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BRS > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

5 functions of the kidney?

A 
Excretion if metabolic products
Excretion of foreign substances
Homeostasis
Regulate BP
Secrete hormones
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2
Q

What is the function of the detrusor muscle?

A

Contracts → bladder pressure rises → urination

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3
Q

What is the function of the trigone?

A

Sends signals to the brain when stretched to indicate need for urination

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4
Q

Function and control of internal and external sphincters?

A

Both prevent urination
Int - involuntary
Ext - voluntary

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5
Q

Function of bulbourethral gland?

A

Only in males

Produces thick lubricant which is added to semen to aid sperm survival

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6
Q

Which parts of the nephron are rich in mitochondria? (4)

A

PCT
DCT
Thick ascending LoH
Intercalated cells of CD

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7
Q

Nephron parts low in mitochondria?

A

Thin ascending and descending LoH

Principal cells of CD

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8
Q

What are the two types of nephron?

A

Superficial (cortex and outer medulla)
Juxtamedullary (cortex, outer and inner medulla)

More superficial

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9
Q

What are the constituents of the juxtaglomerular apparatus?

A

Macula densa - distal convoluted tubule
Extraglomerular mesangial cells
Juxtaglomerular cells - afferent arteriole

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10
Q

Function of the JGA?

A

GFR regulation via tubulo-glomerular feedback mechanism

Renin secretion for Bp

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11
Q

Which cells secrete renin?

A

Juxtaglomerular cells

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12
Q

How does fluid move from the glomerulus into bowmans capsule?

A

Passive

Hydrostatic pressure of heart

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13
Q

Describe how the structure of capillary endothelium supports transport?

A

It’s fennestrated so it’s highly permeable to fluid and solutes but impermeable to cells and proteins

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14
Q

Describe structure of glomerular basement membrane

A

Epithelial Podocytes

Slit diaphragm between podocytes thin and porous to allow through small molecules and water

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15
Q

What are the differences between hydrostatic and oncotic pressure?

A

HP - pressure exerted by fluid, solute and fluid are pushed out

OP - pressure exerted by solute, fluid molecules drawn in a cross semipermeable membrane

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16
Q

Net ultrafiltration pressure equation?

A

HP in glomerular capillaries - HP in BC - OP in GC

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17
Q

What is the glomerular filtration rate?

A

Amount of fluid filtered from glomeruli into bowmans capsules per unit time

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18
Q

GFR equation?

A

Ultrafiltration pressure x Kf (ultrafiltration coefficient)

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19
Q

Normal GFR ranges?

A

M - 90-140

F - 80 - 125

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20
Q

What can a fall in GFR show?

A

Renal disease

Increase in waste products in plasma

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21
Q

What are the 2 ways GFR is regulated?

A

Myogenic mechanism

Tubulo-glomerular feedback mechanism

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22
Q

Explain the myogenic mechanism

A 
Arterial pressure increases 
Afferent arteriole stretches
Arteriole contracts so vessel resistance rises
Reduced blood flow
GFR maintained
23
Q

Explain the tubule-glomerular feedback mechanism

A 
Increase GFR
Increased NaCl in LoH
Change detected by macula densa
Increased ATP and adenosine discharged
Afferent arteriole contracts
GFR decreases to stabilise

Vice verse for decrease

24
Q

What is renal clearance?

A

Volume of plasma that is completely cleared of a substance per unit time
Only concerned with excretory role of kidneys
Rate of removal of a substance from the blood via excretion in the urine

25
Q

Renal clearance equation?

A

C= (u x v) / p

U : concentration of substance in urine
V : rate of urine production
P : concentration in plasma

26
Q

How can GFR be measured practically?

A

By measuring the renal clearance for a substance that is freely filtered and not reabsorbed nor secreted in the nephron

Amount filtered = amount excreted

27
Q

What is the ideal molecule for GFR measurement and why is it not used?

