exam 4 Flashcards
1
Q
In individuals on a very low carbohydrate, high fat (ketogenic) diet the liver produces ketones, which enter the blood. Ketones are acidic. You would expect someone on a ketogenic diet to have _____________________arterial PCO2 compared to individuals on a standard American diet.
A
Lower
2
Q
The primary determinate of hemoglobin saturation is
A
PO2
3
Q
Which of the following would increase the affinity of hemoglobin for oxygen? (select all that apply)
Increase temperature
Increase the PCO2
Increase pH
Increase conc. Of DPG
A
Increasing pH
4
Q
Which of the following values is/are zero in healthy individuals? (select all that apply)
Oncotic pressure in Bowman’s capsule
Oncotic pressure in the glomerulus
Hydrostatic pressure in Bowman’s capsule
Hydrostatic pressure in the glomerulus
A
Oncotic pressure in bowman’s capsule
5
Q
what PO2 would cause a substantial increase in minute ventilation over normal levels
A
less than 60 mmHg
6
Q
what PCO2 would cause a substantial increase in minute ventilation over normal levels
A
greater than 40 mmHg
7
Q
Excessive water consumption during exercise or mental stress can lead to death by
A
hyponatremia
8
Q
The urinary bladder stretch receptor afferent neuron is
A
glutamatergic
9
Q
Activation of the urinary bladder stretch receptor leads, directly or indirectly, to
A
inactivation of the sympathetic and somatic
activation of the parasympathetic
10
Q
Activation of the urinary bladder stretch receptor directly leads to
A
activation of the parasympathetic
11
Q
If a substance is freely filtered in the renal corpuscle, and its concentration in the afferent arteriole is 35 mg/ml, what is its concentration in Bowman’s capsule in mg/ml?
A
35 mg/ml
12
Q
The location with the highest osmolarity in the body is
A
the inner renal pyramids
13
Q
V2 vasopressin receptors are located in
A
cortical collecting ducts
medullary collecting ducts
14
Q
Mineralocorticoid receptors are found in
A
distal convoluted tubules
cortical collecting ducts
15
Q
aldosterone does what to sodium
A
increases sodium reabsorption
16
Q
Atrial natriuretic factor does what to sodium
A
decreases sodium reabsorption
increases sodium filtration
17
Q
Reabsorption of bicarbonate ion occurs in all segments of the nephron EXCEPT
A
descending loop of Henle
18
Q
Aldosterone in the kidney does what to potassium
A
stimulates potassium secretion
19
Q
Calcium excretion is regulated in the
A
distal convoluted tubule
cortical collecting duct
20
Q
Regulation of renal phosphate excretion occurs in the
A
proximal convoluted tubule
21
Q
Parathyroid hormone does what
A
decreases phosphate reabsorption
increases calcium reabsorption
22
Q
T OR F: in healthy people, the renal excretion of glucose varies w/ glucose intake
A
false (there is unregulated reabsorption of glucose in healthy ppl)
23
Q
the fenestrae in glomerular capillaries are __ than in most other capillary beds
A
larger
24
Q
as plasma flows through the glomerular capillary there is largest
A
increase in oncotic pressure
25
net filtration pressure at the end of the glomerular capillary is usually
zero
26
the entire plasma volume is normally filtered how frequently
60 times per day
27
changing the level of smooth muscle activity in the afferent and/or efferent arterioles changes what
changes glomerular hydrostatic pressure
28
in non-regulated reabsorption, usually ___ of a filterest substance gets reabsorbed in the nephron
all
29
which of the following would tend to increase glomerular filtration rate
afferent arteriole vasodilation
efferent arteriole vasoconstriction
30
__ and anything bound to them in the plasma will not be filtered in to Bowman's capsule
protein
31
__ and anything bound to them in the plasma will not be filtered in to Bowman's capsule
proteins
32
approx what percent of the CO2 produced by cells stays in the blood as dissolved CO2
10%
33
approx what percent of the CO2 produced by cells binds to hemoglobin in the blood
30%
34
what is the name for hemoglobin that has CO2 bound to it
carbaminohemoglobin
35
normal body pH
7.4
36
venous blood pH
7.36
37
approx how much of the plasma that enters a glomerulus is usually filtered into Bowman's capsule
20%
38
what protein buffers blood pH by binding to hydrogen ions
deoxyhemoglobin
39
where, specifically, do you find the rhythm-generation neurons for respiration
pre-Botzinger complex
40
what organ makes DPG and what stimulates its release into the blood
kidney in response to low oxygen delivery
41
what are the names of the areas in the pons that regulate breathing
pneumotaxic center
apneustic center
42
where specifically do you find the peripheral chemoreceptors
aortic bodies
carotid bodies
43
peripheral chemoreceptors are directly sensitive to which two chemicals in the blood
oxygen and hydrogen
44
what effect do the pontine respiratory regions have on breathing
smooths the transition from inspiration to expiration and back to inspiration
45
