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Anatomy and Physiology > Lec #2 - Kidneys > Flashcards

Lec #2 - Kidneys Flashcards

1
Q

What are the functions of the urinary system?

A
  1. Removes waste from blood in the form of urine.
  2. Regulates blood (pressure, volume, pH, consumption, sugar levels) - also stimulates production of red blood cells.
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2
Q

Which kidney is lower?

A

Right kidney due to the liver pushing it down.

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3
Q

What vertebral level is associated with the kidneys?

A

T12-L3

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4
Q

What angle are the kidneys oriented in the body?

A

kidneys are obliqued 30 degrees towards the midline

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5
Q

Which aspect of the kidney is more posterior?

A

The superior part is the most posterior. They follow the curve of the lumbar spine.

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6
Q

What patient position should be used to demonstrate the left kidney.

A

RPO 30 degrees oblique – demonstrates the left kidney parallel to the IR, demonstrates right kidney in profile.

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7
Q

Be able to label the following on a diagram.

A
  1. Right and left kidney
  2. Ascending & Descending colon
  3. Aorta
  4. IVC
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8
Q

What is the purpose of the adipose capsule?

A

Adipose capsule – fat layer – for protection – helps hold the kidney in place

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9
Q

What is ptosis of the kidneys?

A

Ptosis is the dropping of the kidney from supine to erect (2” or 5 cm)
- greatest in asthenic pateints.

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10
Q

What is Nephroptosis?

A

dropping of the kidneys

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11
Q

What is renal fascia?

A

outermost layer of kidney - connests kidneys to abd wall, lumbar vertebrae, and diaphragm.

  • (since attached to diaphragm) –> Kidneys will move up and down 1inch from inspiration to expiration (respiratory excursion)
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12
Q

How many renal pyramids does typical person have?

A

8-18 per kidney.

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13
Q

What is the function of the renal papilla?

A

Drain urine into minor calyces (8-18)

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14
Q

How many major calyces does a typical person have?

A

2-3 per kidney.

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15
Q

What do the major calyces drain into?

A

drains into 1 renal pelvis –> connects to the ureters.

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16
Q

What is the name for the artery between lobes of the kidney called?

A

Interlobar

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17
Q

How many minor calyces does a typical person have?

A

8-18

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18
Q

What is a nephron?

A

the functional unit of the kidney.
~ 1 million per kidney
- located in the renal cortex and renal pyramid (medulla)

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19
Q

What are the 2 parts of the nephron?

A
  1. Renal Corpuscle
  2. Renal Tubule
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20
Q

What are the two parts of the renal corpuscle?

A
  1. Glomerulus - (network of capillaries)
  2. Bowman’s Capsule (double walled cup)
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21
Q

Which part of the nephron isn’t found in the renal cortex?

A

All parts of the nephron are in the renal cortex except the Loop of Henle which is in the renal medulla

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22
Q

Where specifically does filtration take place in the kidneys?

A

The renal corpuscle.

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23
Q

What are the 3 parts of the renal tubule?

A
  1. Proximal Convoluted Tubule
  2. Distal Convoluted Tubule
  3. Loop of Henle (Nephron Loop)
24
Q

How is blood supplied to the kidneys? (know long list of how blood is transported)

A

Renal Artery (right is longer than the left one)
Segmental Arteries (1 supplies each segment (5))
Interlobar arteries - pass thru renal columns
Arcuate arteries - arch between renal medulla and cortex
Cortical radiate arteries - radiate outwards into renal cortex
Afferent arterioles - one per nephron
Glomerular capillaries - capillary network
Efferent arterioles - carries blood away from glomerulus
Peritubular capillaries - surround tubular parts of nephron

“Rats sneak’ in away, creating a good escape plan.”

