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Z YEAR 1 BRS Gastroentology > Genitourinary System > Flashcards

Genitourinary System Flashcards

1
Q

What is the function of the kidney?

A
  1. Excretion of metabolic products e.g. urea, uric acid and creatinine
  2. Excretion of foreign substances e..g. drugs
  3. Regulation of body fluids, electrolytes and acid base balance
  4. Control of blood pressure
  5. Secretes hormones e.g. erythropoietin. renin
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2
Q

What is the process form renal artery to glomerular capillaries?

A
  1. Renal artery
  2. Segmental artery
  3. Interlobar artery
  4. Arcuate artery
  5. Interlobular artery
  6. Afferent arteriole
  7. Glomerulasr capillaries
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3
Q

What is process of glomerular capillaries to renal vein?

A
  1. Glomerular capillaries
  2. Efferent arterioles
  3. peritubular capillaries
  4. Interlobular bein
  5. Acute vein
  6. Interlobar vein
  7. renal vein
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4
Q

What is the function of the detrusor muscle?

A

Contracts to build pressure in the urinary bladder to support urianstion

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5
Q

What is the function of trigone?

A

Stretching of this triangular region to its limit single the brain about the need for urination

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6
Q

What is the function of the internal sphincter?

A

Involuntary control to prevent urination

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7
Q

What is the function of external sphincter?

A

Voluntary control to prevent urination

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8
Q

What is the function of the bulbourethral gland?

A

Produces thick lubricant which is added to watery semen to promote sperm survival

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9
Q

What happens in proximal convoluted tubule?

A
  • Reabsorption of Na+ (and Cl-)
  • Reabsorption of most solute
  • Reabsorption of water
    1. epithelial cells rise in mitochondria
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10
Q

What happens Loop of Henle?

A
  • Loop of Henle
    1. Pump salt out by thick ascending loop of Helene (lot of mitochondria)
    2. Reabsorption of water in thin descending loop of Henle
    3. Passive process in thin ascending loop of henle to epithelial cells have low density of mitochondria
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11
Q

What happens in distal convoluted tubule?

A
  • Reabsorption of Na+ and Cl-

- Rich in mitochondria

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12
Q

What happens in collection duct?

A
  • Reabsorption or water and Na+ and Cl-
  • Intercalated cells rich in mitochondria
  • Principal cells low mitochondria density
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13
Q

What are the different types of nephron?

A
  1. Superficial nephron (cortex to out medulla)
  2. Juxtamedullary nephron (cortex to outer medulla to inner medulla)
    - around 10:1 ratio for superficial to juxtamedullary nephron
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14
Q

What are the constituents of juxtaglomerular apparatus?

A
  1. Macula Densa (distal convoluted tubule)
  2. Extraglomerular mesangial cells
  3. Juxtaglomerular cells (afferent arteriole)
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15
Q

What is function of juxtaglomerular apparatus?

A
  1. GFR regulation through tubule-glomerular feedback mechanism
  2. Renin secretion for regulating blood pressure
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16
Q

Which runs blood vessel branches out to form peritubluar capillaries?

A

Efferent arteriole

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17
Q

What is glomerular filtration?

A

Passive process: Fluid is ‘driven’ through the semipermeable glomerular capillaries into the Bowman’s capsule space by the hydrostatic pressure of the heart.

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18
Q

What is the filtration barrier like?

A

The filtration barrier (size and charge dependent):

  • Highly permeable to fluids and small solutes.
  • Impermeable to cells and proteins
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19
Q

What is hydrostatic pressure?

A
  • Pushing
  • Fluid exerts this pressure
  • Solute and fluid molecules shoved out
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20
Q

What is oncotic pressure?

A
  • Pulling
  • Solute e.g. proteins expert this pressure
  • Fluid molecules dress in across a semipermeable membrane
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21
Q

How do you calculate ultrafiltration pressure?

A

PUF = HP(GC) - HP(BW) - PI(GC)

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22
Q

What is glomerular filtration rate?

