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BS453: Physiology > Chapter 6: Renal Physiology > Flashcards

Chapter 6: Renal Physiology Flashcards

1
Q

a fluid containing water, ions, and small soluble compounds

A

urine

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2
Q

(1), aka (2), is the elimination of urine

A
  1. urination
  2. micturition
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3
Q

transports urine toward the urinary bladder

A

ureter

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4
Q

temporarily stores urine prior to elimination

A

urinary bladder

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5
Q

conducts urine to exterior; in males, transports semen as well

A

urethra

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6
Q

the kidneys are stabilized by the ff:

A
  1. peritoneum
  2. adjacent organs
  3. supporting connective tissues
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7
Q

the kidney is a () organ -> lies behind the peritoneum

A

retroperitoneal

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8
Q

the left renal vein lies between the (1) and (2); (3) occurs when the left renal vein is compressed -> causes abdominal pain and hematuria

A
  1. abdominal aorta
  2. superior mesenteric artery
  3. nutcracker syndrome
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9
Q

blood in urine

A

hematuria

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10
Q

3 main regions of the kidney

A
  1. cortex - outer region
  2. medulla - central region
  3. papilla - innermost tip
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11
Q

the medulla is divided into:

A

inner and outer medulla

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12
Q

functional unit of the kidney

A

nephron

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13
Q

general segments of a nephron

A
  1. glomerular capillaries and Bowman’s space
  2. proximal tubule
  3. Loop of Henle
  4. distal (convoluted) tubule
  5. connecting tubule
  6. collecting duct
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14
Q

a nephron consists of (1) + (2)

A
  1. glomerulus
  2. renal tubule
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15
Q

2 kinds of nephrons

A
  1. superficial cortical nephron
  2. juxtamedullary nephron
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16
Q

() nephron has a short loop of Henle

A

superficial cortical

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17
Q

() nephron has larger glomeruli and GFR; longer loop of Henle -> makes it essential for concentrating urine

A

juxtamedullary

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18
Q

() is a form of specialized epithelium and maintains homeostasis in the nephron; part of the distal convoluted tubule

A

macula densa

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19
Q

homeostatic functions of the kidney

A

excretory, regulatory, endocrine

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20
Q

the kidney stabilizes blood pH by controlling ()

A

the loss of H+ and HCO3-

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21
Q

hormones secreted by the kidney

A

renin, erythropoietin, calcitriol

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22
Q

% of blood volume occupied by RBC (typically 0.45)

A

hematocrit

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23
Q

interstitial fluid is the () of plasma

A

ultrafiltrate

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24
Q

solutes such as NaCl and NaHCO3 are confined to () -> this is where ingested sodium is added

A

ECF

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25
Q

Substances which are unable to penetrate the membrane between compartments, and therefore they are effective in their contribution to the osmotic pressure gradient.

A

effective osmole

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26
Q

major solutes of ECF and plasma

A

Na+, Glucose, BUN (blood urea nitrogen)

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27
Q

losing more H2O than Na+

A

hyperosmotic volume contraction

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28
Q

losing more Na+ than H2O

A

hyposmotic volume contraction

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29
Q

volume of plasma completely cleared of a substance by the kidneys per unit ime (mL/min)

A

renal clearance

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30
Q

substances with the (highest/lowest) renal clearances may be completely removed on a single pass of blood through the kidneys

A

highest

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31
Q

normally, urine must not contain any:

A

albumin, glucose

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32
Q

substances that have renal clearances above 0 -> filtered and partially absorbed

A

Na+, urea, phosphate, Cl-

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33
Q

clearance of () reflects volume of blood filtered at glomerulus (renal clearance = GFR)

A

inulin

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34
Q

renal clearance of () represents renal plasma flow because it is filtered and secreted

A

para-aminohippuric acid (PAH)

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35
Q

describe substance clearance ratio

A

renal clearance of substance / inulin clearance

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36
Q

renal blood flow is directly proportional to ()

A

pressure gradient bet. renal artery and renal vein

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37
Q

renal blood flow is inversely proportional to ()

