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LF209 - Blood & Circulation > Lecture 1: The Kidney > Flashcards

Lecture 1: The Kidney Flashcards

1
Q

What is the kidney renal function and contribution to homeostasis?

A

Blood ionic composition

Blood pH

Blood volume

Blood pressure

Blood osmolarity (concentration of solutes)

Excretion of waste

Hormone production

Glucose levels

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2
Q

What are signs and symptoms of hypovolaemia?

A

DEHYDRATED

Thirst, dizziness on standing, confusion

Low Jugular venous pressure, postural hypotension, weight loss, dry mucous membranes, reduced skin turgor, reduced urine output

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3
Q

What are signs and symptoms and hypervolaemia?

A

FLUID OVERLOAD

Ankle swelling, breathlessness

Raised Jugular venous pressure, oedema, weight gain, hypertension

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4
Q

What is too little an too much body fluid volume called?

A

Too little - Hypovolaemia

Too much - hypervolaemia

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5
Q

How is blood pressure controlled through the kidneys?

A

Regulation of extracellular sodium and water

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6
Q

What is osmolarity?

A

The measurement of solute concentration or osmotically active solutes osmoles

(osmol/L) or (Osm/L) or (mOsm/L)

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7
Q

What is osmotic pressure?

A

The pressure which needs to be applied to the solution to prevent an inward movement of fluid across a semi permeable membrane

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8
Q

What is oncotic pressure (colloid oncotic pressure)?

A

The osmotic pressure exerted by the proteins in the blood plasma or filtrate which attracts water into that compartment

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9
Q

What is hydrostatic pressure?

A

The force exerted by a fluid against a capillary wall

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10
Q

What are the characteristics of a hypotonic solution?

A

Low osmotic pressure outside

High osmotic pressure inside

Liquid in

<300 mOsml/L of solute

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11
Q

What are the characteristics of an iso-osmotic solution?

A

No not movement

Equal osmotic pressure

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12
Q

What are the characteristics of hyperosmotic solution?

A

> 300 mOsm/L of solute

Very high osmotic pressure outside

High osmotic pressure inside

Liquid out

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13
Q

If hydrostatic pressure > osmotic pressure?

A

Fluid will leave the capillary promoting filtration of the plasma

Large diameter of afferent arteriole entering capillary bed
Small diameter of efferent arteriole leaving the capillary bed

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14
Q

How does high hydrostatic pressure promote filtration?

A

Result of different diameters overcomes inward pull of fluid as a result of osmotic pressure

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15
Q

If hydrostatic pressure < osmotic pressure?

A

Fluid leaving the capillary will be greatly reduced inhibiting filtration of the plasma

Medium diameter of afferent arteriole entering the capillary bed
Medium diameter of efferent arteriole leaving the capillary bed

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16
Q

How does low hydrostatic pressure promote filtration?

A

Similar diameters only just overcomes the inward pull of fluid as a result of osmotic pressure

17
Q

What is the structure/ flow of the kidney?

A
  1. Collecting duct
  2. Minor calyx
  3. Major calyx
  4. Renal pelvis
  5. Ureter
  6. Bladder
18
Q

What is the Renal corpuscle composed of?

A

Bowman’s capsule
Glomerulus

19
Q

What is the renal tubule composed of?

A

Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule

20
Q

What is composed of the Juxtamedullary nephron?

A

Descending limb of the nephron loop

Thick ascending limb of the nephron loop

Thick ascending limb of nephron loop

21
Q

What is the functional overview of the nephron?

A
  1. Filtration (filtration under pressure - water and blood solutes)
  2. Tubular reabsorption - 99% of water and many solutes reabsorbed back into blood via passive and active processes
  3. Tubular secretion - renal tubule and duct cells secrete wastes, drugs, excess ions out of blood into filtrate
  4. Urine excretion - renal tubule and duct cells secrete waste, drugs, excess ions out of the blood into the filtrate
22
Q

What is the average Glomerular filtrate rate per day/ minute?

A

180 L/day

125 mL/ min

23
Q

What is the Juxtaglomerular apparatus functioning?

A

JG granular cells secrete an enzyme RENIN in response to falls in extracellular volume/ low sodium

Falls in ECF detected by baroreceptors around the body

24
Q

What is the aim of the Juxtaglomerular apparatus response?

A

To increase sodium reabsorption and therefore water reabsorption

25
Q

How does glomerular filtration occur?

A

Fenestration (pore) of glomerular endothelial cells prevents filtration of blood cells
0.07-0.1 um in diameter - everything but RBC and platelets removed

Basal lamina negatively charged prevents large negatively charged molecules (proteins)

Slit membrane between pedicles prevents filtration of medium-sized proteins
Allows molecules less than 0.0006-0.0007 um

26
Q

Why does glomerular filtration happen to a greater extent in the renal corpuscle than any other capillary bed in the body?

A

Large surface area of glomerular capillaries regulated by mesangial cells

Endothelial membrane is thin and fenestrated - 50x leakier than other capillaries

Blood pressure is much higher owing to the differences in diameter of afferent and efferent arterioles

27
Q

What is net filtration pressure?

A

The total pressure that promotes filtration

28
Q

How is net filtration pressure (NFP) calculated?

A

NFP = GBHP - CHP - BCOP

GBHP - Glomerular blood hydrostatic pressure
CHP - Capsular hydrostatic pressure
BCOP - Blood Colloid osmotic pressure

29
Q

What 3 mechanisms control GFR?

A

Renal autoregulation (myogenic, tubuloglomerular) feedback

Neuronal regulation

Hormonal regulation

30
Q

What 2 ways do control of glomerular filtration rate occur?

A

Adjustment of blood flow into and out of the glomerulus

Alteration of glomerular capillary surface area

31
Q

What is glomerular filtration rate dependent on?

A

The difference between hydrostatic pressure of the glomerular capillary and Bowman’s capsule and the oncotic pressure of the capillary and capsule

Permeability of the filtration barrier and filtration surface area

32
Q

What is glomerular filtration rate?

A

Amount of filtrate formed by all renal corpuscles of both kidneys per minute

33
Q
A

LF209 - Blood & Circulation (1 decks)

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