane

44
Q

normal filtration pressure is

A

10 mm Hg

45
Q

factors that can alter GFR

A
  • increased renal blood flow
  • dilation of the afferent arteriole
  • increased resistance in the efferent arteriole

all increase GFR

46
Q

what structure regulates GFR

A

juxtaglomerular complex

*distal convoluted tubule lies between the afferent and efferent arterioles *

46
Q

what decreased GFR

A

afferent arteriole constriction and efferent arteriole dilation

47
Q

cells of the distal tubule encountering the arterioles are __, and therefore are referred to as the __ __

A

dense; macula densa

48
Q

smooth muscle cells of both aff & eff arterioles consist of

A

juxtaglomerular cells, which contain renin

49
Q

decreased glomeruli filtration causes

A

overabsorption of Na and Cl in the ascending limb of the loop of Henle resulting in a reduction in the delivery of these ions to the macula densa

49
Q

macula densa function

A

detect small changes in osmolarity

49
Q

the structure is arranged to allow fluid in the distal tubule to alter aff & eff arteriole

A

tone and thus regulate GFR

50
Q

decreases in Na and Cl concentrations causes __ arterioles to dilate, thus increasing ___ & __

A

afferent; RBF; GFR

51
Q

permeability at the glomerulus is __ to __ times greater than most capillaries

A

100 to 150

52
Q

glomeruli capillary containes

A

negatively charged pores

freely permeable to water and small molecules

52
Q

glomerulus is almost impermeable to all

A

plasma proteins but highly permeable to most other dissolved substances

53
Q

conversion of glomeruli filtrate to urine is the result of

A

filtration at the glomerulus, tubular reabsorption, or transport from the tubular lumen to the renal cell, and secretion or transport from the renal cell to the filtrate

54
Q

approx __% if plasma filtrate is reabsorbed in the nephron

A

99%

55
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A
56
Q

once blood has reacherd the peritubullary capillary

A
57
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69
Q

tubular reabsorption permits conservation of substances such as:

A

water, glucose, amino acids, and electrolytes

water and Na are reabsorbed throughout the nephron

70
Q

proximal tubule

A
  • active transport of NA is the primary function
  • reabsorption of water leaves an increased concentration of urea within the tubular lumen
  • hydrogen ions are actively secreted in exchange for Na
71
Q

Loop of Henle

A
  • function is to establish a hyperosmotic state within the medullary area –> vital to conserve salt and water
  • the longer the loop, the greater the concentration gradient –> as the gradient increases, the movement of water is enhanced
72
Q

late distal tubule

A
  • Na under the influence of aldosterone is reabsorbed
  • K is excreted into the lumen in exchange for Na
  • secretes H ions against a concentration gradient –> role in acid/base balance and determines the final degree of urine acidification
  • area is permeable to H2O only in the presence of ADH
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NA 1 (15 decks)

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