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My Own Renal Physiology > Kidneys > Flashcards

Kidneys Flashcards

1
Q

How many types of nephrons do we have?

A
  1. In cortex- cortical nephrons
    In medulla- juxtamedullary nephrons
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2
Q

Kidney contains

A

800,000 to 15 million nephrons

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3
Q

2 major functions of kidneys

A

Excretory

Non excretory

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4
Q

Excretory functions

A 
Production of hormones
Excretion of waste products
Homeostatic regulation of ph
Maintains ion balance
Regulates osmolarity
Regulates bp
Regulates ecf volumr
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5
Q

Non excretory functions

A

Production of hormones
Activation of vit D
Produces glucose through gluconeogensis
Degrade lots of hormones

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6
Q

Cortical nephrons have

A

Short loop of henle which only penetrates outer renal medulla

Malpighian corpuscles in outer cortex

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7
Q

Juxtamedullary nephrons have

A

Long loop of henle which traverses whole length of medulla

Renal corpucles at base of the pyramids

More vasa recti around loop of henle

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8
Q

Arteriole bringing blood to kidney

A

Afferent arteriole—-> glomerular capillaries

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9
Q

Blood leaves kidney via

A

Efferent arteriole—-> peritubular capillaries or vasa recti

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10
Q

Peritubular capillaries are designated as

A

Vasa recti

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11
Q

Where does filtration primarily take place

A

Bowmans capsule

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12
Q

Everything in blood is filtered except

A

Formed elements
Proteins

Due to their size and molecular weight

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13
Q

Filtration process

A

Starts from renal corpuscle—>bowmans capsule(main)—>PCT(filtrate)

Whatever us left goes to efferent or peritubular capillaries

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14
Q

Steps in producing urine

A

Filtration
Reabsorotion
Secretion
Excretion

First 3 occur concurrently

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15
Q

Reabsorption of filtrate starts in

A

Pct

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16
Q

Process of reabsorption

A

Filtrate reabsorbed to interstitial space and subsequently to peritubular capillaries

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17
Q

Process of secretion

A

Materials in peritubular capillaries that were not reabsorbed will be secreted in to pct, dct, collecting tubule

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18
Q

Reabsorption amd secretion occir everywhere except

A

Loop of henle

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19
Q

What is reabsorbed into peritubular capillaries end in the

A

Renal veins

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20
Q

Whats ultrafiltration?

A

Filtration without RBC or proteins

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21
Q

Summary of whole process

A

Blood via afferent—> bowmans capsule—> filtration.—>pct
what wasnt filtered—>efferent

Filtrate in pct—> reabsorption and secretion—>loop of henle—> reabsorption—>dct—> reabsorption and secretion—>collecting duct—>reabsorption md secretion

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22
Q

What do you expect of filtrate volume and osmolarity along nephron?

A

It is expected to change .

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23
Q

Volume and osmolarity of fluid in bomans capsule.

A

180l/day and 300mosM

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24
Q

End of proximal tubule change in volume and osmolarity

A

54L from 180 and 300mosm osmolarity maintained

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25
Q

End pf loop pf henle volume and osmolarity change?

A

54l to 18 L 300-100 mosm

26
Q

Volume and osmarity change at end of collecting duct

A

18 to 1.5 L. With osmolarity 50-1200mosm

27
Q

Amount of solute excreted

A

Amount filtered-(amount reabsorbed+amount secreted)

28
Q

What structure allows for filtration in renal corpuscles?

A

Podocytes.

Giant cells with footlike structures that enables gaps for filtration

29
Q

Forces that influence filtration or GFR?

A 
Hydrostatic pressure
Colloid osmotic pressure
Fluid pressure
Myogenic response
Tubuloomerular feedback
Hormones and autonomic response
Blood pressure
Alteration of resustance in renal blood flow
30
Q

How does hydrostatic pressure affect gfr

A

The higher the hydrostatic pressure the greater the transudation and movement of fluid

31
Q

How does oncotic pressure affect gfr?

A

The lesser the oncotic pressure the lesser the adsorption meaning it cant hold on to water thus increasing transudation amd increasing gfr

32
Q

Filtration pressure in renal corpuscke depends on

A

Hydrostatic pressure

33
Q

Filtration pressure in renal corpuscle is opposed by

A

Osmotic pressure

Capsule fluid pressur

34
Q

Value of gfr

A

125ml/min

35
Q

Whats the juxtaglomerular apparatus?

