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ISAP > How The Kidneys Regukate Body Fluid And Volume Compostion? > Flashcards

How The Kidneys Regukate Body Fluid And Volume Compostion? Flashcards

1
Q

What percentage of cardiac output do the kidneys receive when the body is at rest?

A

20-25% (1.0-1.25 litres blood per minute).

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2
Q

Identify two structural differences between the afferent and efferent arterioles?

A
  1. Lumen of the efferent arterioles is much narrower.

2. Afferent arterioles contains the granular cells juxtaglomerular apparatus.

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3
Q

What are the main functions of the kidneys and the urinary system?

A
  • Excretion: filters blood (plasma) to remove wastes and foreign substances and maintain blood volume.
  • Helps to regulation blood ionic composition, blood pH and osmolality.
  • Waste (urine) flows from each kidney, down its ureter to the bladder (temporarily stored).
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4
Q

How are kidney function and blood pressure homeostasis related to each other?

A

Because the kidneys are able to adjust extracellular fluid volumes by varying sodium and water loss in the urine this in turn affects the plasma volume and ultimately blood volume and pressure.

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5
Q

What is the main general function of the bowman’s capsule?

A

Filtration.

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6
Q

What is the main general function of the proximal convoluted tubule?

A

Majority of the reabsorption and secretion of solutes.

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7
Q

What is the main general function of the loop of henle?

A

Sets up salt gradient in the medulla.

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8
Q

What is the main general function of the distal convoluted tubule?

A

Some (less than PCT) reabsorption and secretion of solutes.

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9
Q

What is the main general function of the collecting ducts?

A

Water reabsorption.

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10
Q

Where are the kidneys located?

A

Between T12 and L3. The hilum is in line with L2. The right kidney is slightly lower due to the position of the liver.

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11
Q

What is the function of perirenal fat (adipose tissue)?

A

It protects and supports the kidney attaching it to the posterior wall of the abdomen.

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12
Q

What structures are found posterior to the kidneys?

A
  • diaphragm.
  • ribs.
  • posterior body wall.
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13
Q

What structures make up the renal corpuscle?

A

Glomerulus and bowman’s capsule.

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14
Q

What structures contribute to the striated appearance of the medullary pyramids?

A

The long loops of henle, collecting ducts and the loops of the vasa recta.

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15
Q

Where is the juxtaglomerular apparatus located?

A

Where the DCT meets the afferent arteriole of the nephron.

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16
Q

What are the relative percentages of cortical and juxtamedullary nephrons in a kidney?

A
  • 85% cortical.

- 15% juxtamedullary.

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17
Q

Comment on the position of the kidney cortex, loop of henle and blood supply in the cortical nephron.

A
  • renal corpuscle in outer portion of cortex.
  • short loop of henle.
  • get blood from peritubular capillaries.
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18
Q

Comment on the position of the kidney cortex, loop of henle and blood supply in the juxtamedullary nephron.

A
  • renal corpuscles deep in cortex, close to medulla.
  • long loop of henle.
  • blood from peritubular capillaries and bass recta.
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19
Q

What is the correct sequence a drop of urine takes from its point of formation in the nephron to the urinary bladder?

A

Collecting duct, papillary duct in renal pyramid, minor calyx, major calyx, renal pelvis, ureter and the bladder.

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20
Q

In which body cavity does the bladder lie and in which body cavity does the bladder protrude into when full?

A

Pelvic and protrudes into the abdominal cavity when full.

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21
Q

Why do the ureters enter the bladder on an oblique angle?

A

When the bladder fills, the uretal openings are closed off by the pressure in the bladder which, prevent the backflow of urine.

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22
Q

What is the trigone of the bladder?

A

Triangular region at the base of the bladder which lies between the openings of the two ureters and urethra.

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23
Q

What is the name of the thick layer of smooth muscle in the bladder?

A

Detrusor muscle.

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24
Q

What is the epithelium that lines the bladder and what is its function?

A

Transitional epithelium- designed to allow expansion.

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25
Q

When the bladder is moderately full, what volume does it hold?

A

About 500mL.

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26
Q

What is the maximum volume the bladder holds?

A

About 1000mL.

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27
Q

Identify two main differences between male and female urethra’s?

A

The male urethra is a shared duct of both the urinary and reproductive systems. Male has associated reproductive glands. There are two different ducts in females.

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28
Q

Name the two factors that determine which plasma components will pass across the filtration membrane.

A

Size and charge.

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29
Q

List some plasma components that pass through the filtration membrane.

A

Glucose, water, small fats, amino acids, urea, Na+, Cl-.

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30
Q

List some blood components that are prevented from passing across the filtration membrane.

A

Red blood cells, white blood cells, plasma proteins.

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31
Q

What type of capillaries are the glomerular capillaries? Why would this type of capillary be necessary in this location?

A

Fenestrated; pores for filtering.

32
Q

What are podocytes and what do they contribute to the filtration membrane?

A

Create filtration slits-pores; cells with foot processes that create slits.

33
Q

What three pressures are responsible for creating the net forces which control glomerular filtration?

A
  • glomerular capillary pressure.
  • blood colloidal pressure.
  • capsular hydrostatic pressure.
34
Q

What is glomerular capillary pressure (GCP)?

A

Blood pressure in the glomerulus.

35
Q

What is blood colloidal osmotic pressure (BCOP)?

A

Osmotic pressure from proteins in plasma.