what three variables determine the glomerular filtration rate
net filtration pressure
surface area available for filtration
permeability of corpuscular membranes
46
what is the equation for renal excretion based on the three basic renal processes
filtered + secreted - reabsorbed
47
what happens to the CO2 produced by cells and transported in the blood that does not stay dissolved or bound to hemoglobin
carbon dioxide is converted to bicarbonate ion (CO2+H2O equilibrium to H2CO3 via carbonic anhydrase equilibrium to HCO3- + H+)
48
what happens in the chloride shift in red blood cells
chloride is exchanged for HCO3- across the red blood cell plasma membrane
49
what are the five functions of the kidney that were mentioned in the video
regulates water and inorganic ion balance
removal of metabolic waste products
removal of foreign chemicals
gluconeogenesis
produces hormones/enzymes
50
what is the mechanism of action and effect of mesangial cells in the kidney
they contract around and close off glomeruli to decrease surface area for filtration
51
filtered load is calculated by
GFR * plasma concentration
52
excretion rate calculated by
concentration in urine * rate of urine collection (needs to be a number between 1-1000)
53
T OR F: increasing sodium consumption significantly increases blood pressure in most people
false
54
T OR F: how sodium gets across the apical membrane of kidney tubular cells varies depending on the segment of the tubule
true
55
T OR F: how sodium gets across the basolateral membrane of kidney tubular cells varies depending on the segment of the tubule
false
56
T OR F: water is actively reabsorbed by the kidney
false (water only moves by osmosis)
57
as sodium is reabsorbed, how does the osmolarity change in both the tubule and in the blood
tubule osmolarity decreases and blood osmolarity increase
58
activation of the ___ nervous system leads to micturition
parasympathetic
59
contraction of the detrusor muscle does what to urinary bladder compliance and pressure
decrease urinary bladder compliance and increases pressure
60
most water-soluble vitamins (are they filtered in kidney and how are they reabsorbed)
are filtered in the kidney and reabsorbed by transporters
61
sodium is reabsorbed in
ascending loop of henle
cortical collecting ducts
distal convoluted tubule
proximal convoluted tubule
62
sodium is NOT reabsorbed in
descending loop of Henle
medullary collecting ducts
63
reabsorption of many substances in the kidney is tied to the reabsorption of what ion
sodium
64
secretion of many substances in the kidney is tied to reabsorption of what ion
sodium
65
what nerve carries out post-ganglionic sympathetic axons toward the urinary bladder/sphincters
hypogastric
66
what nerve carries pre-ganglionic parasympathetic axons toward the urinary bladder/sphincters
pelvic nerve
67
what nerve carries alpha motor neuron axons toward the urinary bladder/sphincters
pudendal nerve
68
what nerve carries alpha motor neuron axons toward the urinary bladder/sphincters
pudendal nerve
69
what receptor for sympathetic nervous system/circulating epinephrine is present on the internal urinary sphincter and what type is it
alpha-1 adrenergic (Gq PCR)
70
what receptor for the sympathetic nervous system/circulating epinephrine is present on the detrusor muscle and what type is it
beta-2 adrenergic (Gs PCR)
71
what nerve carries urinary bladder stretch receptor afferents to the spinal cord
pelvic nerve
72
what receptor for the parasympathetic nervous system is present on the internal urinary sphincter, what type is it
M2 muscarinic (Gi PCR)
73
what receptor for the parasympathetic nervous system is present on the detrusor muscle and what type is it
M3 muscarinic (Gq PCR)
74
the micturition reflex cannot consciously be controlled until children are about how old
about 2 years
75
what is the name of the channel for sodium in the apical membrane of distal convoluted tubular cells
ENaC channel
76
substance is freely filtered in renal corpuscle, what is the concentration in the efferent arteriole vs. the afferent
they are equal (and equal to the concentration in bowman's capsule)
77
substance is freely-filtered, not secreted, not reabsorbed, what is the clearance equal to
clearance is = to GFR
78
equation for clearance
clearance = (urine concentration of substance * urine volume)/plasma concentration of substance
79
if clearance is less than the GFR then there is net ___
reabsorption
80
what are the three substances normally excreted from the body that contain sodium (and which has the greatest variation in the amount of sodium excreted based on needs of the body)
urine (most variation bc regulated)
sweat
feces
81
what are the four locations where water is normally lost from the body (which is regulated to control total body water)
urine (regulated)
feces
sweat
respiration
82
what are four conditions mentioned in the video that can lead to greater than normal sodium and water loss
