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Renal Physiology > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

What four things contribute to net filtration pressure?

A

Bowman’s capsule colloid osmotic pressure – 0mmHg
 Bowman’s capsule hydrostatic pressure – 18mmHg
 Glomerular hydrostatic pressure – 60 mmHg
 Glomerular capillary colloid osmotic pressure – 32mmHg

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1
Q

What is the net filtration pressure?

A

10mmHg

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2
Q

If kf is 12.5 what is the GFR?

A

125mL/min

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3
Q

What if we decrease the amount of functional glomerular capillaries?

A

It decreases surface area for filtration = decrease in kf

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4
Q

What if we increase the thickness of the capillary membrane(hypertension or diabetes mellitus)?

A

Decreases the permeability of the capillary membrane=decreasein Kf

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5
Q

What is the end result from a decrease in kj?

A

a decrease in GFR

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6
Q

What is the most common way that the body regulates GFR?

A

Increase in glomerular hydrostatic pressure

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7
Q

What effect does Norepinephrine & epinephrine have on GFR?

A

decrease

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8
Q

What effect does Endothelin have on the GFR?

A

Decrease

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9
Q

What effect does Angiotension II have on GFR?

A

prevents a decrease

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10
Q

What effect does Endothelial-derived nitric oxide have on GFR?

A

increase

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11
Q

What effect does Prostoglandins have on the GFR?

A

increase

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12
Q

What three factors determine the urinary excretion rate?

A

 Glomarular filtration (+)
 Reabsorption of substances from the renal tubules
into the blood (-)
 Secretion of substances from the blood to the renaltubules (+)

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13
Q

What are the four ways that the kidney handles substances?

A

 Freely filtered by the glomerulus & not reabsorbedor secreted
 Freely filtered & partially reabsorbed
 Freely filtered & totally reabsorbed
 Freely filtered & not reabsorbed and additional
amounts of the substance are secreted

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14
Q

What are the substances that freely filtered & not reabsorbed or secreted?

What is the urinary excretion rate compared to the glomerular filtration rate?

A

Creatinine, urea, uric acid and other by productsof metabolism are handled this way

Urinary excretion rate = glomerular filtration rate

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15
Q

Substances that are freely filtered & partially reabsorbed what does the excretion rate equal to?

excretion rate is less than or more than filtration rate

what substances are handled this way?

A

Excretion rate=filtration rate-reabsorption rate

less then

Many electrolytes (sodium, bicarbonate ions &chloride ions)

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16
Q

What are the three parts of the Loop of Henle?

A

Thin descending segment
thin ascending segment
thick ascending segment

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17
Q

What is the first portion of the distal tubule called?

It is part of what complex?

A

macula densa

Juxtaglomerular complex

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18
Q

The proximal tubule before the loop of Henle is _______ active and __________ reabsorbtion.

a. high; active
b. high; passive
c. low; active
d. low; passive

A

b

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19
Q

Excess water in the body=urine with osmolarity as low as _______mOsm/L

A

50

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20
Q

Deficit of water in the body=urine with anosmolarity as high as ________mOsm/L

A

1400

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21
Q

The concentration of the urine is ____________ solute concentration

a. dependent on
b. independent of

A

b

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22
Q

What is the result of an increase in osmolarity of the body?

A 
Increased release of ADH 
Increase in water permeability of the distal tubule and collecting ducts 
Large reabsorption of water 
Concentration of urine 
No marked change in excretion of solutes
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23
Q

What determines whether the kidneys excrete dilute or concentrated urine?

A

Concentration of ADH

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24
Q

Osmolarity of filtrate at the beginning of proximal tubule=

A

300mOsm/L

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25
Q

Osmolarity of filtrate a the end of the proximal tubule=

A

300mOsm/L

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26
Q

Osmolarity of plasma=

A

300mOsm/L

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27
Q

The proximal tubule is _________.

a. hypertonic
b. hypotonic
c. isotonic

A

c

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28
Q

How so we create a hyperosmotic renal medullary interstitial fluid?

A

Countercurrent mechanism
Juxtamedullary nephrons
Vasa recta
Collecting ducts (that travel through thehyperosmotic renal medulla)

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29
Q

Interstitial fluid is around __________ in most ofthe body

A

300mOsm/L

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30
Q

For the countercurrent mechanism the to work we need a?

