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Physiology Renal > Lecture 1 & 2- Introduction > Flashcards

Lecture 1 & 2- Introduction Flashcards

1
Q

Cortex

A

Outer region, located under the kidney capsule

has interstitial osmolarity close to plasma

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2
Q

Medulla

A

central region, divided into an outer and inner medulla

has HIGH interstitial osmolarity, which allows kidney to generate concentrated urine

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3
Q

Papilla

A

innermost tip of the inner medulla (extension of the ureter)

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4
Q

Nephron order

A

Fluid filtered at glomerulus -> Bowman’s capsule -> proximal tubule -> thin descending -> thin ascending -> thick ascending -> distal tubule -> collecting duct

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5
Q

Filters

A

the blood to generate a fluid free of cells and most proteins

(plasma minus proteins)

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6
Q

Reabsorbs

A

certain solutes and water from tubular fluid (Na, Cl, glucose)

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7
Q

Secretes

A

other solutes from tubular fluid (uric acid)

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8
Q

Excretes

A

in the urine the water and solutes that remain in the tubular fluid after passing through the renal tubule

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9
Q

How much of plasma gets filtered?

A

20%

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10
Q

How much plasma exits through efferent arteriole?

A

80%

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11
Q

Cortical nephrons (90%)

A
  1. Glomeruli in outer cortex
  2. Short loops of Henle
  3. Efferent arterioles that form peritubular capillaries
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12
Q

Juxtamedullary nephons (10%)

A
  1. Glomeruli at the borderof the cortex and medulla
  2. Long loops of Henle
  3. Efferent arterioles that form peritubular capillaries and also vasa recta
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13
Q

Macula Densa

A

functions to monitor the renal fluid composition

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14
Q

juxtaglomerular cells

A

produce renin and help control constriction of the afferent and efferent arterioles

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15
Q

glomerular filtration

A

filtration of a fraction of plasma (minus proteins) into Bowman’s Space

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16
Q

tubular reabsorption

A

transport of solutes from blood into renal fluid

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17
Q

excretion

A

elimination of water and solutes in urine

18
Q

excretion =

A

filtration- reabsorption + secretion

19
Q

capillary membrane

A
  1. capillary endothelial cells
  2. basement membrane- contains fixed negative charges that selectively filter proteins
  3. podocytes- final barrier
20
Q

nephrin

A

transmembrane protein embedded in the podocyte membrane

-localizes to diaphagms covering the filtration silts

21
Q

nephrotic syndrome

A

mutations in nephrin

loss of protien in urine, edema, and eventually renal failure

22
Q

GFR

A

rate at which fluid is filtered through the glomerulus

= Kf x (net filtration pressure)

23
Q

increased Pbs

A

indicates tubular obstruction (e.g. kidney stones)

24
Q

RPF

A

the rate at which plasma is delivered to the kidneys

= RBF (1-Hct)

25
Q

Glomerulonephritis

A
  • renal disease initiated by immune response
  • antigen-antibody complexes accumulate in the glomerular basement membrane, cause REDUCED GFR
  • WBC aslo accumulate so can lead to proteinuria
26
Q

Filtration Fraction

A

fraction of plasma filtered through the glomerulus
20%
=GFR/RPF
can be used to solve for GFR by moving around equation

27
Q

Renal Clearance

A

=U(x)V/P(x)

volume of plasma per unit time from which x has been completely removed and excreted

28
Q

Measurement of GFR

A
  1. freely filtered
  2. not reabsorbed or secreted
  3. not metabolized or produced by the kidney
  4. does not alter GFR

measure by the clearance of INULIN or CREATININE

29
Q

Measurement of RPF

A
  1. freely filtered
  2. efficiently secreted
  3. not reabsorbed

measuring clearance of PAH
-extraction efficiency is 90% (only about 90% of PAH that enters the kidney is secreted into the tubule

30
Q

Measurement of tubular secretion rate

A

for a compound that is freely filtered, secreted, but not reabsorbed:

secretion = excretion rate - filtration rate

31
Q

Measurement of Tubular Reabsorption Rate

A

for a compound that is freely filtered and reabsorbed, but not secreted

reabsorption = filtration rate -excretion rate

32
Q

properties of glucose reabsorption

A

glucose is completely reabsorbed if Pglucose < 2
2-3: glucose appears in urine since some glucose escapes uptake
>3 glucose uptake is saturated and glucose appears in urine

33
Q

Diabetes Mellitus

A

failure to produce insulin in Beta cells or failure to respond to insulin lead to excess blood sugar levels

  • excess glucose appears in urine
  • glucose that remains in tubule acts to retain water in tubule, leading to polyuria
34
Q

Clearance Ratio

A

CR(x)= C(x)/GFR
Cx = GFR; CR =1, no net reabsorption or secretion (inulin)
Cx < GFR; CR>1, reabsorption must be occurring (glucose)
Cx > GFR; CR<1, secretion occurring (PAH)

35
Q

how are RBF and GFR regulated?

A

constriction or dilation of the afferent and efferent arterioles

36
Q

vasoconstrictors

A

norepinephrine

  • Released by renal nerves in response to decreased blood pressure or volume
  • Constricts afferent and efferent arterioles
  • Decreases GFR and RBF; helps to restore blood pressure and conserve fluid
37
Q

vasodilators

A

nitric oxide
Released by endothelial cells in response to increased intake of NaCl
-Dilates afferent and efferent arterioles
-Increases GFR and RBF; helps to increase excretion of water and NaCl and reduce blood pressure

38
Q

Myogenic mechanism

A

Constriction of smooth muscle of afferent arteriole when stretched

39
Q

Tubuloglomerular feedback

A

increased Tubular flow sensed by macula densa –> signal from juxtaglomerular apparatus –> constriction of afferent arteriole

40
Q

A patient has a urinary glucose concentration of 100 mg/ml and a urine flow rate of 1.25 ml/min. Assuming a reabsorption rate for glucose of 375 mg/min and a plasma glucose concentration of 5 mg/ml, what is this patient’s GFR?

A

100 ml/min

41
Q

A patient being treated with penicillin has a plasma penicillin concentration of 0.10 mg/ml, a urinary penicillin concentration of 20 mg/ml and a urine flow rate of 2.5 ml/min. Measurement of creatinine gives values of Pcreat = 0.025 mg/ml and Ucreat = 1 mg/ml. What is the secretion rate of penicillin?

A

40 mg/min

Physiology Renal (4 decks)

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