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renal system 1 > kidney structure and function > Flashcards

kidney structure and function Flashcards

1
Q

what is the main function of kidneys?

A

regulate blood and fluid

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2
Q

what is the waste product excreted by kidneys?

A

urine

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3
Q

the ureter, vessels and nerves enter the kidney via what?

A

renal hilum

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4
Q

what vessel supplies the kidney with oxygenated blood?

A

renal artery

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5
Q

which vessel drains the kidney?

A

renal vein

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6
Q

where does the renal artery arise from ?

A

left interior side of abdominal aorta

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7
Q

the renal vein connects the kidney to which structure?

A

inferior vena cava

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8
Q

which structure transfers urine from the kidney to the bladder?

A

ureter

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9
Q

the tube leaving the kidney and entering the bladder is known as what?

A

ureter

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10
Q

the kidney id situated behind the peritoneal cavity, what is it described as?

A

retroperitoneal

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11
Q

what is the peritoneal cavity?

A

space between the parietal peritoneum and the visceral peritoneum

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12
Q

when viewed macroscopically, the kidney consists of 3 distinct parts, what are these?

A
  • cortex (outermost part)
  • medulla
  • pelvis (inner most part)
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13
Q

what does the renal cortex contain?

A

85% of all kidney tubules (nephrons)

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14
Q

what may a nephron also be referred to as?

A

kidney tubule

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15
Q

what is the function of the renal medulla?

A
  • site where urine is concentrated

- prevent excess water loss

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16
Q

what is the function of the renal pelvis?

A

collection area for which urine is funnelled into the ureter

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17
Q

renal arteries deliver blood from which main blood vessel?

A

abdominal aorta

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18
Q

name the stages of blood flow from interlobular arteries to interlobular veins

A
  • interlobular arteries
  • afferent arteriole
  • glomerular capillaries’
  • efferent arterioles
  • peritubular capillaries
  • interlobular veins
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19
Q

what is unique about the renal vasculature?

A

arterioles > capillaries > arterioles

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20
Q

what essentially is the glomerulus?

A

network of cappilaries

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21
Q

what is the basic functional unit of the kidney?

A

nephron

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22
Q

what is the glomerulus surrounded by?

A

bowman capsule

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23
Q

what is the general function of the loop of henle?

A

urine concentration and water resorption

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24
Q

which structures of a nephron are found in the renal cortex?

A
  • glomerulus
  • bowman capsule
  • proximal convoluted tubule
  • distal convoluted tubule
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25
Q

which structures of a nephron are found in the renal medulla?

A
  • loop of henle

- collecting tubule

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26
Q

what is the general function of the distal convoluted tubule?

A

git rid of excess water

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27
Q

name the 2 different types of nephrons?

A
  • cortical nephrons

- juxtamedullary nephrons

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28
Q

which typeof nephron, cortical or juxtamedullary, contains a longer loop of henle?

A

juxtamedullary

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29
Q

the blood filtering component of the kidney is known as what ?

A

renal corpuscle

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30
Q

what structures of a nephron does the renal corpuscle consist of?

A
  • glomerulus

- bowman capsule

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31
Q

which structures of a nephron are involved in reabsorption and secretion?

A
  • proximal convoluted tubule
  • loop of henle
  • distal convoluted tubule
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32
Q

describe the structure of glomerulus?

A
  • single layer endothelial cells surrounded by basement membrane
  • fenestrated (pores)
  • surrounded by bowman capsule
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33
Q

bowman capsule consists of 2 layers, what are these layers?

A
  • parietal (outer layer)

- visceral (inner layer)

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34
Q

the space between the parietal and visceral layers of the bowman capsule is known as what?

A

bowman space

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35
Q

the visceral layer of the bowman capsule is compromised of what specialised epithelium?

A

podocytes

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36
Q

together the glomerulus and bowman capsule are known as what?

A

renal corpuscle

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37
Q

how are the podocytes arranged around the glomerular capillaries?

A

long branched pedicels of podocytes wrap around the glomerular capillaries

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38
Q

what is the renal filtration barrier composed of?

A
  • glomerular endothelium
  • basement membrane
  • pedicels from filtration barrier
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39
Q

the - glomerular endothelium, basement membrane and the pedicels from filtration barrier together form what?

A

filtration barrier

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40
Q

what do the pedicels share a basement membrane with?