A

high osmolarity in the renal medulla

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31
Q

At the papilla of the renal pyramids the osmolaritycan be as high as ________

A

1200mOsm/L

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32
Q

What are the four ways that fluid are regulated in the body?

A

Respiration
GI tract
Through the skin
Obligatory urine volume loss

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33
Q

How much plasma volume is there?

How much is the GFR/day?

How many times a day does the blood plasma get filtered?

A

3L

180 L/day

60 times a day

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34
Q

Large amounts of fluid are filtered from the

glomerular capillaries to what area?

A

Bowman’s capsule

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35
Q

Glomerular filtrate does not contain what two substances?

A

No proteins, no cellular elements

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36
Q

Glomerular filtrate substances (salts & organicmolecules) = what?

A

plasma

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37
Q

GFR is determined by what two substances?

A

hydrostatic pressure and colloid osmotic pressure

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38
Q

the capillary filtration coefficient is determined by what?

A

Permeability of the capillary

Surface area of the capillary

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39
Q

The GFR in a normal non-pathologic adult has a high or low glomerular hydrostatic pressure?

Large or small filtration surface area?

High or low permeability of the glomerular capillary

A

high

Large

High

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40
Q

What is the filtration fraction?

A

amount of renal plasma that is filtered = 20%

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41
Q

How are the glomerular capillary membrane different than others in the body?

A

made of three layers rather than two

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42
Q

What are the three layers of the glomerular capillary membrane?

A

 (1) endothelium
 (2) basement membrane
 (3) epithelial cell layer (podocytes)

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43
Q

What layer of the Glomerular capillary membrane contain fenestrae?

What is the size of the fenestrae?

A

endothelium

8 nanometers

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44
Q

What keeps albumin from passing through the Glomerular capillary membrane?

A

The negative charge of the capillary prevents the passage of plasma proteins

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45
Q

What layer of the Glomerular capillary membrane contains a meshwork of proteoglycan fibrillae & collagen

A

basement membrane?

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46
Q

The glomerular capillary membrane contains a meshwork of proteoglycan fibrillae & collagen what is the function?

A

Allows for the flow of a lot of water and smallsolutes to pass

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47
Q

What is the proteoglycan charge in the basement membrane?

A

negative charge

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48
Q

T/F the epithelium is a continuous layer

A

false

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49
Q

What lines the outer surface of the glomerulus in the epithelium?

A

Podocytes

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50
Q

Long footlike projections that encircle the capillaries

What are filtered through the gaps between the footlike projections?

What are they called?

A

podocytes

water and solutes

slit pores

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51
Q

epithelium is __________ charged?

A

negatively

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52
Q

Filtration barrier is highly dependent on a molecules size and _____________

A

electrical size

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53
Q

What are the three things freely filtered through the Glomerular capillary membrane

A

Water, sodium, glucose

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54
Q

What is more likely to be filtered a negative, neutral, or positively charged particle?

A

neutral, or positively

55
Q

What happens if the basement membrane loses it’s electrical charge?

A

albumin is filtered and the urine is frothy

56
Q

What is the Glomerular hydrostatic pressure

A

60mmHg

57
Q

What is the Bowman’s capsule colloid osmotic pressure?

A

0mmHg

58
Q

What is the Bowman’s capsule hydrostatic pressure?

A

18mmHg

59
Q

What is the Glomerular cap. colloid osmotic pressure?

A

32mmHg

60
Q

What is the net filtration rate?

A

10mmHg

61
Q

What determines GFR?

A

Kf x net filtration rate

Kf = 4.2mL/min/mmHg

62
Q

What are the three things that determine Glomerular capillary hydrostatic pressure?

A

Arterial pressure
Afferent arteriolar resistance
Efferent arteriolar resistance

63
Q

What if we change Glomerular capillary hydrostatic pressure?

A

very little increase due to arterial pressure

64
Q

What happens if there is a 3 fold increase in efferent arteriole constriction?

A

Colloid osmotic pressure of the arteriole will exceedhydrostatic pressure = decreased GFR

65
Q

Renal Blood Flow is ________ of the cardiac output?