A

resistance of renal vasculature (afferent and efferent arterioles)

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38
Q

vasoconstriction of renal afferent arteriole (increases/decreases) GFR

A

decreases

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39
Q

vasoconstriction of renal efferent arteriole (increases/decreases) GFR

A

increases

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40
Q

Both afferent and efferent arterioles are innervated by sympathetic nerve fibers that produce vasoconstriction by activating

A

alpha1 receptors

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41
Q

(afferent/efferent) arterioles express far more alpha1 receptors compared to the other arterioles

A

afferent

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42
Q

due to increased expression of alpha receptors in afferent arterioles, increased sympathetic activity (increases/decreases) both RBF and GFR

A

decreases

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43
Q

potent vasoconstrictor of both afferent and efferent arterioles; however the latter are more sensitive

A

angiotensin II

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44
Q

GFR is increased by (high/low) levels of angiotensin II; conversely, GFR is decreased by (high/low) levels

A
  1. low
  2. high
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45
Q

() is secreted from the atrium in response to atrial wall distension -> dilation of afferent art., constriction of efferent art. -> net effect: increase GFR

A

atrial natriuretic peptide (ANP)

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46
Q

() are locally produced in the kidney; causes vasodilation of both afferent and efferent art. -> maintained RBF in case of hemorrhage to protect kidney

A

prostaglandins

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47
Q

low levels of dopamine (dilate/constrict) renal arterioles -> dopamine can be used in the treatment of hemorrhage to protect vital organs

A

dilate

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48
Q

renal arterial pressure can vary from () mmHg, yet RBF will be kept constant

A

80 - 200

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49
Q

as renal arterial pressure increases/decreases, renal resistance must ()

A

increase or decrease proportionately

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50
Q

the juxtaglomerular complex/junction is composed of ()

A

macula densa and juxtaglomerular (JG) cells

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51
Q

fenestrated endothelium has ()

A

pores

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52
Q

in the glomerular filtration barrier, (1) are present on the endothelium, basement membrane, and the epithelium – a barrier not for (2), but for (3)

A
  1. negatively charged glycoproteins
  2. small molecules such as ions
  3. larger molecules such as plasma proteins
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53
Q

GFR is the product of (1) and the (2)

A
  1. Kf (filtration coefficient)
  2. net ultrafiltration pressure.
54
Q

The net ultrafiltration pressure, the driving force, is the algebraic sum of the three Starling pressures, except the ()

A

oncotic pressure in Bowman’s space

55
Q

For glomerular capillaries, the
net ultrafiltration pressure always favors (1), so the direction of fluid movement is always (2)

A
  1. filtration
  2. out of the capillaries.
56
Q

assumptions used to simplify calculation of effective renal plasma flow

A
  1. [PAH] in RV = 0
  2. [PAH] in RA = [PAH] in any peripheral vein
57
Q

GFR is measured by the clearance of a ()

A

glomerular marker

58
Q

3 characteristics of a glomerular marker

A
  1. freely filtered across glomerular capillaries
  2. can’t be reabsorbed or secreted by renal tubule
  3. can’t alter GFR when infused
59
Q

endogenous marker for GFR

A

creatinine

60
Q

in chronic heart failure, GFR is decreased due to ()

A

reduced renal perfusion

61
Q

BUN and creatinine is (increased/decreased) in blood in chronic heart failure

A

increased

62
Q

increased BUN/creatinine ratio

A

prerenal azotemia

63
Q

in chronic renal failure, GFR is decreased due to ()

A

renal dysfunction

64
Q

in chronic renal failure, both BUN and creatinine are (increased/decreased) in blood

A

increased

65
Q

unlike in chronic heart failure, (urea/creatinine) reabsorption is decreased in chronic renal failure

A

urea

66
Q

The amount of a substance filtered into Bowman’s space per unit time is called the ().

A

filtered load

67
Q

The fluid in Bowman’s space and in the lumen of the nephron is called ()

A

tubular fluid or luminal fluid.

