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renal physiology > exam 1 > Flashcards

exam 1 Flashcards

1
Q

what is the importance of body fluid osmolality

A

maintain cell volume, carry on normal cardiovascular function

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2
Q

foreign substances eliminated by the kidney

A

chemicals in food, insecticides, herbicides, drugs

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3
Q

hormones synthesized and secreted by the kidney

A

renin, calcitriol, erythropoietin

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4
Q

function of renin

A

activates renin-angiotensin-aldosterone system, regulates blood pressure via Na/K balance

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5
Q

function of calcitriol

A

normal resorption of calcium by GI tract, bone deposition

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6
Q

function of erythropoietin

A

stimulates RBC formation by the bone marrow, controls oxygen carrying capacity of blood

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7
Q

what could happen in renal failure when erythropeoietin is not produced or secreted

A

anemia

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8
Q

normal physiological pH

A

6.8-7.8

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9
Q

the coordinated action of which organs help regulate pH

A

lungs, liver, kidney

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10
Q

accumulation of nitrogenous waste in blood

A

azotemia

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11
Q

what happens when a person has less than 10% of their glomerular filtration rate

A

they develop end stage renal disease (ESRD)

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12
Q

treatments for ESRD

A

renal replacement therapy, peritoneal dialysis, hemodialysis, recombinant human erythropoietin, renal transplant

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13
Q

urine production in a day

A

1-2L

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14
Q

urine production in excess of 2L/day

A

polyuria/diuresis

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15
Q

urine production less than 500mL/day

A

oliguria

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16
Q

urine production less than 100mL/day

A

anuria

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17
Q

possible causes of anuria

A

kidney disease, dehydration, prostate enlargement

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18
Q

why is it important for urine production levels to stay above 400mL/day

A

if it is less than 400mL/day then the body cannot maintain a safe low concentration of waste material in the blood (azotemia)

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19
Q

the amount of a substance dissolved in a solution

A

molarity

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20
Q

if a solution dissociates into more than one particle when dissolved in a solution, its concentration is expressed in which terms ____________ . It refers to the interaction between cations and anions, determined by the valence of these ions

A

equivalence

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21
Q

for univalent ions, such as Na and Cl, what is the difference in determining their equivalence from their molarity

A

For univalent ions (Na+, Cl-), concentrations expressed in terms of molarity and equilivanlence are identical

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22
Q

What is the driving force for the movement of water across cell membranes

A

osmotic pressure difference

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23
Q

2 chambers separated by a semi-permeable membrane, 1 filled with distilled water (B) and 1 filled with solute (A). which chamber will increase in volume

A

water will move from B to A, down its gradient. so the volume of fluid in chamber A increases

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24
Q

At equilibrium, what will stop the movement of water from B to A

A

hydrostatic pressure (this pressure will be equal and opposite to osmotic pressure)

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25
Q

pressure determined solely by the number of solute particles in the solution

A

osmotic pressure

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26
Q

necessary equation to calculate osmotic pressure in atm

A

? = nCRT (Van’t Hoff’s), n = # of dissociable particles per molecule, C = Total solute concentration, R = Gas constant, T = Absolute temperature in degrees Kelvin (K)

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27
Q

molecular weight for Ca2+

A

40.1 g/mol

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28
Q

number of solution particles per 1 L of solvent

A

osmoLARity

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29
Q

number of solution particles per Kg of solvent

A

osmoLALity

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30
Q

yes or no: is osmolarity temperature dependent

A

yes. proportional to temperature

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31
Q

yes or no: is osmolality temperature dependent

A

no

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32
Q

units expressed as Osmol/Kg H2O

A

osmolality

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33
Q

effect of a solution on cell volume

A

tonicity

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34
Q

a solution that causes a cell to swell may be referred to as (lysis)

A

hypotonic

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35
Q

a solution that causes a cell to shrink (crenation)

A

hypertonic

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36
Q

a solution that does not change cell volume

A

isotonic

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37
Q

what factors effect tonicity

A

osmolality, permeability

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38
Q

a solution that contains a solute that cannot cross a membrane so that it exerts an osmotic pressure equal and opposite to the osmotic pressure generated on the other side of the membrane

A

effective osmole. This action would be displayed by an isotonic solution

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39
Q

a solution that contains a solute that can cross a membrane so that it exerts an osmotic pressure not equal to the osmotic pressure generated on the other side of the membrane

A

ineffective osmole. This action would be displayed by a hypotonic solution

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40
Q

is urea dissolved in water an ineffective osmole or an effective osmole

A

ineffective

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41
Q

is sucrose dissolved in water an ineffective osmole or an effective osmole

A

effective

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42
Q

in cases of ineffective and effective osmoles having a value equal to ?, how can the van’t hoff’s equation be modified

A

? = ? (nCRT)

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43
Q

if a solution is freely permeable to a membrane, what will its ? value be

A
  1. if the 0 is plugged into the van’t hoff’s equation the osmotic pressure is also equal to 0
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44
Q

if a solution is impermeable to a membrane, what will its ? value be

A
  1. if the 1 is plugged into the van’t hoff’s equation it renders a value for osmotic pressure; therefore, an effective osmole
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45
Q

