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AU2017 Physio Exam 3 > Lecture 9- Renal- Kidney structure and function > Flashcards

Lecture 9- Renal- Kidney structure and function Flashcards

1
Q

2 main fxns of the kidney

A

regulation of water and salt balance

removal of metabolic wastes/drugs

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2
Q

2 other functions of the kidney besides the main 2

A

gluconeogenesis

production of hormones

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3
Q

3 hormones of the kidneys

A

erythropoietin

renin

1,25-dihydroxyvitamin D

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4
Q

chronic ESRD requires

A

dialysis

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5
Q

ESRD patients have a reduced ability to eliminate … and excess … is converted to …

A

nitrogenous wastes

nitrogen

ammonium

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6
Q

excess ammonium in ESRD patients has direct effects on oral health– the blood is … which leads to an …. pH in the oral cavity

A

alkalized

increased

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7
Q

manifestations of renal disease on oral health include…

A

ammonia breath

gingival enlargement

xerostomia

teeth problems (premature loss, narrow pulp chambers, necrosis beneath fillings/crowns)

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8
Q

contraindications for ESRD patients

A

nephrotoxic drugs such as tetracycline, acyclovir, aspirin, NSAIDs

increased susceptibility to bleeding due to destruction of platelets

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9
Q

the kidney is a … organ in the abdominal cavity with a … and …

A

retroperiotoneal

inner medulla

outer cortex

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10
Q

kidney is composed of many …. which is the functional unit of the kidney

A

nephrons

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11
Q

in the renal cortex, blood is filtered in … and filtrate passes through the tubules of the nephron

A

glomeruli

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12
Q

in the renal medulla, there are portions of nephron tubule involved with … and … of urine

A

concentration

collection

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13
Q

tubules empty into …. and then into the ureter

A

renal pelvis

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14
Q

ureters drain into the …. and the… is drained by the urethra

A

bladder

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15
Q

each kidney contains about …. nephrons

A

1.2 x 10^6

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16
Q

a nephron includes a cluster of … and a long, hollow tube with a wall that is …

A

capillaries

one cell layer thick

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17
Q

what are the parts of a nephron

A

renal corpuscle= glomerulus +capsule

proximal (convoluted) tubule

loop of henle

distal (convoluted) tubule

collecting duct (chared by several nephrons)

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18
Q

there are 2 types of nephrons that differ in the position of the renal corpuscle and length of the medullary tubules

A

superficial or cortical nephrons

juxtamedullary nephrons

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19
Q

regulating blood composition involves these 3 renal processes

A
  1. filtration
  2. secretion
  3. reabsorption
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20
Q

filtration occurs in the …. capillaries; … % of plasma entering glomerulus is filtered

A

glomerular

15-20%

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21
Q

blood leaving the glomerular capillaries then flows into ….

A

peritubular capillaries (vasa recta)

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22
Q

during filtration, solutes (and water they are dissolved in) pass from the blood into the … in the …

A

tubular fluid

renal capsule (Bowmans space)

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23
Q

during secretion, substances are transported from the … in the peritubular capillaries into the ….

A

blood

tubular fluid

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24
Q

during reabsorption, substances are transported from the … into the … in the peritubular capillaries

A

tubular fluis

blood

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25
Q

what remains in the tubular fluid at the end of the collecting ducts is….

A

excreted

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26
Q

a … is a dense capillary bed where filtration occurs surrounded by renal capsule (bowmans capsule) which collects the filtrate from the blood entering via the afferent arterioles

A

glomerulus

27
Q

filtered blood leaves via …. and flows into peritubular capillaries

A

efferent

28
Q

blood flow through the glomerulus is regulated by several mechanisms:

A

smooth muscle contraction in afferent and efferent arterioles

response of juxtaglomerular apparatus (JGA)

sympathetic nervous system

29
Q

the …. is located at the intersection of the macula densa of distal tubule with afferent and efferent arterioles – the … secretes the hormone renin which regulates systemic BP and therefore glomerular blood flow

A

juxtaglomerular apparatus

30
Q

the … drains the renal caosule

A

proximal tubule

31
Q

the proximal tubule reabsorbs …. of filtered salt and water

A

2/3

32
Q

the proximal tubule reabsorbs all filtered … and …

A

glucose

amino acids

33
Q

will diuretics work in the proximal tubule?