A

through its journey, the ascending loop of henke comes to lie between the affarent abd efferent arterioles. Cells of alop are modified into macula densa cells. This in addition to 2 arterioles and granular cells, cells in the walls of arterioles make up macula densa cells

36
Q

What are mesengial cells

A

Macula densa+granular cells.

37
Q

Tubuloglomerular feedback

A

Increased GFR—>increased hydrostatic pressure and filtrate—>increased flow across macula densa cells—>increased release of renin, a paracrine hormone which affects arteriolar cells—> contriction on afferent arteriole-> decreased fluid entering bowmans capsule-> decreased hydrstatic pressure and decreasef GFR

38
Q

How tubular reabsorption occurs

A
  • Na reabsorbed by active transport from luminal side to interstitial fluid
  • An electrochemical gradient is formed and cl follows Na
  • Movement of water follows from luminal side to IF via osmosis
  • Via diffusion,conc solutes left in tubular side that are permeable enters IF
39
Q

Transepithelial transport

A

Where substances pass through basolateral and apical surfaces

40
Q

Paracellular pathway

A

Where substances pass through junction between two adjacent cells

41
Q

Tubular maximun

A

highest rate at which the renal tubules can transfer a substance either from the tubular luminal fluid to the interstitial fluid or from the interstitial fluid to the tubular luminal fluid, beyond which it may be excreted in the urine. Ther is a limit to what can be reabsorbed.

42
Q

Renal threshold

A

concentration of a substance dissolved in the blood above which the kidneys begin to remove it into the urine.

43
Q

Tubular macimun for glucose

A

375mg/min

44
Q

Gfr in males

A

90-140ml/min

45
Q

Gfr in females

A

80-125mls/min

46
Q

Secretion amd excretion

A

Directly proportional

47
Q

Renal blood flow

A

1.25L/min

25% of cardiac output

48
Q

Functions of renal blood flow

A

Rate determines rate of reabsorption
Delivers substances to be excreted
Involved in concentrating or diluting urine

49
Q

Hormones(Vasoconstrictors) that affect rbf and gfr

A

Sympathetic nerves
Angiotensin 2
Endothelin

50
Q

Hormones(vasodilators) that affect gfr and rbf

A

Prostraglandin
Bradykinin
Atrial natriuretic peptide
Nitric oxide

51
Q

Main form of clearance in the body

A

Renal clearance

52
Q

Factors that affect clearance

A

Filtration-directly proportional
Reabsorption-inversely proportional
Secretion-directly proportional
Characteristic of compound-bound or unbound
Size and molecular weight-directly proportional

53
Q

Importance of renal clearance

A

Assess damage to kidneys
Gives an idea about gfr
Secretion and reabsorption pf different substances

54
Q

Renal clearance eqn

A

Cx=(Ux x V)/Px
Ux=concentration of subs x in urine
V= rate of excretion of subs x
Px=conc of subs x in plasma

55
Q

Endogenous Substances used to check clearance

A

Creatinine
Urea
Uric acid

56
Q

Exogenous substances to check for clearance

A

Inulin
Para amino hippuric acid
Diodrast

57
Q

Factors that affect choice of material for gfr

A
  • freely filtered at glomerulus
  • must not be reabsorbed or secreted
  • must not be metabolized
  • not stored in cells of body
  • not synthesized in the body
  • must not be bound to protein
  • must not be toxic
  • must be easily measured in plasma and urine
  • Must not affect gfr, ie artriolar constriction or dilitation
58
Q

Why inulin isnt usually used

A

Has to be given in large quantities

59
Q

Why creatinine instead of inulin

A

Measurment of creatinine does not require infusion into patient

60
Q

Creatinine is not a perfect marker of gfr why?

A

Creatinine excreted is higher than filtered because a small amount is secreted into tubules

There is a measurment error that leads to an overestimate.

Both however cancel out

61
Q

Substances used to measure gfr cant be used to measure rbf? Why

A

Only 1/5 of plasma that enters kidneys get filtered.Inulin clearance only represents this and not necessarily the the whole thing ie filtered +unfiltered and hence cant represent rbf

My Own Renal Physiology (3 decks)

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