A

Inulin
Not toxic, measurable in urine and plasma

But not found in mammals so needs to be transfused

28
Q

What molecule is commonly used to measure GFR and why?

A

Creatinine - waste product from creatine muscle metabolism
Amount released is fairly constant
Freely filtered and not reabsorbed

29
Q

What can indicate renal foliage relating to creatniine?

A

Low creatinine clearance

High plasma creatinine

30
Q

What is one problem with creatinine and how is it resolved?

A

A small amount is secreted into nephron but this is taken into account in GFR calculations

31
Q

What is renal plasma flow?

A

Volume of plasma that reaches kidneys per unit time

32
Q

When does renal clearance equal renal plasma flow?

A

When total amount of a molecule entering the kidney is excreted

33
Q

What molecule is used in measured rpf and why?

A 
Para aminohiupparte (PAH)
All is removed from plasma via filtration and secretion
34
Q

What is the filtration fraction?

A

The ratio of the amount plasma that is filtered and the amount that arrives at afferent arteriole

=GFR/RPF

35
Q

What is the normal range for filtration fraction?

A

0.15 - 0.20

36
Q

What substances are 100% reabskrbed in PCT?

A

Glucose

Amino acids

37
Q

What other substances are reabsorbed in PCT?

A 
Na+
Cl-
HCO3-
Water
Urea
38
Q

What substances are secrete into pct?

A 
Drugs
Ammonia
Bile salts
Prostaglandins 
Vitamins
39
Q

What are the 3 transporters involved in sodium and bicarbonate reabsorption?

A

Na+ H+ antiporter
Na+K+ATPase pump
Na+HcO3- symporter

40
Q

How are carbonate ions formed in pct cells?

A

CO2 diffuses into cell

Combines with water in presence carbonic anhydrase to form Hc and HCO3-

41
Q

What are the 3 transporters in glucose reabsorption in the pct?

A

SGLT2 - Na+ glucose symporter
Na+K+ATPase pump
GLUT2 glucose transporter

42
Q

What substances are reabsorbed in LoH?

A

Water
Na+
Cl-

43
Q

Outline the reabsorption in LoH

A

Thin descending limb - water moves out, impermeable to ions
Bottom = hyperosmolar fluid

Thin ascending limb - impermeable to water, ions passively move out

Thick ascending limb - ions are actively pumped out

Top = hypo-osmolar fluid

44
Q

What substance move through the paracellular pathway in thick AL?

A

Ca2+
Na+
K+
Mg2+

45
Q

What 3 transporters are in the thick ascending limb?

A

Na+K+Cl- symporter
Na+K+ATPase pump
K+Cl- symporter

46
Q

What substances are reabsorbed in the early DCT?

A

Na+
Cl-
Ca2+

47
Q

What transporters are in the early DCT?

A

Na+ Cl- : Na+Cl- symporter , ATPase pump, K+Cl- symporter

Ca2+ : ATPase pump, Na+Ca2+ antiporter, Ca2+ATPase pump

48
Q

What are the 2 types of cells in the distal DCT and CD? + functions

A

Principal - Na+ , water reabsorption, K+ secretion

Intercalated cell - maintain acid-base balance

49
Q

How is Na+ reabsorption regulated?

A

Aldosterone increases apical Na+ channels and basolateral ATPase pumps

50
Q

How is water reabsorption regulated?

A

ADH increases apical aquaporins

51
Q

Outline reabsorption and secretion in distal DCT and CD

A

Sodium moves in through apical sodium channels
It is exchanged with potassium via basolateral ATP pump
Potassium is secreted into tubular fluid via potassium channels
Water is reabsorbed by aquaporins on apical and basolateral membranes

52
Q

What are the 2 types of intercalated cells and their functions?

A

a - HCO3- reabsorption, H+ sercretion

B - H+ reabsorption, HCO3- secretion

53
Q

What are the 2 transporters found on intercalated cells

A

H+ATPase pump

Cl-HCO3- antiporter

BRS (7 decks)

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