68
Q

in reabsorption, water and many solutes are reabsorbed from the glomerular filtrate into the ()

A

peritubular capillary blood

69
Q

(): the sum of filtration, reabsorption, and secretion

A

excretion

70
Q

3 transporters found in proximal tubule cells that are involved in glucose reabsorption

A
  1. Na+ - K+ ATPase (primary active transport)
  2. Na+-glucose transporters (SGLT) (secondary active transport)
  3. glucose transporters GLUT1, GLUT2 (facilitated diffusion)
71
Q

(): reabsorption approaching saturation, but not fully saturated

A

Splay

72
Q

the plasma concentration at which glucose is first excreted in the urine is called the (1), but this occurs lower at a plasma concentration than does (2)

A
  1. threshold
  2. tubular transport maximum, Tm (SGLT is completely saturated)
73
Q

excretion or spilling of glucose in the urine

A

glucosuria

74
Q

common causes of glucosuria

A
  1. uncontrolled diabetes mellitus
  2. pregnancy (gestational diabetes)
  3. SGLT abnormalities
75
Q

SGLT abnormalities result in (increased/decreased) Tm, thus glucose is excreted in the urine at ()

A
  1. decreased
  2. lower than normal plasma concentrations
76
Q

the transporters for PAH and other organic acids are located in the () of proximal tubule cells

A

peritubular membranes

77
Q

weak acids and bases are (1) and (2)

A
  1. filtered in the glomerulus
  2. secreted in the proximal tubule
78
Q

relative amounts of charged and uncharged species depend on ()

A

urine pH

79
Q

only the (charged/uncharged) species can diffuse across cells

A

uncharged

80
Q

() uring treats aspirin overdose

A

alkalinizing

81
Q

in all cases, water always follows () when membrane is permeable to water

A

Na+

82
Q

Na+ - phosphate cotransport is inhibited by ()

A

parathyroid hormone (PTH)

83
Q

Na+ - H+ exchange is stimulated by ()

A

angiotensin II

84
Q

generation of () urine accompanies release of angiotensin II

A

acidic

85
Q

() is a diuretic that inhibits carbonic anhydrase -> leads to urine alkalinization

A

acetazolamide

86
Q

() cells are responsible for making acidic urine

A

early proximal convoluted tubule

87
Q

major cellular component of cells in the late proximal convoluted tubule is ()

A

Cl- - formate anion exchanger

88
Q

the [TF/P] compares the concentration of a substance in (1) with its concentration in (2)

A
  1. tubular fluid (TF)
  2. systemic plasma (P)
89
Q

bicarbonate level (increases/decreases) along the length of the proximal tubule; (2) concentration remain the same because they are absorbed isosmotically

A
  1. decreases
  2. Na+ and Cl-
90
Q

() is the major regulatory mechanism of the proximal tubule, describing the balance between filtration and reabsorption

A

glomerulotubular (GT) balance

91
Q

GT balance ensures that ()

A

constant fraction of filtered load is reabsorbed by proximal tubule

92
Q

changes in ECF volume cause changes in () in the peritubular capillary blood -> affects reabsorption in proximal tubule

A

Starling forces

93
Q

() cause increased Na+ and water excretion owing to the presence of a poorly absorbed substance in the lumen of the proximal tubule

A

osmotic diuretics

94
Q

example of osmotic diuretic: filtered by not absorbed

A

mannitol

95
Q

example of osmotic diuretic: filtered load exceeds reabsorption capacity

A

untreated diabetes mellitus

96
Q

isosmotic requirement in proximal tubule is due to ()

A

very permeable membrane

97
Q

in the loop of Henle, the () is impermeable to water -> called the diluting segment

A

thick ascending limb

98
Q

examples of loop diuretics

A

furosemide, bumetanide, ethacrynic acid

99
Q

() increases Na+ - K+ - 2Cl- cotransporter activity -> helps generate osmolarity gradient that is required for reabsorption of water in loop of Henle

A

antidiuretic hormone (ADH)