Is the osmotic pressure generated by macromolecules. (such as proteins)

A

oncotic pressure

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46
Q

the weight of a volume of a solution divided by the weight of an equal volume of distilled water

A

specific gravity

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47
Q

what is the specific gravity of water

A

1

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48
Q

clinical use of specific gravity

A

assess the concentration ability of the kidneys, varies in proportion to its osmolarity, depends on both number and weight of solute particles

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49
Q

total body water

A

60% of body weight in a 70kg individual. 42L

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50
Q

ECF based on a 70kg individual

A

20% of body weight. 14L

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51
Q

ICF based on a 70kg individual

A

40% of body weight. 28L

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52
Q

ISF based on a 70kg individual

A

75% of ECF. (.75)(14) = 10.5L

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53
Q

plasma based on a 70kg individual

A

25% of ECF. (.25)(14) = 3.5L

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54
Q

is ISF a component of the ECF or the ICF

A

ECF

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55
Q

which component of the ECF contains more protein plasma or ISF

A

plasma

56
Q

which ion is the major determinant of ECF osmolality

A

Na

57
Q

what is a rough estimate of the ECF osmolality

A

double the Na concentration

58
Q

why measure plasma osmolality

A

osmolality of ECF and ICF, H2O is in osmotic equilibrium across capillary endothelium and cell membrane, Equilbrium between ICF and ECF occurs by movement of water

59
Q

which ion is the major cation of the ICF

A

K

60
Q

which two forces determine the free movement of water between the various body fluid compartments

A

hydrostatic pressure, osmotic pressure

61
Q

reflects the intrinsic permeability of the capillary wall to the movement of fluid and the surface area available for filtration

A

Filtration coefficient of the capillary wall

62
Q

a force for the movement of fluid from the lumen into the interstitium

A

hydrostatic pressure within capillary lumen

63
Q

Retards the movement of fluid out of the capillary lumen

A

Oncotic pressure of the plasma

64
Q

Is difficult to measure (its value is near 0 or slightly negative) under normal conditions. It will cause fluid to move out of the capillary

A

Hydrostatic pressure of interstitium

65
Q

The proteins that leak across the capillary wall into the interstitium exert a pressure and promote the movement of fluid out of the capillary lumen. what is this pressure called

A

Oncotic pressure of the ISF

66
Q

a measure of the relative ability of the solute to cross a cell membrane

A

reflection coefficient

67
Q

What causes fluid to leave the lumen (filtration) along its entire length

A

the balance of starling forces across muscle capillaries

68
Q

once the fluid from muscle capillaries is filtered out, how does it get back into the blood stream

A

lymphatics

69
Q

when an isotonic solution of NaCl is added to the ECF, how are the volumes of the ECF and ICF affected

A

ECF - increases, ICF - stays same

70
Q

when a hypertonic solution of NaCl is added to the ECF, how are the volumes of ECF and ICF affected

A

ECF - increase, ICF - decrease

71
Q

when a hypotonic solution of NaCl is added to the ECF, how are the volumes of ECF and ICF affected

A

ECF - increased, ICF - increased

72
Q

are the kidneys retroperitoneal or intraperitoneal organs

A

retroperitoneal

73
Q

what percentage of blood flows through kidneys

A

25% of cardiac output (1.25 L/min)

74
Q

kidneys constitute what percentage of total body weight

A

< .5%

75
Q

sequence of blood supply to the kidney

A

renal artery - interlobar artery - arcuate artery - interlobular artery - afferent arteriole - glomerular capillaries - efferent arteriole - peritubular capillaries

76
Q

which vessel supplies blood to the nephron

A

peritubular capillaries (afferent arteriole brings blood into the nephron)

77
Q

serves as osmotic exchanges for producing concentrated urine

A

vasa recta

78
Q

each kidney contains how many nephrons

A

1.2 million

79
Q

blood is ultra-filtered across glomerular capillaries into where

A

bowman’s capsule

80
Q

what is the first step in urine formation

A

blood being ultra-filtered across the glomerular capillaries into the bowman’s capsule

81
Q

glomerular capillary covered by epithelial cells

A

podocyte

82
Q

function of podocyte

A

phagocytic (endocytic)

83
Q

the process of podocytes interdigitate to cover basement membrane separated by gaps

A

filtration slits

84
Q

function of the filtration slits

A

to retard the filtration of some proteins and macromolecules

85
Q

transmembrane protein of slit diaphragm

A

nephrin

86
Q

mutation of the nephrin gene can lead to

A

abnormal filtration slit diaphragm leading to massive proteinuria and renal failure

87
Q

phagocytic cells that secrete prostaglandins and cytokines and can influence GFR

A

mesangial cells

88
Q

involved in immune complex mediated glomerular disease that obliterates glomerulus

A

mesangial cells

89
Q

lining of the renal tubule

A

single layer of epithelial cells

90
Q

in which portion of the renal tubule is there a burshborder

A

proximal convoluted tubule

91
Q

which portion of the renal tubule has a high density of mitochondria in its cells

