exam 1 Flashcards
1
Q
what is the importance of body fluid osmolality
A
maintain cell volume, carry on normal cardiovascular function
2
Q
foreign substances eliminated by the kidney
A
chemicals in food, insecticides, herbicides, drugs
3
Q
hormones synthesized and secreted by the kidney
A
renin, calcitriol, erythropoietin
4
Q
function of renin
A
activates renin-angiotensin-aldosterone system, regulates blood pressure via Na/K balance
5
Q
function of calcitriol
A
normal resorption of calcium by GI tract, bone deposition
6
Q
function of erythropoietin
A
stimulates RBC formation by the bone marrow, controls oxygen carrying capacity of blood
7
Q
what could happen in renal failure when erythropeoietin is not produced or secreted
A
anemia
8
Q
normal physiological pH
A
6.8-7.8
9
Q
the coordinated action of which organs help regulate pH
A
lungs, liver, kidney
10
Q
accumulation of nitrogenous waste in blood
A
azotemia
11
Q
what happens when a person has less than 10% of their glomerular filtration rate
A
they develop end stage renal disease (ESRD)
12
Q
treatments for ESRD
A
renal replacement therapy, peritoneal dialysis, hemodialysis, recombinant human erythropoietin, renal transplant
13
Q
urine production in a day
A
1-2L
14
Q
urine production in excess of 2L/day
A
polyuria/diuresis
15
Q
urine production less than 500mL/day
A
oliguria
16
Q
urine production less than 100mL/day
A
anuria
17
Q
possible causes of anuria
A
kidney disease, dehydration, prostate enlargement
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)
19
Q
the amount of a substance dissolved in a solution
A
molarity
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
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
22
Q
What is the driving force for the movement of water across cell membranes
A
osmotic pressure difference
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
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)
25
pressure determined solely by the number of solute particles in the solution
osmotic pressure
26
necessary equation to calculate osmotic pressure in atm
? = 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)
27
molecular weight for Ca2+
40.1 g/mol
28
number of solution particles per 1 L of solvent
osmoLARity
29
number of solution particles per Kg of solvent
osmoLALity
30
yes or no: is osmolarity temperature dependent
yes. proportional to temperature
31
yes or no: is osmolality temperature dependent
no
32
units expressed as Osmol/Kg H2O
osmolality
33
effect of a solution on cell volume
tonicity
34
a solution that causes a cell to swell may be referred to as (lysis)
hypotonic
35
a solution that causes a cell to shrink (crenation)
hypertonic
36
a solution that does not change cell volume
isotonic
37
what factors effect tonicity
osmolality, permeability
38
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
effective osmole. This action would be displayed by an isotonic solution
39
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
ineffective osmole. This action would be displayed by a hypotonic solution
40
is urea dissolved in water an ineffective osmole or an effective osmole
ineffective
41
is sucrose dissolved in water an ineffective osmole or an effective osmole
effective
42
in cases of ineffective and effective osmoles having a value equal to ?, how can the van't hoff's equation be modified
? = ? (nCRT)
43
if a solution is freely permeable to a membrane, what will its ? value be
0. if the 0 is plugged into the van't hoff's equation the osmotic pressure is also equal to 0
44
if a solution is impermeable to a membrane, what will its ? value be
1. if the 1 is plugged into the van't hoff's equation it renders a value for osmotic pressure; therefore, an effective osmole
45
Is the osmotic pressure generated by macromolecules. (such as proteins)
oncotic pressure
46
the weight of a volume of a solution divided by the weight of an equal volume of distilled water
specific gravity
47
what is the specific gravity of water
1
48
clinical use of specific gravity
assess the concentration ability of the kidneys, varies in proportion to its osmolarity, depends on both number and weight of solute particles
49
total body water
60% of body weight in a 70kg individual. 42L
50
ECF based on a 70kg individual
20% of body weight. 14L
51
ICF based on a 70kg individual
40% of body weight. 28L
52
ISF based on a 70kg individual
75% of ECF. (.75)(14) = 10.5L
53
plasma based on a 70kg individual
25% of ECF. (.25)(14) = 3.5L
54
is ISF a component of the ECF or the ICF
ECF
55
which component of the ECF contains more protein plasma or ISF
plasma
56
which ion is the major determinant of ECF osmolality
Na
57
what is a rough estimate of the ECF osmolality
double the Na concentration
58
why measure plasma osmolality
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
which ion is the major cation of the ICF
K
60
which two forces determine the free movement of water between the various body fluid compartments
hydrostatic pressure, osmotic pressure
61
reflects the intrinsic permeability of the capillary wall to the movement of fluid and the surface area available for filtration
Filtration coefficient of the capillary wall
62
a force for the movement of fluid from the lumen into the interstitium
hydrostatic pressure within capillary lumen
63
Retards the movement of fluid out of the capillary lumen
Oncotic pressure of the plasma
64
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
Hydrostatic pressure of interstitium
65
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
Oncotic pressure of the ISF
66
a measure of the relative ability of the solute to cross a cell membrane
reflection coefficient
67
What causes fluid to leave the lumen (filtration) along its entire length
the balance of starling forces across muscle capillaries
68
once the fluid from muscle capillaries is filtered out, how does it get back into the blood stream
lymphatics
69
when an isotonic solution of NaCl is added to the ECF, how are the volumes of the ECF and ICF affected
ECF - increases, ICF - stays same
70
when a hypertonic solution of NaCl is added to the ECF, how are the volumes of ECF and ICF affected
ECF - increase, ICF - decrease
71
when a hypotonic solution of NaCl is added to the ECF, how are the volumes of ECF and ICF affected
ECF - increased, ICF - increased
72
are the kidneys retroperitoneal or intraperitoneal organs
