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Block 3: Physiology > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Functions of the Kidneys?

A

-Remove wastes
-Regulate volume and composition of ECF
-Acid-Base Balance
-Blood Pressure Regulation
-Removal of Foreign Substances
-RBC Production
-Vitamin D Activity

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2
Q

Blood Supply to the Kidneys?

A

3 Capillary Beds
-Glomerular capillaries
-Peritubular capillaries
-Vasa recta

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3
Q

Afferent Arteriole?

A

Enter

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4
Q

Efferent Arteriole?

A

Exit

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5
Q

Peritubular Capillaries?

A

Wraps around tubule to allow diffusion between capillary and tubule

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6
Q

Vasa Recta?

A

-Branch of Efferent Arteriole
-Ascending limb is next to descending limb of another nephron
-ONLY in medullary nephron and no exchange of nutrients for away from tubules

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7
Q

Cortical Nephron located in?

A

Cortex of Kidney

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8
Q

Juxtamedullary Nephron located in?

A

Medulla of Kidney

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9
Q

Innervation of Kidneys?

A

Sympathetic
-Afferent and Efferent Arterioles
-Juxtaglomerular Cells
-Tubule

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10
Q

(Innervation of Kidneys)
Afferent and Efferent Arterioles?

A

Vascular Resistance

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11
Q

(Innervation of Kidneys)
Juxtaglomerular Cells?

A

Secretes renin to increase blood pressure

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12
Q

(Innervation of Kidneys)
Tubule?

A

Increase reabsorption

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13
Q

Histology of Nephron?

A

Form follows function:
-Proximal tubule has brush border for large surface area
-Thin ascending limb has few mitochondria, little active transport
-Other segments have many mitochondria and other organelles

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14
Q

(Histology of Nephron)
Proximal tubule has brush border for large surface area?

A

-Increase mitochondria because need ATP for ATP-ase
-Increase absorption

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15
Q

(Histology of Nephron)
Thin ascending limb has few mitochondria, little active transport?

A

Because moving H2O

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16
Q

Functional Unit of Kidney?

A

Nephron

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17
Q

Glomerular Filtration?

A

Production of a protein - free filtrate of plasma

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18
Q

(Glomerular Filtration)
Driving Force?

A

Diameter differences between capillaries for osmotic pressure differences

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19
Q

(Glomerular Filtration)
Reabsorption?

A

Tubular lumen into peritubular capillaries

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20
Q

(Glomerular Filtration)
Secretion?

A

Outflow from capillary to lumen

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21
Q

(Glomerular Filtration)
Excretion?

A

Urine

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22
Q

Glomerular Membrane (3 Sieves in Series)?

A

-Capillary Endothelium
-Basement Membrane
-Bowman’s Capsule Epithelium (podocytes)

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23
Q

(Glomerular Membrane)
Capillary Endothelium?

A

Allows for filtration

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24
Q

(Glomerular Membrane)
Basement Membrane?

A

Mainly lamnin in ECM

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25
Q

(Glomerular Membrane)
Bowman’s Capsule Epithelium (podocytes)?

A

Keeps proteins out of urine
(podocytes are finger-like projections)

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26
Q

Damage of podocytes causes?

A

Increase protein in urine and cannot be regenerated (ex. hypertensive patients)

27
Q

GFR = ?

A

GFR = Kf [(Pgc - Pbc) - pi gc]

28
Q

(GFR Equation)
Kf?

A

Filtration Coefficient

29
Q

(GFR Equation)
PGC?

A

Glomerular Capillary

30
Q

(GFR Equation)
PBC?

A

Bowman’s Capsules

31
Q

(GFR Equation)
PiGC?

A

Oncotic Pressure in Capillaries

32
Q

(GFR Equation)
Changes in Kf?

A

(Permeability or Surface Area)
-Mesangial Cell Contraction or Relaxation
-+ ANP, NO (cGMP = vasodilation)
– A pi, Endothelin, Norepinephrine, Epi, ADH (contract mesangial cell = vasoconstriction)

33
Q

(GFR Equation)
Relaxation?

A

-Increase Surface Area
-Increase Kf

34
Q

(GFR Equation)
Contraction?

A

-Decrease Surface Area
-Decrease Kf

35
Q

Filtration Coefficient (Kf) or Hydraulic Conductance?