severe sweating
hemorrhage
vomiting
diarrhea
83
physiological definition of clearance
the volume of plasma completely cleared of a particular substance per unit of time
84
T OR F: decreasing mean arterial pressure decreases hydrostatic pressure in the glomerulus
true
85
T OR F: atrial natriuretic factor stimulates aldosterone production
false
86
T OR F: atrial natriuretic factor is not usually important in regulating sodium in the body of healthy people
true
87
T OR F: increases in blood pressure can increase sodium reabsorption directly
false
88
vasopressinergic neurons are more sensitive to changes in __ around the normal range
osmolarity
89
vasopressin is released in response to
high body osmolarity
90
stress tends to do what to vasopressin
increase vasopressin release
91
the arterial end of renal vasa recta capillaries absorbs __ solute than water
more
92
normally, __ of the sodium filtered is excreted in the urine
a variable amount
93
activation of the sympathetic nervous system to the kidney ____ glomerular filtration rate
decreases
94
as filtrate travels up a juxtamedullary loop of Henle, its osmolarity ____ as _____ are ____
osmolarity decreases as ions are reabsorbed
95
the greatest osmolarity difference that can develop across a tubular cell apical membrane in the loop of Henle is about
200 mOsm
96
sodium is actively transported across ___ of ascending loop of Henle tubular cells
the basolateral membrane
97
potassium is actively transported across ___ of ascending loop of Henle tubular cells
both the apical and basolateral membranes
98
chloride is actively transported across ____ of ascending loop of Henle tubular cells
the apical membrane
99
the countercurrent systems in the kidney can create an interstitium osmolarity of up to about
700 mOsm
100
in the kidney, sodium is
freely filtered and reabsorbed
101
the sympathetic nervous system causes (___ arteriole vaso__)
afferent arteriole vasoconstriction
no effect on efferent
102
atrial natriuretic factor causes (___ arteriole vaso___)
afferent arteriole vasodilation
efferent arteriole vasoconstriction
103
when more water is reabsorbed in the medullary collecting duct (effect on sodium and urea?)
more urea is reabsorbed
(sodium is independent of water in this segment)
104
a decrease in total body sodium, without a change in total body water will do what to blood volume
decrease blood volume
105
which adrenergic receptor is present on renal arteriolar smooth muscle
alpha-1 adrenergic receptor
106
what type of receptor is the V2 vasopressin receptor
Gs PCR
107
what type of receptor is the mineralocorticoid receptor
intracellular receptor
108
what is the specific water channel that can be on the apical membrane of a collecting duct tubule cell
aquaporin-2
109
which type of nephrons help create the hypertonic interstitium in the renal pyramids
juxtamedullary nephrons
110
what is the rate-limiting enzyme in the production of angiotensin II
renin
111
what word means increase sodium in the urine
natriuresis
112
what solute is the most concentrated in the urine
urea
113
where is vasopressin released into the blood
posterior pituitary
114
what hormone was mentioned in the video as a stimulator of aldosterone production
angiotensin II
115
what organ and part of that organ produces aldosterone
adrenal cortex
116
where specifically is vasopressin made
supraoptic nucleus and paraventricular nucleus (both of the hypothalamus)
117
which three ions are transported by the co-transporter on the apical membrane of ascending loop of Henle tubular cells
Na+, K+, Cl-
118
three genes whose transcription increases with the activation of the mineralocorticoid receptor
ENaC
Na+/K+ pump
apical K+ leak channels
119
describe the mechanism of action for caffeine as a diuretic
inhibits the release of vasopressin
120
what does countercurrent mean in renal physiology
liquid flows through tubes with hairpin loops so that the liquid flows in opposite directions right next to each other
121
which two structures in the kidney have a countercurrent
loop of Henle and vasa recta
122
T OR F: almost all of the potassium in the glomerular filtrate is reabsorbed in the proximal convoluted tubule and loop of Henle
true
123
T OR F: usually more water and electrolytes are secreted into the digestive tract each day than are consumed
true
124
T OR F: if the kidney reabsorbs all of the bicarbonate ion from the tubule, it will stop the secretion of hydrogen ion
false
125
T OR F: buffers remove hydrogen from the body
false, they can bind to it
126
higher consumption of potassium is associated with ___ blood pressure
lower
127
the secretion of hydrogen across the apical membrane of renal tubular cells is
active
128
the reabsorption of bicarbonate ion across the basolateral membrane of tubular cells is
passive
129
carbonic acid is a ___ acid
weak acid
130
which organ system can respond quicker to changes in blood pH (pulmonary or urinary?)
