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Year 2 Urinary > Intro to Urinary > Flashcards

Intro to Urinary Flashcards

1
Q

How much of cardiac output goes to the kidney as a percentage?

A

22%

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2
Q

Where are the kidneys?

A

Retroperitoneal

T11/T12–>L2/L3

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3
Q

How much does a kidney weigh?

A

150g

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4
Q

How does the kidney connect to the bladder and what is the function of the bladder?

A

A single ureter leaves each kidney and take urine to the bladder in the pelvis.
The bladder stored urine until we decide to urinate at whhich point it ejects urine through the urethras.

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5
Q

What is a ureter?

A

Pulsatile smooth muscle tube from kidney to bladder. They run along the tips of the transverse processes to the sacroiliac joint to enter the

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6
Q

Which kidney sits lower?

A

The right, the liver is a big intra-abdominal organ that pushes stuff down.

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7
Q

What is the outer layer of kidney called?

A

Cortex

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8
Q

What is the inner area of kidney known as?

A

Medulla

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9
Q

Which part of the kidney does the ureter plumb into?

A

Renal pelvis

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10
Q

What is the function of the kidney?

A

Maintains a stable internal environment (milieu interieur)

  • regulates key ECF substances
  • excretes waste
  • endocrine; renin, erythropoietin and prostaglandins
  • metabolism; activates vitamin d, catabolises insulin, PTH and calcitonin
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11
Q

Review the body fluid compartments of a 70kg man

A

42L water—> 28L intracellular + 14L ECF–> 11L interstitium + 3L intravascular

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12
Q

What drives the movement of water across cell membranes?

A

Water crosses freely and is driven by osmotic force

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13
Q

Define Osmolality

A

Number of osmoles per litre of solute (conc of substances that cannot cross the membrane)- includes ions and proteins and is measured in milliosmoles

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14
Q

What is a normal plasma osmolality?

A

280-310mOsm/kg or 280-310mmol/L

note its the same in the intracellular fluid and interstitial fluid under normal conditions

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15
Q

If you have serum sodium how might you predict serum osmolality?

A

[Na+] x2

80% of serum osmolality is Na+ and Cl- and 20% is K+

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16
Q

Is a hypotonic solution dilute of concentrated?

A

Dilute

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17
Q

If ECF osmolarity is high what happens to the cells?

A

Water will be drawn out into the hypertonic ECF and so the cell will shrink

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18
Q

The concentration of which substances are higher in the cell?

A

K+ and many large organic anions (proteins)

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19
Q

Na+, Cl- and HCO3- are highest in concentration where?

A

Extracellularly

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20
Q

Which pump maintains the difference in ion concentrations inside and outside the cell?

A

Sodium Potassium ATPase

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21
Q

If the membrane potential is altered what can happen?

A

Electrical function disrupted, fluid balance may change

22
Q

If ECF is not tightly regulated by the kidney what can go wrong?

A

BP changes
Cell function loss (ICF is dependent on ECF remember)
Oedema

23
Q

How does the kidney contribute to plasma pH?

A

Kidney controls bicarbonate absorption

24
Q 
Which organ does all of the following-
control volume 
control osmolarity 
helps maintain pH
excretes waste
A

The Kidney

25
Q

How much fluid does the kidney filter in a day?

A

180L

26
Q

How much urine do we produce on average each day?

A

1.5L (almost all of the 180L of plasma that is filtered is reabsorbed)

27
Q

What is found in ultrafiltrate?

A

Water, ions and other small molecules

28
Q

What is the functional unit of the kidney?

A 
The nephron (a filter connected to a long reabsorption tube)
1.5 million nephrons/kidney
29
Q

Which bits of the nephron sit in the cortex?

A

Glomerulus
PCT
DCT

30
Q

Where do you find the Loop of Henle and collecting duct?

A

The medulla

31
Q

where is the filtrate relative to the body?

A

the filtrate in the lumen is outside the body (cavity with a cavity)

32
Q

Outline the key reabsorption percentages in the kidney.

A 
Substance	% reabsorbed by PCT
Na+, H2O	60-70
K+	                80-90
Bicarbonate	90
Glucose and amino acids 	100
33
Q

What substance might we actively secrete in the kidney (to get rid of it in urine)?

A

H+

34
Q

How does the glomerulus filter fluid to the tubule?

A

Water, electrolytes and small molecules are forced out of the heavily fenestrated capillaries by a constant high filtration pressure. (slightly more dilated afferent arteriole than the efferent)

35
Q

What is the major site of reabsorption?

A

PCT

60-70% Na+ and water, 80-90% K+, 90% bicarbonate, 100% of glucose and aminoacids

36
Q

Is the filtrate in the PCT hypotonic, isotonic or hypertonic compared to plasma?

A

Isotonic (the water is following the osmoles)

37
Q

Which tubule cell membrane has the sodium pump on it?

A

Basolatteral

38
Q

Which lateral cell to cell junction are found in the kidney?

A

Tight Junctions

39
Q

What property of the membrane of tubule cells allows for transport across them with different finishing concentrations either side?

A

Different membrane permeability on each side because of differing transporter expression.

40
Q

Which membrane would express the SGLT?

A

The luminal one

41
Q

What is the function of the Loop of Henle?

A

Creates osmolarity gradient from medulla to cortex by counter current multiplication
further salt reabsorption

42
Q

Why do we need counter current multiplication?

A

The osmolarity gradient it creates is needed to make concentrated urine when we are trying to conserve fluids.

43
Q

Where is the site of variable water and electrolyte reabsorption?

A

DCT

44
Q

The fluid leaving the Loop of Henle is what tonicity?

A

Hypotonic- very dilute

45
Q

What does the distal convolute tubule do interms of salt?

A

Removes more NaCl from the already hypotonic filtrate.

46
Q

In the DCT what happens to H+ ions?

A

Active secretion

47
Q

Where in the kidney does water not necessarily follow electrolytes?

A

the DCT

48
Q

The Loop of henle sets up a very concentrated medulla relative to the cortex, where does this result in the formation of a concentrated urine?

A

The collecting duct- water will move out of the collecting duct

49
Q

Which hormonal systems affect Na+ recovery?

A

RAAS (ECF volume the end result)

50
Q

How is water recovery controlled?

A

Anti-diuretic hormone (DCT permeability changes with ADH so ECF osmolarity is affected)

Year 2 Urinary (9 decks)

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