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Phys 3 > Final: Renal > Flashcards

Final: Renal Flashcards

1
Q

Total body water ___ of body weight

A

60%

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2
Q

2-3 of 60% is in

A

ICF

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3
Q

1/3 of 60% is

A

ECF

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4
Q

3/4 of ECF is

A

ECF in interstitial fluid

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5
Q

1/4 of ECF is

A

ECF in plasma

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6
Q

Presence of excess fluid in body tissues

A

Edema

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7
Q

Intracellular edema due to

A

Hyponatremia
Metabolic depression
Lack of adequate nutrition

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8
Q

Extracellular edema due to

A 
Fluid leakage
Lymphatic failure (lymphedema)
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9
Q

Hypernatremia can be due to

A

Dehydration (water loss)

Over hydration (excess NaCl)

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10
Q

Effects of hypernatremia tend to be

A

Less severe

Cells resist damage from shrinkage

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11
Q

Dehydration causing hypernatremia can be due to

A

Excessive sweating

Lack ADH production (diabetes insipidus)

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12
Q

Over hydration resulting in hypernatremia can be due to

A

Abnormally high secretion of aldosterone

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13
Q

MC electrolyte disorder

A

Low Na

Hyponatremia

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14
Q

Hyponatremia can result in

A

Edema
Brain swelling and damage
Death

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15
Q

Normal levels of Na

A

135-145 meq/L

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16
Q

Hyponatremia can be due to

A

Dehydration (loss of NaCl)

Overhydration (over retention of water)

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17
Q

Over retention of water due to

A

Abnormally high secretion of ADH

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18
Q

Dehydration causing hyponatremia due to

A

Diarrhea

Vomiting

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19
Q

Cell in hypertonic fluid

A

Shrink (water moves out of cell)

More than .9% NaCl solution
More than 5% glucose solution

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20
Q

Cell in hypotonic solution

A

Cell swells (water moves in)

Less than .9% NaCl
Less than 5% glucose solution

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21
Q

Isotonic solution means impermeable solutes have osmolarity of about

A

290 mOsm/L

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22
Q

Osmolarity

A

Osmoles per L of water

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23
Q

Osmolality

A

Osmoles per kg of water

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24
Q

Osmoles

A

Number of particles in solution

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25
Q

Equilibrium pressure between hydrostatic pressure and

A

Osmotic forces generated by addition of solute

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26
Q

Osmotic pressure is proportional to

A

Number of active or dissociable solutes in solution

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27
Q

Kidney synthesizes and secretes what 3 major hormones

A
  1. Renin
  2. EPO
  3. 1,25 dihydroxycholecalciferol
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28
Q

Renin

A

Stimulates angiotensin 2 formation and aldosterone secretion

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29
Q

EPO

A

Stimulates RBC production

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30
Q

Activated Vit. D

A

Widespread effects including Ca absorption from GI tract

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31
Q

Kidneys excrete

A

Harmful substances

Things in excess

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32
Q

Kidneys regulate

A

Volume
Composition
PH

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33
Q

Role of renal system

A 
Filtration 
Reabsorption 
Secretion 
Excretion 
Water/electrolyte balance
PH regulation 
Control circulating volume
Hormone secretion 
Site of hormone action 
Gluconeogenesis
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34
Q

Examples of water soluble wastes excreted by renal system

A

Urea
Creatinine
Uric acid

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35
Q

Function of ADH

A

Concentrate urine

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36
Q

Activated Vit D also enhances ___

A

Immune function

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37
Q

Activated Vit D aka

A

Calcitriol

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38
Q

Gluconeogenesis uses what 3 things

A

AA (alanine)
Glycerol
Lactate

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39
Q

Renal functions to reabsorb virtually all filtered glucose in

A

PCT

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40
Q

2 kidneys, ___ each

A

150 grams

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41
Q

Standing, kidneys located

A

L1-L4

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42
Q

T/F

Kidneys retroperitoneal

A

True

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43
Q

Calyces, renal pelvis, and ureter contract to

A

Propel urine to bladder

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44
Q

Sym. Pre fibers from

A

T10 to L2

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45
Q

Symp Post SNS fibers to kidney via

A

Renal plexus

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46
Q

Symp post fibers project to

A

Individual nephrons

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47
Q

SNS stimulation

A

Constriction of arterioles

Decrease urinary output

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48
Q

SNS can also signal kidneys to

A

Increase sodium reabsorption

Increased renin release

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49
Q

Unique blood flow of kidneys

A

2 sets capillary beds

2 sets arterioles in series

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50
Q

Afferent arterioles give rise to ___ which are drained by ____ which give rise to ___