retroperitoneal
73
what percentage of blood flows through kidneys
25% of cardiac output (1.25 L/min)
74
kidneys constitute what percentage of total body weight
\< .5%
75
sequence of blood supply to the kidney
renal artery - interlobar artery - arcuate artery - interlobular artery - afferent arteriole - glomerular capillaries - efferent arteriole - peritubular capillaries
76
which vessel supplies blood to the nephron
peritubular capillaries (afferent arteriole brings blood into the nephron)
77
serves as osmotic exchanges for producing concentrated urine
vasa recta
78
each kidney contains how many nephrons
1.2 million
79
blood is ultra-filtered across glomerular capillaries into where
bowman's capsule
80
what is the first step in urine formation
blood being ultra-filtered across the glomerular capillaries into the bowman's capsule
81
glomerular capillary covered by epithelial cells
podocyte
82
function of podocyte
phagocytic (endocytic)
83
the process of podocytes interdigitate to cover basement membrane separated by gaps
filtration slits
84
function of the filtration slits
to retard the filtration of some proteins and macromolecules
85
transmembrane protein of slit diaphragm
nephrin
86
mutation of the nephrin gene can lead to
abnormal filtration slit diaphragm leading to massive proteinuria and renal failure
87
phagocytic cells that secrete prostaglandins and cytokines and can influence GFR
mesangial cells
88
involved in immune complex mediated glomerular disease that obliterates glomerulus
mesangial cells
89
lining of the renal tubule
single layer of epithelial cells
90
in which portion of the renal tubule is there a burshborder
proximal convoluted tubule
91
which portion of the renal tubule has a high density of mitochondria in its cells
proximal convoluted tubule (increases surface area for increased resorption)
92
components of the loop of henle
thin descending limb, thin ascending limb, think ascending limb (TAL)
93
resorption of K happens in which portion of the renal tubule
distal convoluted tubule (in the principal and intercalated cells)
94
the two types of nephrons
superficial cortical nephron, juxtamedullary nephron
95
location of superficial cortical nephron
glomeruli located in outer cortex (short loop of henle that extends into outer medulla)
96
location of juxtamedullary nephron
Glomeruli located near corticomedullary border (long loop of henle that extends deep into medulla and papilla)
97
which nephron type is the largest
jextamedullary nephron
98
structures formed by the efferent arterioles
the efferent arteriole forms not only a network of peritubular capillaries, but also forms a series of vascular loops called the vasa recta
99
what percent of renal blood flow enters the vasa recta
\< 0.7%
100
function of vasa recta
osmotic exchange, concentrate and dilute urine, convey oxygen and nutrients to nephron segments, return reabsorbed water and solutes to blood
101
a segment which is actually a plaque in its wall of the distal convoluted tubule
macula densa
102
juxtaglomerular apparatus includes
macula densa, extragolmerular mesangial cells between afferent and efferent arterioles, renin-producing granular cells of the afferent arteriole
103
What are granular cells and what do they do
Modified smooth muscle cells, produce renin
104
function of Tubuloglomerular Feedback Mechanism
involved in autoregulation of RBF and GFR
105
nerve supply of kidney
nerves from celiac plexus (sympathetic)
106
does the kidney have parasympathetic innervation
no
107
adrenergic fibers release NE and dopamine for what purpose
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
condition characterized by increase in protein permeability in glomular capillaries.
nephrotic syndrome
109
proteinuria is an indication of what
renal failure/disease (leaky glomerulus lets protein out)
110
conditions that can cause nephrotic syndrome
uncontrolled diabetes, membranous glomerulaopathy, foot process disease leading to leaky glomerulus, amyloidosis
111
symptoms of alport's syndrome
hematuria, glomerulonephritis
112
defects in type IV collagen of basement membrane in which the basement membrane fails to serve as an effective filtration barrier
alport's syndrome
113
where do the ureters enter the bladder
on its posterior aspect near the base and above the bladder neck
114
how long are the ureters
30cm long
115
two parts of the bladder
fundus, neck (2.3cm, funnel shaped, connects with urethra)
116
Region of posterior bladder wall. (found above posterior urethra and below ureters)
trigone
117
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
detruser muscle: inner and outer longitudinal layer, middle circular layer
118
Smooth muscle fibers in bladder neck. Not a true sphincter and not under conscious control
internal sphincter
119
function of the internal sphincter
stops urine flow for storage
120
which type of muscle is the external sphincter
skeletal muscle
121
function of the external sphincter
Can be used to prevent or interrupt urination, especially in males
122
innervation of external sphincter
sacral pudendal nerves
123
The walls of the ureters, bladder, and urethra are highly folded and very distensible. what are these folds called
rugae
124
what is the volume change the bladder can experience
10mL - 400mL (5cm of H2O pressure change)
125
the renal calyces, pelvis, ureter, and bladder are lined with what kind of epithelium
transitional epithelium
126
three types of cells in the transitional epithelium of the renal calyces, pelvis, ureter, and bladder
columnar layer (basal), cuboidal layer (intermediate), squamous layer (superficial)
127
how are the fibers arranged in the detrusor muscle
randomly
128
innervation of the bladder
Sympathetic innervation from the hypogastric nerves, parasympathetic innervation from the pelvic nerves
129
part of the bladder that contract due to sympathetic innervation from the hypogastric nerves
neck and urethra
130
sympathetic innervation of the bladder works with which receptors
alpha - adrenergic
131
parasympathetic innervation of the bladder works with which receptors
muscarinic
132
nephrolithiasis
kidney stones (renal calculi)
133
incidence of nephrolithiasis
5-10% of americans
134
cystitis
urinary tract infection
135
if cystitis goes untreated how could it manifest
infection of ureters and finally renal pelvis (pyelitis), infection of renal cortex (pylonephritis)
