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Physiology > Exam #3: Renal Phys > Flashcards

Exam #3: Renal Phys Flashcards

0
Q

What is the first step in urine formation?

A

Blood being ultrafiltrated across the glomerular capillaries and into Bowman’s space.
-p.239 Cos

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1
Q

List the constituents of the nephron/renal tubule (5; one of them with its own three subdivisions)

A
  1. ) Proximal convoluted tubule
  2. ) Proximal STRAIGHT tubule
  3. ) Loop of Henle: a.) Thin descending limb b.) Thin ascending limb c.) Thick ascending limb
  4. ) Distal convoluted tubule
  5. ) Collecting ducts
    - p.239 Cos
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2
Q

What is the unique feature of the epithelial cells lining the proximal convoluted tubule and what purpose does it serve?

A

A BRUSH BORDER (an extensive development of microvili) on their luminal side. The brush border provides a large surface area for the major resorptive function of the proximal convoluted tubule.
-p.240 Cos

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3
Q

Name and distinguish between the two types of nephrons

A
  1. ) Superficial cortical nephrons:
    - Have their glomeruli in the OUTER CORTEX.
    - These nephrons have relatively short loops of Henle, which descend only into the OUTER MEDULLA.
  2. ) Juxtamedullary nephrons:
    - Have their glomeruli near the corticomedullary border.
    - Their glomeruli are larger than the of the superficial cortical nephrons and, accordingly…
    - have HIGHER GLOMERULAR FILTRATION RATES.
    - Characterized by long loops of Henle that descend deep into the inner medulla and papilla and are essential for the concentration of urine.
    * p.238 Cos*
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4
Q

What are the major differences between the two types of nephrons (2)?

A
  1. ) Juxtamedullary have larger glomeruli than superficial cortical nephrons and thus have a higher glomerular filtration rate.
  2. ) They also have LONGER LOOPS OF HENLE (descend into the inner medulla and papilla).
    - p.240 Cos
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5
Q

How are the two types of nephrons distinguished from one another? Describe

A

They are distinguished by the location of the glomeruli:

  • Superficial cortical nephrons have their glomeruli in the OUTER CORTEX
  • Juxtamedullary nephrons have their glomeruli near the CORTICOMEDULLARY BORDER
  • p.240 Cos
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6
Q
  1. ) What type of vessels deliver blood to the glomerular capillaries?
  2. ) What type of vessels carry blood away from the glomerular capillaries?
A
  1. ) Afferent arterioles
  2. ) Efferent arterioles
    - p.240 Cos
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7
Q

Describe the difference in blood supply to the two types of nephrons

A

1.) Superficial cortical nephrons have PERITUBULAR CAPILLARIES that branch off of efferent arterioles and deliver nutrients to the epithelial cells. These capillaries also serve as the blood supply for reabsorption and secretion.

  1. ) Juxtaglomerular nephrons have peritubular capillaries with a specialization called the VASA RECTA –> these are long, hairpin- shaped blood vessels that follow the same course as the loop of Henle. The VASA RECTA serve as osmotic exchangers for the production of concentrated urine.
    - p.240 Cos
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8
Q

Water accounts for ____ to _____ % of body weight, with an average value of about _____ %.

A

Accounts for 50-70%, average value is 60%

-p.214 Cos

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9
Q
  1. ) The percentage of total body water depends on what two things?
  2. ) Body water content correlates INVERSELY with _______.
A
  1. ) Gender and amount of Adipose Tissue
  2. ) Body water content inversely correlates with FAT CONTENT
    - p.241 Cos
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10
Q

In the absence of other explanations, a sudden weight loss of 3kg reflects a loss of _______.

A

a loss of 3kg (≈ 3L) of TOTAL BODY WATER.

-p.241 Cos

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11
Q

a. ) How/where is total body water distributed (2 places)? Give the relative distribution in a fraction.
b. ) Give the relative distribution in terms of % of total body weight.

A
  1. )
    a. ) 2/3 in Intracellular Fluid (ICF)
    b. ) 40% of total body weight in ICF (2/3 of 60%)
  2. )
    a. ) 1/3 in Extracellular Fluid (ECF)
    b. ) 20% of total body weight in ECF (1/3 of 60%)
    p. 241 Cos
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12
Q

What does the 60-40-20 rule state?

A

The 60-40-20 rule states that 60% of body weight is water, 40% is ICF, and 20% is ECF.
-p.241 Cos

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13
Q

How is fluid divided within ECF? Describe/define

A

1.) Approximately 3/4 of ECF is in the INTERSTITIAL COMPARTMENT (interstitial fluid BATHES THE CELLS).

