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Pathophysiology > kidneys > Flashcards

kidneys Flashcards

1
Q

Structures of the Renal System

A
  1. The kidneys are paired structures lying bilaterally between the twelfth thoracic and third lumbar vertebrae and behind the peritoneum of the abdominal cavity.
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2
Q

Structures of the Renal System

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  1. The kidney is composed of an outer cortex and an inner medulla.
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3
Q

Structures of the Renal System

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  1. The calyces receive urine from the distal convoluted tubules and join to form the renal pelvis,
    which is continuous with the upper end of the ureter.
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4
Q

Structures of the Renal System

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  1. The nephron is the urine-forming unit of the kidney and is composed of the glomerulus, proximal
    convoluted tubule, hairpin loops of Henle, distal convoluted tubule, and collecting duct.
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5
Q

Structures of the Renal System

A
  1. The glomerulus contains loops of capillaries supported by mesangial cells. The capillary walls
    serve as a filtration membrane for the formation of the primary urine.
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6
Q

Structures of the Renal System

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  1. The proximal tubule is lined with microvilli to increase surface area and enhance reabsorption of
    water, solutes, and electrolytes.
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7
Q

Structures of the Renal System

A
  1. The hairpin loops of Henle transport solutes and water, contributing to the hypertonic state of the
    medulla, and are important for the concentration and dilution of urine.
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8
Q

Structures of the Renal System

A
  1. The distal convoluted tubule adjusts acid–base balance by excreting acid into the urine and
    forming new bicarbonate ions. It reabsorbs water with the influence of antidiuretic hormone and
    reabsorbs sodium and excretes potassium with the influence of aldosterone.
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9
Q

Structures of the Renal System

A
  1. The ureters extend from the renal pelvis to the posterior wall of the bladder. Urine flows through
    the ureters and into the bladder by means of peristaltic contraction of the ureteral muscles.
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10
Q

Structures of the Renal System

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  1. The bladder is a bag composed of the detrusor and trigone muscles and innervated by
    parasympathetic fibres. When accumulation of urine reaches 250 to 300 mL, mechanoreceptors, which respond to stretching of tissue, stimulate the micturition reflex.
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11
Q

countercurrent system

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12
Q

ventiricular remodelling

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13
Q

nephron

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14
Q

Renal Blood Flow

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  1. Renal blood flows at about 1 000 to 1 200 mL/min, or 20 to 25% of the cardiac output.
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15
Q

blood flow

A
  1. Renin is an enzyme secreted from the juxtaglomerular apparatus in response to decreased blood
    pressure and causes the generation of angiotensin II, a potent vasoconstrictor. The renin- angiotensin-aldosterone system is thus a regulator of RBF.
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16
Q

blood flow

A
  1. Blood flow through the glomerular capillaries is maintained at a constant rate in spite of a wide
    range of arterial pressures by autoregulation of the glomerular capillaries.
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17
Q

blood flow

A
  1. The glomerular filtration rate (GFR) is the filtration of plasma per unit of time and is directly
    related to the perfusion pressure of renal blood flow (RBF).
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18
Q

kidney function

A
  1. The major function of the nephron is urine formation, which involves the processes of glomerular filtration, tubular reabsorption, tubular secretion, and excretion.
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19
Q

kidney function

A
  1. Because most molecules are reabsorbed by active transport, the carrier mechanism can become
    saturated at a point known as the transport maximum (Tm). Molecules not reabsorbed are excreted with the urine.
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20
Q

kidney function

A
  1. Glomerular filtration is favoured by capillary hydrostatic pressure and opposed by oncotic pressure in the capillary and hydrostatic pressure in the Bowman capsule. The balance of favouring and opposing filtration forces is known as net filtration pressure.
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21
Q

kidney function

A
  1. The GFR is approximately 120 mL/min, and 99% of the filtrate is reabsorbed.
22
Q

kidney function

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  1. The proximal convoluted tubule reabsorbs about 60 to 70% of the filtered sodium and water and
    90% or more of other electrolytes.
23
Q

