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Renal > Lecture 3 - Renal concentrating mechanisms and urine formation II > Flashcards

Lecture 3 - Renal concentrating mechanisms and urine formation II Flashcards

1
Q

The Renin Angiotensin System is stimulated by:

A
  • Decrease in B/P
  • Decrease in Fluid Volume
  • B1 Sympathetic
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2
Q

The Renin Angiotension System is inhibited by:

A
  • Increase in B/P
  • Increase in Fluid Volume
  • Decrease in B1 Sympathetic ANP
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3
Q

T/F: The juxtaglomerular apparatus is the site of renin synthesis.

A

TRUE

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4
Q

What four components is the juxtaglomerular apparatus comprised of:

A
  • Smooth muscle cells in afferent arteriole
  • Smooth muscle cells in the efferent arteriole
  • Extraglomerular mesangial cells
  • Macula Densa cells in the distal tubule
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5
Q

The mongioceles are responsible for production of ____________.

A

prostaglandins

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6
Q

Renin causes _____________ to be cleaved to angiotensin I.

A

-angiotensinogen

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7
Q

Angiotension I converted to angiotensin __ in the ____ by angiotensin converting enzyme.

A
  • II

- lung

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8
Q

T/F: Angiotensin is the second most potent vasoconstrictor known.

A

FALSE (It is the most potent)

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9
Q

What are the actions of angiotension II:

A
  • Vasoconstriction
  • Increase B/P
  • Increase aldosterone synthesis and release
  • Increase ADH
  • Increase thirst
  • Feedback inhibition of renin release
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10
Q

What hormone is produced to keep the afferent and efferent arterioles open when Angiotension is trying to close them:

A

Prostaglandins

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11
Q

T/F: Aldosterone is syntesized in the the zona glomerulosa of the adrenal cortex.

A

TRUE

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12
Q

What stimulates the synthesis and release of aldosterone:

A
  • Increased K in the ECF
  • Angiotensin II
  • Dereased Na levels
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13
Q

Aldosterone acts on _______ tubule and ______ ducts to cause _____ secretion and also ____ in exchange for ____.

A
  • Distal
  • Collecting
  • Potassium
  • Hydrogen
  • Sodium
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14
Q

Electrolytes lost by aldosterone is:

A

Potassium (K+)

Hydrogen (H+)

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15
Q

Conn’s syndrome is:

A

Tumor producing to much aldosterone leading to hypertension, hypernatremia, and hypokalemis.

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16
Q

What are the four concentrating and diluting mechanism of:

A
  • Antidiuretc hormone (ADH)
  • Atrial natriuretic peptide (ANP)
  • Countercurrrent multiplier
  • Role of urea
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17
Q

What is the maximal urine concentration of the human kidney:

A

1200 - 1400 mOsm/L

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18
Q

What is the obligatory urine volume of a 70 kg human in one day?

A

0.5 liters/day

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19
Q

Where is ADH synthesized at withing the human body:

A

Hypothalamus

20
Q

Where is ADH stored and release:

A

Posterior pituitary

21
Q

What cells in the hypothalamus respond to ECF osmolality:

A
  • Osmoreeptors
22
Q

T/F: An increase in osmolality will cause an decrease in the release of ADH.

A

FALSE

23
Q

___________ in the atria and aorta will detect decreases in volume and stimulate ADH release.

A

-Mechanoreceptors

24
Q

What stimuli will cause a increase ADH release:

A
  • Angiotensin II
  • Fright
  • Nausea,
  • Pain
  • anesthesia
  • Nicotine
  • Cyclophosphamide
25
Q

What inhibits the release of ADH:

A
  • Alcohol
  • Clonidine (antihypertensive drug)
  • Haloperidol (dopamine blocker)
26
Q

What will ADH do in the collecting ducts of the kidney:

A

-Increase the permeability to allow water through

27
Q

T/F: ADH also increases urea permeability in the medullary collecting ducts.

A

TRUE

28
Q

In order for ADH to work there must be a ______ force to move water out of the tubules into the interstiu. (Means you must have a __________ interstitium.

A
  • driving

- hypertonic

29
Q

T/F: the Countercurrent multiplier is crucial in the ability of the kidney to concentrate urine

A

TRUE

30
Q

What makes the Countercurrent multiplier so effective in urine concentration:

A

-U shape of the loop of Henle (Gives the countercurrent its name)
-Different permeability of certain nephton segments
-

31
Q

What type of energy is used for the Countercurrent:

A

-ATP (Na/K ATPase)

32
Q

What is the anatomy the makes the medullary countercurrent mutliplier system work:

A
  • Juxta-medullary nephrons with long loops of Henle & vasa recta peritubular capillaries reach into medulla
  • Special anatomical arrangement of Juxta medullary nephrons and collecting ducts critical for countercurrent mechanism
  • Anatomical relationshop allow the creation of a hyperosmotic gradient in renal medulla interstitium
33
Q

T/F: Urea is a byproduct of amino acid metabolism consisting of 2 ammonia molecules.

A

True

34
Q

Approximately ________ grams/day of urea is made in the liver.

A

25 - 30

35
Q

What is the role of urea?

A
  • medullary interstitium has a high concentration of urea

- This plays an important role in generating a hypertonic interstitium

36
Q

T/F: The TAL is impermeable to water and urea.

A

TRUE

37
Q

How does the medullary interstitium generate such a high urea concentration?

A

PHASE 1: When ADH is present water is reabsorbed into the cortex and outer medulla

PHASE 2: The The tubular contents thus become more concentrated and a high concentration of urea reaches the inner medulla

PHASE 3: The inner medulla is permeable to urea ONLY in the presence of ADH and urea diffuses into the interstitum and becomes trapped there.

38
Q

T/F: The THIN ascending limb is urea permeable so some diffuses into the tubule and is recycled.

A

TRUE

39
Q

T/F: urea contributes to 80% of osmolarity of renal medulla gradient during max urine concentration.

A

FALSE (Urea contributes to 40% ….)

40
Q

T/F: Urea actively passes from medullar collecting duct ruing water deficits when ADH is present.

A

FALSE (Urea passibely diffuses from medullar..)

41
Q

T/F: Urea is recirculated from medulla interstitium into loop of Henle and returned to tubular fluid.

A

TRUE

42
Q

What is the role of the Vasa Recta:

A
  • Remove reabsorbed fluid from the interstitium

- Minimize solute uptake from the medulla (Maintain medullary hypertonicity)

43
Q

How much blood does the medullary get in the kidney?

A

1 - 2 %

44
Q

What good is the sluggish blood flow in the medullary.

A

minimizes solute loss

45
Q

T/F: In the descending Vasa Recta fluid leaves the Vasa Recta because of the rapid flow more fluid leaves than solute enters.

A

TRUE

46
Q

T/F: In the ascending Vasa Recta fluid leaves the Vasa Recta because of the rapid flow more fluid leaves than solute enters.

A

FALSE (The ascending Vasa Recta the situation reveerses because of decreasing hydrostatic pressure and increasing osmolality of blood)

Renal (5 decks)

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