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BDS1 > Kidney structure and function > Flashcards

Kidney structure and function Flashcards

1
Q

What is the function of kidneys?

A

Process blood and rid the body of the waste products of metabolism via urine
Maintain internal homeostasis of fluid

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2
Q

What do kidneys play an important role in?

A

Blood Pressure
Acid/base ratio
Calcium/vitamin D metabolism
Erythropoietin (formation rbc)

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3
Q

What is the function of the ureters?

A

Transfer urine from kidney to bladder

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4
Q

Are kidneys retroperitoneal?

A

yes

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5
Q

What is the fatty tissue that kidneys are stored in?

A

Renal fat pad

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6
Q

What is the function of the cortex?

A

Contain 85% of kidney tubules (nephrons)

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7
Q

What is the function of the medulla of kidney?

A

Where urine is concentrated
Prevents excessive water loss

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8
Q

What is the function of the pelvis of the kidney?

A

Collection areas for urine which is funnelled into the ureter

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9
Q

What artery delivers blood to the kidneys from the abdominal aorta?

A

Renal artery

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10
Q

What is the capillary bed of the kidneys called?

A

Glomerular capillaries

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11
Q

What is the function of the peritubular capillaries?

A

Water reabsorption
Provides nutrients to kidneys

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12
Q

What is the basic functional unit of kidney?

A

Nephron

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13
Q

What is the function of the glomerulus and Bowman’s capsule?

A

Site of plasma filtration

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14
Q

What are the two types of nephron?

A

Cortical nephron (located in cortex)
Juxtamedullary nephrons (next to medulla, long loops of Henle)

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15
Q

Why is it important that the capilarries within glomerulus are ‘leaky’?

A

Allows for rapid filtration

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16
Q

What is the specialised epithelium found in the Bowman’s capsule?

A

Podocytes

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17
Q

What is the glomerulus and bowman’s capsule known as?

A

Renal corpuscle

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18
Q

What forms the filtration barrier?

A

Glomerular endothelium
Basement membrane
Pedicels of podocytes

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19
Q

What is the permeability of the filtration barrier?

A

Freely permeable to water and small molecules but not large proteins or cells

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20
Q

How does unfiltered blood arrive at the glomerulus?

A

Via the afferent arteriole

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21
Q

How is filtration through the filtration barrier facilitated?

A

Through a pressure gradient

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22
Q

What is filtered through the filtration barrier?

A

Urea
Creatinine
Water
Glucose
Amino acids
Na+
Cl-
etc

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23
Q

What is the glomerular filtration rate (GFR)?

A

The rate at which blood is filtered through the glomerulus into the bowman’s capsule

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24
Q

What can the glomerular filtration rate be influenced by?

A

Hydrostatic pressure
Osmotic pressure
Blood pressure
Renin-angiotensin system
Disease

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25
Q

What is the normal health glomerulus filtration rate?

A

125ml/min (180l a day)

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26
Q

What can be used to estimate the GFR?

A

Serum creatinine (and urea) measurements

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27
Q

How much of the filtrate is reabsorbed?

A

99%

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28
Q

What is the renal tubule made up of?

A

Proximal convoluted tube
Loop of henle
Distal convoluted tubule
Collecting duct

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29
Q

What is the function of the renal tubule?

A

Reabsorption and secretion

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30
Q

What can you find on apical surface of proximal convulated tubule?

A

Cilia

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31
Q

What capillaries are closely associated with the convoluted tubule?

A

Peritubular capillaries

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32
Q

What substance is NOT reabsorbed in the proximal convoluted tubule?

A

Creatinine

33
Q

What is the reabsorption of water facilitated by?

A

Presence of aquaporins in membrane

34
Q

How do glucose and amino acids move across the apical surface?

A

Sodium co transporters via passive diffusion

35
Q

What does the proximal tubule use to reabsorb 2/3 of filtrate?

A

Na+K+ Pump on basolateral membrame

36
Q

How does the Na+K+ pump work?

A

Use ATP to carry Na against the concentration gradient

37
Q

What can the Na+K+ pump transferring the nutrients be known as?

A

Facilitated passive transport

38
Q

What process do juxtamedullary nephrons take part in?

A

Counter-current multiplication

39
Q

What are the three sections of the loop of henle?

A

Thin descending limb
Thin ascending limb
Thick ascending limb

40
Q

What is a rule about both thick and thin ascending limbs?

A

DO NOT contain aquaporins and are IMOERMEABLE to water

41
Q

What is the thick ascending limb the site of?