kidney function

A
  1. The concentration or specific gravity of the final urine is a function of the level of antidiuretic hormone (ADH). This hormone stimulates the distal convoluted tubules and collecting ducts to reabsorb water. The countercurrent exchange system of the long loops of Henle and their accompanying capillaries establishes a concentration gradient within the renal medulla to facilitate the reabsorption of water from the collecting duct.
24
Q

kidney function

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  1. The kidney secretes or activates a number of hormones having systemic effects, including vitamin D, erythropoietin, and the natriuretic hormone urodilatin.
25
Q

Tests of Renal Function

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  1. Creatinine, a substance produced by muscle, is measured in both plasma and urine to calculate a commonly used clinical measurement of GFR.
26
Q
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  1. Plasma creatinine concentration, cystatin C level, and blood urea nitrogen (BUN) level are estimates of glomerular function. BUN value also is an indicator of hydration status.
27
Q

tests

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  1. Formulas for estimating GFR can be helpful clinical indicators of renal function.
28
Q

tests

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  1. Urinalysis involves evaluation of colour, turbidity, protein, pH, specific gravity, sediment, and
    supernatant. Presence of bacteria, red blood cells, white blood cells, casts, or crystals in the urine sediment may indicate a renal or bladder disorder.
29
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urine formation

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30
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nephron xc

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31
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32
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33
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35
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36
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37
Q

Glomerular Disorders

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  1. Glomerular disorders are a group of related diseases of the glomerulus that can be caused by immune responses, toxins or medications, vascular disorders, and other systemic diseases.
38
Q

Glomerular Disorders

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Nephritic syndrome is characterized by hematuria and red blood cell casts with less severe proteinuria.

39
Q

Glomerular Disorders

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Acute glomerulonephritis commonly results from inflammatory damage to the glomerular
filtration membrane as a consequence of immune reactions (e.g., after a streptococcal infection).

40
Q

Glomerular Disorders

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  1. Immune mechanisms in glomerulonephritis include the deposition of circulating antigen–antibody
    complexes often with complement components or the in situ formation of antibodies, or both,
    specific for the glomerular basement membrane.
41
Q

Glomerular Disorders

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  1. Diabetic nephropathy is the most common cause of glomerular injury progressing to chronic
    kidney disease (CKD) as well as end-stage kidney disease
42
Q

Glomerular Disorders

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  1. Chronic glomerulonephritis is related to a variety of diseases that cause deterioration of the
    glomerulus and a progressive loss of renal function.
43
Q

Glomerular Disorders

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  1. Nephrotic syndrome is the excretion of 3.5 grams or more of protein (primarily albumin) in the
    urine per day because of glomerular injury with increased capillary permeability and loss of membrane negative charge. Its principal signs are hypoproteinuria, dyslipidemia, and edema. The liver cannot produce enough protein to adequately compensate for urinary loss.
44
Q

Acute Kidney Injury

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  1. Acute kidney injury (AKI) is a sudden decline in kidney function with a decrease in glomerular filtration rate (GFR) and urine output and with an elevation in plasma creatinine and blood urea nitrogen levels.
45
Q

Chronic Kidney Disease

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  1. CKD is the progressive loss of renal function. Plasma creatinine levels gradually become elevated as GFR declines; sodium is lost in the urine; potassium is retained; acidosis develops; calcium and phosphate metabolism are altered; and erythropoietin production is diminished. All organs systems are affected by CKD.
46
Q
A
  1. Prerenal AKI is caused by inadequate kidney perfusion with a decreased GFR, ischemia, and tubular necrosis.
47
Q

AKI

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  1. Intrarenal AKI is associated with several systemic diseases but is commonly related to acute tubular necrosis.
    hours.
48
Q

AKI

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  1. Postrenal AKI is associated with diseases that obstruct the flow of urine from the kidneys. 5. Oliguria is urine output of less than 400 mL/24
49
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50
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51
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Pathophysiology (17 decks)

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