36
Q

What is capsular hydrostatic pressure (CHP)?

A

Resistance pressure caused by pushing filtrate.

37
Q

What is the process called which allows the kidneys to protect themselves from normal fluctuations in blood pressure?

A

Autoregulation: ultimately brings about a change in afferent arteriole diameter.

38
Q

How can a change in afferent arteriole diameter affect glomerular filtration?

A

-an increase in the diameter of the afferent arteriole increases the blood flow to the glomerulus and therefore pressure in the glomerulus, increasing GFR and vice versa.

39
Q

Where in the kidneys does aldosterone exert its action?

A

Cells in the DCT and collecting ducts of the nephrons.

40
Q

What effect does aldosterone secretion have on blood volume and therefore, blood pressure?

A

Increases both.

41
Q

Hypothalamic sensors that monitor plasma osmolality are called?

A

Osmoreceptors.

42
Q

Where in the kidneys does ADH exert its action?

A

DCT and collecting ducts,

Makes them permeable to water as they are usually not.

43
Q

Would ADH secretion increase if a person was dehydrated?

A

Yes.

44
Q

Would ADH secretion increase if a person suffered from a haemorrhage?

A

Yes.

45
Q

How does ADH secretion affect urine volume?

A

In presence of ADH urine volume is reduced and more concentrated.

46
Q

Can you suggest why ADH is also known as vasopressin?

A

It is a powerful vasoconstrictor substance.

47
Q

What makes up the filtration membrane?

A
  1. Fenestrated endothelium (glomerulus).
  2. Basement membrane.
  3. Podocyte cell layer (filtration slits).
48
Q

What epithelium is in the proximal convoluted tubule?

A

Cuboidal epithelium with microvilli.

49
Q

Percentage or cortical nephrons and juxtamedullary nephrons?

A
  • cortical nephrons: 80%.

- juxtamedullary nephrons: 20%.

50
Q

What epithelium lines the distal convoluted tubule?

A

Cuboidal epithelium with few microvilli.

51
Q

What epithelium lines the collecting ducts?

A

Cuboidal epithelia.

52
Q

What is a discriminating process?

A

Tubular reabsorption.

53
Q

What are the mechanisms the kidneys have whereby they can change blood pressure?

A

Intrinsic mechanisms and extrinsic mechanisms.

54
Q

What are intrinsic mechanisms?

A

-autoregulation: which protects the kidneys from the minute-to-minute changes in blood pressure in the body.
-juxtamedullary cells detect decreased blood pressure in the afferent arteriole and secrete an enzyme called RENIN.
BOTH these mechanisms rely on the juxtaglomerular apparatus (JGA).

55
Q

What are extrinsic mechanisms?

A

Sympathetic nervous control of GFR to deliberately change blood pressure.

56
Q

What equation shows that glomerular filtration is directly dependent on blood pressure?

A

Pefferent= BHP-(BOP+CHP).

57
Q

What happens when GFR increases (autoregulation)?

A

Construction of afferent arteriole => decreased blood flow => decreased GFR.

58
Q

What happens when GFR decreases (autoregulation)?

A

Dilation of afferent arteriole => increased blood flow => increased GFR.

59
Q

Where is dilute or concentrated urine formed?

A

Achieved by loops of henle, they act as a countercurrent multiplier mechanism (CCMM).

60
Q

What is the multiplier mechanism?

A

The movement of ions is achieved in small steps which multiply into a big effect.

61
Q

How is a steep osmotic gradient set up in the kidneys? (Mechanisms).

A
  1. Movement of water and ions from filtrate.

2. The relative permeabilities of tubular cells in the descending and ascending limbs of the loop of henle.

62
Q

Is the descending or ascending limb permeable to water?

A

The descending limb is permeable to water but impermeable to Na+ and Cl-. The ascending limb is opposite.

63
Q

The vasa texts prevents the dissolution of what?

A

Of the salt gradient.

64
Q

Main kidney functions?

A
  • excretion.
  • regulation of blood volume.
  • regulation of blood pressure.
  • release of erythropoietin and calcitrol.
65
Q

What does GCP do and what pressure?

A
  • moves fluid from the blood into bowman’s capsule.

- 50mm Hg.

66
Q

What does CHP do and what pressure?

A
  • moves fluid from bowman’s capsule into the blood.

- 10mm Hg.

67
Q

What does BCOP do and what pressure?

A
  • moves fluid from the bowman’s capsule into the blood by osmosis.
  • 30mm Hg.
68
Q

Approximately what is the rate of renal blood flow (glomerular filtration)?

A

1.25 litres per minute.

69
Q

Approximately what is GFR?

A

-125ml per minute= 180 litres per day.

70
Q

How much filtrate does the nephron reabsorb?

A
  • 99.5%.

- approx. 178.5-179 litres per day.

71
Q

What is completely reabsorbed in the first half of the PCT?

A

-glucose, amino acids, lactic acid, water soluble vitamins and other nutrients.

72
Q

What helps to reabsorb materials from the tubular filtrate?

A

-Na+ symporters.

73
Q

% Na and water reabsorption in the PCT?

A
  • Na: 67%.

- water: 65%.

74
Q

% Na and water reabsorption in the loop of henle?

A
  • Na: 25%.

- water: 15%.

75
Q

% Na and water reabsorption in the DCT and CD?

A
  • Na: 8%.

- water: 20%.

ISAP (13 decks)

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