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Adv Pathophysiology > Chapter 33: Disorders of Renal Function > Flashcards

Chapter 33: Disorders of Renal Function Flashcards

1
Q

Hilus

A

medial border of the kidney where the renal artery enter and renal vein and ureters exit

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2
Q

Nephron

A

functional unit of kidney that cannot be regenerated

Two types: cortical (85%) and juxtamedullary (15%)

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3
Q

Juxtamedullary Nephrons

A

largely concerned with urine concentration

area where renin is released

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4
Q

Glomerulus

A

high-pressure capillary filtration system

encased in thin, double-walled capsule called Bowman’s Capsule

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5
Q

Afferent arterioles

A

carry blood containing nitrogenous wastes to glomerulus

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6
Q

Efferent arterioles

A

carry filtered pure blood from glomerulus back to the circulatory system

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7
Q

The PSNS causes bladder ____

A

emptying

contracts the detrusor muscle and relaxes the internal sphincter

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8
Q

The SNS promotes bladder _____

A

filling

relaxes the detrusor muscle and contracts the internal sphincter

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9
Q

The parasympathetic lower motor neruons for the detrusor muscle and external sphincter are located ______

A

in the sacral segments S2 - S4

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10
Q

Pelvic Nerve

A

part of the PSNS

acetylcholine bins to M3 receptor = contraction of detrusor muscle (sensation of needing to urinate)

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11
Q

Pudendal Nerve

A

somatic

acetylcholine binds to nicotinic receptors = causes external sphincters to contract (hold urine)

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12
Q

Hypogastric Nerve

A

SNS
norepinephrine binds to alpha and beta receptors
alpha 1 = contraction of the internal sphincter (not under our control)
beta 3 = relaxation of the detrusor muscle

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13
Q

Detrusor-Sphincter Dyssynergia

A

interruption of pontine control that results in inhibited spinal reflex-controlled contraction of bladder without relaxing the external sphincter

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14
Q

Glomerular Filtration Rate (GFR)

A

how much filtrate is formed every minute
measure of overall function of the kidney
serum creatinine levels reflect the GFR

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15
Q

Renal Threshold

A

plasma level at which a substance appears in the urine

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16
Q

Proximal Tubule

A

responsible for apprx 65% of all reabsorption and secretory processes
almost complete reabsorption of nutritionally important substances

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17
Q

Loop of Henle

A

absorbs more Na+ and Cl- than water
25% of filtered Na, Cl, and K is reabsorbed and allows for excretion of free water
loop diuretics work here

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18
Q

Distal and Collecting Tubules

A

relatively impermeable to water
determines final Na concentration of urine
have intercalated cells and principle cells

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19
Q

Intercalated Cells

A

reabsorbs K+ ions

secretes H+ ions and reabsorbs bicarb

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20
Q

Principle Cells

A

where aldosterone exerts its action

reabsorbs Na and facilitates movement of K+ into the urine

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21
Q

Antidiuretic Hormone (ADH)

A

assists in maintenance of the ECF volume by controlled the permeability of the medullary collecting tubules
released for posterior pituitary in response to increased osmolality

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22
Q

Aquaporin-2 channels

A

move into the cell membrane when ADH binds to vasopressin

results in increased water permeability

23
Q

Renal Function is innervated by ____

A

sympathetic nervous system (SNS)

increased SNS activity will cause vasoconstriction = decrease in renal blood flow

24
Q

______ causes vasoconstriction

A

Angiotensin II
ADH
Endothelin-1

25
_____ causes vasodilation
dopamine nitric oxide prostaglandins
26
Juxtaglomerular Complex
feedback control system that determines how much renin should be released to keep the BP within normal range (to maintain a constant GFR)
27
Aldosterone
reabsorbs Na (water follows) and excretes K+
28
Atrial Natriuretic Peptide (ANP)
secreted by atrial muscle cells inhibits kidneys from reabsorbing Na and inhibits the renal secretion of renin (disrupts the RAAS) works with BNP to decrease preload
29
______ can compete with uric acid excretion
Salicylates | high uric acid seen in gout or renal calculi
30
BUN
measures the kidney excretion of urea (end product of protein metabolism) BUN = 10 - 20
31
BUN is elevated in ______
kidney failure, high-protein diets, excessive muscle breakdown, and reduced GFR (dehydration)
32
Serum Creatinine
measures skeletal muscle metabolism | poor test for elderly who have less muscle mass
33
Drugs need to be _____, ______, and ______ to be excreted.
unbound, ionized, and water-soluble
34
Erythropoietin
kidney is the main site that releases erythropoietin to produce more RBCs in response to tissue hypoxia
35
Active form of _____ increases intestinal calcium absorption.
``` vitamin D (active 1,25 dihydroxycholecalciferol = calcitriol) ```
36
Parathyroid Hormone (PTH)
increases calcium in the blood and excretes phosphate | kidney is the site of PTH action
37
RAAS
Renin -- Angiotensin 1 -- [ACE] = Angiotensin II and stimulates aldosterone = increase blood pressure
38
Hydronephrosis
urine-filled dilation of the renal pelvis and calices d/t obstruction of outflow of urine
39
Calcium Renal Calculus
caused by calcium supplements, calcium-containing antacids, foods high in oxalate, immobilization, hyperparathyroidism
40
Magnesium-ammonium Phosphate Renal Calculi
staghorn stones certain bacteria use urease to convert uric acid to ammonia (making urine more alkaline) alkaline environment = crystalline Mg tx the UTI and make urine more acidic
41
Uric Acid Stones
seen with high purine diet, dehydration, and obesity forms an acidic environment tx w/ Probenecid, hydration, and make urine more alkaline
42
Renal Colic
pain that accompanies stretching of duct or ureter | acute, intermittent (with peristaltic movement) and severe flank pain
43
Noncolicky Pain
caused by stones that distend renal calyx or pelvis | dull, deep ache in flank or back exaggerated by movement and drinking large amounts of water
44
Glomerulonephritis
inflammation of the capillary loops of the glomeruli | can be acute, rapidly progressive, or IgA neuropathy
45
Acute Post-Infectious Glomerulonephritis
antigen-anitbody complexes are formed and trapped in the glomerulus following a strep infection causing dec in GFR and increased porosity
46
Signs/Symptoms of Acute Glomerulonephritis
``` hematuria proteinuria salt and water retention azotemia headache ```
47
Rapidly Progressing Glomerulonephritis
build antibodies against the glomerular basement membrane and obstruct Bowman's space usually associated with autoimmune disorders like lupus (SLE) or Goodpasture's
48
S/Sx of Rapidly Progressing Glomerulonephritis
flu-like symptoms oliguria abdominal or flank pain
49
IgA Neuropathy Glomerulonephritis
Buerger disease deposits of IgA immune complexes deposit in the in glomerulus causing inflammation common cause in Asians 20 - 30 gross hematuria is major sign
50
Nephrotic Syndrome
protein wasting thta occurs with glomerular damage rsulting in large amounts of protein loss difficult to replace with diet
51
S/Sx of Nephrotic Syndrome
edema (due to loss of colloidal oncotic pressure) decreased BP lipiduria, hyperlipidemia, hypoalbuminemia, loss of globulins (antibodies)
52
Hypoalbuminemia puts patients at risk for _____
drug toxicity | drugs bind to albumin
53
Pyelonephritis
inflammation of the kideny pelvis and parenchyma from a bacterial infection (most commonly E. coli)
54
S/Sx of Pyelonephritis
absurpt onset of fever/chills CVA tenderness can have lower UTI symptoms untreated can lead to sepsis and renal failure

Adv Pathophysiology (22 decks)

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