A

fenestrated endothelium

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41
Q

what is the renal filtration barrier freely permeable to?

A

water, glucose, amino acids, sodium, chloride, calcium, phosphate, potassium, bicarbonate, urea, creatine

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42
Q

what is the renal filtration barrier not freely permeable to?

A

large proteins (haemoglobin), cells, negative proteins (albumins)

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43
Q

what type of charge does the filtration barrier have?

A

negative

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44
Q

the filtration barrier carries out non-selective filtration based on what ?

A

charge and size

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45
Q

unfiltered blood enters the glomerulus via?

A

afferent arteriole

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46
Q

filtered blood leaves the glomerulus via?

A

efferent arteriole

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47
Q

which glomerular arteriole, afferent or efferent is wider?

A

afferent

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48
Q

how does the afferent arteriole being bigger than the efferent aid filtration from the glomerulus?

A

increases hydrostatic pressure - force builds up pushing small molecules out

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49
Q

the rate at which blood is filtered through the glomerulus into bowman capsule is known as what?

A

glomerular filtration rate (GFR)

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50
Q

what is GFR primarily driven by?

A

glomerular hydrostatic pressure

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51
Q

what is GFR counteracted by?

A
  • hydrostatic pressure in bowman capsule

- glomerular osmotic pressure

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52
Q

what is GFR influenced by?

A
  • hydrostatic pressure
  • osmotic pressure
  • systemic BP
  • renin-angiotensin system
  • disease
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53
Q

what is the GFR of the average person?

A

125ml/min or 180l/day

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54
Q

what effect does kidney damage have on GFR?

A

reduces GFR

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55
Q

what effect does a reduced GFR have?

A
  • ineffective blood clearance
  • ineffective waste removal
  • waste products accumulate in blood
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56
Q

what substance can be measured in order to asses GFR?

A

serum creatine levels

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57
Q

what do high serum creatine levels indicate about the kidney?

A

not functioning properly

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58
Q

what does the high fenestrations on the glomerular endothelium?

A

allow rapid transfer of blood plasma

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59
Q

molecules are filtered from the blood in the glomerular capillaries to where?

A

bowman capsule

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60
Q

the parietal layer of the bowman capsule contains which type of epithelium?

A

simple squamous

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61
Q

how does the structure of the filtration barrier prevent large molecules passing through?

A

very small gaps between pedicels

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62
Q

what structural component of the filtration barrier prevents the small slits between the pedicels from stretching under pressure and negative molecules passing?

A

pedicels coated with protein network, protein network is negative which prevents negative molecules passing

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63
Q

what do blood proteins in urine indicate?

A

kidney damage in glomerulus

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64
Q

what is the bowman capsule osmotic pressure usually equal to?

A

0

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65
Q

how is glomerular filtration pressure calculated?

A

glomerular hydrostatic -glomerular osmotic -capsular hydrostatic

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66
Q

increased BP has what effect on GFR?

A

increases GFR

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67
Q

where in the nephron is the major site of reabsorption?

A

proximal convoluted tubule

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68
Q

where in the nephron is fine-tuning carried out?

A

distal convoluted tubule

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69
Q

during reabsorption, where does the filtrate pass through?

A

filtrate in tubule lumen > through epithelial tubule wall > interstitial space > into blooding peritubular capillaries

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70
Q

180 litres of filtrate is produced each day however, only 1-2 litres of urine is produced, why is this?

A

99% of filtrate is reabsorbed

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71
Q

what structures make up the renal tubule?

A

PCV, loop of henle, DCT

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72
Q

what is the main function of the renal tubule?

A

reabsorption (main) and secretion

73
Q

what mechanism does the loop of henle employ?

A

counter current multiplier

74
Q

the counter current multiplier mechanism reabsorbs what to substances?

A

sodium and water

75
Q

renal reabsorption refers to the movement of molecules from where to where?

A

filtrate within renal tubule moving through the tubule wall and interstitial space into the blood in the peritubular capillary

76
Q

renal secretion refers to the movement of molecules from where to where?

A

molecules in the blood moving through the interstitial space through the tubule wall into the filtrate in the renal tubule

77
Q

is renal secretion active or passive?

A

active

78
Q

the renal tubule uses sodium handling in a number of ways, what are the functions of this?

