CVPR Week 7: Hemodynamics Flashcards

1
Q

Objectives

A
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2
Q

Question 1

A

D. Angiotensin

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3
Q

Question 2

A

A. β adrenergic receptors

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4
Q

Question 3

A

I think it is B but not 100%

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5
Q

Identify

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6
Q

Identify

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7
Q

Identify

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8
Q

Determinants of renal blood flow

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9
Q

Renal blood flow % of CO

A

20%

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10
Q

Pressure in renal arteries

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11
Q

Renal capillaries properties

A
  • Highly fenestrated capillaries have a high degree of permeability
  • Two distinctly different capillary beds arranged in series
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12
Q

Distinct capillary beds of the renal system

A
  • Glomerular capillaries
  • Peritubular capillaries
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13
Q

Glomerular capillaries function

A

Filtration

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14
Q

PEritubular capillaries function

A

Reabsorption

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15
Q

Juxtoglomerular cells location

A
  • Afferent arteriole
  • abut closely to the distal tubule
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16
Q

Identify

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17
Q

Juxtaglomerular cells structure

A

Modified smooth muscle cells

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18
Q

Juxtaglomerular cells function

A

Produce and secrete renin

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19
Q

Identify

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20
Q

Identify

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21
Q

Vasa Recta Capillaries function

A
  • Supply medullary blood flow
  • maintain concentration gradient in the renal medulla
  • Delivers nutrients
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22
Q

Vasa Recta Capillaries location

A

Form long loops paralleling loops of Henle

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23
Q

Identify

A

Vasa Recta Capillaries

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24
Q

Vasa Recta Capillaries % of renal blood flow

A

10% of renal blood flow

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25
Control mechanisms of renal blood flow 2 listed
* Intrarenal (Autoregulation) * Extrarenal (extrinsic regulation)
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Intrarenal regulation AKA
Autoregulation
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Autoregulation of renal blood flow AKA
Intrarenal
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Autoregulation of renal blood flow mechanisms and effects
* Myogenic tone * Tubuloglomerular feedback Maintain constant RBF & GFR almost constant when arterial pressure changes
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Extrinsic regulation of renal blood flow AKA
Extrarenal
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Extrarenal regulation of renal blood flow AKA
Extrinsic regulation
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Extrinsic regulation of renal blood flow mediators & effects
* Sympathetic nerves * Renin-angiotensin system * Other hormone regulators Regulate renal function to maintain whole body fluid homeostasis
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Renal autoregulation
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Myogenic tone
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Myogenic tone is affected by?
* Myogenic tone is independent of extrarenal forces * Stretch stimulates VSMC contraction
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36
Identify
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Identify
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Identify
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Role of the sympathetic nerves in renal extrinsic regulation
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Vascular smooth muscle cells sympathetic receptors for renal vasculature
α adrenergic receptors
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Identify
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Juxtaglomerular cells sympathetic receptors
Juxtaglomerularcells contain β1 adrenergic receptors
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sympathetic effects on juxtaglomerular cells
Stimulate renin release Leads to formation of angiotensin II
45
Identify
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Identify
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Hypoxia activation of SNSA does what?
Affects renal function
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Organ systems affected by SNSA
* Kidneys * Vascular smooth muscle * Endocrine
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Kidney effects of SNSA
* Constricts afferent and efferent arterioles t decrease renal blood flow * Potently increases Na+ reabsorption in the proximal tubule * Large activation decreases GFR
50
Vascular smooth muscle effects on SNSA
* Constricts arteries to decrease renal blood flow
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Endocrine effects of SNSA
Stimulates renin secretion (β1 receptors) to increase levels of angiotensin II and vasopressin
52
Describe the Renin-Angiotensin System
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Effects of activating the Renin-Angiotensin system 5 listed
* Thrist * Vasoconstriction * Water reabsorption * Sodium reabsorption results in increased extracellular fluid volume
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Summary of the Renin-Angiotensin system
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Describe the juxtaglomerular apparatus
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Mediators of the RAS
* SNSA * Aldosterone * ADH
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SNSA AKA
Sympathetic nervous system activation
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RAS AKA
Renin-Angiotensin System
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Aldosterone effects on RAS
Aldosterone increases distal tubulue Na+ reabsorption * Increases Na/K-ATPase activity in distal tubule basolateral membrane * Increases lumiinal membrane Na+ and K+ permeability
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ADH effects on the RAS
ADH causes water reabsorption * Stimulates water reabsorption in the collecting duct * Increases urea reabsorption in the collecting duct
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Effects of Angiotensin on vascular smooth muscle
Causes constriction of arteries increasing peripheral resistance resulting in increased arterial blood pressure
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Effects of Angiotensin on the central and peripheral nervous systems
Facilitate sympathetic transmission resulting in: * constriction of arteries leading to increased peripheral resistance leading to increased arterial blood pressure * increased cardiac output resulting in increased arterial blood pressure
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Effects of Angiotensin on Adrenal cortex
increased aldosterone secretion leading to increased sodium reabsorption leading to increased sodium & water reabsorption leading to increased cardiac output resulting in increased arterial blood pressure
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Effects of Angiotensin on direct effects on the kidneys on the tubules and arterioles
* increased sodium reabsorption and decreased GFR leading to sodium and water retention leading to increased cardiac output resulting in increased arterial blood pressure
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Effects of Angiotensin on the brain
Causes increased thirst leading to increased water reabsorption and Increased ADH leading to increased water reabsorption causing sodium and water retention causing increased cardiac output resulting in increased arterial blood pressure
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Angiotensin II effects on vascular smooth muscle
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Angiotensin II effects on central and peripheral nervous systems
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Angiotensin II effects on adrenal cortex
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Angiotensin II effects on renal tubules and arterioles
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Angiotensin II effects on the brain
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Prostaglandins effect on renal blood flow
* Typically do not regulate renal blood flow or GFR under normal conditions (i.e. cyclo-oxygenase inhibition does not alter renal blood flow) * Vasodilator PG's limit constriction of afferent arteriole * PG-induced vasodilation maintains glomerular blood flow during volume or sodium depletion * Cyclo-oxygenase inhibitors can cause acute renal failure during dehydration or following a stress such as surgery
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Cyclo-oxygenase inhibitors and renal function
Acute renal failure during dehydration or following a stress such as surgery
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Atrial natriuretic peptide is secreted from?
atria in response to stretch
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Atrial natriuretic peptide effects on GFR
Dilates afferent arteriole and also constricts efferent arteriole to increase GFR
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Atrial natriuretic peptide effects on urine production
Decreases Na reabsorption in medullary collecting to cause diuresis and natriuresis
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Diuresis description
increased urine production
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Natriuresis description
excretion of sodium in the urine
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Brain natriuretic peptide secreted from
ventricles
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Atrial natriuretic peptide and Brain natriuretic peptide levels in renal failure
increased levels in renal failure
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ANP and BNP effects in renal failure
Increased levels in renal failure resulting in * reduced renal clearance * increased synthesis