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Renal Physiology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the 6 functions of Renals?

A 
Electrolyte Balance
Excretion
Hormone secretion
PH regulation
Control circulating volume
Glucogenesis
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2
Q

The function of riding body of water soluble wastes such as urea, creatinine, uric acid, bilirubin etc is called?

A

Excretion

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3
Q

What two electrolytes are balanced by renals?

A

Sodium and Potassium

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4
Q

How do renals regulate PH?

A

Reabsorption/excretion of hydrogen vs bicarb ions

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5
Q

What system of renal function controls the circulating blood volume?

A

Renin-angiotensin-aldosterone system

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6
Q

Which hormones are secreted due to renal function?

A

Renin and Erythropoietin

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7
Q

What is the average fluid intake per day?

A

2300ml/day

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8
Q

How much water per day do we lose by breathing and through the skin?

Sweating?

Feces?

By Kidneys?

A

600-800 ml

100ml

100ml

1300 ml

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9
Q

What percent of total body weight is intracellular fluid?

A

40%

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10
Q

What percent of total body weight is extracellular fluid?

Two components of extracellular fluid?

A

20%

Plasma and interstitial fluid

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11
Q

High levels of sodium, chloride, and bicarbonate ions are found in which fluid?

A

Extracellular

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12
Q

Interstitial fluid and plasma are separated by what structure that is highly permeable except proteins?

A

Capillary Membrane

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13
Q

Large amounts of potassium and phosphate ions are found in which fluid?

A

Intracellular

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14
Q

The cell membrane between intracellular and extracellular fluid allows free exchange of what?

What does it not let through mostly?

A

Water

Electrolytes

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15
Q

What is the net diffusion of water across a selectively permeable membrane from region of high water concentration to one that is lower?

A

Osmosis

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16
Q

What is the equilibrium pressure between the hydrostatic pressure and the osmotic forces generated by addition of the solute?

What is it proportional to?

A

Osmotic pressure

The number of active or dissociable solutes

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17
Q

1 osmole = ___ mole(s) of a solute particle?

1 mole of a pure substance is ______ particles of that substance

A

1

6.02x10^23

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18
Q

What is Osmolality?

Osmolarity?

A

Osmoles per kilogram of water

Osmoles per liter of water

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19
Q

A solute that is unable to pass between extracellular and intracellular fluid and is capable of causing water movement across a membrane creating a change in pressure is what refereed to what type of osmoles?

A

Effective Osmoles

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20
Q

What are the three effective osmoles?

A

Na+
Glucose
K+

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21
Q

A solute that does not cause water movement across the cell membrane is referred to as what?

A

Ineffective Osmoles

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22
Q

Two types of ineffective osmoles

A

Urea and Ethanol

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23
Q

What is Van’t Hoff’s law?

A

A way to calculate the potential osmotic pressure of a solution across an impermeable membrane

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24
Q

What are the percent sodium chloride solution and glucose solution for Isotonic?

A

0.9% NaCL

5% Glucose

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25
Q

How long does osmotic equilibrium occur between intercellular and extracellular compartments?

How long does whole body equilibrium take after drinking water?

A

Seconds to minutes

30 minutes

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26
Q

Four ways you can dehydrate?

A

No fluid intake
Loss from GI tract
Sweating
Loss from kidneys

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27
Q

What is a good indicator of patients fluid status?

A

Plasma sodium concentration

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28
Q

What is hyponatremia?

Cell would swell or shrink?

A

Decreased sodium concentration in the extracellular fluid

Swell

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29
Q

What is the most common electrolyte disorder seen in clinical practice (15-25% hospitalized patients)?

A

Hyponatremia

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30
Q

What occurs with rapid hyponatremia?

Slow evolution of hyponatremia

A

Rapid cell swelling has major effect on brain. Neuro symptoms, headache, nausea, brain damage.

Tissues respond and transport solutes into extracellular space to slow tissue swelling

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31
Q

What is hypernatremia?

Cause cell swelling or shrinkage?

A

Increased extracellular sodium concentrations

Shrinkage

32
Q

How does the body respond to hypernatremia?

Promotes a strong ______ sensation?

A

Transporting solutes into cells

Thirst

33
Q

1 mole of sodium chloride is how many osmoles?

A

2

34
Q

What is more common extracellular or intracellular edema?

A

Extracellular

35
Q

What 5 things cause intracellular edema?

A

Hyponatremia

Depression of metabolic systems in tissues

Decreased nutrition to cells

Decreased blood flow

Inflammed tissue

36
Q

What 7 things cause extracellular edema?

A

Abnormal leak of fluid from llama to interstitial spaces across capillaries

Failure of lymphatics to return fluid from interstitium back to blood

Increased capillary filtration

Lymphedema - failure to return fluid and protein to blood

Heart failure (common cause)

Decreased excretion of salt and water by kidneys

Decreased plasma proteins

37
Q

What are the three ways that body protects with edema?

A

Interstitail fluid hydrostatic pressure in loose subcutaneous tissues

Increase lymph flow

“Washdown”

38
Q

Describe “Washdown” of proteins

A

Inc. in interstitial fluid pressure = inc. lymph flow

Dec. interstitium protein conc. as we inc. lymph flow

This dec. in proteins decreases osmotic pressure so fluid is prevented from capillaries to interstitial fluid

39
Q

How much does each kidney weigh?