A

yes, some will

34
Q

the loop of henle can be divide into these 3 segments

A

thin descending limb

thin ascending limb

thick ascending limb (TAL)

35
Q

the loop of henle is the site of …. needed to produce concentrated urine but the loop itself produces a …. filtrate

A

countercurrent multiplication

dilute

36
Q

very powerful diuretics work in the ….

A

loop of henle

37
Q

the … drains the loop of henle

A

distal tubule

38
Q

functions of the distal tubule

A

continued reabsorption of solutes

regulation of calcium

site of action for some diuretics

39
Q

the collecting duct extends from … through the …

A

cortex

medulla

40
Q

the collecting duct regulates …., …, and …

A

Na, K, H2O

41
Q

do diuretics act in the the collecting ducts?

A

yes, some

42
Q

… is the rate of excretion of a solute through the kidney, expressed as amount per unit time

A

renal clearance

43
Q

… represents the volume of plasma from which all of a particular substance is removed to the urine and is a clinically important concept for monitoring renal fxn

A

renal clearance

44
Q

…. rate is the amount of blood filtered by the kidney, expressed as volume per unit time.

A

glomerular filtration rate

45
Q

can renal clearance be used to measure GFR?

A

yes based on 3 criteria:

  1. substance is freely filtered in glomerulus
  2. substance is not secreted
  3. substance is not reabsorbed
46
Q

in a normal kidney, GFR (for all nephrons) is …. or … in females and …. in males

A

125 ml/min
180 L/day
90-140 ml/min

47
Q

… and … are substancces that can be used to measure renal clearance

A

inulin

creatinine

48
Q

…. is a small polysacharride; freely filteres and not secreted or reabsorbed

A

inulin

49
Q

…. is a product of muscle metabolism; freely filtered, not reabsorbed, almost no secretion

A

creatinine

50
Q

normal creatinine levels?

A

less than 1 + or - .5 mg/dl

need dialysis if greater than 10

51
Q

glomerular capillaries are fenestrated; …. cells around the capillaries form filtration slits

A

podocytes

52
Q

filtrate is acellular and essentially … free

A

protein

53
Q

glucose, salts and amino acids are freely….

A

filtered

54
Q

size is a factor in filtration:
less than …. are free filtered

more than …. not filtered

A

20 A

42 A

55
Q

charge is a factor in filtration because the basal lamina is …. charged so filtration of moderately sized …. charged solutes is limited

A

negatively

negatively

56
Q

despite changes in BP, renal blood flow remains fairly …. which means GFR remains ….

A

constant

constant

57
Q

autoregulation involves intrinsic mechanisms that adjust bloodflow through the glomerulus; it is achieved by these 2 mechanisms

A
  1. myogenic mechanism

2. tubuloglomerular feedback- feedback from the JGA adjusts afferent arteriole diameter and thus GFR

58
Q

GFR equations

A

(Pgc-Pbs)- (Oncgc- Oncbs)

59
Q

effect on renal blood flow and net ultrafiltration pressure:
increased afferent resistance

A

decrease in both

60
Q

effect on renal blood flow and net ultrafiltration pressure:

decreased afferent resistance

A

increase both

61
Q

effect on renal blood flow and net ultrafiltration pressure:

increased efferent resistance

A

decrease flow

increase filtration press

62
Q

effect on renal blood flow and net ultrafiltration pressure:

decreased efferent resistance

A

increase flow

decrease filtration press

63
Q

4 extrinsic factors that affect RBF and GFR

A

diet

dehydration

symp. NS

angiotensin 2, aldosterone, natriuretic peptide

64
Q

tubuloglomerular feedback:
increase in GFR increases NaCl in tubular fluid which increases NaCl at the ….which causes an increase in …. in the afferent arterioles ultimately leading to a decrease in …

A

macula densa

resistance

GFR

AU2017 Physio Exam 3 (12 decks)

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