Kidney Flashcards
All of the structures reside in the renal cortex EXCEPT the:
a. distal tubule
b. collecting duct
c. glomerulus
d. proximal tubule
b. collecting duct
The twin bean-shaped kidneys reside in the
retroperitoneal space between the levels of T12 and L3
The __________ is the functional unit of the kidney
nephron
The kidney can be divided into two parts:
renal cortex
renal medulla
renal medulla consists of
the loops of Henle & collecting ducts
The renal cortex includes
the glomerulus
Bowman’s capsule
proximal tubules
distal tubules
____________– is an indentation that provides the point of entry and exit for the renal artery, renal vein, nerves, lymphatics, and ureters
the hilium
The ___- surrounds the glomerulus
Bowman’s capsule
The kidney produces (Select 3):
a. calcitriol
b. antidiuretic hormone
c. aldosterone
d. renin
e. erythropoietin
f. angiotensinogen
a. calcitriol
d. renin
e. erythropoietin
The kidney has ______ major functions
6
The six major functions of the kidney include
- maintenance of extracellular volume and composition
- blood pressure regulation (long- and intermediate-term)
- excretion of toxins and metabolites
- maintenance of acid-base balance
- hormone production (erythropoietin, calcitriol, prostaglandins)
- blood glucose homeostasis
__________________ reduces EPO production and leads to chronic anemia
Severe kidney disease
The lungs and the kidneys are the primary regulators of _______________ where the lungs excrete ________, and the kidneys excrete ____________
acid-base balance; volatile acids (Co2), & the kidneys excrete non-volatile acids
Inadequate oxygen delivery to the kidney causes it to release
erythropoietin
Clinical examples that lead to an increase in erythropoietin include
anemia
reduced intravascular volume
& hypoxia (high altitude, cardiac & pulmonary failure
Low blood calcium level increases __________ release which increases the ___________ level
parathyroid hormone release which increases the serum calcitriol
___________ controls extracellular fluid volume (Na+ and water are reabsorbed together)
Aldosterone
________ controls plasma osmolarity (water is reabsorbed, but Na+ is not)
Antidiuretic hormone (vasopressin)
the kidneys regulate
potassium
chloride
phosphate
magnesium
hydrogen
bicarbonate
glucose
urea
Long-term control of BP is carried out by the
thirst mechanism (intake) and sodium and water excretion (output)
Short-term control of BP is carried out by the
baroreceptor reflex
Intermediate-term control of BP is carried out by the
RAAS
Renin is produced by the
juxtaglomerular cells
Aldosterone is synthesized by the
adrenal cortex
Glomerular filtration and tubular secretion clear the blood of
metabolic byproducts, toxins, and drugs
The kidneys maintain acid-base balance by titrating hydrogen in the
tubular fluid which creates acidic or basic urine
______________ vasodilate the renal arteries
PGE2 & PGI2
_______ constricts the renal arteries
thromboxane A2
Calcitriol affects the serum Ca2+ level in three ways:
stimulates the intestine to absorb Ca2+ from food
instructs the kidney to reduce Ca2+ & phosphate excretion
increases the deposition of Ca2+ into the bone
Which statement BEST describes the pathway of blood through the kidney?
a. glomerular capillary bed> afferent arteriole> peritubular capillary bed> efferent arteriole
b. glomerulus> proximal tubule> loop of Henle> distal tubule > collecting duct
c. afferent arteriole> efferent arteriole> glomerular capillary bed > peritubular capillary bed
d. afferent arteriole> glomerular capillary bed> efferent arteriole> peritubular capillary bed
d. Afferent> glomerular> efferent> peritubular
The kidneys receive _________ of the cardiac output
20-25%
Renal blood flow is directly proportional to the difference between
MAP & renal venous pressure
Renal blood flow is inversely proportional to
renal vascular resistance
_____________ maintains renal blood flow within a wide range of systemic blood pressures (MAP 50-180 mmHg)
autoregulation
Key contributors of renal autoregulation include
myogenic mechanism*
tubuloglomerular feedback* (two most important)
RAAS
atrial natriuretic peptide
prostaglandins
autonomic tone
Of the blood delivered to the kidney, only ______ is filtered at the glomerulus
20%
After filtration, ________ of the ultrafiltrate is reabsorbed into the
99%; peritubular capillaries
the surgical stress response includes a transient state of
vasoconstriction & sodium retention resulting in oliguria & edema
Vasoconstriction during the surgical stress response predisposes the kidneys to
ischemic injury and the effects of nephrotoxic drugs
In the neonate, RBF ____________ in the first two weeks of life and achieves an adult level by
doubles; two years of age
______________ is more sensitive to ischemia due to a lower PO2
the Renal medulla
Tubuloglomerular feedback about the _____ and _________- composition in the distal tubule affects arteriolar tone
sodium and chloride composition
If the renal artery pressure is elevated, the myogenic mechanism ___________________________ to protect the glomerulus from excessive pressure
constricts the afferent arteriole
The kidneys receive sympathetic innervation from
T8-L1
What is more represented in the kidney SNS or PNS?
SNS
How does renal blood flow change after age 50?
it decreases by 10% per decade
What renal structures are innervated by the SNS?
afferent and efferent arterioles