A
  • Na transport facilitates reabsorption of nutrients, water and ions
  • facilitates secretion of hydrogen ions and water
79
Q

how much of the sodium filtered across the glomerular filtration barrier is reabsorbed in the proximal convoluted tubule?

A

65%

80
Q

how much of the sodium filtered across the glomerular filtration barrier is reabsorbed in the loop of henle?

A

25%

81
Q

how much of the sodium filtered across the glomerular filtration barrier is reabsorbed in the distal convoluted tubule?

A

8%

82
Q

what does the majority of the kidneys energy go towards ?

A

sodium reabsorption (80%)

83
Q

how much filtrate is reabsorbed in the proximal convoluted tubule?

A

2/3 of the filtrate

84
Q

how does the long convoluted structure of the PCT aid its function?

A

increases SA for more reabsorption

85
Q

how does the structure of the convoluted tubule maximise its function?

A
  • long and convoluted to maximise SA

- microvilli on epithelium to maximise SA

86
Q

the proximal convoluted tubule is closely associated with what capillary ?

A

peritubular capillary (for absorption into it)

87
Q

filtrate entering the proximal convoluted tubule has a high concentration of what, how does this compare to that of the blood in the peritubular capillaries ?

A
  • ions
  • waste products
  • nutrients
  • blood
    blood in peritubular capillaries has low conc of all these
88
Q

is reabsorption of molecules from the tubule lumen into proximal convoluted tubule to blood in the peritubular capillaries active or passive?

A

passive

89
Q

although reabsorption of molecules from the PCT to blood is passive, it still requires either of 2 things, what are these?

A

pores or carrier proteins

90
Q

how does water move through the phospholipids bilayer of the PCT?

A

aquaporin channels

91
Q

what are aquaporin channels ?

A

free pores that allow the movement of water down its concentration gradient

92
Q

how do glucose and amino acids move through the phospholipids bilayer of the PCT?

A

they are transported via sodium co transporters on the apical membrane between the tubule lumen and tubule wall

93
Q

where is the apical membrane?

A

between the tubule lumen and tubule wall

94
Q

glucose and amino acids move from the filtrate into the blood via sodium co transporters, where are these transporters found?

A

apical membrane

95
Q

what are the 2 types sodium transporters found on the apical membrane the PCT?

A
  • amino acid co transporters

- glucose co transporters

96
Q

do glucose and amino acids pass through the apical membrane of the PCT actively or passively?

A

passively

97
Q

how much of the filtrate is reabsorbed passively ?

A

50%

98
Q

50% of filtrate is reabsorbed by the kidneys passively, what happens to the remaining 50% of the filtrate ?

A

active sodium reabsorption in PCT

99
Q

where in the kidneys does active sodium reabsorbtion take place?

A

proximal ct

100
Q

sodium is actively transported across the basolateral membrane of the PCT by which mechanism?

A

sodium potassium pump

101
Q

where is the basolateral membrane?

A

between tubule wall and interstitial space

102
Q

sodium portassium pumps use 1 ATP to move how many sodium ions out and how many potassium ions in?

A

3 sodium out

2 potassium in

103
Q

how does the movement of sodium across the basolateral membrane by sodium potassium pumps move other substances?

A

other things follow sodium:

  • water moves by osmosis
  • glucose and amino acids are co transported across the apical membrane as Na moves across the basolateral membrane
  • negative ions such as Cl follow
104
Q

describe the movement of sodium from the filtrate in the tubule lumen to the epithelium the tubule wall?

A

sodium ions move from an area of high concentration in the tubule lumen to an area of low concentration in the tubule wall

105
Q

describe the movement of sodium from the tubule wall to the interstitial fluid?

A

sodium moves across the basolateral membrane actively, from an area of low concentration in the tubular wall to an area of high concentration in the interstitial fluid via sodium potassium pumps

106
Q

describe the movement of sodium from the interstitial space to the blood?

A

sodium moves passively from a high conc in insterstitial fluid to a low conc in blood

107
Q

where in the sodium reabsorption pathway is sodium found in high concentrations?

A
  • filtrate (tubule lumen)

- interstitial fluid (interstitial space)

108
Q

the inclusion of the sodium potassium pumps increase sodium reabsorption in the PCT from 50% to what?

A

65%

109
Q

where does the loop of henle in cortical nephrons extend to?

A

medulla

110
Q

where does the loop of henle in juxtamedullary nephrons extend to?