A

Glomerular capillaries
Efferent arterioles
Peritubular capillaries

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51
Q

All filtration takes place in

A

Glomerular capillaries

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52
Q

All reabsorption takes place in

A

Peritubular capillaries

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53
Q

Glomerular capillaries have ___ hydrostatic pressure

A

High

Kept constant by efferent arterioles

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54
Q

Peritubular capillaries have ___ hydrostatic pressure

A

Lower

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55
Q

Functional unit of kidney

A

Nephron

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56
Q

Each kidney has ___ nephrons

A

800,000 to 1 million nephrons

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57
Q

85% of nephron

A

Cortical nephron

58
Q

In cortical nephron, glomerulus is

A

Higher to cortex

59
Q

15% of nephrons

A

Juxtamedullary nephron

60
Q

Juxtamedullary nephron glomerulus closer to

A

Medulla

61
Q

___ capable of concentrating urine

A

Juxtamedullary nephron

62
Q

T/F

Kidney able to regenerate nephrons

A

False

63
Q

Approximate loss of nephrons

A

10% loss every 10 years

64
Q

Can live with ____ of original number of nephrons

A

25%

65
Q

Major step in emptying bladder

A

Contraction of detrusor muscle

Increase pressure by 40-60 mmHg

66
Q

Ureters enter bladder at

A

Upper trigone

67
Q

Surface of trigone

A

Smooth mucosa

68
Q

Surface of bladder mucosa

A

Folded rugae

69
Q

Tone of ___ shuts down ureters

A

Detrusor

70
Q

Bladder neck composed of

A

Detrusor muscle

Elastic tissue

71
Q

Muscle at bladder neck is

A

Internal sphincter (only in males)

72
Q

External sphincter muscle is ___ and under

A

Skeletal muscle

Voluntary control

73
Q

Pudendal N innervates

A

External bladder sphincter

Under voluntary control

74
Q

Sympathetic innervation to bladder through _____ and stimulates ____

A

Hypogastic Nerves (L2)

Blood supply to bladder

75
Q

Pelvic nerves supplying bladder

A

Through sacral plexus

S2, S3

76
Q

Sensory fibers in bladder detect

A

Stretch of bladder wall

77
Q

Para motor fibers in bladder innervate

A

Detrusor muscle

78
Q

Order of urine flow

A 
Nephron 
Collecting ducts 
Renal calyces 
Ureters 
Bladder
79
Q

Urine flow from collecting ducts to renal calyces causes

A

Peristaltic contractions

80
Q

Peristaltic contractions occur in

A

Renal pelvis and ureters

Forces urine from kidneys to bladder

81
Q

Ureterorenal reflex

A

Severe pain (kidney stone)

Reflex constriction of renal arterioles
Decrease flow of fluid to kidney with blocked ureter

82
Q

Micturition reflex causes a nervous reflex to cause

A

An urge to urinate

83
Q

Micturition reflex controlled by

A

ANS (coordinated by Centers in midbrain)

84
Q

When bladder is filling ___ Control predominates

A

SNS

85
Q

Filling of bladder, SNS causes

A

Relaxation of detrusor (beta)

Contraction of internal sphincter (alpha)

86
Q

Full bladder sensed by ____ in bladder wall

A

Mechanoreceptors

87
Q

To empty bladder, PSNS does what?