pulmonary
131
if you have acidosis and both blood CO2 and bicarbonate levels are low, what is the cause of the acidosis (kidneys or lungs)?
kidneys
132
if you have alkalosis and both blood CO2 and bicarbonate levels are low, what is the cause of the alkalosis (kidneys or lungs)
lungs
133
tubular cells in all segments of the nephron have potassium channels on ___ membrane
their basolateral
134
increasing blood potassium levels directly __
increases potassium secretion
135
most of the regulation of the final composition of the urine occurs in the
distal convoluted tubule and collecting ducts
136
bicarbonate ion is a
weak base
137
in the kidney, calcium is
reabsorbed
138
in the kidney, phosphate is
reabsorbed
139
phosphoric acid and sulfuric acid result from the breakdown of __ in the body
proteins
140
what hormone is the primary regulator of potassium in the kidney
aldosterone
141
scientific word for chewing
mastication
142
what ion can directly stimulate the release of aldosterone
potassium
143
what abnormal condition can lead to alkalosis if not compensated for
vomiting
144
what abnormal condition can lead to acidosis if not compensated for
diarrhea
145
what two hormones are the primary regulators of calcium excretion by kidney
vitamin D
parathyroid hormone
146
what are the three stimuli for thirst
increased blood osmolarity
decreased plasma volume
dry mouth/throat
147
which stimulus for thirst may involve angiotensin II
decreased plasma volume
148
most common forms of carbohydrates consumed
which of these can be absorbed
starch, disaccharides, monosaccharides
monosaccharides absorbed
149
what form of proteins can be absorbed
amino acids
150
most common forms of lipids consumed
which can be absorbed?
triglycerides
monoglycerides + free fatty acids can be absorbed
151
the circadian rhythm of gastric acid secretion leads to a ___ stomach luminal pH in the morning
higher
152
there is no strong evidence that the sympathetic nervous system innervates anything in the digestive tract except
blood vessels
153
contraction that moves material through digestive tract by a wave that moves distally through the organ
peristalsis
154
what protein moves hydrogen across the apical membrane of a parietal cell
H+/K+ pump
155
what protein moves chloride across the basolateral membrane of a parietal cell
Cl-/HCO3- exchanger
156
what is the primary purpose of stomach acid
kill pathogens
157
gastric phase of gastric acid secretion is primarily dependent on which secretagogue of gastric acid
gastrin
158
what type of receptor is the M4 muscarinic receptor
Gi PCR
159
which two nerves carry parasympathetic pre-ganglion neurons to the gut
vagus nerve
pelvic nerve
160
two secretagogues for histamine in the stomach
gastrin
acetylcholine
161
two effects the secretagogues for gastric acid have in the parietal cell that lead to the secretion
cause insertion of the tubulovesicles containing the H+/K+ pumps into the apical plasma membrane
increases activity of the H+/K+ pumps
162
names of the two enteric plexes, where is each located in the walls of the GI tract
myenteric plexus - between the longitudinal and circular muscularis externa
submucosal plexus - between the submucosa and the muscularis externa
163
two inhibitors of acid secretion that act on the parietal cell
what type of receptor does each act on
somatostatin and prostaglandins
both act on Gi PCRs
164
two other ways that somatostatin and prostaglandin decrease gastric acid secretion (besides direct effects)
inhibit gastrin and histamine secretion
165
stimuli for acetylcholine secretion onto parietal and ECL cells
smell, taste, thought of food, tactile sensation of food in the mouth
gastric distension
166
stimuli for gastrin release into the blood
peptides in lumen of antrum
gastrin releasing peptide
167
three phases of gastric acid secretion in response to meal (and what percent of total acid in each phase)
cephalic (30%)
gastric (50-60%)
intestinal (5-10%)
168
what is the mechanism for the cephalic phase of gastric acid secretion
acetylcholine release from activation of vagus nerve onto ECL and parietal cells + gastrin releasing peptide on G cells
169
steps of deglutition
voluntary phase - tongue pushes bolus toward pharynx
pharyngeal phase - soft palate moves up, elevation of pharynx, bolus push epiglottis down, open upper esophageal sphincter
esophageal phase - peristaltic contractions, lower esophageal sphincter opens
170
secretagogues of gastric acid
gastrin, acetylcholine, histamine
171
what receptor does gastrin act on and what type of receptor is it
CCKB - Gq PCR
172
what receptor does acetylcholine act on and what type of receptor is it
M3 muscarinic - Gq PCR
173
what receptor does histamine act on and what type of receptor is it
H2 - Gs PCR
174
The primary central input to the enteric nervous system comes from the ________________ nervous system.