A

deep into the medulla

111
Q

juxtamedullary nephrons are specialised at concentrating urine using what mechanism?

A

counter current multiplier

112
Q

which type of neuron, cortical or juctamedullar, are most numerous?

A

cortical

113
Q

the tubule walls of the loop henle can be subdivided into 3 sections, what’s are these?

A
  • thin descending limb
  • thin ascending limb
  • thick ascending limb
114
Q

what happens in the thin descending limb of the loop of henle?

A
  • permeable to water

- no sodium reabsorption occurs

115
Q

what happens in the thin ascending limb of the loop of henle?

A
  • permeable to water

- no sodium reabsorption occurs

116
Q

what happens in the thick ascending limb of the loop of henle?

A
  • impermeable to water (no aquaporin channels)
  • reabsorbs sodium (25% total filtrate)
  • generates osmotic gradient
  • facilitate water reabsorption from thin ascending
117
Q

why can water not be reabsorbed in the thick ascending limb of the loop henle?

A

no aquaporin channels

118
Q

when sodium is actively pumped across the thick ascending limb of the loop of henle, it creates which type of gradient?

A

osmotic

119
Q

describe the fluid in the interstitial of the loop henle and how creates an osmotic gradient?

A
  • fluid in the interstitium is salty as when sodium moves out of the thick ascending limb water cannot follow
  • this salty interstitium draws water out of the thin descending limb osmotically
120
Q

how is sodium drawn into the thick ascending limb in the loop of henle?

A
  • sodium potassium pumps in basolateral membrane

- NKCC2 transporters on apical membrane

121
Q

how does sodium transportation differ in the PCT and Loop of henle?

A
  • both have sodium potassium pump on basolateral membrane
  • PCT uses sodium co transporters on apical membrane
  • loop of henle uses NKCC2 transporters on apical membrane
122
Q

which molecules does a NKCC2 pump ?

A

1 sodium ion, 1 potassium ion, 2 chloride atoms

123
Q

is the NKCC2 (sodium potassium chloride) pump passive or active?

A

passive

124
Q

what is the target site for diuretic drugs and how do the work?

A

NKCC2 - prevent sodium and water resorption

125
Q

the ionic concentration of the renal medulla never reaches equilibrium, why is this?

A

constant pumping action of sodium in ascending limb

126
Q

which structure maintains the concentration gradient in the loop of helm ensuring blood doesn’t wash it away?

A

vasa recta

127
Q

what is the function of the vasa recta?

A

maintains the concentration gradient in the loop of helm ensuring blood doesn’t wash it away

128
Q

describe the rate of blood flow through the vasa recta?

A

slow and sluggish

129
Q

what is the function of the distal convoluted tubule?

A

fine-tuning of filtrate by reabsorption of water and salts

130
Q

what effect does dehydration have on water absorption in distal convoluted tubule?

A

more water resorbed

131
Q

the distal convoluted tubule is the target site for which hormones?

A
  • ADH
  • Aldosterone
  • ANH
132
Q

what effect does ADH have on the distal convoluted tubule?

A

increase water reabsorption

133
Q

what effect does Aldosterone have on the distal convoluted tubule?

A

increase sodium reabsorption

134
Q

what effect does ANH have on the distal convoluted tubule?

A

promote sodium secretion

135
Q

tubule fluid entering the distal convoluted tubule can be described as what, hypotonic or hypertonic, in relation to the interstitium of the cortex?

A

hypotonic

136
Q

where is ADH released?

A

pituitary

137
Q

where is aldosterone released?

A

adrenal gland

138
Q

where is ANH produced?

A

smooth muscle in heart atria

139
Q

how does ADH aid water reabsorption?

A

inserts aquaporin channels into distal convoluted tubule and collecting duct

140
Q

what effect does dehydration have on BP?

A

decreases

141
Q

how does ANH work?

A

inhibits ADH and aldosterone therefore inhibiting water and sodium reabsorption

142
Q

which tubule, the PCT or DCT, is longer?

A

proximal

143
Q

what effect does elevated BP have on volume and concentration of urine produced?

A

large vol dilute urine produced

144
Q

what effect does reduced BP have on volume and concentration of urine produced?

A

small vol concentrated urine

145
Q

which structure connects the glomerulus with the distal convoluted tubule?

