Kidney's Part 1 Flashcards
What do the kidneys regulate
blood volume (pressure, concentration of waste, concentration of electrolytes, pH
Where is urine produced in kidneys drained into?
urine pelvis
Why is the outer cortex of the kidneys reddish brown?
many capillaries
What separates renal pyramids
renal columns
each pyramid projects into a small depression called a _____ which unite to form _____
minor calyx, major calyx
How is the ureter similar to the digestive tract?
peristaltic waves
What controls wavelike contratins in the ureter?
pacemake in the calyces and pelvis
Kidney stones also called
nephrolithiases
how to treat severe kidney stones?
lithotripsy
What drains the urinary bladder?
urethra
What stands in front of the bladder in men?
prostate
What is the muscular wall in the urinary bladder?
detrusor muscle
What innervates the smooth muscle of the bladder and what stimulates it?
parasympathetic neurons- ach stimulates muscarinic ach in detrusor muscle
in the urethra, the ____ sphincter is composed of skeletal muscle and the _____ is composed of smooth muscle
external urethral sphincter, internal urethral sphincter
What exercise can help incontinence?
kegel’s
process of urination
micturation
When the bladder is stretched, this stimulation evokes
voiding reflex
Where is the micturation center?
pons
What kind of nerves innervate the external urethral sphincter and what specific nerve is stimulated?
somatic motor neurons, pudendal nerve
What reflex permits bladder filling
guarding reflex
Urine leakage due to sneezing, coughing, laughing
stress urinary incontinence
What kinds of tests diagnose urinary incontinence?
urodynamic testing, cystometric test
What surgery can treat urinary incontinence
sling surgery
What is another name for a urinary catheter?
foley catheter
Functional unit of the kidney
nephron
Journey of blood from entrance to kidney to to the capillary network surround the renal tubules
renal arter, interlobar artery, arcuate artery, interlobular artery, afferent arterioles, glomeruli, efferent arteriole, peritubular capillaries
What is unique about the blood vessels of the kidneys
It is only one which a capillary bed (glomerulus) is drained by an arteriole (rather than vein) and delivered to a second capillary bed (peritubular capillaries_
Order of nephron tubules
glomerular capsule, proximal convoluted tubule, loop of henle (nephron loop (descending and ascending limbs), distal convoluted tubule, collecting duct
What composes the renal corpuscle
the glomerular (bowman’s) capsule and the glomerulus inside
Reabsorption of salt, water, and other things are transported though what into what
tubular cells into peritubular capilaries
Where is the renal corpuscle located?
renal cortex
What carries fluid into the medulla and what returns it to the cortex?
descending limb, ascending limb
Characteristics of juxtamedullary nephrons
inner one third of cortex, next to medulla, have longer nephron loops
Most common type of nephron
cortical nephron
when is filtrate considered urine?
as it passes through renal pyramid
What are the pores called in the glomerular endothelium and what can they preven the passage of?
fenestrations, rbc’s, wbc’s and platalets
What is the first filtration barrier?
capillary fenestrae
What is the second filtration barrier and what is it made of?
glomerular basement membrane made of collagen IV and proteogycans
How could a genetic defect in collagen IV affect kidneys?
produce glomerulonephritis (alport’s syndrome)
Fluid filled cysts that form in the nephron
Polycyctic kidney disease
Inherited PKD is called what and what proteins are responsible?
autosomal dominant polycystic kidney disease, polycystin 1 and polycystin 2
Where is the third filtration barrier?
inner (visceral) layer of glomerular capsule
What is the third filtration barrier composed of?
podocytes and foot processes
What is the last potentital filtration barrier?
slit diaphragm
Defect where wold cause proteinuria?
slit diaphragm
Fluid that enters the glomerular capsule is called what and formed by what?
filtrate (ultrafiltrate), formed by hydrostatic pressure of blood from left ventricular systole
Filtrate formation is similar to tissule fluid formation via
starling forces
How does severe dehydration lead to acidosis?
decreases bp and blood volume, increases transit time to remove wastes which leads to more retention of metabolic wastes, and decreases glomerular filtration rate so less wastes enter the capsule for elimination
high plasma urea concentration
uremia
The volume of filtrate porduced by both kidneys in a minte
glomerular filtration rate
GFR average per day
45 gallons
vasoconstriction or vasodilation of what vessels affects the GFR?
afferent arterioles
How would increased sympathetic nerve activity affect GFR and urine production
both decrease
Cardiogenic shock would ______ afferent arterioles
vasoconstrict
What is the minimum urine per day needed to excrete metabolic wastes?
400ml, obligatory water loss
Where is most of glomerular filtrate reabsorbed in a constant, unregulated way and how?
proximal tubules and descending limbs of the nephron loops, osmosis
How does the osmolality of filtrate compare to plasma, and how does this affect reabsorption by osmosis?
isosmotic, must create concentration gradient
Reabsorption in the PROXIMAL tubule occurs by _____ transport of _____ out of the ____ followed by ____ transport of _____ and ____ follows by osmosis. All of these enter ____
active, sodium, filtrate, passive, chloride, water, peritubular capillaries
Reabsorption of salt and water occus constantly w/o hormone regulation where?
proximal tubule and descending limb
What percent of the initial filtrate is actually altered to maintain homeostasis?
15%
Where does fine tuning of reabsorption occur?
distal convoluted tubule and collecting duct
In order for water to be reabsorbed by osmosis, the surrounding interstitial fluid must be
hypertonic
What segment of the ascending limb connects to the distal convoluted tubule?
thick segment
What happens to the ions in the ascending loop of henle
Na+ moves passively from filtrate into tubular cells, this powers secondary active transport of K+ and CL- into filtrate, Na+ is the actively transported out and CL- follows
The fluid entering the distal tubule is _____ and the interstitial fluid is ____
hypotonic, hypertonic
Why is the fluid in the distal tubule hypotonic
because the ascending loop of henle is not permeable to water
What secretes vasopressin?
posterior pituitary
How does ADH regulate water reabsorption
ADH binds to receptors in collecting duct and stimulates cAMP which causes exocytosis of aquaporins–> more reabsorption and less urine
Where is the thirst center?
hypothalamus
What tract facilitates the production and then secretion of ADH?
hypothalamo hypophyseal tract
Drinking sea water leads to
osmotic diuresis
Main symptoms of diabetes insipidus?
polyuria, thirsts, polydipsia
type of diabetes caused by inadequate sercretion of ADH?
central diabetes insipidus
Diabetes caused by inability of kidneys to respond to ADH?
nephrogenic diabetes insipidus
synthetic ADH
desmopressin
“kidney on fire”
pyelonephritis
What test was ordered for the young woman who couldn’t stop vomitting
urinalysis