parasympathetic
175
Relaxation of the fundus during gastric accommodation is dependent on
the vagus nerve
176
Which cells release somatostatin?
D cells
177
What receptor for acetylcholine is on D cells
M4 muscarinic receptor
178
hemoglobin has ___ affinity for oxygen in the pulmonary capillaries versus the systemic capillaries
higher
179
carbonic anhydrase is found
in red blood cells but not the plasma
180
T OR F: carbon dioxide binds covalently to hemoglobin
FALSE
181
hyperventilation leads to respiratory ___
alkalosis
182
inspiratory neurons are found in the
both the dorsal and ventral respiratory groups
183
expiratory neurons are found in the
ventral respiratory group
184
T OR F: lung stretch receptors are important regulators of breath depth at rest
false
185
central chemoreceptors respond (directly or indirectly) to changes in which arterial blood chemicals
carbon dioxide
186
what is the primary organ to do gluconeogenesis in the body
liver
187
all epithelial cells have the sodium-potassium pump in
their basolateral membrane
188
in non-regulated reabsorption, the substance
may appear in the urine if the blood concentration is high enough
189
T OR F: the renal clearance of all freely-filtered substances equals the glomerular filtration rate
false
190
the clearance of creatinine is ___ related to the glomerular filtration rate
greater than the GFR
191
the internal urinary sphincter is innervated by
sympathetic nervous system
192
the parasympathetic nervous system innervates the (muscles of the bladder?)
detrusor muscle and internal urinary sphincter
193
the somatic nervous system innervates the (muscles of the bladder)
external urinary sphincter
194
aquaporin-2 can be found
inside the tubule cell
the apical membrane of a tubule cell
195
the V2 vasopressin receptor can be found
basolateral membrane of a tubule cell
196
vasopressin causes water channels to move from
intracellular vesicles to the apical membrane
197
T OR F: all cells always have aquaporin channels in their plasma membrane
true
198
vasopressin does what to water in the kidney
increases water reabsorption in the kidney
199
low vasopressin levels leads to
water diuresis
200
diabetes mellitus is associated with
osmotic diuresis
201
T OR F: the highest osmolarity the urine can have is close to 300 mOsm
false
202
T OR F: all the loops of Henle participate in creating a hypertonic interstitium in the renal pyramids
false
203
as filtrate travels down a long loop of Henle
its osmolarity increases as water is reabsorbed
204
sweat is __osmotic
hypoosmotic
205
the primary stimulus for thirst in most situations is
high body osmolarity
206
T OR F: if you are thirsty and drink water, you will stop feeling thirsty before your osmolarity returns to normal
true
207
changes in blood potassium levels has the biggest effect on the
heart
208
it is more important for our survival to regulate ___ levels
potassium levels
209
in the kidney, potassium is
freely filtered, reabsorbed, secreted
210
in order to regulate blood potassium concentration, renal ___ of potassium is regulated
secretion
211
in the kidney, bicarbonate ion is
freely filtered, reabsorbed, secreted
212
increasing extracellular potassium causes cells to
depolarize
213
T OR F: enteric neurons can be post-ganglionic neurons in the parasympathetic nervous system
true
214
circulating epinephrine ____ digestion
slows down
215
generally, sphincters contract in response to increased ___ pressure
distal
216
T OR F: the lower esophageal sphincter in humans allows backflow
true
217
in response to proximal pressure, the reflex response of the external anal sphincter is to
contract
218
in response to food entering the stomach
the fundus of the stomach relaxes
219
T OR F: gastric pressure usually increases as the volume of food in the stomach increases from zero
false
220
about _____ of chyme is delivered to the small intestine from the stomach at a time
two teaspoons
221
gastrin ___ somatostatin secretion
stimulates
222
acetylcholine ___ somatostatin secretion
inhibits
