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BDS 1 > KIDNEY > Flashcards

KIDNEY Flashcards

1
Q

What kind of relationship does systemic diseases have on body systems?

A

Multidirectional.

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2
Q

Describe the relationship between periodontitis and kidney disease.

A

The number of people that have kidney disease and periodontitis together was higher than those who were healthy. Mortality rates are higher in individuals that have period and periodontitis.
Oral inflammation more likely in people with systemic inflammatory disease. Higher death rate in patients with combined CKD and perio compared with CKD only

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3
Q

Describe the relationship between periodontitis and kidney disease.

A

The number of people that have kidney disease and periodontitis together was higher than those who were healthy. Mortality rates are higher in individuals that have period and periodontitis.
Oral inflammation more likely in people with systemic inflammatory disease. Higher death rate in patients with combined CKD and perio compared with CKD only.

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4
Q

What is the functional unit of the kidney?

A

The nephrons.

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5
Q

What are the three distinct parts of the microscopic kidney?

A
  1. cortex (85% of all kidney nephrons here)
  2. medulla (the site where urine is concentrated, prevents excessive water loss)
  3. pelvis (collection area for urine which is funnelled into the ureter)
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6
Q

What are the three distinct parts of the microscopic kidney?

A
  1. cortex (85% of all kidney nephrons here)
  2. medulla (the site where urine is concentrated, prevents excessive water loss)
  3. pelvis (collection area for urine which is funnelled into the ureter to bladder).

Capsule, cortex, renal papilla of pyramid, pelvis, column, pyramid.

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7
Q

What type of fibrous tissue outlines the kidney?

A

Dense irregular fibrous tissue.

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8
Q

Where does the kidney get its blood supply from and how many litres of blood does the kidney process a day?

A
  • The renal artery (which comes from the abdominal aorta).
  • 1500 litres of blood a day (contains 20% of blood volume).
  • Processes 1.2 litres of blood per minute (1/5 of CO).
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9
Q

What are the blood vessels of the kidney in order?

A
  1. renal artery
  2. segmental arteries
  3. lobar arteries
  4. interlobar arteries
  5. arcuate arteries
  6. interlobular arteries
  7. afferent arterioles
  8. glomelular capillaries
  9. efferent arterioles
  10. peritubular capillaries
  11. interlobular veins.
  12. arcuate veins
  13. lobar veins
  14. segmental veins
  15. renal vein
  16. inferior vena cava.

THE SHAPE OF THESE CAPILLARIES HAVE AN IMPORTANT ROLE IN WATER REABSORPTION.

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10
Q

What do the kidneys secrete in response to a fall in blood pressure and also hypoxia?

A

Renin. Erythropoetin.

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11
Q

What are the two types of nephrons and what do they do?

A

Corticol- primarily located within the cortex- they have short loop of henre that ony jjust extends into medulla

Juxtamedullary- next to medulla, thes hav very long loops that extend long into medulla- reabsorb water and conc urine.

15% are jux nephrons.

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12
Q

What are the two types of nephrons and what do they do?

A

Corticol- primarily located within the cortex- they have short loop of henre that only just extends into medulla.

Juxtamedullary- next to medulla, they have very long loops that extend long into medulla- reabsorb water and conc urine.

15% are jux nephrons.

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13
Q

What are the two parts of the nephron and what do they consist of?

A

Renal corpuscle- glomerulus and the bowman capsule.

Renal tubercle- proximal convoluted tubule, loop of Henle, distal convoluted tubule and the collecting ducts.

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14
Q

What forms the filtration barrier?

A

Glomerular epithelium, basement membrane and pedicles.

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15
Q

What does a decrease in glomerular filtration rate result in?

A

Inefficient removal of waste products- they accumulate in the blood.

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16
Q

How can you check kidney function?

A

By checking serum creatinine levels- high levels means its not been reabsorbed.

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17
Q

What does the renal corpuscle do?

A

Filtration.

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18
Q

What does the proximal and distal convoluted tubules do?

A

Reabsorption and secretion.

19
Q

What does the collecting duct do?

A

Urine collection.

20
Q

What process is Na reabsorbed?

A

Primary active transport.

21
Q

What process are nutrients reabsorbed?