A

-Permeability
-Surface Area

36
Q

What would promote an increase in GFR?

A

Decrease Renal Sympathetics

37
Q

Clearance?

A

Volume of plasma from which a substance is completely removed by kidneys per unit time

38
Q

Clearance Equation?

A

Cx= (UF * Ux)/(Px) = Volume/Time

39
Q

(Clearance Equation)
UF?

A

Urine Flow

40
Q

(Clearance Equation)
Ux?

A

Urine Concentration of X

41
Q

(Clearance Equation)
Px?

A

Plasma Concentration of X

42
Q

Inulin can be used to measure?

A

GFR

43
Q

What are the 6 criteria needed by a substance to achieve GFR?

A

1) Freely Filtered
2) Not Reabsorbed
3) Not Secreted
4) Not Metabolized
5) Does Not Change in GFR
6) Not Produced

44
Q

GFR and Inulin Equation?

A

GFR = ((UF * Uin)/(Pin)) = Cin

45
Q

Daily Production of Creatinine is always equal to?

A

Daily excretion of Creatinine

46
Q

Daily Creatinine Excretion?

A

-Varies based on weight and gender
-Equals creatinine production
-May be normal even in chronic renal failure

47
Q

GFR for Creatinine Equation?

A

GFR = (UF * Ucreatinine)/ (Pcreatinine)

48
Q

(Renal Blood Flow (RBF))
Normal?

A

1200-1300 mL/min (both kidneys)
20-25% of Cardiac Output

49
Q

(Renal Blood Flow (RBF))
Renal Plasma Flow (RPF)?

A

( RPF = RBF (1 - hematocrit))
600-700 mL/min (both kidneys)

50
Q

(Renal Blood Flow (RBF))
Filtration Fraction (FF)?

A

How much plasma is being filtered out
(FF = (GFR)/(RPF))
125 mL/min/650 mL/min
20%

51
Q

Most Distribution of Blood Flow?

A

Cortex (1000 mL/min) (75%)

52
Q

Least Distribution of Blood Flow?

A

Inner Medulla (60 mL/min) (5%)

53
Q

Distribution of Blood Flow?

A

-Cortex (1000 mL/min (75%))
-Outer Medulla (240 mL/min (20%))
-Inner Medulla (60 mL/min (5%))

54
Q

(Measurement of Renal Plasma Flow (RPF))
Fick Method?

A

Infuse a substance in a patient to achieve a steady plasma concentration
(Xartery/min) = (Xvein/min) + (XUreter/min)

55
Q

ERPF(CPAH)/0.9 = ?

A

RPF

56
Q

Autoregulation of Renal Blood Flow?

A

-GFR and RBF are auto-regulated in parallel because need steady blood flow for filtration
-Autoregulation fails as arterial blood pressure falls below 80 mmHg

57
Q

Autoregulation fails as?

A

Arterial Blood Pressure falls below 80 mmHg

58
Q

Changes in Vascular Resistance determine both?

A

Renal Blood Flow (RBF) and GRF

59
Q

Mechanisms of RBF Autoregulation?

A

1) Tubuloglomerular (endothelial cells) feedback (TGF) which is a flow-sensitive mechanism
2) Myogenic response, which is a pressure-sensitive mechanisms intrinsic to vascular smooth muscle (directly to cells without brain function)

60
Q

Tubuloglomerular Feedback (TGF)?

A

-Increased filtering with increased GFR
-Increased flow sensed by increased NaCl
-Increased contraction leads to constrict afferent arteriole and decreased GFR and decreased RBF

61
Q

Control of Renal Blood Flow?

A

-Blood Pressure
-Intrinsic
-Extrinsic

62
Q

(Control of Renal Blood Flow)
Blood Pressure?

A

Autoregulation

63
Q

(Control of Renal Blood Flow)
Intrinsic?

A

Autoregulation
1) Myogenic (macula densa)
2) Tubuloglomerular feedback prostaglandins (increased pressure, increased prostaglandins; vasodilation to increased blood flow to kidney)

64
Q

(Control of Renal Blood Flow)
Extrinsic?

A

-Nerves: sympathetic
-Hormones: angiotensin II (strongest)

Block 3: Physiology (7 decks)

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