100
Q

other terms for ADH

A

vasopressin

101
Q

a terminal nephron consists of ()

A

distal tubule + collecting duct

102
Q

the terminal nephron is impermeable to (1) -> called (2)

A
  1. water
  2. cortical diluting segment
103
Q

class of diuretics that inhibits Na+ - Cl- cotransporter, activated basolateral Na+/Ca2+ exchanger and apical Ca2+ channel leading to Ca2+ reabsorption

A

thiazide

104
Q

() cells are responsible for reabsorption of Na+, Cl-, and Ca2+

A

early distal tubule

105
Q

in the cells of the early distal tubule, Ca2+ enter via (1), which is reciprocally regulated by (2)

A

1, calbindin
2. PTH and calcitonin

106
Q

types of cells in the late distal tubule

A

principal cells, intercalated cells, distal convoluted tubule cells

107
Q

principal and intercalated cells are the only cells found in the ff parts of the collecting duct

A
  1. cortical collecting duct (CCD)
  2. outer medullary collecting duct (OMCD)
  3. initial inner medullary collecting duct (iIMCD)
108
Q

the types of cells present in the terminal inner medullary collecting duct (tIMCD) are ()

A

inner medullary collecting duct (IMCD) cells

109
Q

aquaporin (1/2) is not controlled by ADH -> always present to reabsorb water

A

aquaporin 1 (AQP1)

110
Q

the late distal tubule and collecting duct are permeable to water via (), which is controlled by ADH -> more ADH in blood, more H2O reabsorption

A

aquaporin 2 (AQP2)

111
Q

reabsorption of Na+ in the late distal tubule and collecting duct is ()-dependent

A

aldosterone

112
Q

Na+ reabsorption in the early distal tubule (DCT cells) is ()-dependent

A

load

113
Q

in the late distal tubule and collecting duct, principal cells secrete

A

K+

114
Q

examples of K+-sparing diuretics

A

spironolactone, amiloride, triamterene

115
Q

K+-sparing diuretic: blocks aldosterone receptor

A

spironolactone

116
Q

K+-sparing diuretic: blocks epithelial Na+ channel (ENaC)

A

amiloride, triamterene

117
Q

() causes natriuresis by inhibiting ENaC and Na+-K+ ATPase; secreted by the heart

A

atrial natriuretic peptide (ANP)

118
Q

in the late distal tubule and collecting duct, intercalated cells reabsorb (1) and secrete (2)

A
  1. K+
  2. H+
119
Q

in the late distal tubule and collecting duct, aldosterone stimulates (1) to increase H+ secretion

A

H+ ATPase

120
Q

only (alpha/beta) intercalated cells have primary active transporters at the apical membrane

A

alpha

121
Q

when blood is basic, intercalated cells switch () type

A

from alpha to beta

122
Q

beta intercalated cells are responsible for ()

A

HCO3- disposal

123
Q

thirst is triggered by () of plasma

A

increase osmolarity

124
Q

only the terminal inner medullary collecting cells (tIMCD) have ()

A

urea transporter 1 (UT1)

125
Q

() is driving force of water reabsorption

A

osmolarity gradient

126
Q

benefits of countercurrent multiplication

A
  1. allows efficient reabsorption of solutes and water while leaving organic waste in tubular fluid
  2. establishes concentration gradient that permits reabsorption of water from tubular fluid (regulated by ADH)
127
Q

capillary that travels along loop of Henle; participates in countercurrent exchange

A

vasa recta

128
Q

() is a purely passive process that helps maintain the osmotic gradient generated by countercurrent multiplication

A

countercurrent exchange

129
Q

() of vasa recta allows the osmolarity of blood and interstitium to always be the same

A

free permeability

130
Q

main effects of ADH is to stimulate:

A
  1. Na+-K+-2Cl- cotransporter (thick ascending limb)
  2. AQP2 (principal cells of late distal tubule and collecting duct)
  3. UT1 at tIMCD cells

BS453: Physiology (6 decks)

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