Exam 2 Flashcards
Urinary system components and functions
- Kidneys: form urine
- Ureters: deliver urine to bladder
- Bladder: stores urine
- Urethra: expels urine from body
renal anatomy
- Kidneys are retroperitoneal and protected by lower ribs and adipose tissue
- Renal hilum: indented area that’s an entrance for renal artery, renal vein, ureter, nerves, lymphatics
External layers of renal anatomy: has connective tissue (superficial to deep)
- Renal fascia: anchors kidneys to other structures
- Adipose capsule: protects kidneys
- Renal capsule: adheres to kidney surface and protects spread of infection
Internal renal anatomy:
- Renal cortex: highly vascularized outer layer of kidneys with granular appearance
- Renal medulla: inner region used to creates concentrated urine
- Renal pyramids: urine-secreting apparatus and tubules
- Renal columns: anchors cortex
Cortical nephron:
- short loops of Henle that only extend to medulla’s outer region
- Renal corpuscle in outer portion of cortex
- Creates dilute urine with osmolarity similar to blood
- If hydrated ⇒ cortical dilutes water since there’s enough to spare
Juxtamedullary nephron:
- long loops of Henle that goes deep in medulla
- Renal corpuscle deep in cortex
- Receives blood from peritubular capillaries and vasa recta
- Ascending limb has thick and thin regions
- Enables kidneys to secrete very concentrated urine
- If dehydrated ⇒ juxtamedullary retains more water
What are the 2 parts of the renal corpuscle
- glomerulus
- glomerular (bowman’s) capsule
what is the glomerulus and what are the 3 layers of filtration?
- mass of capillaries that’s fed by afferent arteriole and drains to efferent arteriole
1. Glomerular endothelial cells: have fenestration (large pores) that are leaky = allowing for stuff from blood plasma to move in/out
2. Basement membrane: prevents filtration of larger proteins
3. Slit membrane between pedicels: prevents filtration of medium-sized proteins
what is the Glomerular (Bowman’s) Capsule and its function?
- has visceral layer of podocytes that wrap around capillaries
- Filtrate collected between visceral and parietal layers
Juxtaglomerular Apparatus
- region where ascending loop makes contact with afferent arteriole at macula densa
- arteriole walls have granular cells
- Regulates blood pressure in kidneys with help of autonomic nervous system
Renin-Angiotensin-Aldosterone System
Low salt levels ⇒ lowers blood volume b/c of inhibition of ADH secretion ⇒ pee more ⇒ less water reabsorbed in CT and more excreted in urine ⇒ lowered blood volume detected by granular cells that secrete renin to afferent arteriole ⇒ converts angiotensin → angiotensin I ⇒ angiotensin-converting enzyme (ACE) converts angiotensin I → angiotensin II ⇒ stimulates adrenal cortex to make aldosterone that stimulates K+ excretion and Na+ H2O reabsorption from CT ⇒ increases water reabsorption ⇒ increases blood volume and raises blood pressure
Glomerular Filtration + Secretion – Reabsorption = Excretion of Solute
- Glomerular filtration: blood plasma and dissolved substances get filtered in glomerular capsule
- Tubular secretion: happens along renal tubule and CT where substances and excess ions get secreted from peritubular capillaries to renal tubule to be excreted in urine
- Tubular reabsorption = happens along renal tubule and CT where water, ions, substances get reabsorbed from renal tubule to peritubular capillaries to be in blood
Glomerular filtration:
- Driven by blood pressure
- Opposed by capsular hydrostatic pressure and blood colloid osmotic pressure
- Capsular hydrostatic pressure: pressure of the fluid inside a capsule space
- Blood colloid osmotic pressure: amount of proteins in blood
- More proteins in blood than glomerulus space ⇒ opposes b/c it would want to drive things back into blood
- Water and small molecules move out of glomerulus
Glomerular filtration rate
- amount of filtrate formed by both kidneys each minute
- Homeostasis requires kidneys to maintain relatively constant GFR
- High GFR ⇒ substances pass too quickly and aren’t reabsorbed ⇒ higher BP
- Low GFR ⇒ almost all substances reabsorbed and some waste products not adequately excreted ⇒ lower BP
what are the 3 ways the kidneys are regulated?
- autoregulation (myogenic and tubuloglomerular)
- neural
- hormonal
2 types of autoregulation
- Myogenic mechanism:
- High BP ⇒ smooth muscle cells in afferent arterioles contract (b/c high BP means filtrate substances pass too fast and aren’t reabsorbed)
- Low BP ⇒ smooth muscle cells in afferent arteriole dilate (b/c low BP means almost all filtrate substances reabsorbed and barely any secreted)
- Tubuloglomerular feedback:
- High GFR ⇒ no reabsorption ⇒ macula densa inhibits release of nitric oxide (vasodilator) ⇒ afferent arterioles constrict
Neural regulation
strong sympathetic stimulation ⇒ afferent arterioles constrict ⇒ reduced urine output ⇒ more blood available for other organs
Hormonal regulation
- High GFR?
- High BP?