25
Where does gas exchange occur?
Gas echanges in the peritubular capillaries
26
Which is thicker the afferent or efferent arteriole?
Afferent is thicker than the efferent arteriole
27
What are the two types of nephrons?
1. Cortical Nephrons (80-85%) - outer part of renal cortex 2. Juxtamedullary Nephrons (15-20%) - close to medulla
28
Where is the loop of henle located?
In the renal medulla
29
How does the network of capillaries in the glomerulus allow waste to be filtered?
network of capillaries. (allows the waste (solutes to leak out but not big enough for blood to escape). - should never have blood in the urine.
30
What are the 3 steps to renal physiology? (*important*)
1. Glomerular Filtration 2. Tubular Reabsorption 3. Tubular Secretion *filtration in the renal corpuscle*
31
Why is the volume of fluid filtered by the renal corpuscle much greater than other capillaries?
** - Due to the large surface area & thin porous membrane w/ large pores.
32
What is larger vs smaller efferent vs afferent arteriole?
Efferent is much smaller than afferent leads to high blood pressure
33
What makes up net filtration pressure? (NFP)
Glomerular Blood Hydrostatic Pressure (GBHP) – filters blood Capsular Hydrostatic Pressure (CHP) – (pushes back into the glomerulus) – doesn’t help with filtration Blood Colloid Osmotic Pressure (BCOP) – pulls fluid back into the blood (doesn't help with filtration) Hydrostatic pressure – pushes fluid out Osmotic pressure – pulls fluid in NFP = GBHP - CHP - BCOP
34
At what NFP level will no filtration occur? NFP = GBHP - CHP - BCOP
When the GBHP passes below 45.
35
What happens to NFP if afferent gets bigger and efferent stays same size?
If afferent gets bigger and efferent stays the same (higher pressure) – higher number for NFP
36
What happens to NFP if efferent gets bigger and afferent stays same size?
IF afferent same size and efferent bigger – NFP lowers.
37
What is the average NFP value?
10
38
What happens if the Capsular Hydrostatic Pressure (CHP) value is changed due to kidney stones.
filtrate and urine still produced but cant leave the capsular space will fill up and equal hydrostatic pressure in kidney. (therefore no movement of the substrate/urine)
39
How much fluid is filtered per day by the kidneys?
180L for adult male.
40
What is eGFR used to measure?
Use eGFR to measure how much kidneys are filtering. (affected by age, gender, race, creatinine levels)
41
At what eGFR value are the kidneys working properly?
at a value of 90. - If the eGFR is found to be below 60 will need to have radiologist decide if contrast is still administered.
42
How is GFR (glomerular filtration rate) directly related to NFP (net filtration pressure)
- GFR is the amount of fluid filtered by the glomeruli per minute. - NFP is the driving force for filtration across the glomerular capillaries and is determined by the balance of the following pressures: GHP, BCOP, CHP Therefore inc in NFP will inc GFR.
43
Tubular reabsorption - What % of water is reabsorbed?
99% is reabsorbed of the 180L filtered each day. - on avg eliminate 1.8L urine a day (1% of 180L)
44
What are the 2 types of water reabsorption?
1. Obligatory (does not require energy) – goes from high conc to low conc. – majority of water reabsorption is in the PCT (proximal convoluted tubule). 2. Facultative – (adapts to a need - occurs mainly in the DCT) – (ADH –antidiuretic hormone) – will increase reabsorption, decrease urination
45
How much sugar is found in urine?
0g unless diabetic.
46
What percentage of water is reabsorbed at the PCT.
65% of water occurs here. (obligatory reabsorption - no energy needed)
47
For the loop of Henle what are the descending and ascending portions permeable to?
Descending loop – is impermeable to solutes – but is permeable to water Ascending loop – is not permeable to water but is to sodium and chloride (countercurrent multiplication - vid we watched in class)
48
What does Angiotensin II do/responsible for? * (when blood pressure drops)
Angiotensin II (potent vasoconstrictor) – makes blood vessels smaller, increases blood pressure. --> Triggers adrenal glands to release aldosterone (promotes sodium reabsorption and leads to water retention) – also inc BP.
49
How does ADH (Antidiuretic Hormone) counteract low BP.
(ADH) counteracts low blood pressure (BP) by increasing water reabsorption and promoting vasoconstriction, which restores blood volume and pressure. - Promotes facultative water reabsorption in the kidney back into blood.
50
What is ANP (atrial natriuretic peptide)
Will cause afferent to get bigger – decrease GFR – decrease fluid in body. - released from the heart when stretched (blood volume is too high)
51
When is the waste in the kidneys considered urine?
Once in the minor calyces (since composition wont change.
52
What part of ureter is most anterior?
middle part
53
Where do the ureters enter the bladder?
pass thru bladder at the bottom into the trigone. - (UVJ) ureterovesicle junction
54
Where are the 3 most common spots kidney stones get caught?
1. UP junction (ureteropelvic junction right where ureter starts) 2. UV junction (closer to floor of the bladder) 3. Where Ureter crosses pelvic brim anterior to iliac vessels
55
What does a RPO 30 degrees patient position best demonstrate?
RPO 30 – best demonstrates right UP junction also RPO 30 – left kidney parallel to IR RPO 30 – right kidney in profile
56
What would a RPO 45 demonstrate?
RPO 45 – best demonstrates left UV junction
57
How are the male and female urethra different?
Male 20 cm Prostatic Membranous Spongy (penis) Female 4 cm Directed inferiorly and anteriorly

Anatomy and Physiology (4 decks)

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