  1. ) 1/4 is found in the PLASMA (fluid that circulates in BLOOD VESSELS).
    - p.242 Cos
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14
Q

Define ICF and ECF

A
  1. ) ICF (intracellular fluid) is the water INSIDE THE CELLS in which ALL intracellular solutes are dissolved. Constitutes 2/3 of total body water, or 40% of total body weight.
  2. ) ECF (extracellular fluid) is the water OUTSIDE the cells. Constitutes 1/3 of total body water, or 20% of total body weight.
    - p.242 Cos
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15
Q

What are the major cation(s) and anion(s) in:

  1. ) ICF
  2. ) ECF
A

1.) ICF cations: K+, Mg2+
ICF anions: Proteins and organic phosphates (e.g. ATP, ADP, AMP).

2.) ECF cation: Na+
ECF anions: Cl-, HCO3- (bicarbonate)

-p.242 Cos

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16
Q

Plasma is the ____ component of ______, i.e. it is the fluid in which ______ are _______.

A

Plasma is the AQUEOUS COMPONENT of BLOOD, i.e. it is the fluid in which BLOOD CELLS are SUSPENDED.
-p.243 Cos

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17
Q

Plasma constitutes ____% of blood volume. What constitutes the rest?

A

Plasma constitutes 55% of blood volume, BLOOD CELLS constitute the remaining 45%.
-p.243 Cos

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18
Q

The percentage of blood volume occupied by RBCs is called _____, which averages about ______%, and is higher in _______.

A

It is called HEMATOCRIT, and averages about 45%. It is higher in MALES (approx. 48%) than in females (42%).
-p.243 Cos

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19
Q

Plasma proteins constitute approximately ____% of plasma by volume.

A

7%

-p.243 Cos

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20
Q

Interstitial fluid is a(n) _______ of plasma

A

Interstitial fluid is an ULTRAFILTRATE of plasma

-p.243 Cos

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21
Q

What is interstitial fluid and what is its composition?

A

It is an ultrafiltrate of plasma and has nearly the same composition apart from: It has not plasma proteins and no blood cells.
-p.243 Cos

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22
Q

Describe the relative concentrations of small cations and small anions in plasma. What explains this distribution?

A

Slightly higher [small cations], e.g. Na+, and slightly lower [small anions], e.g. Cl-. Explained by the Gibbs-Donovan Effect.
-p.243 Cos

23
Q

What do longer loops of Henle facilitate?

A

MORE concentrating ability.

-Slides (lecture 37)

24
Q

In a typical nephron, give the relative quantities of short vs long loops of Henle expressed as fractions

A
  • 7/8 Cortical/Short loops of Henle
  • 1/8 Juxtamedullary/Long loops of Henle

-Slides (lecture 37)

25
Q

What are the markers used to measure the following volumes:

  1. ) Total body water
  2. ) ECF volume
  3. ) Plasma volume
  4. ) ICF volume
  5. ) Interstitial fluid volume
A
  1. ) Isotopic water (e.g. D2O, titrated water [THO]), and antipyrine (a lipid soluble substance).
  2. ) Substances that distribute throughout the ECF but don’t cross cell membranes, e.g. large MW sugars (mannitol, inulin), and large MW anions (e.g. Sulfate).
  3. ) Substances that distribute in plasma but not in interstitial fluid because they are too large to cross capillary walls, e.g. radioactive ALBUMIN, Evans blue (a dye that binds to albumin).
  4. ) No marker –> Total body water – ECF volume = ICF volume
  5. ) No marker –> ECF volume – Plasma volume = ISF volume
    - p.243 Cos
26
Q

How is the volume of a marker substance calculated? Give equation and define variables.

A

Volume = Amount ÷ Concentration
where…
Volume = Volume of distribution (L) or Volume of body fluid compartment (L)
Amount = Amount of marker injected – Amount excreted (mg)
Concentration = Concentration in plasma (mg/L)

-p.244 Cos Do sample problem on this page!!!

27
Q
  1. ) How can one determine blood volume from plasma and hematocrit volume?
  2. ) or plasma volume from blood volume and hematocrit?
A
  1. ) Blood volume = Plasma volume ÷ (1 – Hematocrit)

2. ) Plasma volume = Blood volume · (1 – Hematocrit)

28
Q

The volume of a body fluid compartment depends on the _______. Give an example.

A

Depends on the AMOUNT OF SOLUTE IT CONTAINS, e.g. ECF volume is determined by the amount of NaCl and NaHCO3 it contains.
-p.245 Cos

29
Q

What is osmolarity? What is the normal value for osmolarity of the body fluids?

A

Osmolarity is the concentration of osmotically active particles, expressed as milliosmoles per liter (mOsm/L).

  • Normal value is 290 mOsm/L, or, for simplicity, 300 mOsm/L*
  • p.245 Cos
30
Q

In a steady state, _____ osmolarity is equal to ______ osmolarity. How is this equality maintained?

A

INTRACELLULAR osmolarity equals EXTRACELLULAR osmolarity. This equality is maintained by water shifting freely across cell membranes.
-p.245 Cos

31
Q

If a person ingests a large quantity of NaCl, what compartment will the NaCl be added to and increase the total solute content of? Why?