A

Contract detrusor muscle

Relax internal sphincters

88
Q

Micturition contractions vary in length of ___ and ___ and generally ___ as more urine added

A

Contraction and intensity

Increases

89
Q

As micturition reflex increases, reflex passes through ____ to external sphincter

A

Pudendal N

90
Q

Urination can be facilitated or inhibited by Centers in ___ and ___

A

Pons

Cerebral cortex

91
Q

Voluntary urination involves

A

Contraction of abdominal muscles

Increase pressure in bladder

Increase urine that enters bladder neck

Empties all urine from bladder

92
Q

Input and output of fluid must be adjusted to

A

Maintain ECF

Maintain osmolality

93
Q

Typical daily fluid intake

A

2300 ml/day

94
Q

Insensible water loss includes

A

Breathing

Through skin

95
Q

Loss of body water includes

A

Insensible loss
Sweating
Feces
Excreted via kidneys

96
Q

40% of total body weight

A

Intracellular fluid

97
Q

Intracellular fluid low in

A

Sodium
Calcium
Chloride

98
Q

Intracellular fluid high in

A

Potassium

Phosphate ions

99
Q

20% of total body weight

A

Extracellular fluid

100
Q

Plasma and intestinal fluid make up

A

Extracellular fluid

101
Q

ECF low in

A

Potassium
Phosphates
Protein

102
Q

ECF high in

A

Sodium
Chloride
Bicarbonate

103
Q

Volume of body fluid compartment depends on amount of

A

Solute in contains

104
Q

Major cation in ECF

A

Na

105
Q

Major anions in ECF

A

Cl

HCO3

106
Q

Diarrhea

A

Loss if sig amount of isosmotic fluid from GI tract

Results in decrease in ECF volume

107
Q

Water deprivation (sweating) results in

A

Hyperosmotic volume contraction

108
Q

In hyperosmotic state, ECF osmolarity ___ ICF osmolarity

A

>

109
Q

In hyperosmotic situation, fluid shift from

A

ICF —> ECF

110
Q

Adrenal insufficiency (Addison’s disease) results in

A

Hyposmotic volume contraction

111
Q

Low aldosterone results in

A

High excretion of NaCl in urine

112
Q

In hyposmotic volume contraction, ECF osmolarity ___ ICF osmolarity

A

<

113
Q

Isosmotic volume expansion, all fluid infused up in

A

ECF

114
Q

High NaCl intake results in

A

Hyperosmotic volume expansion

115
Q

Syndrome of inappropriate ADH results in

A

Hyposmotic volume expansion

116
Q

Secrete excess ADH results in

A

Too much water reabsorbed by kidney

117
Q

Measure of renal function

A

Glomerular filtration rate

118
Q

Normal GFR

A

> 90ml/min

119
Q

Chronic kidney disease, GRF ___

A

Reduced

120
Q

If GFR < 15 ml/min

A

Kidney failure

121
Q

Renal clearance

A

Describes rate at which substances removed from plasma

122
Q

Inulin clearance =

A

GFR

123
Q

Inulin is neither ___ or ___

A

Reabsorbed

Secreted

124
Q

Para-aminohippuric acid (PAH)

A

Organic acid both filtered and secreted

Highest clearances

125
Q

Used to estimate GFR in clinical practice

A

Creatinine

126
Q

Kidneys receive about ____ of resting CO

A

1/4

127
Q

More alpha 1 receptors are

A

Afferent arterioles

128
Q

Angiotensin 2 potent vasoconstrictor of both

A

Afferent arterioles

Efferent arterioles

129
Q

__ more sensitive to angiotensin 2

A

EA

130
Q

Low levels angiotensin 2

A

Increase GFR by constricting EA

131
Q

High levels angiotensin 2

A

Lower GFR by constricting both AA and EA

132
Q

SNS stimulates low

A

GFR and RBF

133
Q

SNS stimulates release of

A

Renin from Juxtaglomerular cells

134
Q

Prostaglandins are produced locally and cause

A

Vasodilation of both AA and EA

135
Q

NSAIDS inhibit

A

PG synthesis

136
Q

Low levels of dopamine

A

Dilate renal arterioles and cerebral, cardiac, splanchnic arterioles

Constrict skeletal muscle and cutaneous arterioles

137
Q

Proximal tubules produce

A

Dopamine

138
Q

Dopamine ___ renin secretion

A

Inhibits

139
Q

Myogenic hypothesis

A

Increase arterial BP stretches blood vessels —> cause reflex constriction

140
Q

Tubuloglomerular feedback

A

High RBF —> high GFR

Increase delivery of solute and water to macula densa

Increase resistance of AA by release of local constrictor

141
Q

Charge on glomerular capillary

A

Negative

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