A
  • Amount of fluid filtered form the glomeruli into Bowman’s capsule per unit time (mL/min)
  • Sum of filtration rate of all functioning nephrons
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23
Q

How do you calculate Glomerular Filtration rate?

A

GGFR=P(uf) x K(f)

-K(f) is an ultrafiltration coefficient (membrane permeability and surface area available for filtration)

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24
Q

When will GFR change?

A

-Any changes in filtration forces or Kf will result in GFR imbalances

25
Q

What is normal GFR?

A
  • For healthy male and female adults the GFR can be between 90-140mL/min and 80-125mL/min rework
  • A fall in GFR is cardinal feature of renal disease, with build up of excretory products in the plasma
26
Q

What is the myogenic mechanism for regulation of GFR?

A
  1. Arterial pressure increase
  2. Afferent arteriole stretched
  3. Arteriole contracts
  4. Vessel resistance rises
  5. Blood flow reduces
  6. GFR stays the same
27
Q

What Is tubule-glomerular feedback mechanism for regulation of GFR?

A
  1. Increase/Decrease in GFR
  2. Increased/decreased NaCl in loop of Henle
    3, Change detected by macula densa
  3. Increase/decreased ATP and adenosine discharged
    5, Afferent arteriole contracts/ dilutes
  4. GFR stabilises
28
Q

What is renal clearance?

A

The number of litres of plasma that are completely cleared of the substance per unit time

29
Q

How can you use renal clearance?

A

-This concept can be used to calculate. GFR, renal plasma flow (RFP) and to understand the excretory route of a substance *only filtered or a combination of filtration and excretion etc

30
Q

What is the equation with renal clearance?

A 
C = (UxV)/P mL/min 
U= concentration of substance in urine 
V= rate of urine production 
P= concentration of substance in plasma 
-If C=50 mL/min for a substance this means that 50mL of plasma has been cleared of that substance per minute
31
Q

How do you get a practical determination of GFR?

A
  • If a molecule if freely filtered and neither reabsorbed nor secrete dint he nephron then the amount filtered equals the amount excreted
  • Thus GFR can be measured by measuring renal clearance of this molecule
32
Q

What is the ideal molecule and why?

A

-Inulin
•A plant polysaccharide
•Freely filtered and neither reabsorbed nor secreted
•Not toxic
•Measurable in urine and plasma.
•However not found in mammals so needs to be infused.

33
Q

What is commonly used and why?

A

-Creatine
•Waste product from creatine in muscle metabolism.
•Amount of creatinine released is fairly constant.
•If renal function is stable, creatinine amount in urine is stable.
•Low creatinine clearance or high plasma creatine may indicate renal failure.

34
Q

Why is creatine not perfect?

A

It is freely filtered and not reabsorbed but a small amount is secreted into the nephron therefore its not a perfect molecule. However, the process for estimating creatinine in blood and urine can account for that to allow for GFR calculations.

35
Q

What happens if If the total amount of a substance entering the kidney equals amount excreted?

A

Then the renal clearance of this molecule equals the renal plasma flow (RPF).

36
Q

Why is PAH used for renal plasma flow?

A

PAH (Para aminohippurate) is used as all the PAH is removed from the plasma passing through the kidney through filtration and secretion.

37
Q

What is the ratio?

A
  • The ratio of the amount of plasma which is filtered, and which arrives via the afferent arteriole is defined by the Filtration fraction (FF).
  • Its value ranges from 0.15-0.20 normally. A value of 0.15 implies 15% of the plasma has been filtered.
  • FF=GFR/RPF
38
Q

What are different types of passive transport?

A
  1. Diffusion
  2. Osmosis
  3. Electrical gradient difference
39
Q

What are different types of active transport?

A
  1. Primary active

2. Secondary active / coupled transport

40
Q

What is primary active?