A

Secondary transport.

22
Q

What are the two parts of the loop of Henle and what do they do?

A
  1. Thin ascending part- freely permeable to water.

2. Thick descending part- impermeable to water and actively pumps sodium, chlorine and potassium into interstitium.

23
Q

How does the kidney facilitate water reabsorption from the upper limb?

A

The interstitium becomes salty due the active transport of sodium into it. This generates an osmotic gradient to facilitate water reabsorption.

24
Q

What does ADH do?

A

Increases water reabsorption by encouraging insertion of aquaporin channels.

25
Q

What does aldosterone do?

A

Increases sodium reabsorption.

26
Q

How does aldosterone regulate water absorption?

A

Indirectly through increased sodium reabsorption. Aldosterone works with ADH to reabsorb water. Concentrated urine produced.

27
Q

What does the two parts of the juxtaglomerulus apparatus do?

A

Macula densa cells- detect sodium concentration and release adenosine).

Juxtaglomeruler cells- adjust the diameter of the afferent arteriole.

28
Q

What does adenosine do when it is released by macula densa?

A

When macula densa cells release adenosine it constricts the afferent arteriole. This decreases the glomerular hydrostatic pressure. When homeostasis is reached the afferent arteriole’s large diameter is maintained.

29
Q

How much of the filtrate is reabsorbed in proximal convoluted tubules?

A

2/3s.

30
Q

How do the kidneys decrease blood pressure?

A

When there is an excess of fluid in the blood there is an elevated blood volume. This results in elevated blood pressure> The kidneys produce a large volume of dilute urine to decrease the blood pressure.

31
Q

Where is sodium reabsorbed in the kidneys and what is the percentages?

A

PCT- 65%.

Loop of Henle- 25%.

32
Q

When is renin released?

A

In response to a fall in blood pressure.

33
Q

What is the renin angioteninogen system?

A
  1. Angiotensinogen is released into circulation by the liver in response to a fall in blood pressure. Renin converts angiotensinogen into angiotensin 1. Angiotensinogen converting enzyme converts angiotensin 1 into 2. Angiotensin 2 is a potent vasoconstrictor that rapidly increases blood pressure.
34
Q

How is blood volume restored and what structures do this?

A

Angiotensin 2 is detected by;

Medulla- aldosterone release.
Hypothalmus- ADH release.

35
Q

What does the atrial natruiretic peptide do?

A

Lowers blood pressure by increasing sodium excretion by the kidneys. It counteracts the renin angiotensinogen system.

36
Q

Tubuloglomerular feedback maintains GFR. How does the juxtaglomerular apparatus achieve this?

A

Macula densa signals the juxtaglomerular cells via aldosterone and prostaglandins.

  • adenosine- high GFR- causes the juxtaglomerular cells to vasodilator.
  • prostaglandins- low GFR- causes the juxtaglomerular cells to vasocontrict.
37
Q

What are symptoms of CKD?

A

-nausea, oedema, blood/protein in urine, anaemia, weak bones.

38
Q

What are causes of CKD?

A

-hypertension, diabetes, longterm use of NSAIDS, high cholesterol, kidney infections, kidney stones, glomerulonephritis and polycystic kidney disease.

39
Q

How do you regulate hypertension?

A

-lower salt intake.
-Diruetics- to increase the excretion of water and salts.
Loop and thiazide diuretics.
-ACE inhibitors (captopril) which inhibits angiotensin 2.
-Beta blockers block sympathetic nerve stimulation by stress hormones.

40
Q

How does furosemide work?

A

Blocks action of NKCC2 so sodium is therefore flushed out of the body along with unwanted fluids.

41
Q

What is the consequence of reduced kidney function on pharmacokinetics?

A

Less able to clear drugs from system. CKD is far lower dose than a healthy person.

42
Q

When does an individuaal have kidney failure?

A

When there GFR is below 15%.

43
Q

What are the two types of dialysis?

A
  • haemodialysis-blood is removed for cleansing and is cleaned then returned back to the body.
  • peritoneal dialysis- can leave patient having a normal life. Inserted into the peritoneum of the patient. A semipermeable membrane is formed so dialysis can occur.

BDS 1 (14 decks)

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