-High GFR ⇒ angiotensin II constrict afferent and efferent arterioles ⇒ decreases GFR
- High BP ⇒ Atrial natriuretic peptide (ANP): released in response to stretch of cardiac atria when BP is too high and relaxes mesangial cells in glomerulus ⇒ increases capillary surface area ⇒ low BP
Angiotensin II:
- stimulates adrenal cortex to make aldosterone
- constricts afferent and efferent arterioles
Aldosterone
stimulates K+ excretion and Na+ reabsorption which also reabsorbs H2O because it follows Na+
ADH
stimulates insertion of aquaporins in CD ⇒ increases H2O reabsorption to peritubular capillaries
ANP: atrial natriuretic peptide
during High BP ⇒ inhibits secretion of aldosterone and ADH ⇒ suppresses reabsorption of Na+ and H2O in PCT and CD ⇒ increases excretion of Na+ in urine ⇒ increases urine output ⇒ decreases blood volume and BP
PTH
stimulates opening of Ca2+ channels in DCT ⇒ increases reabsorption of Ca2+
Renin
converts angiotensinogen → angiotensin I
Angiotensin-converting enzyme (ACE)
converts angiotensin I → angiotensin II
Formation of Dilute urine:
- Osmolarity (solute concentration) in tubule when urine is dilute:
- Increases in descending limb
- Decreases in ascending limb
- Decreases more in CD - Thick ascending limb:
- Symporters reabsorb Na+, K+, Cl- ⇒ solutes move out of tubules ⇒ low osmolarity
- Low water permeability = solutes leave and water stays - DCT and CD:
- Both permeable to water upon ADH release
- Low permeability in absence of ADH
Formation of Concentrated urine
- Osmotic gradient created by countercurrent multiplier: medulla osmolarity increases as solutes are pumped out of ascending limb = maintains hypertonicity of medulla for solutes to go out of tubule during descending limb
- With ADH = CD become permeable to water = water moves out and urine becomes more concentrated
- Movement of water carries urea to medulla ⇒ increases osmolarity
where does countercurrent exchange happen?
Loop of Henle of the Juxtamedullary nephron
steps to countercurrent exchange
- Descending limb: permeable to water = water move down osmotic gradient out of tubule to interstitial fluid in medulla because of hypertonicity of medulla
- Medulla already had high hypertonicity b/c it has lots of solutes stuck in medulla capillaries not reabsorbing solutes very well - Ascending limb: impermeable to water but permeable to solutes = sodium and chloride symporters move ions from tubule to interstitial fluid in medulla = increases hypertonicity of medulla further
- DCT & CT: upon ADH release, aquaporin channels will be introduced to DCT & CT = water reabsorption = formation of concentrated urine
- Urea recycling: contributes to hypertonicity of renal medulla by reabsorbed in CD and secreted into nephron loop = goes through nephron loop that’s impermeable so it can’t get out of filtrate until it’s in CD = recycles urea and increase tonicity of interstitial fluid in medulla
urea recycling steps
- PCT: urea is reabsorbed with water, but there’s more water being reabsorbed than urea ⇒ urea concentration in the tubule than in the blood.
- Descending limb: there’s higher concentration of urea in interstitium of medulla already ⇒ urea concentration in tubule is less than urea concentration outside ⇒ high concentration of urea in interstitial medulla moves back into tubules
- Ascending limb: urea is impermeable so it stays in tubule
- DCT and CT: there’s ADH that increases water reabsorption and water already moves out of tubule because surrounding osmolarity in interstitium already high due to some urea and lots of other solutes ⇒ still have lots of urea in tubule due to when urea was secreted back into tubule in descending limb ⇒ concentration of urea in tubule in CT is greater than in interstitium ⇒ some of urea leaves tubule and goes out to interstitium ⇒ urea gets secreted back into descending limb’s bottom of loop ⇒ urea makes its way back up ascending limb to DCT and CT to do process again ⇒ urea recycled
Acute renal failure
- failure of kidneys’ abilities to excrete wastes, regulate blood volume, pH, and electrolytes
- caused by inflammation of tubules or kidney ischemia
- Signs: rise in blood creatinine and decrease in renal plasma clearance of creatinine
Glomerulonephritis
- inflammation of glomeruli
- Autoimmune attack against glomerular capillary basement membranes ⇒ leakage of protein to urine ⇒ decreased colloid osmotic pressure ⇒ edema
Renal insufficiency
- nephrons destroyed
- Results in salt, H2O retention and uremia along with high plasma H+ and K+ ⇒ coma
Polycystic kidney disease (PKD)
inherited disorder where clusters of fluid-filled sacs develop in kidneys ⇒ kidneys enlarge and lose function over time
What are the parts to Fluid compartments and fluid homeostasis
- plasma membrane of cells
- blood vessel walls
- capillary walls
- filtration, reabsorption, diffusion, osmosis
- level of aerobic respiration determines volume of metabolic water formed because…
- when water loss > water gain = dehydration ==> increased thirst
- elimination of excess body water occurs via urine production
Plasma membrane of cells
separates intracellular fluid from interstitial fluid
Blood vessel walls
divide interstitial fluid from blood plasma
Capillary walls
thin enough to allow exchange of water and solutes between blood plasma and interstitial fluid
Filtration, reabsorption, diffusion, osmosis:
- allows continuous exchange of water and solutes among body fluid compartments
1. Balance of inorganic compounds that dissociate into ions (electrolytes) closely related to fluid balance- Low electrolytes = less water reabsorption because water follows solutes (electrolytes)
- Body gains water by ingestion and metabolic synthesis
- When cells use energy they produce metabolic water
- Body loses water via urination, perspiration, exhalation, and in feces
- Water vapor is in air exhaled out
- Low electrolytes = less water reabsorption because water follows solutes (electrolytes)
Level of aerobic respiration determines volume of metabolic water formed b/c…
Amt of water formed is directly proportional to amt of ATP produced