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Block 2 Week 5 > Concentration and Dilution of Urine > Flashcards

Concentration and Dilution of Urine Flashcards

1
Q

(blank) is a mechanism that expends energy to create a concentration gradient. Useful in creating hypertonic urine.

A

a countercurrent multiplier system

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2
Q

The countercurrent flow within the descending and ascending limb thus increases, ormultiplies the (blank) between tubular fluid andinterstitial space

A

osmotic gradient

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3
Q

Where can water leave?

A

descending limb

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4
Q

Where can salt leave?

A

ascending limb

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5
Q

normal urine osmolarity is (blank)

A

hypertonic

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6
Q

What is the normal process of creating hypertonic urine?

A

create isotonic, create hypotonic-> finish with hypertonic

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7
Q

(blank) and (blank) are critical for formation of a hypertonic urine.

A

ADH and interstitial osmotic gradint

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8
Q

The more your interstitial osmotic gradient the more (blank) your urine.

A

hypertonic

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9
Q

What allows for water to leave in the collecting duct?

A

ADH (w/ aquaporins) : )

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10
Q

An interstitial gradient is present from cortex to (blank) region throughout the kidney

A

papillary region

osmotic gradient is lowest (300) at cortex and highest (1200) at papillary region

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11
Q

What is the corticopapillary osmotic gradient primarily composed of?

A

NaCl and Urea

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12
Q

The corticopapillary osmotic gradient is established by (blank) and urea recycling and is maintained by (blank) in the vasa recta/

A

countercurrent multiplication

countercurrent exchange

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13
Q

What does counter current multiplication in the loop of henle depend on?

A

NaCl reabsorption in the thick ascending limb and countercurrent flow in the descending and ascending limbs of the loop of henle

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14
Q

Countercurrent multiplication is augemented by (blank) which stimulates NaCl reabsorption in thick ascending limb.

A

ADH

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15
Q

The presence of (blank) increases the size of the corticopapillary osmotic gradient.

A

ADH

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16
Q

(blank) from the inner medullary collecting ducts into the medullary interstitial fluid also is augmented by ADH

A

Urea recycling

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17
Q

Vasa Recta are the capillaries that supply the loop of henle. They maintain the corticopapillary gradient by serving as (blank).

A

OSMOTIC EXCHANGERS

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18
Q

(blank) equilibrates osmotically with the interstitial fluid of the medulla and papilla.

A

vasa recta

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19
Q

What are the phases and what is happening during counter current multiplication (i.e. active creation of interstitial gradient)?

A

start at equilibrium-> pump ions out of ascending limb of loop of henle (water remains stuck in loop)->increased interstitial fluid osmolarity so water leaves during descending limb->increased osmolality of filtrate entering the ascending limb

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20
Q

As water and solutes are reabsorbed, the loop first concentrates the filtrate and then (blank) it.

A

dilutes

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21
Q

Which nephrons create the gradient?

A

juxtamedullary

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22
Q

Do you get passive secretion of salt in the descending limb of the loop of henle?

A

yes PASSIVE not active

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23
Q

(blank) are specialized peritubular capillaries that remove excess salt and water from the medullary/papillary region.

A

vasa recta

24
Q

Site of reabsorption, results in doubling of flow exiting from it.It provides oxygen and nutrients too!

A

vasa recta

25
Q

What is the purpose of the vasa recta?

A

to prevent salt from being washed away

26
Q

Is this true? Plasma flow exiting from the vasa recta is approximately twice that entering the vasa recta?

A

true!!

27
Q

Is this true? Plasma flow exiting from the glomerular capillaires (toward peritubular capillaries) is app. 20% less than that entering the glomerular capillaries

A

True!

28
Q

Is this true?

Approximately half of the renal blood flow goes to th renal cortex and half to the medullary/papillary region?

A

FALSE!!! 85% to cortex

29
Q

Is this true?

The mean hydrostatic pressure of peritubular capillaries is less than that of glomerular capillaries?

A

True

30
Q

Is this true?

The filtration coefficient (Kf) of glomerular capillaries is greater than for skeletal muscle capillaries?

A

True

31
Q

Where does reabsorption of urea occur?

A

inner medullary collecting duct via ADH

32
Q

Urea is reabsorbed in the innermedullary collectin ducts and then gets put back into the (blank) or (blank)

A

vasa recta or proximal tubule, or loop of henle

33
Q

What percent of urea is actually excreted?

A

40% of filtered load

34
Q

What is the diluting segment of the nephron?

A

thick ascending limb of loop of henle

35
Q

In the late distal tubule, ADH increases the H20 permeability of the (Blank) .

A

principal cells

36
Q

What are the two main functions of ADH?

A

1) Increasing the water permeability of distal tubule and collecting duct cells in the kidney
2) Increasing permeability of the inner medullary portion of the collecting duct to urea

37
Q

The main stimulus for secretion of vasopressin (ADH) is increased (blank)

A

osmolality of plasma

38
Q

(blank) Secretes in response to increases in plasma osmotic pressure is mediated by osmoreceptors in the hypothalamus.

A

ADH

39
Q

ADH make cAMP which create cascades to induce gene transcription of (blank) to collecting duct.

A

AQP

40
Q

Where is ADH located?

A

On membrane of cell

41
Q

What are 4 conditions that lead to changes in the ADH pathway?

A 
Diabetes insipidous nephrogenic
diabetes insipidous neurogenic
SIADH (syndrome of inappropriate ADH release-too much ADH)
Psychogenic polydipsia (drinking too much water)
42
Q

What is diabetes inspidious nephrogenic?

A

lack of kidney response to ADH

43
Q

What is diabetes insipidous neurogenic?

A

lack of synthesis

44
Q

What is the definition of diuresis?

A

urine flow greater than 1 ml/min

45
Q

What is antidiuresis?

A

urine flow rate is less than .5 ml/min (hypertonic urine)

46
Q

what are the four main kinds of diuresis?

A

diuresis, osmotic diuresis, water diuresis, antidiuresis

47
Q

With ADH does your osmolarity of your urine increase or decrease?

A

increases!! cuz you lose so much water and concentrate your urine

48
Q

What are the ions that leave the collecting duct w/ ADH?

A

H20, Salt and Urea

49
Q

What ions leave the collecting duct without ADH?

A

salt

50
Q

H20 is reabsorbed from the distal tubule until the osmolarity of distal tubular fluid equals that of the surrounding interstitial fluid in the renal cortex at what number?

A

300

51
Q

When you have low ADH (water diuresis) what will happen to urine flow rate, urine osmolality, urine concentration of urea and clearance rate of urea?

A

Your flow rate will increase
Your urine osmolality will decrease
your urine conc. of urea will decrease
Your clearance rate of urea will increase

52
Q

When you have high ADH (antidiuresis) what will happen to urine flow rate, urine osmolality, urine concentration of urea and clearance rate of urea?

A

Urine flow rate will decrease
Urine osmolality will increase
urine concentration of urea will increase
clearance of urea will decrease

53
Q

T/F?

urea contributes more to the gradient during antidiuresis than during water diuresis?

A

true

54
Q

T/F the osmotic gradient in the medullary/papillary interstitium is formed by passive transport of salt and water?

A

false

55
Q

With ADH, where do you see the greatest osmolarities within the nephron?

A

in the loop of henle and the closer you get to the end of the collecting duct towards urine

56
Q

What is the most abundant component of urine?

A

Urea

57
Q

WHy is urine yellow?

A

bilirubin breakdown product urobilin

Block 2 Week 5 (7 decks)

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