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Physio Final > Excretory > Flashcards

Excretory Flashcards

1
Q

What are the kindneys drained by?

A

Renal pelvis & ureters into bladder

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2
Q

What drains the bladder?

A

Urethra

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3
Q

Micturition

A

Urination

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4
Q

Minor caylx

A

Where concentrated urine drops into from apilla of renal pyramids –>drops into major caylx

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5
Q

What do the renal pelvis, renal calyces, ureter, and bladder all undergo?

A

Peristalsis

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6
Q

Functional of the kidney?

A

Nephron

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7
Q

What artery & vein delivers blood in between medullary regions of renal pyramids?

A

Interlobar artery & vein

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8
Q

What artery & vein is in between the cortex & medulla?

A

Arcuate artery & vein

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9
Q

What artery & vein are in the cortex of the kidney?

A

Interlobular artery & vein

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10
Q

What is the two capillary beds are linked in the renal system?

A

Glomerular capillaries (fed & drained by artery) & peritubulular capillaries

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11
Q

Where do all the collecting ducts fill into?

A

Renal papillae

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12
Q

Where is the renal glomerulus/renal corpuscle always located?

A

In the cortex

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13
Q

Which kinds of nephrons have longer loops of Henle?

A

Juxtamedullary nephrons

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14
Q

Which type of nephron is more abundant?

A

Cortical nephrons

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15
Q

What is the makeup of the interior of proximal convoluted tubule?

A

Cuboidal cells with many microvilli

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16
Q

What is the importance of the osmotic gradients in the medulla?

A

Countercurrent flow to allow higher capillary pressure & no venous collection

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17
Q

What are the layers of the glomerular capillaries?

A

Fenestrated endothelium
Basal lamina
Slit diaphragm by podocyte pedicels w/ glycogalyx to prevent charged molecules & proteins out

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18
Q

Which arteriole is bigger?

A

Afferent bigger than efferent

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19
Q

Where does aldosterone have an effect?

A

Distal tubule & cortical collecting duct

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20
Q

What effect does the juxtaglomerular apparatus have?

A

Reuptake Na+ to increase blood pressure & GFR

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21
Q

What do granular cells contain?

A

Renin

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22
Q

What does renin do?

A

Convert angiotensinogen to angiotensin I

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23
Q

What converts Angiotensin I to Angiotensin II?

A

ACE

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24
Q

What stimulates aldosterone formation?

A

ACE

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25
Q

What do macula densa cells detect?

A

Detect chloride through glomerular fluid

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26
Q

What negatively feedsback to shut off renin secretion?

A

Chloride in the distal convoluted tubule

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27
Q

3 Things that occur to form concentrated urine?

A

Filtration
Reabsorption
Secretion

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28
Q

Glomerular forces

A

PC= 55mmHg out
Hydrostatic pressure=15 mmHg in
Blood osmotic pressure=30 mmHg in (proteins

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29
Q

Total pressure out in the glomerulus?

A

10 mmHg out

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30
Q

Average blood volume filtered into Bowman’s capsule/GFR

A

180 L/day or 125 mL/minute

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31
Q

Total blood volume

A

5.5 L

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32
Q

How much urine excreted a day?

A

1-2 Liters

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33
Q

How much blood goes straight to kidneys?

A

20-25%

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34
Q

How often is blood volume filtered?

A

Every 40 minutes

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35
Q

What is special about inulin?

A

It is completely filtered- neither reabsorbed or secreted -used to calculate GFR

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36
Q

How to calculate GFR from inulin?

A

urine in 24 hrs x inulin in urine / inulin in plasma = liters plasma filtered in 24 hrs

V x U/P

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37
Q

How does the renal plasma clearance of a substance that is reabsorbed compare to GFR?

A

Less than

38
Q

How does renal plasma clearance of a substance secreted compare to GFR?

A

Greater than

39
Q

What is phosphate concentration used for?

A

Compare to GFR to see if substance was secreted or absorbed- using phosphate concentrations compared to L plasma/day

40
Q

Extrinsic control of GFR

A

Sympathetic nerve innervation due to change in blood pressure or exercise

41
Q

Intrinsic regulation of GFR

A

Renal autoregulation

42
Q

What happens when blood pressure drops or exercise state?

A

Baroreceptor reflex –>Sympathetic nerve activity–> inc cardiac output, vasoconstriction in skin, GI tract, vasoconstriction of afferent arterioles –>Decrease GFR–>decrease urine –>decrease blood volume

43
Q

What is the effect of blood pressure fluctuations on the GFR?

A

Lower blood pressure means less pressure out at the glomerulus & more waste stuck in blood

44
Q

Where does aldosterone come from?

A

Mineralocorticoid in zona glomerulosa of adrenal cortex

45
Q

Autoregulation: What does afferent arteriole constriction do?

A

Decrease GFR, decrease blood pressure during blood pressure increase so it stays the same

46
Q

Autoregulation: What does efferent arteriole constriction/afferent vasodilation do?

A

Increase GFR, increase blood pressure so it stays the same if it drops

47
Q

What causes the osmotic pressure of the blood (30 mmHg)

A

Albumin protein fraction

48
Q

What kind of receptors are in granulosa cells that increase blood pressure?

A

B1 adrenergic

49
Q

What are the 2 forms of renal autoregulation?