A
  1. Na+ and k+ ATPase pump

2. Endocytosis e.g. small proteins reabsorbed in PCT

41
Q

What is Secondary active / coupled transport?

A
  • Movement of one solute alongs its electrochemical gradient provides energy for the other solute to move against it
    1. Symport: Na+-glucose symporter
    2. Antibport: Na+-H+ antiport
42
Q

What happens in paracellular pathway?

A
  1. Water

2. Ca2_, K+, Cl- urea

43
Q

What happens in transcellular pathway?

A
  1. Aquaporin for water
  2. Trasncellular Na+ reabsorption:
    - 1: K+ Na+ ATpase
    - 2: downhill gradient of Na+
44
Q

What is reabsorbed in early proximal convoluted tubule?

A
  1. 67% Na+
  2. 67% Cl-
  3. 90% HCO3
  4. 100% glucose
  5. 67% water
  6. 100% amino acids
  7. 50% urea
45
Q

What is secreted in early proximal tubule?

A
  • Drugs
  • Ammonia
  • Bile salts
  • Prostaglandins
  • Vitamins (folate and ascorbate)
46
Q

What is in early proximal convoluted tubule for sodium and bicarbonate reabsorption?

A
  1. Cabronic anhydride to make H+ and HCO3- and H2O and CO2 to be used in Na+ and H+ antiporter
  2. Na+ and K+ ATPase pump
  3. Na+ and HCO3- symporter
47
Q

What is in early proximal convoluted tubule for glucose reabsorption?

A
  1. Na+ - glucose symporter
  2. Na+-K+ ATPase pump
  3. GLUT2 glucose
48
Q

What happens in Reabsorption in Henle’s loop?

A
  • Thin descending loop
    1. Water passive
    2. No Na+ and Cl-
  • At turning point hperomolar tubular fluid
  • Thin ascending limb
    1. No water
    2. Na+ and Cl- passive
  • Thick asecindg loop
    1. Na+ Cl- active
    2. at tip hypoosmolar tubular fluid
49
Q

What substances are reabsorbed in Henle’s loop?

A
  1. 25% Na+
  2. 25% Cl-
  3. 15% water
50
Q

What happens in the thick ascending limb?

A
  • Na+ and Cl- reabsorption
    2. Na+-K+-2Cl- sy,porter
    3. Na+ K+ Atpase
    4. K+-Cl- symporter
51
Q

What is the paracellular pathway in thick ascding limb?

A

Cations Na+, Ca2+ K+ and Mg2+

52
Q

What is the Na+ and Cl- reabsorption in the early distal convoluted tubule?

A
  1. No water in
  2. Na+ Cl- symporter
  3. Na+-K+ ATPase pump
  4. K+ - Cl- symporter
53
Q

What is the active Ca2+ reabsorption in the early distal convoluted tubule?

A
  1. Ca2+ in
  2. No water
  3. Na+-K+ ATPase pump
  4. Na+-Ca2+ antiporter
  5. Ca2+ ATPase pump
54
Q

What is the principal Cell with Na+ reabsorption and K+ secretion?

A
  1. Na+ in
  2. K+ out
  3. Aquaporin water in and out
  4. Na+-K+ ATPase pump
55
Q

What happen in intercalated cell with maintains acid base balance?

A 
Alpha intercalated cell: 
1. H+-ATPase Pump 
2. Cl-HCO3- antiporter 
Beta intercalated cell
1. Cl- and HCO3- antiporter 
2. H+ ATPase pump
56
Q

What does aldosterone do?

A

-Regulates Na+ reabsorption by increasing apical Na+ channels and basolaterla Na+-K+ ATPase pumps

57
Q

What does ADH do?

A

-Regulates water reabsorption by increasing apical aquaporins

58
Q

What does the alpha intercalated cell do?

A

HCO3- reabsorption and H+ secretion

59
Q

What does. the beta intercalated cell do?

A

HCO3- secretion and H+ reabsorption

Z YEAR 1 BRS Gastroentology (11 decks)

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