A

junta-glomerular apparatus

146
Q

which types of cells does the juxta-glomerular apparatus contain?

A
  • macula densa cells

- juxtaglomerular cells

147
Q

what is the function of the juxta-glomerular apparatus?

A
  • measure sodium concentration of filtrate (macula densa)

- adjust diameter of afferent arteriole (juxtaglomerular cell)

148
Q

increased GFR increases sodium filtrate concentration, this is recognised by cells in the macula densa, what effect will this cause juxtaglomerular cells to have?

A

constrict diameter of afferent arteriole

149
Q

reduced GFR reduces sodium filtrate concentration, this is recognised by cells in the macula densa, what effect will this cause juxtaglomerular cells to have?

A

increase diameter of afferent arteriole

150
Q

what do juxtaglomerular cells secrete when BP falls?

A

renin

151
Q

renin is secreted by juxtaglomerular cells when BP fall, how does this help to increase BP?

A
  • renin activates the renin-angiotensin system which produces angiotensin ii
  • angiotensin ii is a potent vasoconstrictor
152
Q

describe the steps in the renin-angiotensin system?

A
  • angiotensin released into circulation
  • renin converts angiotensin into angiotensin i
  • angiotensin converting enzyme converts angiotensin i into angiotensin ii
153
Q

which 2 structures detect angiotensin ii, and what do they release in response to it?

A
  • adrenal medulla (aldosterone)

- hypothalamus (ADH)

154
Q

which hormone counteracts the renin-angiotensin system?

A

ANH

155
Q

which change in BP results in the release of ANH?

A

increased BP

156
Q

which type of feedback maintains GFR?

A

tubuglomerular feedback

157
Q

which two chemicals do macula densa cells produce in order to signal to juxtaglomerular cells?

A
  • adenosine

- prostaglandins

158
Q

adenosine is released by macula densa cells in response to what?

A

high sodium/high GFR

159
Q

prostaglandins is released by macula densa cells in response to what?

A

low sodium/low GFR

160
Q

juxtaglomerular cells vasoconstrictor in response to what chemical?

A

adenosine

161
Q

juxtaglomerular cells vasodilator in response to what chemical?

A

prostaglandins

162
Q

prostaglandin stimulates juxtaglomerular cells to release what?

A

renin

163
Q

what effect does the renin-angiotensin system have on blood pressure?

A

raises BP

164
Q

renin-angiotensin system raises BP via which molecule?

A

angiotensin ii

165
Q

renin-angiotensin system raises blood volume via which 2 hormones?

A
  • aldosterone

- ADH

166
Q

list some storms of chronic kidney disease

A
  • oedema (ankles, hands, feet, lungs)
  • nausea
  • anaemia
  • weak/painful bones
167
Q

list some causes of chronic kidney disease

A
  • hypertension
  • diabetes
  • kidney infection
  • high cholesterol
  • glomerulonephritis
  • polycystic kidney disease
  • kidney stones
168
Q

chronic kidney disease is closely associated with which other disease?

A

CVD

169
Q

which types of drugs may be used to regulate hypertension?

A
  • diuretics
  • ACE inhibitors (captopril)
  • Beta blockers
  • furosemide
170
Q

how do diuretics work to lower BP and regulate hypertension?

A

break the cycle of high bp caused by increases renin

171
Q

how do ACE inhibitors work to lower BP and regulate hypertension?

A

inhibit angiotensin ii

172
Q

how do beta blockers work to lower BP and regulate hypertension?

A

block sympathetic nerve stimulation by stress hormones

173
Q

how does furosemide work to lower BP and regulate hypertension?

A

block NKCC2

174
Q

what effect does reduced kidney function have on drug metabolism and what alteration must you make when prescribing a drug to someone suffering from reduced kidney function?

A

patients can’t remove the drug effectively so smaller dose is prescribed

175
Q

which stage of kidneys disease is the end stage of renal disease, resulting in less than 15% of kidney function?

A

stage 5

176
Q

what is dialysis?

A

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

177
Q

what are the two types of kidney dialysis?

A
  • haemodialysis

- peritoneal dialysis

178
Q

which type of kidney dialysis can be carries out at home?

A

peritonial dialysis

179
Q

what are the 2 treatment options for stage 5 kidney disease?

A
  • dialysis

- kidney transplant

renal system 1 (1 decks)

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