A

Tubuloglomerular feedback (ascending limb of loop of Henle –>Afferent arteriole

50
Q

Myogenic effect of renal autoregulation

A

Higher BP–>causes afferent vasoconstriction- decrease GFR

Lower BP–> causes afferent vasodilation to increase GFR

51
Q

Where is NaCl reabsorption

A

Most in proximal tubule, remainder in collecting duct under ADH stimulation

52
Q

What is the minimum urine a day to excrete metabolic wastes?

A

400 mL

53
Q

How much of the 180 L/day is reabsorbed unregulated by proximal tubule & decending limb?

A

85%

54
Q

What happens at the ascending limb of Loop of Henle?

A

Apical filtrate:
Cotransporter: Na+ in/K+ out & 2Cl- in to tubular cell
Basolateral side:
ATP transports Na+ out/K+ in & Cl- out into interstitial space

55
Q

What do macula densa cells have to detect GFR?

A

Na+/K+/Cl- pumps that uptake Cl- (due to increased flow)

Release adenosine to decrease GFR

56
Q

What is released by macula densa cells to decrease GFR?

A

Adenosine

57
Q

Different mechanisms for when blood pressure goes up

A

Up: Cl- coming into the cell–>cell swells with water & causes release of ATP –>converts to adenosine–>adenosine constricts afferent & dilate efferent–>GFR goes down

58
Q

Different mechanism when blood pressure goes down

A

Cl- concentration into macula densa goes down–>increases production of prostaglandin E2–>results in release of prostaglandin E2

59
Q

High aldosterone at the distal tubule causes?

A

Hypokalemia & Alkalosis (increased secretion into filtrate)

60
Q

Low aldosterone at the distal tubule causes?

A

Hyperkalemia & acidosis (decreased secretions into filtrate)

61
Q

What is the transport maximum of plasma glucose?

A

375 mg/min

62
Q

What is the max concentration of plasma glucose reabsorbed?

A

300 mg %

63
Q

How is glucose taken up from kidney lumen?

A

1.)Apical cotransport with Na+ into proximal tubule cell
2.)Na+/K+ ATP pump so Na+ out & K+ in
Glucose uses facilitated diffusion to diffuse into blood

64
Q

Where does glucose reabsorption take place?

A

Proximal tubule

65
Q

What causes water reabsorbtion near proximal tubule & decending limb?

A

Active transport of Na+ & Cl- inter interstitial tissues by the ascending limb & reaborption by capillaries

66
Q

What is the osmolarity of blood glucose coming from the glomerulus?

A

300 mOsm

67
Q

Does the decending limb & proximal tubule have hormonal regulation?

A

No

68
Q

Which limb is impermeable to Na+/Cl- & permeable to water?

A

Decending limb

69
Q

What is the osmolarity when nephron = interstital fluid concentration?

A

1400 mOsm

70
Q

What happens as water moves out the decending limb?

A

Filtrate becomes more concentrated

71
Q

Why doesnt concentration gradient wash away?

A

Countercurrent mechanisms in vasa recta to trap NaCl

72
Q

What kind of feedback is in the ascending limb?

A

Counter-current positive feedback, more Na+ out, more concentrated fluid delivered to it

73
Q

Vasa recta is freely permeable to

A

Water (aquaporins) & NaCl

74
Q

Where is permeability regulatable by hormones?

A

Distal tubule& collecting duct

75
Q

Where does ADH come from?

A

posterior pituitary inside Herring bodies from supraoptic & paraventricular nuclei

76
Q

ADH binding causes?

A

prodcution of cAMP to cause vesicles of aquaporins to bind to plasma membrane and release water

77
Q

What causes ADH secretion?

A

Dehydrated state, excess Na+/concentrated blood

78
Q

Where does water flow with more ADH?

A

From collecting duct & into blood

79
Q

Diuretics

A 
Water
Alcohol
Glucose (osmotic diuretic)
Methylzanthines, Thophylline
Furosemide
Thiasize
80
Q

Effect of methylzanthines

A

Decrease tubular reabsorption of Na+ or efferent vasoconstriction

81
Q

Effect of furosamide

A

Decrease sodium & chloride reabsorption in ascending limb

82
Q

Effect of thiazides

A

Decrease Na+ transport in distal tubule only

83
Q

Glycosuria

A

When more glucose spills over into the urine than can be reabsorbed

84
Q

What causes glycosuria?

A

Fasting hyperglycemia (decreased insulin action)

85
Q

Where is bicarbonate reabsorbed?

A

Proximal tubule

86
Q

How is bicarbonate reabsorbed?

A
  1. )Na+/H+ tranporter secretes H+ out into filtrate
  2. )H+ recombines with HCO3- to form H2CO3
  3. )Carbonic anhydrase turns it to CO2 & Water
  4. ) CO2 & Water diffuse into the cell & breakdown to HCO3- to diffuse out basal membrane
  5. )Na+ forced out with Na+/+ pump
87
Q

Urinary buffers from acidification of urine due to bicarb reabsorption?

A

HPo42- –>H2PO4- (phosphate)

NH3–>NH4 + (from glutamine deamination)

88
Q

What effect does aldosterone have at the cortical collecting duct?

A

Stimualates K+ secretion

89
Q

Diabetes incipidus

A

Low water reabsorption bc of decrease in ADH

90
Q

When can ADH be oversecreted?

A

Stress

Trauma

91
Q

Indirect measure of GFR

A

Blood creatinine

Physio Final (10 decks)

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