Where are kidneys located?

A

150 grams

L1 - L4 REtroparitoneal

40
Q

Name for medial side of kidney where artery, vein, lymphatics, nerve supply, and ureter are found.

Kidney surrounded by what?

A

Hilum

Tough renal capsule

41
Q

How many renal pyramids in the medulla?

Base located at what border?

Tip called what?

A

8-10

Cortical-medullary border

Papilla

42
Q

Calyces, renal pelvis and ureter contract to propel urine to where?

A

Bladder

43
Q

What percent of cardiac output is from kidneys?

How many ml per min?

A

22%

1100 ml/min

44
Q

Describe steps in Kidney blood flow

A 
Renal artery
Interlobar arteries
Arcuate arteries
Interlobular arterioles
Afferent arterioles
Glomerular capillaries
Efferent arteriole
Peritubular capillaries
Interlobar vein
Arcuate vein
Interlobular vein
Renal vein
45
Q

Glomerular capillaries are separated by what structures that help regulate hydrostatic pressure in each of the two capillary beds?

A

Efferent arterioles

46
Q

Which capillaries have high hydrostatic pressure (60 mmHg) and cause rapid filtration?

Lower hydrostatic pressure and allows for rapid fluid reabsorption?

A

Glomarular

Peritubular

47
Q

The change in hydrostatic pressure in afferent and efferent arterioles changes the rate of what two things based on body needs?

A

Glomerular filtration and tubular reabsorption

48
Q

How many nephrons in each kidney?

Two different structures?

A

800,000 - 100,000,000

Cortical nephron
Juxtamedullary nephron

49
Q

Can kidneys regenerate new nephrons?

Rate of loss?

A

NO

After 40 years old decrease 10% every 10 years

50
Q

Starting at Bowmans capsule where do we go?

A 
Proximal tubule
Loop of Henle
Macula densa
Distal tubule
Connecting tubule
Cortical collecting duct
Medullary collecting duct
Renal pelvis
51
Q

Which nephron structure has short loops of Henele, only penetrates into medulla a little bit, 70-80% nephrons and surrounded by peritubular cap.?

A

Cortical

52
Q

Which nephron structure has long oops of Henle, Penetrates far into medulla, 20-30% of nephrons, surrounded by specialized peritubular called vasarecta

A

Juxtamedullary

53
Q

Different disorders that damage kidneys causing release of excess protein in the urine fall under what name?

A

Nephrotic Syndrome

54
Q

What are some symptoms of Nephrotic syndrome?

A 
Edema
Protein in urine
Decreased appetite
Weight gain (fluid)
Hypertension
Hyponatremia
Hyperlipidema
55
Q

Nephrotic syndrome increases risk of what?

A

Infection and blood clots

56
Q

What causes Cystitis?

A

Germs (usually bacteria) enter the urethra and bladder

57
Q

Persistent urge to urinate

Burning sensation when peeing

Pelvic discomfort

Lower abdominal pressure

Cloudy or bloody urine with strong odor are all symptoms of what?

A

Cystitis

58
Q

What is the name for an acute infection of the renal pelvis or parenchyma?

Usually due to an ascending what?

A

Pyelonephritis

UTI

59
Q

What is the name for kidney stones?

Most common type?

A

Nephrolithiasis

Calcium oxilate or calcium phosphate

60
Q

Waves of pain, nausea, vomiting, bloody urine is what?

A

Nephrolithiasis

61
Q

Causes of kidney stones

A

Imbalance of water
Urine too conc.
Solutes in urine crystalize

Predisposition to having kidney stones runs in families

62
Q

What is name for a genetic disorder that causes formation and enlargement of cysts in the kidneys?

A

Polycystic Kidney Disease (PKD)

63
Q

High BP
UTI
Liver and pancreatic cysts

A

Polycystic Kidney disease

64
Q

Causes of PKD

A

Genetic disorder autosomal dominant or recessive

65
Q

What is the name of the process of the urinary bladder emptying when filled?

A

Micturition

66
Q

The bladder is a smooth muscle chamber with what two main parts?

Which is the primary part where urine collects?

Which attaches to the urethra?

A

Body and Neck

Body

Neck

67
Q

What is the smooth muscle of the bladder who’s fibers are intertwined and is low-resistance to electrical impulse between muscle cells?

Which part of the bladder contracts?

A

Detrusor Muscle

The whole thing at once

68
Q

On the posterior wall of the bladder, above the bladder neck resides what?

Ureter enter bladder at the what?

A

Trigone

Upper Trigone

69
Q

The tone of the detrusor muscle shuts down the what?

A

Ureters

70
Q

Which muscle prevents emptying of the bladder until the pressure rises above the critical threshold?

A

Internal Sphincter

71
Q

Urethra passes through what diaphragm?

A

Urogenital

72
Q

Innervation of the bladder is through which segments and what plexus?

A

S2 and S3 cord segments

Sacral Plexus

73
Q

Pudendal nerve has what type of nerve fibers?

Innervate what sphincter?

A

Somatic

External bladder sphincter

74
Q

Sympathetic innervation comes from what nerves to stimulate blood supply to the bladder?

A

Hypogastric nerves (L2)

75
Q

Steps to Urine flow starting from nephron

A 
Nephron
Collecting ducts
Renal calyces
Ureters
Bladder

Renal Physiology (1 decks)

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