A

22%

66
Q

T/F the kidney receives 2x the blood flow of the brain

A

true

67
Q

Why does the kidney absorb 2x the oxygen than the brain?

A

because of the high rate of sodium reabsorption in the tubules

68
Q

The kidney receives _____x the oxygen than the brain

A

7

69
Q

What does the blood supply to the kidney do?

A

supplies nutrients and removes waste from the blood

supplies plasma to the kidney for a high rate of GFR

70
Q

difference between renal artery pressureand renal vein pressure divided by total renal vascular resistance.

A

Renal Blood flow

71
Q

Renal arterial pressure

A

systemic arterial pressure

72
Q

Kidneys maintains fairly constant blood flow & GFR of what?

A

80-170mmHg

73
Q

What is the renal vein pressure?

A

3-4mmHg

74
Q

What location does renal vascular resistance take place?

A

Interlobular arteries, Afferent arterioles, Efferent arterioles

75
Q

Renal vascular resistance is controlled by what?

A

sympathetic nervous system, hormones, internal renal control mechanism

76
Q

The renal medulla accounts for what percentage of renal blood flow?

A

1-2%

77
Q

The renal medulla is supplied by what?

A

the vasa recta

78
Q

The vasa recta that descends into the renal medulla accompanies what?

A

the loop of Henle of the juxtamedullary nephron

79
Q

The vasa recta plays a role in what?

A

urine concentration

80
Q

what part of the kidney receives the most blood flow

A

renal cortex

81
Q

What does a mild to moderate sympathetic activation have on blood flow and GFR?

A

little or none

82
Q

What does a strong sympathetic stimulation do to GFR?

A

decreases GFR

83
Q

What would be some reasons for strong sympathetic signal to the kidney?

A

Defense reaction
Brain Ischemia
Severe Hemorrage

84
Q

What is the physiological effect of Epinephrine and Norepinephrine on GFR and blood flow?

What occurs when it is paired with sympathetic activity?

A

Constrict afferent and efferent arterioles

will only decrease GFR in extreme cases such as hemorrhages

85
Q

What hormone is typically released from damaged vascular endothelial cells of the kidney?

What is the end result?

A

endothelin

vasoconstriction to decrease blood loss

86
Q

Endothelin release is seen in what disease states?

What is the end result?

A

toxemia of pregnancy, acuterenal failure & uremia

renal constriction and reduce GFR

87
Q

Angiotension is a powerful vaso__________

A

constrictor

88
Q

What determines the release of Angiotensin II?

A

decreased arterial pressure or decreased blood volumn

89
Q

Which is more receptive to Angiotensin II?

a. afferent arterioles
b. efferent arterioles

A

b

90
Q

What is the purpose of Angiotensin II?

A

maintain GFR

91
Q

What hormone decreases flow through the peritubular capillaries=increase reabsorption of sodium and water in renal tubules

A

Angiotensin II

92
Q

What hormone maintain vasodilation of the kidney?

A

Endothelial derived nitric oxide

93
Q

What hormone allows for normal secretion of water and sodium?

A

Endothelial derived nitric oxide

94
Q

A patient with atherosclerosis and damage to the endothelium of the kidney might have decreased production of what hormone?

What will happen to vasoconstriction?

What will happen to blood pressure?

A

decreased nitric oxide production

increases

increases

95
Q

Prostaglandins and Bradykinin are vasodilators or vasoconstrictors?

What do they counteract?

A

Vasodilators

Vasoconstriction of the afferent tubules

96
Q

After surgery a patient is given a nonsteroidal drug like asperine, what is the purpose of this?

A

decreases the productions of prostoglandins and bradykinins which cause vasodilation

97
Q 
What is the effect of the follow on GFR?
Norepinephrine & epinephrine 
Endothelin 
Angiotension II 
Endothelial-derived nitric oxide
Prostoglandins
A 
decrease
decrease
prevents decrease
increase
increase
98
Q

What is an intrinsic mechanism of the kidneys that keeps blood flow andGFR relatively constant?

A

Autoregulatoin

99
Q

Arterial pressure can range from 75mmHg to 160mmHg with only about _______% change in GFR

A

10

100
Q

Without autoregulation an increase in blood pressure would quickly deplete what?

