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BDS1 BAMS: Renal System > Kidney Structure and Function > Flashcards

Kidney Structure and Function Flashcards

1
Q

Which systemic diseases are associated with poor oral health?

A

Cardiovascular disease, rheumatoid arthritis, respiratory diseases, metabolic diseases, kidney diseases

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2
Q

What are the 2 main hypotheses linking periodontitis with systemic disease?

A
  1. Oral bacteria disseminate through oral cavity to bloodstream to distant sites where they contribute to pathology
  2. Oral diseases contribute to oral inflammation which in turn contributes to burden of systemic inflammation -> contributes to pathology elsewhere in the body
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3
Q

What are some of the shared risk factors between oral disease and systemic diseases?

A

Smoking, alcohol, stress, diet, economic status

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4
Q

What is the function of kidneys?

A
  • Kidneys are excretory organs: process blood and rid the body of waste products of metabolism via urine
  • Kidneys maintain homeostasis of fluid in the body
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5
Q

Describe the urinary system

A

Kidneys produce urine -> ureters convey urine -> bladder stores urine -> urethra carries urine out of the body

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6
Q

What is the indentation on the medial side of the kidney known as?

A

The hilum

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7
Q

Which artery delivers blood to the kidney?

A

Renal artery (from the aorta)

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8
Q

Which vein returns blood from the kidney to the heart?

A

Renal vein (to the vena cava)

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9
Q

What are the 3 distinct parts of the kidney?

A

Cortex: contains 85% of kidney tubules
Medulla: triangular structures; the site where urine is concentrated. Prevents excessive water loss
Pelvis: collection area for urine which is funnelled into ureter

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10
Q

How many litres of blood do the kidneys process per minute?

A

1.2 L of blood per minute

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11
Q

What structure provides the kidneys with protection?

A

Fat pads

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12
Q

Where do the kidneys lie with regards to the peritoneum?

A

They are retroperitoneal i.e. behind the peritoneum

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13
Q

Describe the vascular network in the kidneys

A

Renal artery -> segmental arteries -> lobar arteries -> interlobular arteries -> arcuate arteries -> interlobular arteries -> afferent arterioles -> glomerular capillaries -> efferent arterioles -> peritubular capillaries (vasa recta) -> interlobular veins

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14
Q

What is the basic functional unit of the kidney?

A

The nephron

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15
Q

What is the structure of the nephron optimally evolved to do?

A

Filter blood plasma and excrete waste products of metabolism in the urine

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16
Q

Where are the nephrons located?

A

Cortex

Juxtamedullary region

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17
Q

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

A

Site of filtration, job is to remove products from the blood

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18
Q

What does the nephron consist of?

A

Renal corpuscle

Renal tubule

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19
Q

What is the renal corpuscle composed of?

A

The glomerulus and Bowman’s capsule

20
Q

What is the renal tubule composed of?

A

Proximal Convoluted Tubule (PCT)
Loop of Henle
Distal Convoluted Tubule (DCT)

21
Q

What is the purpose of the renal tubule?

A

Reabsorption and secretion (conservation/fine-tuning)

22
Q

Describe the glomerulus

A
  • A network of fine capillaries
  • A single layer of endothelial cells resting on a basement membrane
  • Fenestrated
  • Enabled rapid filtration of blood plasma
  • Surrounded by the Bowman’s capsule
23
Q

Describe Bowman’s capsule

A
  • A cup-like structure surrounding the glomerulus
  • Parietal outer layer
  • Visceral inner layer comprised of specialised epithelium (podocytes)
24
Q

What are podocytes and what do they do?

A
  • Podocytes are the specialised epithelium that the visceral inner layer surrounding the Bowman’s capsule is made of
  • The long branched process (pedicels) of podocytes wrap around glomerulus capillaries
25
Q

Which 3 structures form the filtration barrier?

A
  1. Glomerulus epithelium
  2. Basement membrane
  3. Pedicels of podocytes
26
Q

Which molecules can/cannot pass through the filtration barrier?

A

Water and molecules can pass through

Large proteins or cells can NOT pass through

27
Q

The filtration barrier acts like a sieve. Which factors determine whether molecules can pass through or not?

A
  • The size of the molecules and the charge
  • Large molecules cannot pass through
  • The filtration barrier has a slight negative charge and so will repel small proteins that are negatively charged
28
Q

What is the first step in blood processing?

A

Glomerular filtration

29
Q

Describe the process of glomerular filtration

A
  1. Unfiltered blood arrives at the glomerulus via the afferent arteriole
  2. Blood components are filtered through the filtration barrier
  3. Filtered blood exits the glomerulus via the efferent arteriole
30
Q

Which arteriole (afferent or afferent) has a larger diameter and what is the significance of this?

A

The afferent arteriole has a wider diameter
This means that blood arrives quicker than it leaves
This generates pressure within the glomerular capillaries: helps to push molecules through the filtration barrier
This pressure is known as Glomerular Hydrostatic Pressure

31
Q

What generates Glomerular Hydrostatic Pressure?

A

The difference in the size of diameter between the afferent and efferent arteriole
Diameter of the afferent arteriole is larger, therefore blood arrives quicker than it leaves
This generates pressure within the glomerular capillaries -> helps to push molecules through the filtration barrier

32
Q

What is filtered through the filtration barrier?

A

Water, glucose, amino acids, urea, creatinine, sodium, chloride, calcium, phosphate, potassium, bicarbonate

33
Q

What is not filtered through the filtration barrier?

A

Cells, large proteins e.g. haemoglobin, negatively charged proteins e.g. albumin

34
Q

What is the Glomerular Filtration Rate (GFR)?

A

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

35
Q

What drives the glomerular filtration rate (GFR)?

A

Glomerular Hydrostatic Pressure

36
Q

What is the glomerular hydrostatic pressure counteracted by?

A

Hydrostatic pressure in the Bowman’s capsule

Glomerular osmotic pressure

37
Q

Which factors influence the GFR?

A
  • Hydrostatic pressure
  • Osmotic pressure
  • Systemic blood pressure
  • Renin-angiotensin system
  • Disease
38
Q

What is a ‘normal’ healthy GFR in L/day?

A

125ml/min -> 180L/day

39
Q

How does systemic blood pressure influence the glomerular filtration rate?

A

Determines the rate at which blood is entering the afferent article

40
Q

What does GFR give us a measure of?

A

Kidney function

41
Q

Is GFR is reduced, what effect will this have?

A

Inefficient blood clearance and waste removal

Waste products accumulate in the blood

42
Q

How can GFR be measured?

A

Serum creatine and urea measurements can be used to estimate GFR
As kidney function decreases, GFR will decrease and levels of creatinine an urea in blood will increase

43
Q

What is the normal GFR score for a healthy individual?

A

90 or higher

44
Q

What does a GFR of 60-89 indicate?

A

Mild loss of kidney function

45
Q

What does a GFR of <15 indicate?

A

Kidney failure

BDS1 BAMS: Renal System (3 decks)

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