A

Active Sodium reabsorption, water does not follow

42
Q

How is sodium reabsorbed in the thick ascending limb on apical membrane?

A

NKCC2 Pump

43
Q

What happens to the medulla due to the the sodium reabsorption?

A

Very salty which allows water to move out tubule by osmosis

44
Q

What happens to the concentration of the filtrate as it descends the thin descending limb?

A

More concentrated

45
Q

What is the main aim of the loop of henle?

A

Reabsorb and retain water

46
Q

In the medulla, how many litres of filtrate is reabsorbed?

A

45l

47
Q

What supports the concentration gradient in the medulla?

A

Vasa recta

48
Q

What is the function of the distal convoluted tubule?

A

Site of fluid volume and electrolyte regulation

49
Q

What hormone is used to increase water absorption?

A

Antidiuretic Hormone (Vasopressin)

50
Q

How does ADH act on distal and collecting tubules?

A

Insertion of aquaporins allowing water to be reabsorbed from the filtrate

51
Q

What hormone signals the cells of the distal convoluted to reabsorb salt?

A

Aldosterone

52
Q

What kind of hormone is aldosterone?

A

Steroid hormone

53
Q

What hormone is released when their is an increase in blood pressure?

A

Atrial Natriuretic Hormone

54
Q

How does ANP act on distal and collecting tubule?

A

Counteracts effects of ADH and aldosterone

55
Q

By what process is sodium reabsorbed across the basolateral surface of epithelial cells lining the proximal convoluted tubule?

A

Active transport

56
Q

What is the primary purpose of counter current multiplication?

A

Water reabsorption

57
Q

What is blood filtering through the bowman’s capsule influenced by?

A

Glomerular hydrostatic pressure
Capsular hydrostatic pressure
Glomerular osmotic pressure
Systematic blood pressure
Ren-angiotensin-aldosterone system
Disease

58
Q

What is the group of specialised epithelial cells which respond to the change in sodium concentration?

A

Macula densa

59
Q

What is the name of the modified smooth muscle cells which modify the diameter of the afferent arteriole?

A

Juxtaglomerular cells

60
Q

What are the function of mesangial cells?

A

Supporting cells

61
Q

What do the macula densa release when sodium concentration is high?

A

Adenosine

62
Q
A

Vasoconstrict

63
Q

Does the macula densa have any effect on systemic blood pressure?

A

No

64
Q

What do the macula densa release when sodium concentration is low?

A

Prostaglandins

65
Q

What does an decrease in blood pressure cause the afferent arteriole to do?

A

Causes juxtaglomerular cells to secrete renin which activates the renin-angiotensin system

66
Q

How does the renin angiotensin system restore blood pressure?

A

-angiotensin is in circulation
-the release of renin converts angiotensin into angiotensin I
-Angiotensin converting enzyme converts angiotensin I into angiotensin II
-Angiotensin II is a potent vasoconstrictor, rapidly increasing blood pressure

67
Q

Where is angiotensin converting enzyme primary produced?

A

The vascular endothelium of lung

68
Q

Where else does angiotensin II have receptors?

A

-Arterioles (constriction)
-Hypothalamus (thirst)
-Pituitary gland (release ADH)
-Adrenal medulla (release aldosterone)

69
Q

What hormone is released to counteracts the renin angiotensin system?

A

Atrial natriuretic peptide (ANP)

70
Q

Where do you find ANP?

A

The heart

71
Q

What receptors in the heart detect change in blood pressure?

A

Baroreceptors

72
Q

What is chronic kidney disease a main cause of?

A

Cardiovascular disease
Hypertension

73
Q

What are causes of chronic kidney disease?

A

Hypertension
Diabetes
High cholesterol
Infections
Kidney stones
Long term use of Anti-inflammatory drugs

74
Q

Symptoms of Chronic kidney disease?

A

Nausea
Oedema
Blood/protein in urine
Anaemia
Weak and painful bones
Hypertension

75
Q

How do patients regulate hypertension?

A

Diet
Anti-hypertensive treatments
Diuretics (furosemide)
Aldosterone agonists (inhibit effect)
Angiotensin receptor blockers

76
Q

What is the target for furosemide?

A

NKCC2 pumps

77
Q

What is dialysis?

A

Artificial removal of waste , solutes, water and toxins from blood

78
Q

What are the 2 main types of dialysis?

A

Haemodialysis
Peritoneal dialysis

BDS1 (43 decks)

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