A

ECF compartment because solutes such as NaCl and NaHCO3, and large sugars such as mannitol do not readily cross cell membranes and are ASSUMED to be confined to the ECF compartment.
-p.245 Cos

32
Q

Define volume CONTRACTION and EXPANSION

A

Volume contraction: Means a decrease in ECF volume.
Volume expansion: Means an increase in ECF volume.
-p.245 Cos

33
Q

Define isosmotic, hyperosmotic, and hypoosmotic disturbances in terms of ECF osmolarity.

A
  1. ) Isosmotic disturbance: No change in ECF osmolarity
  2. ) Hyperosmotic disturbance: Increase in ECF osmolarity
  3. ) Hyposmotic disturbance: Decrease in ECF osmolarity
    - p.245 Cos
34
Q

What type of disturbance occurs as a result of diarrhea or a burn? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

Isosmotic volume contraction.

a. ) Decreased
b. ) NC
c. ) NC
d. ) Increased
e. ) Increased
- p.245 Cos

35
Q

What type of disturbance occurs as a result of sweating, fever, and diabetes insipidus? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

HYPERosmotic volume contraction

a. ) Decreased
b. ) Decreased
c. ) Increased
d. ) NC
e. ) increased
- p.245 Cos

36
Q

What type of disturbance occurs as a result of adrenal insufficiency? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

HYPOsmotic volume contraction

a. ) Decreased
b. ) increased
c. ) decreased
d. ) increased
e. ) increased
- p.245 Cos

37
Q

What type of disturbance occurs as a result of infusion of isotonic NaCl? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

Isosmotic volume contraction

a. ) increased
b. ) NC
c. ) NC
d. ) decreased
e. ) decreased
- p.245 Cos

38
Q

What type of disturbance occurs as a result of high NaCl intake? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

HYPERosmotic volume contraction

a. ) increased
b. ) decreased
c. ) increased
d. ) decreased
e. ) decreased
- p.245 Cos

39
Q

What type of disturbance occurs as a result of Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)? Give the changes in a.) ECF volume, b.) ICF volume, c.) osmolarity, d.) hematocrit, and e.) [plasma protein]

A

HYPOsmotic volume expansion

a. ) increased
b. ) increased
c. ) decreased
d. ) NC
e. ) decreased
- p.245 Cos

40
Q

Sweat is ______ relative to ECF. What does this mean?

A

Sweat is HYPOsmotic relative to sweat. This means that when compared with body fluids, sweat contains relatively MORE WATER THAN SOLUTE.
-p.247 Cos See sample problem on this page

41
Q

What ratio does renal clearance express?

A

The ratio of urinary excretion ([U] x V) to plasma concentration.
-p.249 Cos

42
Q

For a given plasma concentration, renal clearance of a substance increases as _____ increases

A

Urinary excretion

-p.249 Cos

43
Q

______ is filtered and then completely reabsorbed back into the bloodstream.

A

Glucose

-p.250 Cos

44
Q

Autoregulation of RBF is primarily controlled at the level of (afferent or efferent arterioles)?

A

Afferent

45
Q

Kidneys receive ___% of cardiac output (CO) each minute

A

25%

46
Q

List 4 vasoconstrictors and 3 vasodilators

A

Constrictors: Sympathetic nerves, Catecholamines, Angiotensin II (AT II), Endothelin.
Dilators: Prostaglandins (E2, I2), Nitric oxide, Bradykinin

47
Q

What receptors are present in the kidney and what do they do?

A

Alpha = CONSTRICTS (Afferent > Efferent)

NO ß!!! ß-1 does renin only

48
Q

(1 – Hematocrit) is what?

A

The fraction of blood volume that is occupied by plasma

49
Q

What does ultrafiltrate contain?

A

water and small solutes of blood…NO PROTEIN or BLOOD CELLS
-p.254 Cos

50
Q
  1. ) Which layer is the most significant barrier of the glomerular capillary?
  2. ) What are its layers?
A
  1. ) Basement membrane

2. ) Lamina rara interna, lamina densa, lamina rara externa

51
Q

What causes excessive urination in patients with DM or glucose intolerance?

A

The presence of non-reabsorbed glucose in tubular fluid acts as an osmotic diuretic, which holds water and increases urine production.

53
Q

Where is the first 50% of urea filtered out of the blood?

A

Proximal tubule

54
Q

What are the normal ABG values for pH, pCO2, HCO3-, and anion gap range?

A 
pH: 7.40
pCO2: 40
HCO3–: 24
Anion gap: 6-12
L48a, #3
55
Q

Aldosterone increases _______ excretion.

A

ACID excretion.

-Fischer

56
Q

Aldosterone increases _______ excretion.

A

ACID excretion.

-Fischer

Physiology (5 decks)

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