A

proximal convoluted tubule (increases surface area for increased resorption)

92
Q

components of the loop of henle

A

thin descending limb, thin ascending limb, think ascending limb (TAL)

93
Q

resorption of K happens in which portion of the renal tubule

A

distal convoluted tubule (in the principal and intercalated cells)

94
Q

the two types of nephrons

A

superficial cortical nephron, juxtamedullary nephron

95
Q

location of superficial cortical nephron

A

glomeruli located in outer cortex (short loop of henle that extends into outer medulla)

96
Q

location of juxtamedullary nephron

A

Glomeruli located near corticomedullary border (long loop of henle that extends deep into medulla and papilla)

97
Q

which nephron type is the largest

A

jextamedullary nephron

98
Q

structures formed by the efferent arterioles

A

the efferent arteriole forms not only a network of peritubular capillaries, but also forms a series of vascular loops called the vasa recta

99
Q

what percent of renal blood flow enters the vasa recta

A

< 0.7%

100
Q

function of vasa recta

A

osmotic exchange, concentrate and dilute urine, convey oxygen and nutrients to nephron segments, return reabsorbed water and solutes to blood

101
Q

a segment which is actually a plaque in its wall of the distal convoluted tubule

A

macula densa

102
Q

juxtaglomerular apparatus includes

A

macula densa, extragolmerular mesangial cells between afferent and efferent arterioles, renin-producing granular cells of the afferent arteriole

103
Q

What are granular cells and what do they do

A

Modified smooth muscle cells, produce renin

104
Q

function of Tubuloglomerular Feedback Mechanism

A

involved in autoregulation of RBF and GFR

105
Q

nerve supply of kidney

A

nerves from celiac plexus (sympathetic)

106
Q

does the kidney have parasympathetic innervation

A

no

107
Q

adrenergic fibers release NE and dopamine for what purpose

A

affect smooth muscle cells of the renal artery and afferent arterioles, Causes secretion of renin from granular cells of afferent arterioles, Sympathetic activation of these nerves enhances Na+ reabsorption by the nephron segments

108
Q

condition characterized by increase in protein permeability in glomular capillaries.

A

nephrotic syndrome

109
Q

proteinuria is an indication of what

A

renal failure/disease (leaky glomerulus lets protein out)

110
Q

conditions that can cause nephrotic syndrome

A

uncontrolled diabetes, membranous glomerulaopathy, foot process disease leading to leaky glomerulus, amyloidosis

111
Q

symptoms of alport’s syndrome

A

hematuria, glomerulonephritis

112
Q

defects in type IV collagen of basement membrane in which the basement membrane fails to serve as an effective filtration barrier

A

alport’s syndrome

113
Q

where do the ureters enter the bladder

A

on its posterior aspect near the base and above the bladder neck

114
Q

how long are the ureters

A

30cm long

115
Q

two parts of the bladder

A

fundus, neck (2.3cm, funnel shaped, connects with urethra)

116
Q

Region of posterior bladder wall. (found above posterior urethra and below ureters)

A

trigone

117
Q

the muscle of the bladder that forms distinct muscle layers close to the bladder neck. what are the layers called and what is this muscle

A

detruser muscle: inner and outer longitudinal layer, middle circular layer

118
Q

Smooth muscle fibers in bladder neck. Not a true sphincter and not under conscious control

A

internal sphincter

119
Q

function of the internal sphincter

A

stops urine flow for storage

120
Q

which type of muscle is the external sphincter

A

skeletal muscle

121
Q

function of the external sphincter

A

Can be used to prevent or interrupt urination, especially in males

122
Q

innervation of external sphincter

A

sacral pudendal nerves

123
Q

The walls of the ureters, bladder, and urethra are highly folded and very distensible. what are these folds called

A

rugae

124
Q

what is the volume change the bladder can experience

A

10mL - 400mL (5cm of H2O pressure change)

125
Q

the renal calyces, pelvis, ureter, and bladder are lined with what kind of epithelium

A

transitional epithelium

126
Q

three types of cells in the transitional epithelium of the renal calyces, pelvis, ureter, and bladder

A

columnar layer (basal), cuboidal layer (intermediate), squamous layer (superficial)

127
Q

how are the fibers arranged in the detrusor muscle

A

randomly

128
Q

innervation of the bladder

A

Sympathetic innervation from the hypogastric nerves, parasympathetic innervation from the pelvic nerves

129
Q

part of the bladder that contract due to sympathetic innervation from the hypogastric nerves

A

neck and urethra

130
Q

sympathetic innervation of the bladder works with which receptors

A

alpha - adrenergic

131
Q

parasympathetic innervation of the bladder works with which receptors

A

muscarinic

132
Q

nephrolithiasis

A

kidney stones (renal calculi)

133
Q

incidence of nephrolithiasis

A

5-10% of americans

134
Q

cystitis

A

urinary tract infection

135
Q

if cystitis goes untreated how could it manifest

A

infection of ureters and finally renal pelvis (pyelitis), infection of renal cortex (pylonephritis)

renal physiology (1 decks)

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