A

blood volume

101
Q

What feedback mechanism links sodium concentration at the macula densa with renal arteriole resistance?

This type of feedback does what?

A

Tubuloglomerular feedback

ensures a constant delivery of sodium to the distal tubules

102
Q

What does Tubuloglomerular feedback depend on?

A

juxtaglomerular complex (macula densa cells)

103
Q

What do macula densa cells do?

A

sense a decrease in sodium concentration

104
Q

In the Tubuloglomerular feedback mechanism, macula densa cells initiate a process that does what 2 major things?

A

Decreases resistance to blood flow in the afferent arterioles

Renin is released from juxtaglomerular cells

105
Q

How does the macula densa cells decrease resistance to blood flow in the afferent arterioles?

A

increases GFR

raises glomerular hydrostatic pressure

106
Q

What does renin do that is released from the juxtamedullar cells increase the formation of?

A

angiotension I

107
Q

angiotension I from the renin is converted into what?

What does this do to efferent arterioles?

A

angiotension II

Constriction

108
Q

The ability of the individual blood vessels in the body to resist stretching during increased arterial pressure

A

Myogenic mechanism

109
Q

What mechanism is thought to protect the kidney from an increase in blood pressure?

A

Myogenic Mechanism

110
Q

What mechanism of auto-regulation is thought not to have a direct effect on GFR and renal blood flow regulation?

A

Myogenic Mechanism

111
Q

Urinary excretion is equal to what?

A

Glomerular filtration - Tubular reabsorption + Tubular secretion

112
Q

Which is more vital?

a. tubular secretion
b. tubular reabsorbtion

A

b

113
Q

What play a role potassium and hydrogen ion excretion in the urine?

a. tubular secretion
b. tubular reabsorbtion

A

a

114
Q

What is the formula for secretion?

A

Glomerular filtration rate x Plasma concentration

Only works with substances that are freely filtered

115
Q

What is the glucose concentration of:

  1. plasma concentration
  2. Glucose filtered per day
  3. filtration
A
  1. 1g/L
  2. 180L/day
  3. 180g/day
116
Q

Glomerular filtration & tubular reabsorption of substancesare large compared to what?

A

excretion

117
Q

Tubular reabsorption is…

a. highly selective
b. nonselective

A

a

118
Q

Glomerular secretion is…

a. highly selective
b. nonselective

A

b

119
Q

Tubular secretion is…

a. active
b. passive
c. both

A

c

120
Q

What is the process for tubular reabsorption?

A

tubular epithelial membrane -> interstitial fluid -> Peritubular capillary membrane -> blood

121
Q

What are the two routs through the tubular epithelium?

A

trans cellular rout

paracellular rout

122
Q

Which rout goes through the tubular epithelium that goes through the cell membrane?

A

transcellular rout

123
Q

Which route through the tubular epithelium goes through the tight junctions of the cells?

A

paracellular rout

124
Q

What are two forms of active transport?

A

primary and secondary

125
Q

primary active transport is couple with what?

What is an example of this?

A

hydrolysis of ATP

sodium-potassium ATPase pump

126
Q

What kind of tubular reabsorption is coupled indirectly to the energy source (ie) ion gradiant?

What is an example of this?

A

secondary active transport

reabsorption of glucose through the renal tubules

127
Q

Water is primarily absorbed through by what mechanism?

A

passive

128
Q

The movement of sodium from the interstitial fluid to the Peritubular capillary is what kind of process?

A

passive

129
Q

Travel through the peritubular capillary walls into the blood is done by?

A

ultrafiltratioin

130
Q

What is required for secondary active transport?

what are their names?

A

a carrier molecule

Sodium Glucose co-transporters (SGLT2 &SGLT1)

131
Q

Where are the Sodium Glucose co-transporters (SGLT2 &SGLT1) typically located?

A

brush border

132
Q

What is the purpose of Sodium Glucose co-transporters (SGLT2 &SGLT1)?

A

transport glucose against a concentration gradient

133
Q

Where are the SGLT2 located?

A

early part of the proximal tubule

134
Q

Which carrier protein transports 90% of filtered glucose for reabsorption?

A

SGLT2

135
Q

Which carrier protein in located in the last part of the proximal tubule?

A

SGRT1

Renal Physiology (2 decks)

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